Nivolumab-induced lichen planus pemphigoides

Cutis. 2019 Apr;103(4):224-226.

Abstract

Programmed cell death 1 (PD-1) receptor inhibitors, such as nivolumab, are used in the treatment of non-small cell lung cancers, melanoma, and other cancers. Cutaneous adverse events (AEs) associated with anti-PD-1 therapy have been widely documented. Although cutaneous AEs often are mild, some patients can develop notable morbidity. We report an 87-year-old woman with stage IV non-small cell lung cancer who developed a bullous eruption on the trunk and extremities. Biopsy of the lesions revealed a subepidermal bullous lichenoid eruption with positive immunofluorescence in a linear pattern at the basement membrane zone, consistent with lichen planus pemphigoides (LPP). The patient improved with oral prednisone and cessation of nivolumab therapy.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Antineoplastic Agents, Immunological / adverse effects*
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Diagnosis, Differential
  • Female
  • Humans
  • Lichen Planus / chemically induced
  • Lichen Planus / diagnosis*
  • Lichen Planus / pathology
  • Lung Neoplasms / drug therapy*
  • Nivolumab / adverse effects*
  • Pemphigus / chemically induced
  • Pemphigus / diagnosis*
  • Pemphigus / pathology

Substances

  • Antineoplastic Agents, Immunological
  • Nivolumab