Pembrolizumab is a programmed death (PD)‐1 receptor inhibitor and a first‐line treatment for unresectable metastatic melanoma (MM) that is displaying disease progression following treatment with ipilimumab or a BRAF inhibitor. The extent of the dermatological adverse effects (AEs) associated with pembrolizumab has not been fully established. Belum et al. reported that the commonest AEs associated with PD‐1 receptor inhibitors are vitiligo, rash and pruritus, occurring in approximately 8–20% of patients. Given the immunomodulatory nature of PD‐1 receptor inhibitors, the aetiology of these symptoms is considered immune‐mediated, but this is unproven. We report a case of lichen planus (LP) developing during treatment with pembrolizumab.A 46‐year‐old man with atypical naevus syndrome re‐presented with MM in December 2013, 16 years after having two previous melanomas removed and undergoing right axillary node clearance. He reported evolving masses in his right axilla and thigh; subsequent imaging confirmed disease at these areas, along with nodules at the border of the right pulmonary trunk and the hemi‐diaphragm. Histological biopsy of the axillary lesion confirmed the presence of metastatic disease, and dacarbazine was commenced for stage IV MM. The patient received two cycles of treatment before being switched to ipilimumab (patient was negative for BRAF‐V600E mutation) in June 2014
Clinical & Experimental Dermatology – Wiley
Published: Jan 1, 2018
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