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Livia Fucci



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    EP1.04 - Immuno-oncology (ID 194)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Immuno-oncology
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.04-38 - A Case of Lichenoid Reaction as Late and Uncommon Immune-Related Skin Toxicity During Nivolumab Treatment (Now Available) (ID 1408)

      08:00 - 18:00  |  Author(s): Livia Fucci

      • Abstract
      • Slides

      Background

      Immune-checkpoint inhibitors have shown remarkable activity in advanced Non-small cell lung cancer (NSCLC).

      An increasing number of immune-related skin toxicities has been reported , also heterogeneous and unusual. So, these reports could be useful to manage such events.

      Lichenoid dermatitis (LD) identifies a group of dermatoses clinically and histologically reminiscent of idiopathic lichen planus (LP). Pharmacologycal, chemical and viral causes agents can induce skin lichenoid reactions.

      Method

      20190409_143719 (1).jpgWe report the case of a 81-years-old man with stage IV non-small cell lung cancer treated with Nivolumab developing a hitchy, recurrent and polymorphous lichenoid eruption after 36 cycles of treatment (Figure 1).

      Result

      A skin biopsy (Figure 2) showed an area of parakeratosis associated to a dense lympho-histiocytic infiltrate of the papillary derma that obscures the basal membrane and causes vacuolization of the basal layer of the epidermidis with an isolated Civattes body (red arrow), (40figure 2.jpgX, H&E).

      The temporary interruption of Nivolumab , together with short and low-dose cycles of corticosteroids repeated for several times due to the wave evolution of the lichenoid reaction, allowed for the partial recovery of the skin toxicity and the resumption of treatment.

      Conclusion

      Unlike the classic appearance of lichenoid reactions, this patient showed a more polymorphous lesions as compared to the classic forms .

      The correct and early recognition of these uncommon effects is useful to optimally manage and safely continue a treatment while achieving a therapeutical response of neoplastic disease

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