Free Content

PLAIN LANGUAGE SUMMARIES

SCLE and dermatomyositis in anti‐PD‐1 therapy

Linked article

Article first published online: 01 Sep 2019
DOI: 10.1111/bjd.18280

Comment on this article

Summary

PD‐1 inhibitors are a relatively new type of drug that are used to treat patients with metastatic (widespread) cancers. Examples include drugs called pembrolizumab and nivolumab. Unfortunately this type of treatment can be associated with auto‐immune side effects, which means that the body’s immune system, which protects against infection, wrongly attacks some parts of the body. Examples of auto‐immune side effects linked to PD‐1 inhibitors include colitis, thyroid disease and skin inflammation, including eczema‐like rashes and vitiligo. The authors of this study, based at Duke University, USA, describe two patients who developed a type of lupus called subacute cutaneous lupus erythematosus (SCLE) while on PD‐1. SCLE is an autoimmune disease. In one case, the drug that was being used, nivolumab, was discontinued; the oncologists unsuccessfully treated the patient with infliximab, a type of drug called a TNFα inhibitor, but the eruption came under control with creams and hydroxychloroquine treatment by the dermatologists. Because nivolumab was helping to treat the patient’s cancer, the drug was re‐introduced but unfortunately he then developed features of another autoimmune condition, dermatomyositis, and the drug was stopped. The second patient developed SCLE following pembrolizumab treatment, which she discontinued as it was not having an effect on her cancer. Again her SCLE came under control with treatment. The authors observed that treatment with a TNF inhibitor would not be ideal in this situation, because it can itself cause lupus. Whereas SCLE is well recognised as a side effect of many drugs, it is unusual to see two different connective tissue diseases, lupus and dermatomyositis, caused by one drug. The authors advise not continuing the drug in this situation.

Read moreRead more (PDF)

Share this article

0

Favourite

Comments

If you want to submit a letter for publication rather than comment on an article please submit through Scholar One: https://mc.manuscriptcentral.com/bjd

There are no comments for this article yet.

Recent Tweets

@BrJDermatol

20 Oct 2019

A randomized, double-blind placebo-controlled study found that ASN002, an oral, dual Janus kinase and spleen tyrosine kinase inhibitor, had promising efficacy and safety profile for patients with moderate-to-severe atopic dermatitis. https://t.co/9CCBbbM8HV #AD #clinicaltrial https://t.co/x1ueJO8Cny

@BrJDermatol

19 Oct 2019

52F w/ numerous nonpruritic erythematous to brownish annular plaques that gradually expanded centrifugally & coalesced into polycyclic & reticulate appearance w/ partial central atrophy & elevated borders on sun‐exposed areas. What's your Dx? https://t.co/86xi2tenD5 #dermtwitter https://t.co/ZW1DFlJhpG

@BrJDermatol

19 Oct 2019

Skin fibrosis (scarring) remains challenging to assess. This study looks at the utility of using high frequency ultrasound and optical coherence tomography to provide a numerical score of skin fibrosis during the course of wound healing. https://t.co/c5UyZrZrjk #ultrasound #OCT https://t.co/pmBQhGNpcj

@BrJDermatol

18 Oct 2019

This population-based study of over 160,000 participants found that seborrheic dermatitis is a common disease (3.2% of study population) that is more prevalent in men and older individuals. https://t.co/lr5QwCd5J8 #seborrhea #dermatology #epidemiology https://t.co/6M49ovPUed

@BrJDermatol

18 Oct 2019

RT Skin Science Foundation @SkinScienceFDN: In @BrJDermatol: Measuring #clinician#machine agreement in differential #diagnoses for #dermatology: https://t.co/7P8JZ8bDhc

@BrJDermatol

18 Oct 2019

RT Dominique du Crest @ducrest: Management of psoriasis as a systemic disease: what is the evidence? https://t.co/Q8HsEMILgn via @BrJDermatol Biological treatment may prevent or reverse inflammatory damage associated with psoriasis comorbidities. #dermatology #dermatologia #PsoriasisAwareness

Close