ABSTRACT
We present the first detailed report of acneiform eruptions in patients on CTLA-4 inhibitor therapy. Acneiform eruptions commonly occur (up to 75-100%) as a cutaneous adverse event associated with EGFR inhibition; however, acneiform eruptions have not been highly reported as a cutaneous adverse event associated with CTLA-4 inhibitor therapy. We conducted a retrospective chart review of our institution's database to assess cutaneous adverse events associated with ipilimumab and tremelimumab, identifying 12 patients with acneiform eruptions (2 on tremelimumab and 10 on ipilimumab). The median time to onset of rash was 3 weeks after starting CTLA-4 inhibitor therapy, ranging from 0.7-45 weeks. Median time to cutaneous resolution was 6 weeks, ranging from 2 to 282 weeks. Treatment included oral and topical antibiotics, antihistamines, and oral or topical corticosteroids with four patients receiving no treatment. Acneiform eruptions are seen less commonly with CTLA-4 inhibitors than other cancer therapies, but awareness that it does occur is important for clinical practice. Better description is a necessary help to aid in early diagnosis and intervention. While EGFR inhibitor-associated acneiform eruptions are associated with clinical benefit, our sample size is too small to determine whether CTLA-4 inhibitor associated acneiform eruptions display the same correlation.
Subject(s)
Acneiform Eruptions/chemically induced , CTLA-4 Antigen/antagonists & inhibitors , Acneiform Eruptions/immunology , Aged , Antibodies, Monoclonal, Humanized/administration & dosage , Antibodies, Monoclonal, Humanized/adverse effects , Antineoplastic Agents, Hormonal/adverse effects , CTLA-4 Antigen/immunology , Cohort Studies , Female , Humans , Ipilimumab/administration & dosage , Ipilimumab/adverse effects , Male , Middle Aged , Neoplasms/drug therapy , Retrospective StudiesSubject(s)
Acneiform Eruptions/drug therapy , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Neoplasms/drug therapy , Protein Kinase Inhibitors/adverse effects , Retinoids/administration & dosage , Acneiform Eruptions/chemically induced , Acneiform Eruptions/immunology , Administration, Oral , Adult , Aged , Antineoplastic Agents, Immunological/adverse effects , ErbB Receptors/antagonists & inhibitors , Female , Humans , Male , Middle Aged , Mitogen-Activated Protein Kinase Kinases/antagonists & inhibitors , Neoplasms/immunology , Retinoids/adverse effects , Retrospective Studies , Treatment OutcomeABSTRACT
Immune disorders are associated with acne or acneiform lesions secondary to the occurrence of acne vulgaris or acneiform eruptions arising as a result of immunosuppressive medication or infection. In this review, we aim to provide an overview of acne and acneiform eruptions that can arise in the immunosuppressed host. Tips for differentiating between various acneiform entities are discussed, as well as a brief overview of treatment considerations.
