Nivolumab reactivation of hypertrophic lichen planus, a case report and review of published literature

Dermatol Online J. 2018 Jan 15;24(1):13030/qt4xf465w6.

Abstract

We report a case of nivolumab-induced lichen planus (LP) reactivation that was previously in remission following chemotherapy for non-smallcelllung cancer (NSCLC). Chemotherapy-induced immunosuppression allowed for complete resolution of the patient's pre-existing LP, a T-cell mediatedautoimmune process. When the patient was switched to nivolumab immunotherapy owing to progression of NSCLC, PD-1 inhibition led to an overwhelming T-cell response that seemed to have provoked a severe LPreactivation. Although lichenoid reactions have been reported with nivolumab, to our knowledge, this is the first reported case of nivolumab monotherapycausing LP reactivation in a patient with a strong personal and family history of the disease that was previously in remission after chemotherapy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antibodies, Monoclonal / adverse effects*
  • Antineoplastic Agents / adverse effects*
  • Carcinoma, Non-Small-Cell Lung / drug therapy
  • Humans
  • Lichen Planus / etiology*
  • Lichen Planus / pathology
  • Lung Neoplasms / drug therapy
  • Male
  • Middle Aged
  • Nivolumab
  • Programmed Cell Death 1 Receptor / antagonists & inhibitors*
  • Recurrence
  • Skin / pathology

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents
  • PDCD1 protein, human
  • Programmed Cell Death 1 Receptor
  • Nivolumab