Abstract：
:Nivolumab is a programmed cell death receptor-1 (PD-1) antibody used in the treatment of metastatic or unresectable melanoma. Cutaneous reactions are the most common adverse events reported with these agents and are rarely severe or life-threatening. Here we present a case report describing the clinicopathological findings of a patient with a fatal toxic epidermal necrolysis (TEN) eruption associated with use of nivolumab for treatment of metastatic melanoma. The patient developed a pruritic, morbiliform eruption, which slowly progressed over 3 months to a tender, exfoliative dermatosis. Histology initially showed interface dermatitis and subsequently revealed full thickness epidermal necrosis. The diagnosis of TEN was made. From initial biopsy to TEN presentation, there was an increase in the number of CD8+ lymphocytes within the dermal-epidermal junction and an increase of programmed death ligand 1 (PD-L1) expression in both lymphocytes and keratinocytes. Despite treatment with infliximab, high-dose steroids and intravenous immunoglobulin, the patient expired. Herein we describe what we believe is the second case of TEN associated with anti-PD1 therapy reported in the literature. Increased expression of PD-L1 by immunohistochemistry was observed as the eruption progressed to TEN. Early diagnosis and treatment is necessary in these fatal TEN reactions secondary to the anti-PD-1 antibody therapies.
journal_name
J Cutan Patholjournal_title
Journal of cutaneous pathologyauthors
Vivar KL,Deschaine M,Messina J,Divine JM,Rabionet A,Patel N,Harrington MA,Seminario-Vidal Ldoi
10.1111/cup.12876subject
Has Abstractpub_date
2017-04-01 00:00:00pages
381-384issue
4eissn
0303-6987issn
1600-0560journal_volume
44pub_type
abstract：:Traditionally, melanoma has been considered by surgeons to be a highly lethal malignancy, always requiring a radical surgical approach for optimal chance of cure. Yet melanoma patients who are now being referred for treatment frequently have small early lesions, and surgeons should develop a flexible attitude about ma...
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章
doi：10.1111/j.1600-0560.1979.tb01127.x
更新日期：1979-06-01 00:00:00
abstract：:A 48 year-old white male with basal cell nevus syndrome presented with a metastatic basal cell carcinoma with neuroendocrine features. The tumor manifested aggressive behavior, having deep local invasion and metastases to para-aortic lymph nodes and bone. Neuroendocrine differentiation has rarely been associated with ...
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章
doi：10.1111/j.1600-0560.1999.tb01849.x
更新日期：1999-07-01 00:00:00
abstract：:To explore the clinicopathological features of a rare dedifferentiated liposarcoma (DDLPS) with meningothelial-like whorls, we retrospectively analyzed 46 reported cases and 1 case that we encountered. Fluorescence in situ hybridization (FISH) analysis of the MDM2 amplification status of our case was also performed. O...
journal_title：Journal of cutaneous pathology
pub_type：
doi：10.1111/cup.13621
更新日期：2020-02-01 00:00:00
abstract：BACKGROUND:Fibrofolliculomas and trichodiscomas are benign dermal neoplasms that likely derive from the mantle of the hair follicle and can occur sporadically or in association with Birt-Hogg-Dube syndrome (BHDS). Little is known about the pathogenesis and immunophenotypic properties of these entities. METHODS:We inve...
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章
doi：10.1034/j.1600-0560.2002.290904.x
更新日期：2002-10-01 00:00:00
abstract：:Free-living amebae are ubiquitous in our environment, but rarely cause cutaneous infection. Balamuthia mandrillaris has a predilection for infecting skin of the central face. Infection may be restricted to the skin or associated with life-threatening central nervous system (CNS) involvement. We report a case of a 91-y...
journal_title：Journal of cutaneous pathology
pub_type：
doi：10.1111/cup.12748
更新日期：2016-10-01 00:00:00
abstract：BACKGROUND:Cutaneous lymphocyte-associated antigen (CLA) is expressed in resident cutaneous T lymphocytes, high endothelial venules, peripheral monocytes, granulocytes and a small percentage of memory B cells. It has been postulated to be an important factor in homing of lymphocytes to the skin because of its function ...
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章
doi：10.1111/j.1600-0560.2007.00971.x
更新日期：2008-11-01 00:00:00
abstract：BACKGROUND:BRCA1-associated protein 1 (BAP1) represents a recently identified tumor suppressor protein. Loss of BAP1 has been observed in cutaneous epithelioid Spitz tumors. These cutaneous melanocytic tumors show a distinct histopathologic phenotype characterized by an intradermal sheet-like proliferation of epithelio...
journal_title：Journal of cutaneous pathology
pub_type： 临床试验,杂志文章,多中心研究
doi：10.1111/cup.12133
更新日期：2013-06-01 00:00:00
abstract：BACKGROUND:Silver dressings have been widely and successfully used to prevent cutaneous wounds, including burns, chronic ulcers, dermatitis and other cutaneous conditions, from infection. However, in a few cases, skin discolouration or argyria-like appearances have been reported. This study investigated the level of si...
