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Successful use of immunotherapy to treat advanced cutaneous squamous cell carcinoma in recessive dystrophic epidermolysis bullosa
  1. Tony Duong1,
  2. Debra Wong1,2,3,
  3. Alexander Barrett4 and
  4. Harper Price1,5
  1. 1The University of Arizona College of Medicine Phoenix, Phoenix, Arizona, USA
  2. 2Medical Oncology, The University of Arizona Cancer Center, Phoenix, Arizona, USA
  3. 3Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, California, USA
  4. 4Tempus Labs Inc, Chicago, Illinois, USA
  5. 5Division of Dermatology, Phoenix Children's Hospital, Phoenix, Arizona, USA
  1. Correspondence to Dr Debra Wong; debwong{at}


Recessive dystrophic epidermolysis bullosa (RDEB) is a multisystem inherited disorder associated with fragile skin, blister formation and poor wound healing. Patients with RDEB are at significantly increased risk of recurrent and aggressive cutaneous squamous cell carcinoma (cSCC) and because of their disease complexity, conventional therapies may not be possible. Recent advances in cancer immunotherapy have led to the successful use of immune checkpoint inhibitors (ICIs) in melanoma and other malignancies. However, the effects of ICIs in patients with cSCC and RDEB are currently unknown. A 30-year-old woman with RDEB and multiple unresectable cSCCs was found to have high tumour mutational burden and PD-L1 (programmed cell death-ligand 1) expression. She was started on an ICI, which yielded disease control and was well tolerated. Furthermore, her RDEB wounds improved. This case demonstrates successful use of immunotherapy for advanced cSCC in RDEB, a disease that is often challenging to treat with local therapies.

  • dermatology
  • skin cancer
  • cancer intervention
  • immunological products and vaccines
  • immunology

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  • Contributors TD and DW are responsible for conceiving this article, TD, DW, AB and HP performed the literature search and wrote the article, and DW is the guarantor of the article. DW and HP managed the case described and obtained informed consent from the patient to allow drafting and submission of this article for publication. All authors approved of the final manuscript.

  • 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.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

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