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Truong K, Chamberlin CV, Kim J, Carlino MS, Araujo RR. Immune checkpoint inhibitor-induced lichenoid drug eruption-sparing scar burns. Australas J Dermatol 2024; 65:163-166. [PMID: 38009870 DOI: 10.1111/ajd.14192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 10/31/2023] [Accepted: 11/12/2023] [Indexed: 11/29/2023]
Abstract
The authors present a striking case of a patient experiencing a lichenoid drug eruption secondary to immunotherapy, curiously sparing scarred skin from past burns. We observed vastly higher amounts of inflammatory lymphoid cells staining for PD-1; 70% in skin with a lichenoid drug reaction and 50% in scarred skin. The lack of a lichenoid reaction at sites of scarred skin may indicate that a basement membrane component may be causative for a lichenoid drug eruption.
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Affiliation(s)
- Kelvin Truong
- Department of Dermatology, Westmead Hospital, Westmead, New South Wales, Australia
- Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
| | | | - Jennifer Kim
- Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
- Department of Tissue Pathology and Diagnostic Oncology, Institute of Clinical Pathology and Medical Research (ICPMR) Westmead Hospital, NSW Health Pathology, Westmead, New South Wales, Australia
| | - Matteo S Carlino
- Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
- Department of Medical Oncology, Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales, Australia
- Melanoma Institute Australia, Sydney, New South Wales, Australia
| | - Raquel Ruiz Araujo
- Department of Dermatology, Westmead Hospital, Westmead, New South Wales, Australia
- Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
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Malhi K, Singh S, Bishnoi A, Chatterjee D, Narang T, Dogra S. Lepromatous leprosy masquerading as lichenoid infiltrated rash - A diagnostic predicament. Trans R Soc Trop Med Hyg 2024:trad095. [PMID: 38197581 DOI: 10.1093/trstmh/trad095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/15/2023] [Accepted: 12/16/2023] [Indexed: 01/11/2024] Open
Affiliation(s)
- Kittu Malhi
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Sukhdeep Singh
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Anuradha Bishnoi
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Debajyoti Chatterjee
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Tarun Narang
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Sunil Dogra
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
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Agharbi FZ, Aasfara J, Oqbani K, Slamti K, Chiheb S. Lichenoid Drug Eruption Induced by Teriflunomide. Ann Indian Acad Neurol 2023; 26:275-277. [PMID: 37538413 PMCID: PMC10394437 DOI: 10.4103/aian.aian_27_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/12/2023] [Accepted: 02/20/2023] [Indexed: 08/05/2023] Open
Abstract
Lichenoid drug eruptions are a type of skin reaction that is caused by medication and mimics idiopathic lichen planus. Various medications have been known to cause lichenoid drug eruptions, such as antibiotics, anti-convulsants, anti-diabetics, anti-malarials, anti-tubercular drugs, anti-hypertensives, psychiatric drugs, chemotherapeutic agents, diuretics, heavy metals, and non-steroidal anti-inflammatory drugs. Various cutaneous side effects have been reported in association with teriflunomide. We present the case of a patient who developed a lichenoid eruption because of teriflunomide. The dermatologists and neurologists should be aware of these skin side effects.
