Lichen planus pemphigoides after pembrolizumab immunotherapy in an older man

Abstract

IMAGES IN MEDICINEAn 84-year-old Chinese man with stage IV non-small cell lung cancer was initiated on pembrolizumab, an antiprogrammed cell death (PD)-1 monoclonal antibody, 4 times per week. Seven weeks later, on the day of his third cycle, he developed a rash on his chest and right axilla, which subsequently resolved with 1% hydrocortisone cream, and there was no interruption to his immunotherapy. Eleven weeks after the initiation of pembrolizumab, the patient reported new pruritic, purpuric papules on his buttocks, forearms and legs. There were associated blisters seen on his feet. The rash progressively worsened despite topical steroids (Fig. 1).

Autoimmune bullous dermatoses in cancer patients treated by immunotherapy: a literature review and Italian multicentric experience

“…An association between the development of LPP and drugs or pre-existing medical conditions has been previously reported. In recent years, rare cases of anti-PD-1/ PD-L1-induced LPP have been documented and we identified a total of 23 cases (11,33,(61)(62)(63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73)(74)(75)(76)(77).…”