Lichenoid drug eruption on the lower lip caused by anti-PD-1 monoclonal antibody: a case report and literature review

Immunotherapy. 2021 Dec;13(17):1373-1378. doi: 10.2217/imt-2021-0234. Epub 2021 Oct 11.

Abstract

Anti-PD-1/PD-L1 monoclonal antibodies result in a unique spectrum of side effects, widely known as immune-related adverse events. Toripalimab is an anti-PD-1 monoclonal antibody used for the treatment of some cancers. Here we report the first case, to our knowledge, of oral lichenoid drug reaction triggered by toripalimab. A 78-year-old man who was diagnosed with systemic metastatic prostate cancer presented with ulcers on the lower lip after the fifth cycle of toripalimab. We diagnosed him with oral lichenoid drug reaction based on clinical manifestation, histopathological findings and the history of anti-PD-1 therapy. The patient responded well to oral corticosteroids combined with helium-neon laser therapy. The anti-PD-1 therapy was not restarted because of stable disease, and the eruptions did not recur.

Keywords: He-Ne laser; anti-PD-1/PD-L1; corticosteroid therapy; immune checkpoint inhibitors; immune-related adverse events; oral lichenoid drug reactions; prostate carcinoma; toripalimab.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Antibodies, Monoclonal, Humanized* / administration & dosage
  • Antibodies, Monoclonal, Humanized* / adverse effects
  • Drug Eruptions* / pathology
  • Drug Eruptions* / therapy
  • Humans
  • Lichenoid Eruptions* / chemically induced
  • Lichenoid Eruptions* / pathology
  • Lichenoid Eruptions* / therapy
  • Lip / pathology*
  • Male
  • Neoplasm Metastasis
  • Prostatic Neoplasms* / pathology
  • Prostatic Neoplasms* / therapy

Substances

  • Antibodies, Monoclonal, Humanized
  • toripalimab