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Affiliation(s)
- Fatima-Zahra Agharbi
- Department of Dermatology, Sheikh Khalifa Hospital, Faculty of Medicine, Mohamed VI University of Health Sciences, Casablanca, Morocco
| | - Jehanne Aasfara
- Department of Neurology, Sheikh Khalifa Hospital, Faculty of Medicine, Mohamed VI University of Health Sciences, Casablanca, Morocco
| | - Kenza Oqbani
- Department of Pathology, Sheikh Khalifa Hospital, Faculty of Medicine, Mohamed VI University of Health Sciences, Casablanca, Morocco
| | - Khalqui Slamti
- Department of Dermatology, Sheikh Khalifa Hospital, Faculty of Medicine, Mohamed VI University of Health Sciences, Casablanca, Morocco
| | - Soumiya Chiheb
- Department of Dermatology, Sheikh Khalifa Hospital, Faculty of Medicine, Mohamed VI University of Health Sciences, Casablanca, Morocco
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Sapadin YK, Mermelstein E, Phelps RG, Basler CF, Tufariello JM, Lebwohl MG. COVID-19 Vaccine-Induced Lichenoid Eruptions-Clinical and Histopathologic Spectrum in a Case Series of Fifteen Patients with Review of the Literature. Vaccines (Basel) 2023; 11. [PMID: 36851315 DOI: 10.3390/vaccines11020438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/19/2023] [Accepted: 01/31/2023] [Indexed: 02/17/2023] Open
Abstract
Lichen planus is a distinctive mucocutaneous disease with well-established clinical and histopathologic criteria. Lichenoid eruptions closely resemble lichen planus and may sometimes be indistinguishable from it. Systemic agents previously associated have included medications, viral infections and vaccines. Sporadic case reports of lichen planus and lichenoid reactions associated with COVID-19 vaccines have recently emerged. Herein, we review the world literature (31 patients) and expand it with a case series of 15 patients who presented with vaccine-induced lichenoid eruption (V-ILE). The spectrum of clinical and histopathologic findings is discussed with emphasis on the subset whose lesions manifested in embryologic fusion lines termed lines of Blaschko. This rare Blaschkoid distribution appeared in seven of the 46 patients studied. Of interest, all seven were linked to the mRNA COVID-19 vaccines. We believe that all lichenoid eruptions should be approached with a heightened index of suspicion and patients should be specifically questioned with regards to their vaccination history. When diagnosed early in its course, V-ILE is easily treated and resolves quickly in almost all patients with or without hyperpigmentation. Additional investigative studies regarding its immunopathology and inflammatory signaling pathways may offer insight into other Th1-driven autoimmune phenomena related to COVID-19 vaccination.
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Ingen-Housz-Oro S, Milpied B, Badrignans M, Carrera C, Elshot YS, Bensaid B, Segura S, Apalla Z, Markova A, Staumont-Sallé D, Marti-Marti I, Giavedoni P, Chua SL, Darrigade AS, Dezoteux F, Starace M, Torre AC, Riganti J, de Prost N, Lebrun-Vignes B, Bauvin O, Walsh S, Ortonne N, French LE, Sibaud V. Severe blistering eruptions induced by immune checkpoint inhibitors: a multicentre international study of 32 cases. Melanoma Res 2022; 32:205-210. [PMID: 35377864 PMCID: PMC9377568 DOI: 10.1097/cmr.0000000000000819] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Among dermatologic adverse events induced by immune checkpoint inhibitors (ICI), bullous life-threatening reactions are rare. To better define the clinical and histological features, treatment, and prognosis of ICI-related severe blistering cutaneous eruptions. This retrospective case series was conducted between 2014/05/15 and 2021/04/15 by the dermatology departments of four international registries involved in drug reactions. Inclusion criteria were age ≥18 years old, skin eruption with blisters with detachment covering ≥1% body surface area and at least one mucous membrane involved, available pictures, and ICI as suspect drug. Autoimmune bullous disorders were excluded. Each participant medical team gave his own diagnosis conclusion: epidermal necrolysis (EN), severe lichenoid dermatosis (LD), or unclassified dermatosis (UD). After a standardized review of pictures, cases were reclassified by four experts in EN or LD/UD. Skin biopsies were blindly reviewed. Thirty-two patients were included. Median time to onset was 52 days (3-420 days). Cases were originally diagnosed as EN in 21 cases and LD/UD in 11 cases. After review by experts, 10/21 EN were reclassified as LD/UD. The following manifestations were more frequent or severe in EN: fever, purpuric macules, blisters, ocular involvement, and maximal detachment. Most patients were treated with topical with or without systemic corticosteroids. Eight patients (25%) died in the acute phase. The culprit ICI was not resumed in 92% of cases. In three patients, another ICI was given with a good tolerance. Histology did not reveal significant differences between groups. Severe blistering cutaneous drug reactions induced by ICI are often overdiagnosed as EN. Consensus for management is pending.
