Regressed melanocytic nevi secondary to pembrolizumab therapy: an emerging melanocytic dermatologic effect from immune checkpoint antibody blockade

Abstract

Regressed melanocytic nevi are an emerging dermatologic effect from pembrolizumab therapy.

Diverse types of dermatologic toxicities from immune checkpoint blockade therapy

“…Changing melanocytic nevi were seldom (<1%) reported in patients receiving pembrolizumab. 52 As with nivolumab, acneiform, DHR, eczematous, erythematous, lichenoid and bullous pemphigoid were all seldom (<1%) events in patients, and the maculopapular type of dermatologic toxicity sometimes (∼2%) occurred. Radiation-associated dermatitis, psoriasiform reactions and vasculopathic changes were seen with pembrolizumab, but have not yet been reported with nivolumab.…”

“…The relative frequency of vitiligo or pigment alteration‐associated dermatologic toxicity with pembrolizumab was encountered in more patients (∼7%) as compared with nivolumab (∼3%: Table ). Changing melanocytic nevi were seldom (<1%) reported in patients receiving pembrolizumab . As with nivolumab, acneiform, DHR, eczematous, erythematous, lichenoid and bullous pemphigoid were all seldom (<1%) events in patients, and the maculopapular type of dermatologic toxicity sometimes (∼2%) occurred.…”

“…Case of patient treated with pembrolizumab, presented at the 2nd Inflammatory Skin Disease Summit, New York. 2016 …”

Multiple “halo nevi” occurring during pembrolizumab treatment for metastatic melanoma

“…Such Sutton phenomenon seems the most obvious illustration of immune infiltration affecting benign skin lesions during immunotherapy, which probably occurs more frequently than expected. Indeed, one case of nevi inflammation without a halo was recently reported, as was disappearance of lentigines and seborrheic keratosis without a halo during pembrolizumab therapy and regressed melanocytic nevi secondary to pembrolizumab therapy . The fate of cutaneous benign lesions during immunotherapy is probably related to not only the shared antigen‐directed responses but also the nonspecific effect of a PD1 inhibitor on PDL‐1–expressing benign lesions .…”

Gene expression profiling of lichenoid dermatitis immune‐related adverse event from immune checkpoint inhibitors reveals increased CD14+ and CD16+ monocytes driving an innate immune response

“…However, these therapeutic successes must be continuously balanced with accompanying toxicities as cancer patients receiving CPI therapy may develop a diverse array of cutaneous immune‐related adverse events (irAEs) that vary clinically from inflammatory dermatitides to reactions that target cutaneous melanocytes resulting in vitiligo or regression of preexisting nevi . Inflammatory‐related cutaneous irAEs of any grade may occur in up to ~40‐50% of patients treated with CPI therapy .…”