PATIENT 3: LPP-LIKE CHANGES ASSOCIATED WITH NIVOLUMAB
The third affected person within the report was a 63-year-old lady with malignant melanoma obtained adjuvant remedy with nivolumab after full resection of a single cutaneous metastasis. Following 16 weeks of remedy, she reported extreme pruritus and hair loss from the scalp. A biopsy confirmed lichen planopilaris (LPP). Topical remedy with clobetasol 0.5 mg/g answer led to a fast enchancment in pruritus and he or she proceeded with nivolumab.
COMMENT
These are three extra instances of scarring alopecia related to use of checkpoint inhibitor medicine. Hair loss developed 2.5 months, 2 years and 16 weeks after beginning the drug indicating fairly a little bit of variability in when hair loss truly happens.
We want to concentrate on the array of autoimmune pores and skin reactions these medicine may cause particularly the autoimmune lichenoid kind reactions which might have an effect on as much as 17% of sufferers. The scarring alopecias are a possible aspect impact that we want to have the ability to acknowledge and remedy. Topical steroids, steroid injections, topical tacrolimus, doxycycline, hydroxychloroquine and retinoids are all doable remedy concerns.
MAIN REFERENCE
Braasch et al. Scarring Alopecia Beneath Immune Checkpoint Blockade: a Report of Three Circumstances. Acta Derm Venereol. 2022 Oct 11;102:adv00792.
ADDITIONAL REFERENCES
Garcia-Melendo C, et al. Intensive lichen planopilaris as unique lichenoid response secondary to pembrolizumab in a affected person with metastatic melanoma. Dermatol Ther. 2022 Feb 17;e15388.
Uthayakumar AK et al .Extreme progressive scarring pembrolizumab-induced lichen planopilaris in a affected person with metastatic melanoma. Australas J Dermatol. 2021 Aug;62(3):403-406.
Cogen et al. Lichen planopilaris related to pembrolizumab in a affected person with metastatic melanoma. JAAD Case Rep . 2018 Jan 16;4(2):132-134.
Dominguez-Santas M et al. Avelumab-induced lichen planopilaris, a novel affiliation. Int J Dermatol. 2021 Oct;60(10):e414-e416.
