title: Drug-associated dermatomyositis following ipilimumab therapy: a novel immune-mediated adverse event associated with cytotoxic T-lymphocyte antigen 4 blockade.
abstract: OBJECTIVE
  Ipilimumab, a human monoclonal antibody targeted against cytotoxic T-lymphocyte antigen 4, has shown promise in the treatment of metastatic melanoma. However, given its mechanism of action, immune-related adverse effects have been reported with this therapy. Despite increasing reports of immune-related adverse effects related to ipilimumab therapy, dermatomyositis associated with this agent has not previously been reported.
  
  
  METHODS
  We describe a woman undergoing treatment with ipilimumab for metastatic melanoma who developed classic cutaneous findings of dermatomyositis along with proximal muscle weakness and elevated muscle enzymes.
  
  
  CONCLUSIONS
  This case adds to the expanding literature regarding immune-related adverse events associated with ipilimumab. To our knowledge, drug-induced dermatomyositis from ipilimumab has not previously been reported. Physicians should be aware of these potential immune-related adverse events and consider drug-associated dermatomyositis in the differential diagnosis in patients receiving ipilimumab who present with a cutaneous eruption or muscle weakness.
authors.affiliation: King's College London School of Medicine, London, England.
authors.forename: Shirwa
authors.initials: S
authors.lastname: Sheik Ali
authors.affiliation: Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts3Center for Cutaneous Oncology, Dana Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Allison L
authors.initials: AL
authors.lastname: Goddard
authors.affiliation: Melanoma Disease Center, Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Jason J
authors.initials: JJ
authors.lastname: Luke
authors.affiliation: Melanoma Disease Center, Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Hilary
authors.initials: H
authors.lastname: Donahue
authors.affiliation: Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Derrick J
authors.initials: DJ
authors.lastname: Todd
authors.affiliation: Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts3Center for Cutaneous Oncology, Dana Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Andrew
authors.initials: A
authors.lastname: Werchniak
authors.affiliation: Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Ruth Ann
authors.initials: RA
authors.lastname: Vleugels
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D060908:CTLA-4 Antigen / Q000276:immunology*; D003882:Dermatomyositis / Q000139:chemically induced* / Q000276:immunology / Q000473:pathology; D005260:Female; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects*; D000074324:Ipilimumab; D008545:Melanoma / Q000188:drug therapy* / Q000276:immunology; D008875:Middle Aged; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology
chemical_list: D000911:Antibodies, Monoclonal; D060908:CTLA-4 Antigen; D000074324:Ipilimumab