Assuntos
Hamartoma , Escroto , Hamartoma/diagnóstico , Humanos , Masculino , Músculo Liso , Escroto/diagnóstico por imagem , Escroto/cirurgiaRESUMO
Nivolumab and pembrolizumab are humanized IgG4 monoclonal antibodies against programmed cell death 1 (PD-1). Although these agents are effective in treating advanced melanoma, non-small-cell lung carcinoma, and other types of cancers, various adverse events have been reported. Cutaneous adverse events are particularly prevalent and, while granulomatous/sarcoid-like reactions are uncommon, they are increasingly recognized as immune-related adverse events associated with immune checkpoint inhibitors. Herein, we report two cases of granulomatous/sarcoid-like reaction with foreign material, mimicking metastatic malignancy after PD-1 inhibitor treatment. Clinicians should be aware of the existence of cutaneous lesions and perform biopsy if needed to prevent misdiagnosis and unnecessary adjustments to immunotherapy.
Assuntos
Toxidermias , Melanoma , Proteínas de Neoplasias/antagonistas & inibidores , Nivolumabe/efeitos adversos , Receptor de Morte Celular Programada 1/antagonistas & inibidores , Neoplasias Retais , Idoso , Toxidermias/diagnóstico , Toxidermias/metabolismo , Toxidermias/patologia , Humanos , Masculino , Melanoma/diagnóstico , Melanoma/tratamento farmacológico , Melanoma/metabolismo , Melanoma/patologia , Metástase Neoplásica , Proteínas de Neoplasias/metabolismo , Nivolumabe/administração & dosagem , Receptor de Morte Celular Programada 1/metabolismo , Neoplasias Retais/diagnóstico , Neoplasias Retais/tratamento farmacológico , Neoplasias Retais/metabolismo , Neoplasias Retais/patologiaAssuntos
Autoanticorpos/imunologia , Penfigoide Bolhoso/imunologia , Pioderma/imunologia , Ensaio de Imunoadsorção Enzimática , Glucocorticoides/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Penfigoide Bolhoso/tratamento farmacológico , Prednisolona/uso terapêutico , Pioderma/tratamento farmacológicoRESUMO
Pemphigus vulgaris (PV) is an autoimmune blistering disease elicited by anti-desmoglein (DsG) 3 antibody. Although skin lesions tend to be distributed over the entire body, in some patients, they are confined to a restricted area. We report two patients who presented with long-lasting localized PV without detectable anti-DsG antibodies after suffering antibody-positive systemic PV. Initial treatment with prednisolone (PSL) was successful in both patients, but a local relapse occurred on the cheek or lower lip after a reduction in the PSL dose. Biopsy of the localized lesions showed suprabasal acantholysis; no serum DsG antibodies were found. Local immunosuppression therapy was effective in both patients. Based on our findings, we suggest that localized PV without detectable antibodies can develop after systemic PV.