EditorAnti‐programmed death 1 (PD‐1) antibodies are revolutionizing the treatment of many cancers, including melanoma. Cutaneous adverse events (AE) of anti‐PD‐1 antibodies are common (20%) and mainly non‐specific. Bullous pemphigoids (BP) are very rare immune‐related AEs induced by anti‐PD‐1 antibodies, with only 12 cases previously published. We report here three new cases of BP during anti‐PD‐1 therapy with nivolumab.The first patient was a 66‐year‐old man treated for a metastatic choroidal melanoma with nivolumab (Table ). He presented with a moderate diffuse pruritic papular eruption on his back 4 months after nivolumab initiation, associated 3 months later with tense bullae on the trunk (Fig. a). A skin biopsy confirmed the diagnosis of BP with a subepidermal blister associated with an eosinophilic infiltrate and linear IgG and C3 immune deposits along the dermoepidermal junction (DEJ) (Fig. b). Serum BP 180 antibodies by enzyme‐linked immunosorbent assay (ELISA) were positive (34 U/mL), and BP 230 antibodies were not detected. As the patient was responding to nivolumab, this latter was continued and oral prednisone was initiated at a daily dose of 0.5 mg/kg. BP was controlled within 2 weeks, and prednisone doses were gradually tapered. With a 14‐month follow‐up after initiating corticosteroids, BP is still controlled, at a daily dose of prednisone of
Journal of the European Academy of Dermatology & Venereology – Wiley
Published: Jan 1, 2018
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