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章
doi：10.1111/j.1600-0560.2008.01141.x
更新日期：2009-07-01 00:00:00
abstract：:Galli-Galli disease (GGD) and Dowling-Degos disease (DDD) are inherited skin diseases with variable progressive course. They are of benign and harmless behaviour but aesthetically annoying. They are subsumed within the group of reticulate pigmented disorders of the skin to which, additionally, Kitamura's and Haber's d...
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章
doi：10.1111/j.1600-0560.2008.00995.x
更新日期：2009-01-01 00:00:00
abstract：:Recently, T-cell lymphoma localized to the subcutaneous tissue has been reported. We report the clinical, histologic, immunohistochemical, and molecular genetic findings in 6 patients who we believe had this peculiar T-cell lymphoma with its unique morphologic and clinical features. All patients presented with deep-se...
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章
doi：10.1111/j.1600-0560.1994.tb00244.x
更新日期：1994-04-01 00:00:00
abstract：:In past years, association of primary cutaneous B-cell lymphoma (CBCL) with infection by Borrelia burgdorferi has been reported in a few patients. The evidence for a pathogenetic role was based on clinical grounds or raised titre of antibodies in serum. Both methods, however, do not prove the association between the m...
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章
doi：10.1111/j.1600-0560.1997.tb01318.x
更新日期：1997-09-01 00:00:00
abstract：:Histologic, immunologic and electron microscopic studies were performed in a patient with transient acantholytic dermatosis which involved oral mucosa. Hitologic and electron microscopic findings were almost identical in both cutaneous and mucous membrane lesions, and these were similar to pemphigus vulgaris; suprabas...
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章
doi：10.1111/j.1600-0560.1978.tb00933.x
更新日期：1978-02-01 00:00:00
abstract：BACKGROUND:Hypertrophic lichen planus (LP) is a variant of LP favoring the lower extremities and showing prominent epidermal hyperplasia and hyperorthokeratosis. Contrary to dogma that eosinophils are rare in LP and variants, we noticed that some cases of hypertrophic LP have eosinophils in the absence of drug history....
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章
doi：10.1111/cup.12275
更新日期：2014-04-01 00:00:00
abstract：:True human tails are rare vestigial structures that are typically removed in childhood. Here a case is presented in which an inconspicuous sacrococcygeal tail was incidentally discovered in late adulthood. A 56-year-old man with no significant past medical history presented to a dermatology clinic with a chief complai...
journal_title：Journal of cutaneous pathology
pub_type：
doi：10.1111/cup.12820
更新日期：2017-01-01 00:00:00
abstract：:In seven patients suffering from lichen planus (LP) light- and electron-microscopic 3H-thymidine (3HT) labeling studies were performed and the following results were obtained. 1. Using the light-microscope, a large number of 3HT labeled cells can be observed in the dermal infiltrate of LP. Most of the labeled nuclei b...
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章
doi：10.1111/j.1600-0560.1977.tb00906.x
更新日期：1977-09-01 00:00:00
abstract：:Papillary renal cell carcinoma (RCC) is an uncommon subtype of RCC that is typically encountered at early stages and has a high survival rate. Histopathology typically shows well-defined papillary architecture with tumor cells lining fibrovascular cores and can be further subdivided into type 1 and type 2 tumors based...
journal_title：Journal of cutaneous pathology
pub_type：
doi：10.1111/cup.13546
更新日期：2019-12-01 00:00:00
abstract：:Langerhans cell histocytosis (LCH) and Erdheim-Chester disease are two rare histiocytic disorders. Their occurrence in the same patient is more infrequent, but has been described. We report a case of a 38-year-old woman who presented with a diagnosis of single system cutaneous LCH. Subsequently, she developed multiple...
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章
doi：10.1111/cup.12636
更新日期：2016-03-01 00:00:00
abstract：BACKGROUND:Pyoderma gangrenosum (PG) is a non-infectious, autoimmune, chronic ulcer of the skin, often co-existing with inflammatory bowel disease (IBD). Matrix metalloproteinases (MMPs) have been implicated as mediators of tissue destruction in chronic cutaneous and intestinal wounds. METHODS:Twenty-four skin biopsie...
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章
doi：10.1111/j.1600-0560.2007.00744.x
更新日期：2007-12-01 00:00:00
abstract：BACKGROUND:Considerable controversy has surrounded the question of possible biological responses to electromagnetic fields (EMFs) generated from visual display terminals (VDTs), such as personal computers (PCs) and ordinary television sets (TVs). The cellular and molecular mechanisms for such potential harmful health h...
