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Case Reports: Adverse drug reactions and complications
Two rare cases of bullous pemphigoid associated with immune checkpoint inhibitors
  1. Anika Mazumder1,
  2. Kavita Darji2,
  3. Kristin Smith2 and
  4. Mary Guo2
  1. 1Saint Louis University School of Medicine, Saint Louis, Missouri, USA
  2. 2Department of Dermatology, Saint Louis University School of Medicine, Saint Louis, Missouri, USA
  1. Correspondence to Anika Mazumder; anika.mazumder{at}health.slu.edu

Abstract

Bullous pemphigoid is a rare and severe adverse reaction to immune-checkpoint inhibitors that can be life-threatening. Here, we present two cases of bullous pemphigoid secondary to nivolumab and ipilimumab+nivolumab therapy, respectively. Both cases presented months after discontinuation of immunotherapy. Our first case highlights the life-threatening nature of bullous pemphigoid due to its potential to cause laryngeal oedema. Our second case illustrates that cytotoxic T-lymphocyte-associated protein-4 inhibitors can rarely lead to bullous pemphigoid, in addition to programmed cell death-1 (PD-1) and programmed cell death ligand-1 (PD-L1) inhibitors. Both cases emphasise the importance of skin examinations and dermatological follow-up for patients during and even after discontinuation of immunotherapy.

  • Dermatology
  • Unwanted effects / adverse reactions
  • Oncology
  • Cancer intervention

https://doi.org/10.1136/bcr-2022-253059

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    Footnotes

    • Contributors AM wrote the article and conducted the literature review. KD had the idea for the article, wrote the article and conducted the literature review. KS wrote the article. MG had the idea for the article, wrote the article and is the guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.