G. Carlos, R. Anforth, S. Chou, R. Hui,P. Fernandez-Peñas
The innovative blockade of immune checkpoints with targeted
immunotherapies, such us monoclonal antibodies
against programmed cell death-1 (PD-1) is pioneering the
treatment for advanced melanoma, lung carcinoma and
other solid tumours. Potential adverse events of particular
interest with immunotherapy stem from an inflammatory or
immune-related nature.
The following report discusses a case of bullous lichen
planus in a 71-year-old female with metastatic non-small
cell carcinoma treated with pembrolizumab that after 1
month developed painful annular plaques on limbs, hands and feet. Clinical presentation, histopathology and immunofluorescence
confirmed the diagnosis of bullous lichen
planus. A combination of topical diprosone and acitretin
resolved the lesions leaving only post-inflammatory
hyperpigmentation without reducing or stopping
Pembrolizumab.
Patients treated with any type of immunotherapies require
close surveillance by dermatologists in specialised units.
Proper management of cutaneous reactions will avoid dose
reductions or ceasing oncology treatments.