A case report of disappearing pigmented skin lesions associated with pembrolizumab treatment for metastatic melanoma Journal Article

Authors: Wolner, Z. J.; Marghoob, A. A.; Pulitzer, M. P.; Postow, M. A.; Marchetti, M. A.
Article Title: A case report of disappearing pigmented skin lesions associated with pembrolizumab treatment for metastatic melanoma
Abstract: Pembrolizumab is an immune checkpoint inhibitor that targets the programmed cell death (PD)-1 receptor. Common cutaneous adverse side-effects of PD-1 inhibitors include maculopapular rash, pruritus, vitiligo and lichenoid skin and mucosal reactions. Here we describe a man in his sixties with metastatic melanoma treated with pembrolizumab who subsequently developed fading or disappearance of pigmented skin lesions, lightening of the skin, and poliosis of the eyebrows, eyelashes and scalp and body hair. Compared with baseline high-resolution three-dimensional total-body photography, we observed fading or disappearance of solar lentigines, seborrhoeic keratoses and melanocytic naevi, suggesting that PD-1 inhibitors may affect the evolution of these benign skin lesions. With dermatoscopic follow-up, altered lesions showed either blue-grey peppering/granularity or fading in colour without other identifiable features. No halo lesions or lesions with surrounding inflammation were identified. One changed pigmented lesion that showed blue-grey peppering/granularity on dermoscopy was biopsied and interpreted as a macular seborrhoeic keratosis with melanophages. Further studies are required to elucidate the effects of PD-1 inhibition on benign skin lesions. © 2017 British Association of Dermatologists
Keywords: immunohistochemistry; adult; clinical article; middle aged; cancer surgery; histopathology; case report; drug safety; treatment duration; cancer patient; sentinel lymph node biopsy; skin biopsy; skin defect; inflammation; epiluminescence microscopy; three dimensional imaging; skin examination; hyperpigmentation; seborrheic keratosis; scalp; photography; metastatic melanoma; wide excision; lentigo; skin color; pigmented nevus; eyelash; eyebrow; human; male; priority journal; article; pembrolizumab; papillary dermis; macular seborrhoeic keratosis
Journal Title: British Journal of Dermatology
Volume: 178
Issue: 1
ISSN: 0007-0963
Publisher: Blackwell Publishing  
Date Published: 2018-01-01
Start Page: 265
End Page: 269
Language: English
DOI: 10.1111/bjd.15354
PROVIDER: scopus
PMCID: PMC5533648
PUBMED: 28132411
Notes: Article -- Export Date: 6 February 2018 -- Source: Scopus
Citation Impact
MSK Authors
  1. Melissa P Pulitzer
    185 Pulitzer
  2. Michael Andrew Postow
    322 Postow
  3. Ashfaq A Marghoob
    507 Marghoob
  4. Michael Armando Marchetti
    149 Marchetti
  5. Zachary Wolner
    14 Wolner