Stevens-Johnson syndrome associated with radiation recall dermatitis in a patient treated with nivolumab

Stevens–Johnson syndrome associated with radiation recall dermatitis in a patient treated with immune checkpoint inhibitor

“…Immunotherapy with ICI may promote interface dermatitis resulting in radiation recall dermatitis and SJS. Rouyer et al 5 also reported that ICI induced SJS associated with radiation recall dermatitis. ICI is a promising treatment for various malignant tumors, and it is expected that many patients will be treated with combination therapy with ICI and radiation.…”

“…3 The recruitment of circulating Th17 cells to local tissue is mediated by the CCL20-CCR6 axis. 4,5 It has been demonstrated that epidermal keratinocytes produce large amounts of CCL20, 2,4 which selectively recruits CCR6 + Th17 cells. 4 Accordingly, the CCL20 expression is increased in the lesional skin of AD, 1 especially in the epidermal compartment.…”

Severe bullous skin eruptions on checkpoint inhibitor therapy – in most cases severe bullous lichenoid drug eruptions

“…Whenever severe erosive or bullous drug eruptions occur on checkpoint inhibitor therapy, it is essential to diagnose such reactions correctly. Table 1 provides a summary of and commentary to all cases of SJS/TEN and TEN-like reactions on checkpoint inhibitor therapy (CTLA4, PD-1 and PD-L1) (n = 14) published in German, English, and French and listed on PubMed [9][10][11][12][13][14][15][16][17][18][19][20][21]. According to our case analysis, it does seem much more likely that many of the published cases actually represented bullous lichenoid drug eruptions (some of which were associated with lichenoid mucosal involvement) or cases of isolated erosive lichenoid mucositis, as well as cases of epidermolytic reactions in areas previously irradiated (radiation recall).…”

Non-small-cell Lung Cancer with Severe Skin Manifestations Related to Radiation Recall Dermatitis after Atezolizumab Treatment

“…The interval between drug administration and the onset of RRD is several days to weeks (6,7). Recently, in three reports of RRD induced by nivolumab (anti-PD-1 antibody), two out of three patients developed life-threating dermatitis with Stevens-Johnson syndrome, and the interval from nivolumab administration to the onset of RRD was between three days and two weeks (9)(10)(11). In the present case, the grade of RRD was severe, and the interval between atezolizumab administration and the onset of RRD was three weeks, which is consistent with these previous nivolumab-induced RRD case reports.…”