Pembrolizumab-Induced Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis in a Patient With Metastatic Cervical Squamous Cell Carcinoma: A Case Report
- PMID: 31567395
- DOI: 10.1097/DAD.0000000000001527
Pembrolizumab-Induced Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis in a Patient With Metastatic Cervical Squamous Cell Carcinoma: A Case Report
Abstract
We present a rare case of a pembrolizumab-induced Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). A 55-year-old woman with a history of metastatic cervical squamous cell carcinoma presented with a widespread mucocutaneous rash. Seventeen days after receiving her first cycle of pembrolizumab, she presented with fever, difficulty breathing, watery eyes, and painful oral ulcers. Physical examination revealed widespread erythematous papules and papulovesicles involving the trunk, upper extremity, and lower extremity and hemorrhagic plaques on the lower lip and buccal mucosa. Biopsy confirmed a diagnosis of SJS/TEN. This case highlights the importance of awareness of SJS/TEN as a possible adverse reaction for patients receiving pembrolizumab, a medication increasingly being used to treat metastatic or unresectable malignancies.
References
-
- Abe R. Immunological response in Stevens-Johnson syndrome and toxic epidermal necrolysis. J Dermatol. 2015;42:42–48.
-
- Miliszewski MA, Kirchhof MG, Sikora S, et al. Stevens-johnson syndrome and toxic epidermal necrolysis: an analysis of triggers and implications for improving prevention. Am J Med. 2016;129:1221–1225.
-
- Keytruda (Pembrolizumab). Highlights of Prescribing Information. 2018. Available at: https://www.merck.com/product/usa/pi_circulars/k/keytruda/keytruda_pi.pdf. Accessed March 17, 2019.
-
- Goldinger SM, Stieger P, Meier B, et al. Cytotoxic cutaneous adverse drug reactions during anti-PD-1 therapy. Clin Cancer Res. 2016;22:4023–4029.
-
- Vivar KL, Deschaine M, Messina J, et al. Epidermal programmed cell death-ligand1 expression in TEN associated with nivolumab therapy. J Cutan Pathol. 2017;44:381–384.