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Affiliation(s)
- Saskia Ingen-Housz-Oro
- Dermatology department, AP-HP, Henri Mondor hospital, Créteil, France
- Reference center for toxic bullous diseases and severe drug reactions TOXIBUL, Créteil, France
- FISARD group, Paris, France
- Univ Paris est Créteil EpidermE, Créteil, France
- European Task Force “Dermatology for cancer patients” of EADV
- ToxiTEN group, European Reference Network for Rare Skin Diseases, Paris, France
| | - Brigitte Milpied
- Reference center for toxic bullous diseases and severe drug reactions TOXIBUL, Créteil, France
- FISARD group, Paris, France
- European Task Force “Dermatology for cancer patients” of EADV
- ToxiTEN group, European Reference Network for Rare Skin Diseases, Paris, France
- Dermatology department, CHU Bordeaux, Bordeaux, France
| | - Marine Badrignans
- Pathology department, AP-HP, Henri Mondor hospital, Créteil, France
- Université Paris Est Créteil Val de Marne UPEC, Créteil, France
| | - Cristina Carrera
- European Task Force “Dermatology for cancer patients” of EADV
- Dermatology Department, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain
- CIBERER Centro de investigaciones Biomedicas en Red de Enfermedades Raras Insituto de Salud Carlos III, Spain
- Pharmacovigilance Technical Committee Hospital Clinic Barcelona, Spain
| | - Yannick S. Elshot
- European Task Force “Dermatology for cancer patients” of EADV
- Department of Dermatology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
- Department of Dermatology, Amsterdam UMC, Univ. of Amsterdam, The Netherlands
| | - Benoit Bensaid
- Reference center for toxic bullous diseases and severe drug reactions TOXIBUL, Créteil, France
- FISARD group, Paris, France
- Dermatology department, CHU Edouard Herriot, Lyon, France
| | - Sonia Segura
- European Task Force “Dermatology for cancer patients” of EADV
- Dermatology Department, Hospital del Mar, Universitat Pompeu Fabra, Barcelona, Spain
| | - Zoé Apalla
- European Task Force “Dermatology for cancer patients” of EADV
- Second Dermatology Department, Medical School, Aristotle University of Thessaloniki, Greece
| | - Alina Markova
- European Task Force “Dermatology for cancer patients” of EADV
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Dermatology, Weill Cornell Medical College, New York, NY, USA
| | - Delphine Staumont-Sallé
- FISARD group, Paris, France
- Dermatology Department, CHU Lille, University Lille, INFINITE U1286 Inserm, Lille, France
| | - Ignasi Marti-Marti
- European Task Force “Dermatology for cancer patients” of EADV
- Dermatology Department, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain
| | - Priscila Giavedoni
- European Task Force “Dermatology for cancer patients” of EADV
- Dermatology Department, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain
| | - Ser-Ling Chua
- ToxiTEN group, European Reference Network for Rare Skin Diseases, Paris, France
- Department of Dermatology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Anne-Sophie Darrigade
- Reference center for toxic bullous diseases and severe drug reactions TOXIBUL, Créteil, France
- FISARD group, Paris, France
- Dermatology department, CHU Bordeaux, Bordeaux, France
| | - Frédéric Dezoteux
- FISARD group, Paris, France
- Dermatology Department, CHU Lille, University Lille, INFINITE U1286 Inserm, Lille, France
| | - Michela Starace
- European Task Force “Dermatology for cancer patients” of EADV
- Dermatology -IRCCS Policlinico di Sant’Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, Italy
| | - Ana Clara Torre
- European Task Force “Dermatology for cancer patients” of EADV
- Dermatology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Julia Riganti
- European Task Force “Dermatology for cancer patients” of EADV
- Dermatology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Nicolas de Prost
- Reference center for toxic bullous diseases and severe drug reactions TOXIBUL, Créteil, France
- Intensive care unit, AP-HP, Henri Mondor hospital, Créteil, France
| | - Bénédicte Lebrun-Vignes
- Reference center for toxic bullous diseases and severe drug reactions TOXIBUL, Créteil, France
- FISARD group, Paris, France
- ToxiTEN group, European Reference Network for Rare Skin Diseases, Paris, France
- Regional Pharmacovigilance Center, AP-HP, Pitié-Salpêtrière hospital, Paris, France
