New-Onset Psoriasis Induced by Durvalumab

Abstract

Durvalumab is an immune checkpoint inhibitor (ICI) belonging to the anti-programmed death-ligand 1 (PD-L1) class, and it is used in the treatment of various end-stage malignancies. Immune checkpoint inhibitors are associated with various systemic and cutaneous adverse events. Psoriasiform drug eruptions have been clinically observed in patients who have a personal history of psoriasis being treated with ICIs. We present a unique case of de novo psoriasis in a patient being treated for poorly differentiated adenocarcinoma of the lung. The patient responded well to topical treatment and did not require discontinuation of durvalumab. Our case highlights the importance of clinician familiarity with psoriasis presentation, its association with durvalumab therapy, and treatment options for durvalumab-induced psoriasis.

Keywords: clinical dermatology; de novo psoriasis; dermatology case report; drug-induced psoriasis; durvalumab; medication side-effects; onco-immunology.

Figure 1. Clinical presentation of psoriasis induced by durvalumab; left lateral leg with three well-demarcated brown hyperkeratotic plaques are seen.

Figure 2. Histological presentation of psoriasis induced by durvalumab: psoriasiform acanthosis with parakeratosis and presence of Munro microabscesses (hematoxylin-eosin, 10X magnification)