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Related Concept Videos

Skin Diseases and Disorders01:23

Skin Diseases and Disorders

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Skin is the first line of defense and encounters a variety of microbes. Some pathogenic strains are often the cause of a broad range of infections of the skin and other body systems. These conditions can affect people of all ages and may have different causes, including genetic factors, infections, autoimmune reactions, environmental factors, and lifestyle choices.
Gram-positive Staphylococcus spp. and Streptococcus spp. are responsible for many of the most common skin infections. However, many...
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Papillary Dermis01:11

Papillary Dermis

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Dermis
The dermis might be considered the "core" of the integumentary system, as distinct from the epidermis and hypodermis. It contains blood and lymph vessels, nerves, and other structures, such as hair follicles and sweat glands. The dermis is made of two layers of connective tissue that comprise an interconnected mesh of elastin and collagenous fibers, produced by fibroblasts.
Papillary Layer
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Related Experiment Video

Updated: Nov 8, 2025

Recognition of Epidermal Transglutaminase by IgA and Tissue Transglutaminase 2 Antibodies in a Rare Case of Rhesus Dermatitis
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Refractory dermatitis contributed by pityriasis versicolor: a case report.

Mingjia Li1, Natalie Spaccarelli2, Kari Kendra3

  • 1Division of Hospital Medicine, The Ohio State University Comprehensive Cancer Center, Starling Loving Hall, 320 W. 10th Ave, Columbus, Ohio, 43210, USA. mingjia.li@osumc.edu.

Journal of Medical Case Reports
|April 23, 2021
PubMed
Summary
This summary is machine-generated.

Dermatologic toxicity from immune checkpoint inhibitor therapy can be complicated by concurrent infections like pityriasis versicolor. Effective management requires addressing both the immune-related adverse event and the underlying fungal infection for resolution.

Keywords:
DermatitisImmune-related adverse eventPityriasis versicolorSkin infection

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Area of Science:

  • Oncology
  • Dermatology
  • Infectious Diseases

Background:

  • Immune checkpoint inhibitor (ICI) therapy is a standard treatment for metastatic melanoma.
  • Dermatologic toxicity is a frequent immune-related adverse event (irAE) associated with ICI therapy.
  • Concurrent skin infections can mimic or worsen ICI-induced dermatologic toxicity.

Observation:

  • A patient with metastatic melanoma on ICI therapy developed severe, widespread pruritic maculopapular lesions.
  • The patient had a history of pityriasis versicolor, which was suspected to be concurrently active.
  • Initial treatment with topical steroids and antifungals, followed by oral prednisone, provided only partial and temporary relief.

Findings:

  • The patient's dermatitis was ultimately diagnosed as ICI-induced dermatologic toxicity with concurrent pityriasis versicolor.
  • Steroid treatment for the irAE may have exacerbated the fungal infection, while the infection mimicked irAE symptoms.
  • Combination therapy with oral fluconazole and prednisone led to rapid resolution of the severe dermatitis.

Implications:

  • It is crucial to consider and investigate concurrent infections in patients receiving ICI therapy who develop severe dermatitis.
  • Antifungal therapy, in addition to standard irAE management, may be necessary for resolution in cases of co-existing fungal infections.
  • This case highlights the importance of a comprehensive diagnostic approach to manage complex dermatologic toxicities in cancer patients undergoing immunotherapy.