Narrowband ultraviolet B therapy for refractory immune-related lichenoid dermatitis on PD-1 therapy: a case report

Abstract

Treatment with programmed cell death 1 inhibitors is associated with a wide range of cutaneous immune-related adverse events, with lichenoid eruptions representing one of the major cutaneous toxicities. We describe the case of an 81-year-old man with metastatic melanoma treated with pembrolizumab who subsequently developed a delayed-onset generalized lichenoid dermatitis. After failing multiple lines of systemic immunosuppression, narrowband ultraviolet B (NBUVB) phototherapy three times per week for 17 sessions resulted in a significant clinical response in his cutaneous eruption and was well tolerated. NBUVB is a safe, lower-cost modality that induces local, skin-specific immunosuppression without the toxicities of traditional systemic immunosuppressive agents. To date, this is the first report of use of NBUVB in immune-related lichenoid dermatitis resistant to multiple standard therapies.

A retrospective multicentric cohort study of checkpoint inhibitors‐induced pruritus with focus on management

“…Narrow‐band UVB that was highly efficacious in our patients, has not been extensively used in cutaneous irAEs 25,26 . Although the exact mechanism of ICI‐induced pruritus is still unknown, a multifactorial pathogenesis has been assumed.…”

“…Narrow-band UVB that was highly efficacious in our patients, has not been extensively used in cutaneous irAEs. 25,26 Although the exact mechanism of ICI-induced pruritus is still unknown, a multifactorial pathogenesis has been assumed. On the ground of the general immune system activation, release of inflammatory cytokines, such as IL-6 and IL-10, and eosinophilia have been shown.…”