Eosinophilic fasciitis in association with nivolumab: The importance of eosinophilia

Pabón-Cartagena, Gabriela; Lopez, Andrea V.; Watts, Erika; Zavala-Alonso, Norma Verónica

doi:10.1016/j.jdcr.2020.04.017

Cited by 5 publications

(4 citation statements)

References 12 publications

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“…[7] Literature review also revealed eight cases of EF in association with nivolumab and one other in association with ipilimumab. [6,8,9] In seven of eight cases the offending agent was discontinued. [6,[8][9][10] Of the cases that reported treatment, six of seven initiated immunosuppressive therapy with steroids and five of seven also initiated a second agent such as methotrexate, mycophenolate mofetil, and/or cyclosporine.…”

Section: Discussionmentioning

confidence: 99%

“…[6,8,9] In seven of eight cases the offending agent was discontinued. [6,[8][9][10] Of the cases that reported treatment, six of seven initiated immunosuppressive therapy with steroids and five of seven also initiated a second agent such as methotrexate, mycophenolate mofetil, and/or cyclosporine. [6,[8][9][10] Although no treatment guidelines have been established, glucocorticoids are considered first-line.…”

Section: Discussionmentioning

confidence: 99%

“…[6,[8][9][10] Of the cases that reported treatment, six of seven initiated immunosuppressive therapy with steroids and five of seven also initiated a second agent such as methotrexate, mycophenolate mofetil, and/or cyclosporine. [6,[8][9][10] Although no treatment guidelines have been established, glucocorticoids are considered first-line. [6] There is no established ''second-line treatment'' but methotrexate, mycophenolate mofetil, cyclosporine, and infliximab have all been described in literature often used in combination with steroids.…”

Section: Discussionmentioning

confidence: 99%

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Eosinophilic Fasciitis with Concurrent Necrobiotic Granulomatous Dermatitis Related to Checkpoint Inhibition Therapy

Haroon

Tadros

Smith

2022

Journal of Immunotherapy and Precision Oncology

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Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapeutics. However, loss of physiologic tolerance in few cases has triggered rare and novel immune-related adverse events (irAEs). Eosinophilic fasciitis, an infrequently reported diffuse scleroderma-like entity, has been associated with ICI therapy. We report a case of a patient with metastatic melanoma treated with nivolumab who developed eosinophilic fasciitis with concurrent granulomatous dermatitis and lymphadenitis, the latter of which mimicked melanoma recurrence radiographically. Furthermore, this patient had a severe presentation that subsequently proved to be treatment-resistant to both corticosteroid and steroid-sparing therapies. To our knowledge, eosinophilic fasciitis has not been reported concurrently with granulomatous dermatitis in literature. We provide a narrative of this case and a review of therapeutic approaches for severe or refractory irAEs. With the increasing popularity of ICI therapy, we believe it is essential for clinicians to identify novel irAEs and be aware of treatments as late recognition could prove fatal.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Eosinophilic Fasciitis with Concurrent Necrobiotic Granulomatous Dermatitis Related to Checkpoint Inhibition Therapy

Haroon

Tadros

Smith

2022

Journal of Immunotherapy and Precision Oncology

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“…Die EF ist eine seltene Erkrankung und ist in seltenen Fällen auch als immunbedingte Nebenwirkung unter PD1‐Inhibitor beschrieben; unsere Literaturrecherche ergab bisher insgesamt nur 15 Fälle 1,2 . Eine Früherkennung der Diagnose ist sehr wichtig.…”

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