Granulomatous and lichenoid dermatitis after IgG4 anti-PD-1 monoclonal antibody therapy for advanced cancer

Journal of Cutaneous Pathology
Julio A Diaz-PerezThomas L Cibull

Abstract

Nivolumab is a fully human IgG4 monoclonal antibody directed against programmed cell death protein 1 (PD-1). PD-1 inhibition allows T-cell activation and recruitment to destroy cancer cells. Checkpoint inhibitors have shown significant survival advantage and relatively low side-effects in comparison with conventional chemotherapy in several types of advanced cancer. Granulomatous cutaneous reactions have been reported showing sarcoidal and panniculitic morphology. Here we present a case of drug-induced lichenoid and granulomatous dermatitis after checkpoint inhibitor therapy observed in a 63-year-old male treated with nivolumab for advanced glioblastoma. This morphology has not been previously reported. We documented a high number of CD8+ T-cells within the lesions. Additionally, we review the side-effects observed with the use of checkpoint inhibitors, with special focus on cutaneous manifestations.

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Citations

Jun 9, 2020·Dermatologic Therapy·Akmal SidikovEvgeniya V Shalaeva
Oct 28, 2020·American Journal of Clinical Dermatology·Nidhi ShahRoni P Dodiuk-Gad
Aug 31, 2019·Dermatologic Clinics·Leonora BomarChristine Ahn
Dec 10, 2020·JAAD Case Reports·Simran A ChadhaCuong V Nguyen
Apr 23, 2020·Journal of the American Academy of Dermatology·Anne Birgitte SimonsenClaus Zachariae

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