2016
DOI: 10.1016/j.jdcr.2016.06.004
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Pembrolizumab-associated sarcoidosis

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Cited by 84 publications
(48 citation statements)
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“…Other less frequently reported cutaneous toxicities include granulomatous reactions that resemble sarcoidosis , dermatomyositis , vasculitis , Sjogren's‐like syndrome , Sweet's syndrome, alopecia , and skin and hair textural changes .…”
Section: Irae Tumor Boardmentioning
confidence: 99%
“…Other less frequently reported cutaneous toxicities include granulomatous reactions that resemble sarcoidosis , dermatomyositis , vasculitis , Sjogren's‐like syndrome , Sweet's syndrome, alopecia , and skin and hair textural changes .…”
Section: Irae Tumor Boardmentioning
confidence: 99%
“…Immune checkpoint inhibitors can induce sarcoidosis by modifying cytotoxic, Th1/17 and regulatory T-cell ratios 10, 21Table IDrugs that induce cutaneous sarcoidosis and proposed biologic mechanisms of inductionDrugBiologic mechanismIL-1Ra: anakinra 1 Unopposed type I IFN productionFailure of immune regulatory mechanismsImmunosuppression favoring infection with bacterium implicated in sarcoidosisInterferon-α 3 Induction of Th1 cytokinesanti-TNF agents4, 5: entanercept, 6 infliximab, 7 adalimumab 8 Unopposed type I IFN productionMove toward a Th1/Th17 profileDecreased TNF-mediated suppression of Treg expansion/activityAlteration in ratio of membrane bound to soluble TNFR2Process of anti-IFX antibody productionPredisposition secondary to genetic variation of TNF-α genePD-1 inhibitors: pembrolizumab, 9 nivolumab 10 Increased T-cell proliferative capacityNote: PD-1 up-regulation has also been associated with sarcoidosis with a proposed mechanism of decreased T-cell proliferative capacity leading to immunologic derangements conducive to sarcoidosis BRAF inhibitor: vemurafenib 11 Increased TNF-α and IFN-γ levelsNote: Study suggests patients who have sarcoidosis with vemurafenib therapy carry a better prognosisanti-CTLA4 mAb: ipilimumab 12 Enhanced T-cell responsesanti-IgE mAb: omalizumab 13 Decreased expression of dendritic cell IgE high affinity receptor/Th2 cytokine production with subsequent shift from Th2 to Th1 cytokine profileUnmasking of sarcoidosis with prednisone taper accompanying omalizumab treatment initiationFillers for aesthetic procedures: hyaluronic acid 14 Tissue injury and foreign body reaction to fillerInsulin15, 16Traumatic induction (Koebnerization) and foreign body reaction to materials introduced with insulin injectionInflammatory response to zinc component of insulin formulationBotulinum neurotoxin A 17 Foreign body reaction after deposition of crystalline preparation of botulinum neurotoxin A in the skinForeign body reactio...…”
Section: Discussionmentioning
confidence: 99%
“…Granulomatous sarcoidosis‐like processes affecting the lungs, lymph nodes, and skin have previously been reported in patients receiving PD‐1 inhibitor therapy, both with pembrolizumab and nivolumab . Cutaneous sarcoidal reactions have also been described following treatment with ipilimumab, an inhibitor of cytotoxic T‐lymphocyte‐associated antigen .…”
Section: Conflict Of Interestmentioning
confidence: 99%
“…[3][4][5] Granulomatous sarcoidosis-like processes affecting the lungs, lymph nodes, and skin have previously been reported in patients receiving PD-1 inhibitor therapy, both with pembrolizumab and nivolumab. [6][7][8][9] Cutaneous sarcoidal reactions have also been described following treatment with ipilimumab, an inhibitor of cytotoxic T-lymphocyte-associated antigen. 10 In these reported cases, Awareness of a potential sarcoidal reaction in the treatment of metastatic melanoma is particularly critical in that sarcoidosis can closely mimic the signs and symptoms of metastatic melanoma.…”
mentioning
confidence: 99%