| | - Olivia Bauvin
- FISARD group, Paris, France
- Dermatology department, CHU Charles Nicolle, Rouen, France
| | - Sarah Walsh
- ToxiTEN group, European Reference Network for Rare Skin Diseases, Paris, France
- Department of Dermatology, King’s College Hospital, London, United Kingdom
| | - Nicolas Ortonne
- Reference center for toxic bullous diseases and severe drug reactions TOXIBUL, Créteil, France
- Pathology department, AP-HP, Henri Mondor hospital, Créteil, France
- Université Paris Est Créteil Val de Marne UPEC, Créteil, France
| | - Lars E. French
- ToxiTEN group, European Reference Network for Rare Skin Diseases, Paris, France
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilan University (LMU) Munich, Munich, Germany
- Dr. Philip Frost, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL
| | - Vincent Sibaud
- European Task Force “Dermatology for cancer patients” of EADV
- Department of Oncodermatology, Claudius Regaud Institute and University Cancer Institute Toulouse Oncopole, Toulouse, France
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Kou L, Agarwal S, Miceli A, Kolb L, Krishnamurthy K, Schmieder S. Steroid-Refractory Lichenoid Eruption Associated with Pembrolizumab in a Patient with Non-Small Cell Lung Cancer. HCA Healthc J Med 2021; 2:397-400. [PMID: 37427397 PMCID: PMC10324803 DOI: 10.36518/2689-0216.1198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Programmed cell death receptor 1 (PD-1) inhibitors are promising and effective treatments for various cancers. Cutaneous adverse events, such as lichenoid drug eruptions, are well-known common side effects associated with PD-1 inhibitors. Lichenoid drug eruptions associated with PD-1 inhibitors show rapid improvement with high potency topical steroids and do not require cessation of the offending drug. We present the case of an 84-year-old female with progressive pembrolizumab therapy-associated lichenoid eruption that was resistant to several treatments and ultimately required discontinuation of pembrolizumab and treatment with methotrexate to resolve. This report includes histological findings of the pembrolizumab-associated lichenoid eruption.
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Affiliation(s)
- Leon Kou
- St. Petersburg General Hospital, St. Petersburg, FL
| | - Sanjay Agarwal
- Department of Dermatology, Beaumont Trenton Hospital, Trenton, MI
| | - Alyssa Miceli
- Department of Dermatology, William Beaumont Hospital, Royal Oak, MI
| | - Logan Kolb
- Department of Dermatology, Olmsted Medical Center, Rochester, MN
| | | | - Shawn Schmieder
- Mercer University, Atlanta, GA
- Orange Park Medical Center Dermatology Residency Program, Orange Park, FL
- Park Avenue Dermatology, Orange Park, FL
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Manko S, Côté B, Provost N. A case of durvalumab-induced lichenoid eruption evolving to bullous eruption after phototherapy: A case report. SAGE Open Med Case Rep 2021; 9:2050313X21993279. [PMID: 33747513 PMCID: PMC7940716 DOI: 10.1177/2050313x21993279] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/09/2020] [Indexed: 11/29/2022] Open
Abstract
Immune checkpoint inhibitor therapy nowadays became a treatment for a wide range of cancers, and may be responsible for various dermatologic adverse effects, including bullous eruptions. In our report, we present a case of late-onset immunotherapy-induced eruption in a 62-year-old woman treated with anti-programmed cell death-L1 agent durvalumab for metastatic squamous cell carcinoma. Diagnosed as lichenoid dermatitis upon initial presentation, this eruption evolved into necrotic bullous dermatitis after several weeks of phototherapy, with histology and direct immunofluorescence study favoring lichen planus pemphigoides. Thus, this case may be regarded as durvalumab-induced lichenoid dermatitis with phototherapy-triggered progression to necrotic lichen planus pemphigoides-like eruption. The patient’s eruption responded to oral prednisone and immunotherapy interruption. Interestingly, durvalumab reintroduction in this patient led to recurrent lichenoid dermatitis without bullous component. This case of immunotherapy skin toxicity is rather distinctive by its clinical and histopathologic features, with phototherapy as an additional triggering factor.
