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Recurrence of Pemphigus Vulgaris Under Nivolumab Therapy
Sebastian Krammer1, Christian Krammer1, Suzanna Salzer2
1Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany.
Abstract:
For many types of cancer, immune checkpoint inhibitors have proven to be a highly effective treatment. The monoclonal anti-PD-1 antibody nivolumab stimulates the immune system and is one of the newest treatment options for non-small cell lung cancer. In doing so, immune checkpoint inhibitors can trigger many skin lesions that have not yet been completely investigated in their entirety. In this case report, pemphigus vulgaris is identified as a potential adverse event that occurs under the treatment with nivolumab. In addition to the standard methods, we examined our patient's samples with ex vivo confocal laser scanning microscopy. This is a new and innovative diagnostic method that uses vertical scanning to provide fast, high-resolution imaging of freshly excised tissue, even using fluorescently labeled antibodies.
Insights
Immune checkpoint inhibitors like nivolumab treat cancer but can cause skin lesions. This case report identifies pemphigus vulgaris as a potential side effect of nivolumab treatment, highlighting a new diagnostic approach.
Area of Science:
- Oncology
- Immunology
- Dermatology
Background:
- Immune checkpoint inhibitors (ICIs) are effective cancer treatments.
- Nivolumab, an anti-PD-1 antibody, is used for non-small cell lung cancer.
- ICIs can cause various skin lesions, some not fully understood.
Observation:
- A patient treated with nivolumab developed pemphigus vulgaris.
- Pemphigus vulgaris is identified as a potential adverse event associated with nivolumab therapy.
Findings:
- This case report details pemphigus vulgaris as an adverse event in a patient receiving nivolumab.
- Ex vivo confocal laser scanning microscopy was used for advanced diagnostics.
Implications:
- Pemphigus vulgaris should be considered an adverse event of nivolumab treatment.
- Ex vivo confocal laser scanning microscopy offers innovative, high-resolution tissue imaging for diagnostics.
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