Acrixolimab-Induced Radiation Recall Dermatitis with Distinct Features Resembling Erythema Multiforme

Authors

  • Salin Kiratikanon Division of Dermatology, Department of Medicine, King Chulalongkorn Memorial Hospital and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
  • Sutima Luangdilok Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
  • Pravit Asawanonda Photodermatology Unit, Division of Dermatology, Department of Medicine, King Chulalongkorn Memorial Hospital and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
  • Einapak Boontaveeyuwat Photodermatology Unit, Division of Dermatology, Department of Medicine, King Chulalongkorn Memorial Hospital and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Keywords:

Radiation recall, radiation recall dermatitis, immunotherapy, immune checkpoint inhibitors, radiation therapy

Abstract

Immune checkpoint inhibitors (ICIs), working against cancer cells by host immune system activation, have transformed the treatment and prognosis of many advanced cancers. ICIs commonly cause the well documented immune-related cutaneous adverse reactions. However, a rare cutaneous side effect, radiation recall dermatitis (RRD), an inflammatory skin reaction that occurs on the site of previous radiation and triggered by medications, has been recently reported. We present the first case of acrixolimab, a PD-1 inhibitor, induced RRD presenting with target skin lesions and central blisters in a 40-year-old Thai woman with stage IIIC malignant melanoma.

References

Geisler AN, Phillips GS, Barrios DM, et al. Immune checkpoint inhibitor-related dermatologic adverse events. J Am Acad Dermatol 2020;83:1255-1268.

U.S. Department of Health and Human Services. Common terminology criteria for adverse events (CTCAE) version 5.0 (2017). Available at: https://ctep.cancer.gov/ protocoldevelopment/electronic_applications/docs/CTCAE_v5_Quick_Reference_5x7.pdf. (Accessed on 5 February 2023)

McKay MJ, Foster R. Radiation recall reactions: An oncologic enigma. Crit Rev Oncol Hematol 2021;168:103527.

Camidge R, Price A. Characterizing the phenomenon of radiation recall dermatitis. Radiother Oncol 2001;59:237-245.

Chen CH, Yu HS, Yu S. Cutaneous Adverse Events Associated with Immune Checkpoint Inhibitors: A Review Article. Curr Oncol 2022; 29:2871-86.

Thompson JA, Schneider BJ, Brahmer J, et al. Management of Immunotherapy-Related Toxicities, Version 1.2022, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2022;20:387-405.

Yigit E, Guven DC, Aksoy S, Yazici G. Radiation Recall Dermatitis in Patients Treated With Immune Checkpoint Inhibitors: A Case Report and Literature Review. Cureus 2021;13:e15548.

Korman AM, Tyler KH, Kaffenberger BH. Radiation recall dermatitis associated with nivolumab for metastatic malignant melanoma. Int J Dermatol 2017;56:e75-7.

Billena C, Padia S, O'Brien B, et al. Radiation recall dermatitis after treatment of stage IV breast cancer with nivolumab: a case report. Immunotherapy 2020; 12: 123-30.

Deutsch E, Besse B, Le Pavec J, et al. Can radiation-recall predict long lasting response to immune checkpoint inhibitors? Radiother Oncol 2021;154:125-7.

Furuta H, Yoshida T, Shimizu J, Tomita N, Yatabe Y, Hida T. Nivolumab Enhances the Inflammation of the Irradiation Field in Advanced Non-Small Cell Lung Cancer. J Thorac Oncol 2017;12:1733-6.

Shah KM, Rancour EA, Al-Omari A, Rahnama-Moghadam S. Striking enhancement at the site of radiation for nivolumab-induced Stevens-Johnson syndrome. Dermatol Online J 2018;24:13030.

Rouyer L, Bursztejn AC, Charbit L, Schmutz JL, Moawad S. Stevens-Johnson syndrome associated with radiation recall dermatitis in a patient treated with nivolumab. Eur J Dermatol 2018;28:380-1.

Wang YY, Tian XC, Zhu L, Bai XH, Zhao R. Concomitant Radiation Recall Dermatitis and Radiation Recall Pneumonitis Induced by Pembrolizumab. J Thorac Oncol 2020;15:e160-2.

Vaccaro M, Bertino L, Santarpia M, Altavilla G, Cannavò SP. Radiation recall during cemiplimab therapy for locally advanced cutaneous squamous cell carcinoma. Dermatol Ther 2020;33:e14417.

Downloads

Published

2023-04-07

How to Cite

Kiratikanon, S., Luangdilok, S., Asawanonda, P. ., & Boontaveeyuwat, E. . (2023). Acrixolimab-Induced Radiation Recall Dermatitis with Distinct Features Resembling Erythema Multiforme. Thai Journal of Dermatology, 39(2), 35–38. Retrieved from https://he02.tci-thaijo.org/index.php/TJD/article/view/261417

Issue

Vol. 39 No. 2 (2023): April - June

Section

Case Report

License

Copyright (c) 2023 Thai Journal of Dermatology

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

เนื้อหาและข้อมูลในบทความที่ลงตีพิมพ์ในวารสารโรคผิวหนัง ถือเป็นข้อคิดเห็นและความรับผิดชอบของผู้เขียนบทความโดยตรงซึ่งกองบรรณาธิการวารสาร ไม่จำเป็นต้องเห็นด้วย หรือร่วมรับผิดชอบใดๆ

บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในวารสารโรคผิวหนัง ถือเป็นลิขสิทธิ์ของวารสารฯ หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่ต่อหรือเพื่อกระทำการใดๆ จะต้องได้รับอนุญาตเป็นลายลักอักษรจากบรรณาธิการวารสารโรคผิวหนังก่อนเท่านั้น