CC BY-NC-ND 4.0 · Laryngorhinootologie 2022; 101(S 02): S194
DOI: 10.1055/s-0042-1746588
Poster
Head-Neck-Oncology

Cemiplimab-induced, bullous pemphigoid in a patient with cutaneous squamous cell carcinoma

Stefanie Kümpel
1   Universitätsklinikum Jena, Klinik für Hals-, Nasen- und Ohrenheilkunde Jena
,
Steven Goetze
2   Universitätsklinikum Jena, Klinik für Hautkrankheiten Jena
,
Orlando Guntinas-Lichius
1   Universitätsklinikum Jena, Klinik für Hals-, Nasen- und Ohrenheilkunde Jena
,
Katharina Geißler
1   Universitätsklinikum Jena, Klinik für Hals-, Nasen- und Ohrenheilkunde Jena
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Cemiplimab is a PD-1 monoclonal antibody approved for the treatment of adult patients with metastatic or locally advanced cutaneous squamous cell carcinoma.

We report on an 85-year-old male patient with a squamous cell carcinoma of the right preauricular skin pT2N0M1 (parotid gland) R1 (forehead and parotid region right) (first diagnosis 01/2019) treated by surgery and adjuvant radiotherapy in combination with cetuximab. The patient developed a progression in the right ear canal in 11/2020. Therapy with cemiplimab (350 mg i.v. every 3 weeks) began in 12/2020. After six doses, periauricular subepidermal blisters with itching appeared. An acute infection with herpes simplex or varicella zoster was ruled out by taking a swab from the contents of the vesicles. A biopsy showed a moderate infiltrate of lymphocytes and numerous eosinophils and isolated neutrophils. The direct immunofluorescence showed focal IgG and deposits of C3 along the basement membrane, consistent with a bullous pemphigoid. Local therapy with clobetasol propiate cream improved the findings. The patient shows to this day (after 16 doses Cemiplimab) a stabilization of the tumor disease.

Cemiplimab can cause immune-mediated side effects in any organ system. Immune-mediated side effects of the skin make up around 1.6%. So far there is only one other case report (Virgen et al. JAAD Case Rep. 2020; 6: 195-197) of a cemiplimab-induced bullous pemphigoid.



Publication History

Article published online:
24 May 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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