Scleroderma-like syndrome associated with pembrolizumab

Suárez‐Díaz, Silvia; Coto‐Hernández, Rubén; Yllera-Gutiérrez, Carmen; Álvarez-Fernández, Carlos; Trapiella-Martínez, Luis; Caminal-Montero, Luis

doi:10.1177/2397198320905192

Cited by 2 publications

(1 citation statement)

References 11 publications

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“…Pembrolizumab is a selective immunoglobulin G4-kappa monoclonal antibody that inhibits PD-1. The use of pembrolizumab as immunotherapy was first approved in 2014 for the treatment of metastatic melanoma [ 1 , 14 ], and later on for other malignancies such as non-small cell lung cancer [ 3 ], urothelial carcinoma [ 15 ] and triple-negative breast cancer such as in our case.…”

Section: Discussionmentioning

confidence: 99%

Scleroderma Secondary to Pembrolizumab: A Case Report and Review of 19 Cases of Anti-PD-1-Induced Scleroderma

Farrugia,

Mercieca,

Betts

et al. 2023

Case Rep Oncol

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Immune checkpoint inhibitors are increasingly being used to treat various malignancies. Despite their efficacy, they are known to potentially cause immune-related adverse effects, including dermatological manifestations. A rare cutaneous immune-related adverse effect is scleroderma, which has been reported to occur with anti-programmed cell death-1 (PD-1) agents such as pembrolizumab and nivolumab. This may present with skin tightening and hardening at any point during or after immunotherapy. We present the case of a 54-year-old Caucasian woman who, following 16 doses of pembrolizumab for breast cancer, developed clinical features of scleroderma confirmed on histology. She was initially treated with oral corticosteroids, followed by oral psoralen-UVA, with poor response, but eventually improved with methotrexate. A literature review revealed 12 other cases of scleroderma following pembrolizumab treatment and 6 cases of scleroderma following nivolumab treatment. Males and females were both affected, and their ages ranged from 33 to 81 years. Scleroderma developed at different stages of pembrolizumab or nivolumab therapy. Although scleroderma is not commonly drug-induced, anti-PD-1 agents may be a rare cause and it is important to elicit an accurate drug history, including immunotherapy, in such cases.

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