Clinical features, treatment, and outcomes of anti-PD-L1 induced psoriasis

Abstract

Background: This study focuses on rare immune-mediated psoriasis induced by anti-PD-L1 drugs. Given that its clinical features have not been fully defined, the aim is to clarify the clinical manifestations, treatment, and outcomes of anti-PD-L1-induced psoriasis.

Methods: We performed a retrospective analysis of psoriasis cases induced by anti-PD-L1 agents. The study involved systematically retrieving case reports from relevant databases up to April 23, 2025, for comprehensive evaluation.

Results: This study included 31 patients, with 90.2% being male and a median age of 65 years (40-81 years). The anti-PD-L1 agents administered to patients included atezolizumab, durvalumab, and avelumab. Notably, 16 patients (51.6%) developed de novo psoriasis. The median time to psoriasis onset after drug initiation was 54.5 days (7-690 days), with plaque psoriasis being the most common clinical type (54.8%). In terms of treatment strategies, 19 patients (61.3%) discontinued anti-PD-L1 therapy, while 8 patients (25.8%) continued treatment. Following clinical interventions, including primarily the administration of topical steroids, symptomatic improvement or complete remission was reported in 25 patients (80.6%).

Conclusion: When administering anti-PD-L1 agents, close monitoring for the onset of psoriatic symptoms in patients is essential to ensure timely detection and diagnosis. For patients who have been diagnosed with psoriasis, appropriate measures should be taken based on their specific clinical conditions, such as discontinuing anti-PD-L1 therapy or administering psoriasis treatment medications.

Keywords: Anti-PD-L1; Atezolizumab; Durvalumab; Psoriasis; Topical steroids.