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Affiliation(s)
- Svitlana Manko
- Department of Dermatology, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Benoît Côté
- Department of Dermatology, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Nathalie Provost
- Department of Dermatology, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
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Abstract
With recent increase in the use of direct oral anticoagulants (DOACs), several new cases of adverse drug reactions (ADRs) have been identified in pharmacovigilance surveys. These ADRs can result in significant mortality and morbidity if not identified and treated promptly. It is important for physicians to recognize that immunologically mediated delayed hypersensitivity reactions, although rare in occurrence, can have significant impact on patient's quality of life. To the best of our knowledge, we report the first case of lichenoid eruption associated with apixaban. We further provide evidence of tolerance to rivaroxaban in the same patient. PLAIN LANGUAGE SUMMARY Apixaban-induced lichenoid eruption Well documented case reports, although providing evidence of probable causal relationship between a drug and specific adverse drug reactions (ADRs), can increase awareness amongst clinicians treating patients with direct oral anticoagulants (DOACs), especially with its rapid utilization. Rare ADRs are difficult to detect as clinical trials of DOACs lacked enough patient sample, making post-marketing reporting of such events important so both patients and clinicians can be vigilant to help with prompt recognition of such symptoms. We report the first case of lichenoid eruption hypersensitivity reaction associated with apixaban in patient with tolerance to rivaroxaban.
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Affiliation(s)
- Tanvi Patil
- Department of Pharmacy, Salem Veterans Affair Medical Center (SVAMC), 1970 Roanoke Blvd, Salem, VA 24153, USA
| | | | - Wayne Torre
- Department of Pathology, SVAMC, Salem, VA, USA
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Geisler AN, Phillips GS, Barrios DM, Wu J, Leung DYM, Moy AP, Kern JA, Lacouture ME. Immune checkpoint inhibitor-related dermatologic adverse events. J Am Acad Dermatol 2020; 83:1255-68. [PMID: 32454097 DOI: 10.1016/j.jaad.2020.03.132] [Citation(s) in RCA: 198] [Impact Index Per Article: 49.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 12/17/2022]
Abstract
Immune checkpoint inhibitors have emerged as a pillar in the management of advanced malignancies. However, nonspecific immune activation may lead to immune-related adverse events, wherein the skin and its appendages are the most frequent targets. Cutaneous immune-related adverse events include a diverse group of inflammatory reactions, with maculopapular rash, pruritus, psoriasiform and lichenoid eruptions being the most prevalent subtypes. Cutaneous immune-related adverse events occur early, with maculopapular rash presenting within the first 6 weeks after the initial immune checkpoint inhibitor dose. Management involves the use of topical corticosteroids for mild to moderate (grades 1-2) rash, addition of systemic corticosteroids for severe (grade 3) rash, and discontinuation of immunotherapy with grade 4 rash. Bullous pemphigoid eruptions, vitiligo-like skin hypopigmentation/depigmentation, and psoriasiform rash are more often attributed to programmed cell death-1/programmed cell death ligand-1 inhibitors. The treatment of bullous pemphigoid eruptions is similar to the treatment of maculopapular rash and lichenoid eruptions, with the addition of rituximab in grade 3-4 rash. Skin hypopigmentation/depigmentation does not require specific dermatologic treatment aside from photoprotective measures. In addition to topical corticosteroids, psoriasiform rash may be managed with vitamin D3 analogues, narrowband ultraviolet B light phototherapy, retinoids, or immunomodulatory biologic agents. Stevens-Johnson syndrome and other severe cutaneous immune-related adverse events, although rare, have also been associated with checkpoint blockade and require inpatient care as well as urgent dermatology consultation.
