title: Antiepidermis autoantibodies induced by anti-PD-1 therapy in metastatic melanoma.
abstract: Skin rashes induced by anti-PD-1s are often reported; however, their immunological profiles are currently unknown. We report the case of an atypical eruption induced by pembrolizumab, associated with the occurrence of antiepidermis autoantibodies. As the onset of lesions was concomitant with the favorable tumor response, we suggest that this hybrid rash belongs to a new category of paraneoplastic syndrome, reflecting the intense immunomodulation induced by pembrolizumab. With the increasing use of anti-PD-1s, this kind of report may become frequent. For a better understanding of immune-related adverse events, physicians should document the immunological characteristics of atypical skin toxicities. Moreover, the kinetics of induced autoantibodies could provide a proxy measure of anti-PD-1 activity after treatment disruption.
authors.affiliation: Departments of aDermatology bImmunology cPathology, Bichat Claude Bernard Hospital, AP-HP dUniversity of Paris-Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Brunet-Possenti
authors.forename: Sabine
authors.initials: S
authors.lastname: Mignot
authors.forename: Lydia
authors.initials: L
authors.lastname: Deschamps
authors.forename: Vincent
authors.initials: V
authors.lastname: Descamps
mesh_terms: D000368:Aged; D001323:Autoantibodies / Q000627:therapeutic use*; D005076:Exanthema / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000473:pathology; D061026:Programmed Cell Death 1 Receptor / Q000037:antagonists & inhibitors*; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D001323:Autoantibodies; D061026:Programmed Cell Death 1 Receptor