title: Late presentation of generalised bullous pemphigoid-like reaction in a patient treated with pembrolizumab for metastatic melanoma.
abstract: Dermatological toxicity is one of the most commonly reported immune-related adverse events in patients receiving checkpoint inhibitor immunotherapy. We report the gradual development of a widespread bullous pemphigoid-like reaction in a metastatic melanoma patient 8 months after commencing treatment with the programmed-death-1 (PD-1) inhibitor pembrolizumab, requiring prolonged corticosteroid therapy. This case highlights the potential for insidious and late development of severe cutaneous toxicity following PD-1 inhibitor therapy and suggests that even prolonged immunosuppression may not necessarily compromise the efficacy of PD-1 inhibition in advanced melanoma.
authors.affiliation: Medical Oncology Unit, Austin Health, Melbourne, Vic., Australia.|Olivia Newton-John Cancer Research Institute, Melbourne, Vic., Australia.|La Trobe University School of Cancer Medicine, Melbourne, Vic., Australia.
authors.forename: Sagun
authors.initials: S
authors.lastname: Parakh
authors.affiliation: Dermatology Unit, Austin Health, Melbourne, Victoria, Australia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Nguyen
authors.affiliation: Dermatology Unit, Austin Health, Melbourne, Victoria, Australia.
authors.forename: Jacinta M
authors.initials: JM
authors.lastname: Opie
authors.affiliation: Medical Oncology Unit, Austin Health, Melbourne, Vic., Australia.|Olivia Newton-John Cancer Research Institute, Melbourne, Vic., Australia.|La Trobe University School of Cancer Medicine, Melbourne, Vic., Australia.
authors.forename: Miles C
authors.initials: MC
authors.lastname: Andrews
mesh_terms: D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects*; D000074322:Antineoplastic Agents, Immunological / Q000009:adverse effects*; D003875:Drug Eruptions / Q000209:etiology*; D006801:Humans; D008297:Male; D008545:Melanoma / Q000556:secondary / Q000628:therapy*; D010391:Pemphigoid, Bullous / Q000139:chemically induced*; D012878:Skin Neoplasms / Q000473:pathology / Q000628:therapy*; D013997:Time Factors
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000074322:Antineoplastic Agents, Immunological; C582435:pembrolizumab
keywords: bullous pemphigoid; immunotherapy; melanoma; programmed death-1 inhibition