Thursday, November 13, 2014

Skin stuff with Anti-PD1

I have certainly had weird skin things during and after being on Nivo!!!  Of course weird skin thing numero uno was melanoma!!!  Much as we have with ipi, as more folks take the anti-PD1 drugs, we will find out even more things about their side effects and how to deal with them.

Lichenoid dermatitis in two patients with metastatic melanoma treated with anti-PD1 therapy.
Joseph, Goedjen, Gordon, et al.  Cancer Immunol Res. 2014 Oct 6.

The "two most common side effects of anti-PD1/PDL1 therapies include rash and [itching] occurring in about 20% of patients.  While the rash is generally attributed to be immune mediated, the exact mechanisms of the rash remain unclear....We report two cases of lichenoid dermatitis [A scaly, itchy rash...resembling eczema or psoriasis and can be purplish in color.]  in two patients treated with MK-3475 that were characterized with marked T-cell infiltrates with few PD-1 positive cells.  Both patients were taking lisinopril [An ACE inhibitor used to treated increased blood pressure and congestive heart failure.], an agent associated with lichenoid reactions, however, neither had a rash prior to starting MK-3475. Both rashes were relatively mild allowing treatment to continue and responded to topical steroids.

Yours, c

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