Bullous pemphigoid is a serious and rare complication of immunotherapy. Here, we present a case of bullous pemphigoid secondary to ipilimumab/nivolumab checkpoint inhibitor therapy in a patient with metastatic melanoma. Immune checkpoint inhibitor therapy is more widely used now to treat cancer patients, bringing more challenging cases of adverse events associated with their use. Bullous pemphigoid can be a difficult diagnosis to make in the initial stages as the rash is similar to other red rashes before transforming into the typical appearance of a blister. As bullous pemphigoid can be a life-threatening adverse event, early identification is key to increasing patient survival.
Introduction: Sarcoidosis is often an overlooked differential diagnosis in many disease processes. It is a nonspecific inflammatory disease marked by granulomas. Being nonspecific makes it a more difficult disease to diagnose. It is a challenging diagnosis as it is a great mimicker of many other conditions and therefore missed. The finding of a granuloma is not specific for sarcoidosis as other disorders may present with granulomas. It is an important differential to keep in mind because of significant morbidity and mortality associated with this disease. Case Report: Here we present a case of a female patient with vision loss and an intracranial mass. The mass was initially thought to be cancer and hence referred to our Cancer Center for further evaluation and workup. Upon biopsy the mass was diagnosed as sarcoidosis. She had no other systemic involvement at time of diagnosis. What makes this case of sarcoidosis rare is her solitary optic nerve involvement. Conclusion: Sarcoidosis is a more difficult disease to diagnose than other diseases, such as coronary artery disease, hyperlipidemia, and diabetes as these diseases have very specific, easily accessible
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