Nivolumab-Induced Lichen Planopilaris: Case Report and Literature Review of Hair Disorders Associated with Targeted Oncological Therapies.

Autor: Asfour L; The Dermatology Centre, Salford Royal NHS Foundation Trust, Salford, UK., Rutkowski D; The Dermatology Centre, Salford Royal NHS Foundation Trust, Salford, UK.; Centre for Dermatology Research, University of Manchester, MAHSC and NIHR Manchester, Biomedical Research Centre, Manchester, UK., Chaudhry IH; Department of Dermatopathology, Liverpool Clinical Laboratories, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK., Harries MJ; The Dermatology Centre, Salford Royal NHS Foundation Trust, Salford, UK.; Centre for Dermatology Research, University of Manchester, MAHSC and NIHR Manchester, Biomedical Research Centre, Manchester, UK.
Jazyk: angličtina
Zdroj: International journal of trichology [Int J Trichology] 2023 May-Jun; Vol. 15 (3), pp. 105-107. Date of Electronic Publication: 2023 Dec 01.
DOI: 10.4103/ijt.ijt_95_21
Abstrakt: Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapies. Their mechanism promotes a cytotoxic T-cell activation against the tumor cells, but as a consequence, immune-mediated toxicities are increasingly being identified. Cutaneous immune-mediated adverse events (AE) occur in 32% of patients, with possible higher grade AEs seen with anti-programmed cell death protein 1, such as nivolumab. A 67-year-old woman with metastatic melanoma, previously treated for 2 years on dual ICI (ipilimumab and nivolumab), had her treatment interrupted due to grade-3 hepatitis. She was subsequently recommenced on single-agent nivolumab with good response, before discontinuation due to remission. She reported worsening scalp pruritus with associated erythema, scaling, and global hair thinning. On examination, she had significant erythema throughout the scalp with perifollicular scaling and evidence of scarring. She reported severe distress from her symptoms. Her scalp biopsy demonstrated features of scarring alopecia with infundibular and isthmic inflammation and interface change in keeping with lichen planopilaris. Follicular toxicities are rarely reported, possibly due to imprecise AE phenotyping or underreporting. However, growing evidence suggests that patients can develop follicular pigmentary changes and nonscarring alopecia. To our knowledge, this is the first case of scarring alopecia reported with nivolumab. Current treatments for ICI-induced toxicities are limited.
Competing Interests: There are no conflicts of interest.
(Copyright: © 2023 International Journal of Trichology.)
Databáze: MEDLINE
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