Drug-associated dermatomyositis following ipilimumab therapy: a novel immune-mediated adverse event associated with cytotoxic T-lymphocyte antigen 4 blockade

JAMA Dermatol. 2015 Feb;151(2):195-9. doi: 10.1001/jamadermatol.2014.2233.


Importance: Ipilimumab, a human monoclonal antibody targeted against cytotoxic T-lymphocyte antigen 4, has shown promise in the treatment of metastatic melanoma. However, given its mechanism of action, immune-related adverse effects have been reported with this therapy. Despite increasing reports of immune-related adverse effects related to ipilimumab therapy, dermatomyositis associated with this agent has not previously been reported.

Observations: We describe a woman undergoing treatment with ipilimumab for metastatic melanoma who developed classic cutaneous findings of dermatomyositis along with proximal muscle weakness and elevated muscle enzymes.

Conclusions and relevance: This case adds to the expanding literature regarding immune-related adverse events associated with ipilimumab. To our knowledge, drug-induced dermatomyositis from ipilimumab has not previously been reported. Physicians should be aware of these potential immune-related adverse events and consider drug-associated dermatomyositis in the differential diagnosis in patients receiving ipilimumab who present with a cutaneous eruption or muscle weakness.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal / adverse effects*
  • Antibodies, Monoclonal / therapeutic use
  • CTLA-4 Antigen / immunology*
  • Dermatomyositis / chemically induced*
  • Dermatomyositis / immunology
  • Dermatomyositis / pathology
  • Female
  • Humans
  • Immunity, Cellular / drug effects*
  • Ipilimumab
  • Melanoma / drug therapy*
  • Melanoma / immunology
  • Middle Aged
  • Skin / pathology
  • Skin Neoplasms / drug therapy*
  • Skin Neoplasms / immunology
  • T-Lymphocytes / immunology


  • Antibodies, Monoclonal
  • CTLA-4 Antigen
  • Ipilimumab