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Immune checkpoint inhibitor-related dermatologic adverse events.
Geisler, Amaris N; Phillips, Gregory S; Barrios, Dulce M; Wu, Jennifer; Leung, Donald Y M; Moy, Andrea P; Kern, Jeffrey A; Lacouture, Mario E.
Afiliación
  • Geisler AN; Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
  • Phillips GS; State University of New York Downstate Health Sciences University, Brooklyn, New York.
  • Barrios DM; Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
  • Wu J; Chang Gung Memorial Hospital Linkou, Chang Gung University School of Medicine, Taoyuan, Taiwan.
  • Leung DYM; Division of Pediatric Allergy and Immunology, Department of Pediatrics, National Jewish Health, Denver, Colorado.
  • Moy AP; Department of Pathology, Memorial Sloan Kettering Cancer, New York, New York.
  • Kern JA; Division of Pediatric Allergy and Immunology, Department of Pediatrics, National Jewish Health, Denver, Colorado.
  • Lacouture ME; Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medicine, New York, New York. Electronic address: lacoutum@mskcc.org.
J Am Acad Dermatol ; 83(5): 1255-1268, 2020 Nov.
Article en En | MEDLINE | ID: mdl-32454097
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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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Erupciones por Medicamentos / Inhibidores de Puntos de Control Inmunológico / Neoplasias Límite: Humans Idioma: En Revista: J Am Acad Dermatol Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Erupciones por Medicamentos / Inhibidores de Puntos de Control Inmunológico / Neoplasias Límite: Humans Idioma: En Revista: J Am Acad Dermatol Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos