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Updated: Dec 9, 2025
07:22
A Standardized Procedure of Dressing Management for Toxic Epidermal Necrolysis
Published on: March 14, 2025
935
Immune-Mediated Toxic Epidermal Necrolysis.
Dinesh Keerty1, Viktoriya Koverzhenko2, Dalila Belinc1
1Internal and Hospital Medicine, Moffitt Cancer Center, Tampa, USA.
Cureus
|September 14, 2020
Summary
Immune checkpoint inhibitors like nivolumab can cause severe skin reactions, including fatal toxic epidermal necrolysis. Physicians must monitor patients for these serious dermatological adverse events during melanoma treatment.
Area of Science:
- Oncology
- Immunology
- Dermatology
Background:
- Immune checkpoint inhibitors, including programmed death receptor 1 (PD-1) and cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitors, represent advanced melanoma treatments.
- PD-1 inhibitors are associated with multi-system adverse reactions, with dermatological events ranging from mild pruritus to severe toxic epidermal necrolysis.
Observation:
- This report details a fatal case of toxic epidermal necrolysis (TEN) occurring secondary to nivolumab therapy.
- The patient's outcome highlights the potential severity of immune checkpoint inhibitor-related dermatologic toxicity.
Findings:
- Toxic epidermal necrolysis is a rare but life-threatening adverse event associated with PD-1 inhibitor therapy.
- Early recognition and management of dermatological complications are crucial for patient outcomes.
Implications:
- Checkpoint inhibitors are increasingly used in various malignancies, necessitating ongoing vigilance regarding their safety profile.
- Physicians must be aware of the spectrum of dermatological toxicities and the risk of opportunistic infections or sepsis in immunocompromised patients or those on combination therapy.
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