Intracorneal pustular drug eruption, a novel cutaneous adverse event in anti-programmed cell death-1 patients that highlights the effect of anti-programmed cell death-1 in neutrophils

Melanoma Res. 2017 Dec;27(6):641-644. doi: 10.1097/CMR.0000000000000397.


The introduction of anti-programmed cell death-1 (anti-PD1) monoclonal antibodies has revolutionized the treatment of various advanced malignancies. Despite its efficacy, anti-PD1 therapy is accompanied by a variety of cutaneous adverse events. A 79-year-old man developed erythematous scaly plaques and pustules of the forehead, legs and arms after four cycles of nivolumab infusions every 2 weeks. Histology showed intracorneal pustules with dermal neutrophils and eosinophils. He was treated successfully with topical corticosteroids without discontinuation of nivolumab. We report subcorneal pustular eruption as a novel cutaneous adverse event in patients on anti-PD1 therapy. Other neutrophilic eruptions (psoriasis, Sweet's syndrome, acute generalized pustulosis) have been reported in patients on anti-PD1 treatments, suggesting the neutrophil as another cell type modulated by anti-PD1 antibodies.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cell Death
  • Cornea / pathology*
  • Drug Eruptions
  • Drug-Related Side Effects and Adverse Reactions / etiology*
  • Humans
  • Male
  • Neutrophils / metabolism*
  • Neutrophils / pathology
  • Programmed Cell Death 1 Receptor / antagonists & inhibitors*
  • Skin Neoplasms / complications*
  • Skin Neoplasms / pathology


  • Programmed Cell Death 1 Receptor