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Case Report: sintilimab-induced Stevens-Johnson Syndrome in a patient with advanced lung adenocarcinoma

Xueqin Li, Guanghui Li, Diangang Chen, Linxi Su, Rupeng Wang, Yi Zhou

2023Frontiers in Oncology13 citationsDOIOpen Access PDF

Abstract

Immune checkpoint inhibitors (ICIs) have been widely applicated in clinical therapy in recent years. Skin-related adverse reaction is one of the most common adverse events for ICIs. Stevens-Johnson syndrome (SJS) is one of the serious cutaneous reactions threatening the life. Here, we reported a case of 76-year-old male patient with poorly differentiated metastatic lung adenocarcinoma, after 9 weeks exposure of sintilimab (3 doses) combined with paclitaxel liposome after concurrent chemotherapy/radiotherapy, experienced Stevens-Johnson syndrome involving limbs, trunk, lip and the oral mucosa. Biopsy of the skin tissue showed infiltration of CD4 and CD8 positive T lymphocytes. We also found PD-L1 expression in the glands and the basal layer of the skin. This finding is distinct from the previously reported expression of PD-L1 on the surface of epidermal keratinocytes in patients with SJS due to immunotherapy.

Topics & Concepts

MedicineRadiation therapySkin biopsyChemotherapyCD8LungAdverse effectAdenocarcinomaImmunotherapyBiopsyPaclitaxelToxic epidermal necrolysisDermatologyInternal medicineOncologyPathologyImmune systemImmunologyCancerDrug-Induced Adverse ReactionsChemotherapy-related skin toxicityAutoimmune Bullous Skin Diseases