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章
doi：10.1034/j.1600-0560.2001.281004.x
更新日期：2001-11-01 00:00:00
abstract：:A 35-year-old woman was examined because of a symptomless multiple annular eruption. The lesion consisted of rings of closely set, smooth, firm papules that were brown in color. Hemosiderotic histiocytoma was diagnosed by light and electron microscopy. Ultrastructurally, the lesion consisted of fibroblastic and histio...
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章
doi：10.1111/j.1600-0560.1981.tb01006.x
更新日期：1981-06-01 00:00:00
abstract：AIM:Adnexal tumors with divergent lines of differentiation are uncommon. Herein, I report a hamartoma of the eyelid with follicular, sebaceous and apocrine differentiation that exhibited prominent melanin pigmentation. METHODS:A 63-year-old white woman had a nodule present on her left upper eyelid for 15 years. The no...
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章
doi：10.1111/j.1600-0560.2007.00745.x
更新日期：2007-11-01 00:00:00
abstract：BACKGROUND:We encountered a distinctive pattern of dysplastic intraepidermal melanocytic proliferation, which defies classification as a dysplastic melanocytic nevus, but in which the morphologic features fall short of a diagnosis of melanoma in situ. We designate such lesions as de novo intraepidermal epithelioid mela...
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章
doi：10.1111/j.0303-6987.2005.00314.x
更新日期：2005-10-01 00:00:00
abstract：:The present study was undertaken to characterize further the structure and function of cutaneous nerves which we have previously shown to associate with skin immune cells (Hosoi et al., Nature 1993: 363:159). Ultrastructurally, axons were prominent within the superficial dermis and epidermis in neonatal murine skin, b...
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章
doi：10.1111/j.1600-0560.1998.tb01685.x
更新日期：1998-01-01 00:00:00
abstract：:Alpha-1 anti-trypsin (A1AT) deficiency is an inherited enzyme deficiency that manifests with fatal lung and liver complications. In addition to pulmonary and hepatic involvement, the disease has also been linked to an increased incidence of vasculitic syndromes and autoimmune diseases, including Wegener's granulomatos...
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章
doi：10.1111/j.0303-6987.2005.00304.x
更新日期：2005-04-01 00:00:00
abstract：:A 24-year-old black woman from Uganda was seen for treatment of multiple papules on her hands and feet. The lesions corresponded microscopically to foci of hyperkeratosis and acanthosis. Acid orcein stain revealed marked elastic fiber fragmentation. Acrokeratoelastoidosis of Costa (AKE) was diagnosed. The same damage ...
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章
doi：10.1111/j.1600-0560.1998.tb01745.x
更新日期：1998-11-01 00:00:00
abstract：:Extraskeletal Ewing's sarcoma has been recognized as being histologically indistinguishable from Ewing's sarcoma of bone. Although the occurrence of extraosseous Ewing's sarcoma in deep soft tissues has been well described, such cutaneous lesions are rare. We report the clinical history, histopathologic findings, and ...
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章
doi：10.1111/j.1600-0560.1985.tb00446.x
更新日期：1985-12-01 00:00:00
abstract：:Differing classification schemes for malignant lymphomas have been used in Europe and the United States. Attempts to translate between the principle classifications have been unsuccessful and historically it has been difficult to arrive at an unified approach. In addition, many new lymphoma entities have been recogniz...
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章,评审
doi：10.1111/j.1600-0560.1997.tb00801.x
更新日期：1997-07-01 00:00:00
abstract：:We report a hitherto undescribed unusual CD30+ clonal T-cell proliferation in a 46-year-old man with the lymphocytic variant of hypereosinophilic syndrome with a 17-year history of pruritus, generalized persistent papulonodular skin lesions and peripheral blood hypereosinophilia. A skin biopsy showed an eosinophil-ric...
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章
doi：10.1111/cup.12454
更新日期：2015-02-01 00:00:00
abstract：BACKGROUND:Distinguishing an irritated seborrheic keratosis (ISK) from a squamous cell carcinoma in situ (SCCIS) can occasionally be challenging, both histologically and clinically. The purpose of this study was to determine if an immunohistochemical profile of select markers can aid in differentiating these two entiti...
journal_title：Journal of cutaneous pathology
pub_type： 杂志文章
doi：10.1111/cup.13269
更新日期：2018-08-01 00:00:00
abstract：:Superficial acral fibromyxoma (SAFM) is an uncommon mesenchymal soft tissue tumor with a predilection for the acral extremites and nail bed involvement. SAFM is diagnosed with clinicopathological and immunohistochemical examination. Awareness of this rare tumor is important because of amounts of benign and malignant n...
journal_title：Journal of cutaneous pathology
pub_type：
doi：10.1111/cup.13128
更新日期：2018-06-01 00:00:00
