Neutrophilic dermatoses as adverse effects of checkpoint inhibitors: A review

Area of Science:

• Immunology
• Dermatology
• Oncology

Background:

• Checkpoint inhibitors (programmed cell death (PD-1) receptor, its ligand (PD-L1), and cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4)) enhance anti-tumor immunity.
• Increased immune activity can lead to adverse cutaneous reactions.
• Neutrophilic dermatoses are a potential side effect of these immunotherapies.

Purpose of the Study:

• To review and summarize cases of neutrophilic dermatoses associated with checkpoint inhibitor therapy.
• To inform dermatologists about these rare adverse events and their management.

Main Methods:

• A literature search was conducted using the PubMed database.
• The search focused on identifying case reports of neutrophilic dermatoses linked to checkpoint inhibitors.

Main Results:

• Eleven cases were identified: four Sweet syndrome, four pustular eruptions, two pyoderma gangrenosum, and one bullous lupus erythematosus.
• The majority of patients (9 of 11) experienced complete resolution of their dermatoses.
• Treatment primarily involved topical or systemic corticosteroids.

Conclusions:

• Checkpoint inhibitors can induce rare but significant neutrophilic dermatoses.
• Awareness and prompt treatment with corticosteroids are crucial for managing these adverse reactions.
• As checkpoint inhibitor use expands, dermatologists must be prepared for these cutaneous side effects.