Checkpoint inhibitor–induced lichen planus differs from spontaneous lichen planus on the clinical, histological, and gene expression level
Barbara Meier, C. Zecha, Sarah Zierold, Isabel Kolm, Magdalena Röckel, Waltraud Fröhlich, Nora Mittag, Christina Schmitt, Joerg Kumbrink, Jessica C. Hassel, Carola Berking, Dorothée Nashan, Lars E. French, Julio Vera-González, Reinhard Dummer, Katrin Kerl-French, Lucie Heinzerling
Abstract
Background: Although highly efficacious, immune checkpoint inhibitors induce a multitude of immune-related adverse events including lichenoid skin reactions (irLP) that are often therapy-resistant. Objectives: To compare the clinical, histological, and transcriptional features of irLP with spontaneous lichen planus (LP). Methods: Clinical and histological presentations of irLP and LP, as well as the gene expression profiles of irLP and LP lesional and healthy skin were assessed. Results: levels and a possible role of phagosome signaling compared with LP. Limitations: The study is descriptive and necessitates further investigation with larger cohorts and broader analyses. Conclusion: irLP differs from spontaneous LP on the clinical, histopathological, and gene expression level. The inflammatory gene signature in irLP suggests that topical JAK inhibitors could be an effective treatment, targeting local skin inflammation without systemic immunosuppression.