Paraneoplastic subacute cutaneous lupus erythematosus with mucositis

Abbott, James; Westerdahl, Johan; Wada, David A.; Klein, Stephanie; Mathis, Jason

doi:10.1016/j.jdcr.2022.02.001

Cited by 2 publications

(1 citation statement)

References 12 publications

(14 reference statements)

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“…It has been hypothesized the presence of tumor antigens, homologous to those present in the body, stimulate autoantibody production leading to an autoimmune skin reaction. For a diagnosis of PNSCLE to be suspected, it should satisfy McLean’s criteria, in which: (1) the dermatosis should develop after the malignancy, but may be present before the cancer diagnosis, (2) the dermatosis and malignancy should follow a parallel course, and (3) the rash should regress with treatment of the malignancy ( 42 ). In a published review of 37 PNSCLE cases, most patients had locally advanced or metastatic cancer.…”

Section: Discussionmentioning

confidence: 99%

Immune checkpoint inhibitor-induced subacute cutaneous lupus erythematosus: a case report and review of the literature

Khorasanchi,

Korman,

Manne

et al. 2024

Front. Med.

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Immune checkpoint inhibitor (ICI) use has been associated with numerous autoimmune side effects, known as immune related adverse events (irAEs). Cutaneous irAEs are common and affect up to 50% of patients treated with ICIs. There have been an increasing number of cases reported in the literature regarding ICI-induced subacute cutaneous lupus erythematosus (SCLE). ICI-induced SCLE is important to recognize as it can result in a delayed and/or prolonged skin reaction despite treatment discontinuation. We describe a patient with gastro-esophageal adenocarcinoma who developed SCLE following one cycle of nivolumab treatment. A 75-year-old man presented to our clinic with a new photo-distributed rash composed of oval scaly pink papules and plaques involving his chest and arms. Despite treatment with topical corticosteroids, he presented to the emergency department 1 week later with worsening rash. Skin biopsy showed vacuolar interface pattern, along with superficial perivascular lymphocytic infiltrate, consistent with a drug eruption. The clinicopathological presentation was consistent with ICI-induced SCLE. Nivolumab treatment was discontinued due to the severity of the rash. The rash remitted with systemic corticosteroids, high potency topical steroids, and hydroxychloroquine. Unfortunately, the patient developed intraperitoneal metastatic disease, and was enrolled in hospice care. In this paper, we highlight the importance of early identification and treatment of this irAE. A review of the literature, including a discussion on the management of ICI-induced SCLE is also provided.

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Section: Discussionmentioning

confidence: 99%