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Singh S, Singh A, Mallick S, Arava S, Ramam M. Lichenoid pseudovesicular papular eruption on nose: A papular facial dermatosis probably related to actinic lichen nitidus or micropapular polymorphous light eruption. Indian J Dermatol Venereol Leprol 2020; 85:597-604. [PMID: 31293275 DOI: 10.4103/ijdvl.ijdvl_347_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Facial papules are a feature of several clinical conditions and may present both diagnostic and therapeutic challenges. Aim To describe a grouped papular eruption on the nose and adjoining cheeks that has not been well characterized previously. Materials and Methods A series of consecutive patients with a papular eruption predominantly involving nose and cheeks were evaluated, treated and followed up prospectively at tertiary care centers. Demographic details, clinical features, histopathology and response to treatment were recorded. Results There were five men and six women (mean age 29.9 ± 6.9 years) who had disease for a mean duration of 17.3 ± 11.1 months. All patients presented with a predominantly asymptomatic eruption of monomorphic, pseudovesicular, grouped, skin colored to slightly erythematous papules prominently involving the tip of nose, nasal alae, philtrum and the adjoining cheeks. A total of 15 biopsies from 11 patients were analyzed and the predominant finding was a dense, focal lymphoid infiltrate restricted to the upper dermis with basal cell damage and atrophy of the overlying epidermis. The eruption ran a chronic course from several months to years. Limitations Direct immunofluorescence could not be performed except in one case. Immunohistochemical stains for CD4 and CD8 could not be done owing to nonavailability. Phototesting was undertaken in one patient only. Conclusion Small grouped papules on the nose and adjoining skin with a lichenoid histopathology appear to represent a distinct clinicopathological entity. It may be related to actinic lichen nitidus/micropapular variant of polymorphous light eruption.
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Affiliation(s)
- Saurabh Singh
- Department of Dermatology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Ashok Singh
- Departments of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Saumyaranjan Mallick
- Departments of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Sudheer Arava
- Departments of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - M Ramam
- Departments of Dermatology, All India Institute of Medical Sciences, New Delhi, India
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11
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Feng X, Ye X, Xu J, Li C. Mixed lichenoid and psoriasiform drug eruption induced by rifampicin. Australas J Dermatol 2019; 61:e231-e233. [PMID: 31840241 DOI: 10.1111/ajd.13222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 11/14/2019] [Accepted: 11/21/2019] [Indexed: 11/28/2022]
Abstract
Rifampicin is an essential first line anti-tuberculosis drug. However, several cases of adverse reactions associated with this drug have been reported, the most common of which are cutaneous drug reactions. We report a case of mixed lichenoid and psoriasiform drug eruption induced by rifampicin.
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Affiliation(s)
- Xia Feng
- Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xin Ye
- Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jixiang Xu
- Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Changqiang Li
- Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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Affiliation(s)
- Emily Baumrin
- Dermatology Department, Brigham and Women's Hospital, Boston, Massachusetts
| | - Anisa Mosam
- Dermatology Department, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Ncoza C Dlova
- Dermatology Department, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
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Abstract
A 58-year-old man presented with complaints of blackish discoloration of forearms and face of five months duration. The lesions occurred episodically after taking anti-cancer medications, each episode lasting for two weeks. Histopathology confirmed a lichenoid eruption. Photolichenoid eruption to docetaxel is a dermatological adverse effect not reported in literature earlier.
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Affiliation(s)
- Biju Vasudevan
- Department of Dermatology, Base Hospital, Delhi Cantt, New Delhi, India
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