Zusammenfassung
Nivolumab ist ein monoklonaler Antikörper, der an den PD-1-Rezeptor auf T‑Zellen bindet und die Interaktion mit den Liganden PD-L1 und PD-L2 auf Krebszellen hemmt. Dadurch hat Nivolumab immunstimulierende Eigenschaften. Zu den bekannten Nebenwirkungen dieser Therapie gehören Hautausschlag, Müdigkeit, Dysfunktion der Schilddrüse und Kolitis. Diese werden durch die immunregulatorischen Mechanismen des Medikaments erklärt. Hier berichten wir über den Fall eines 58-jährigen Patienten mit metastasiertem Zungengrundkarzinom, der unter einer Therapie mit Nivolumab eine de novo getriggerte Psoriasis entwickelt hat. Der Patient wurde monatelang mit der Diagnose einer generalisierten Mykose erfolglos behandelt. Dieser Fall hebt hervor, wie wichtig es ist, auch auf unerwartete kutane Nebenwirkungen einer Therapie mit immunstimulierenden Checkpoint-Inhibitoren zu achten.
Abstract
Nivolumab is a monoclonal antibody that binds to the PD-1 receptor on T cells and inhibits the interaction with the PD-L1 and PD-L2 ligands on cancer cells. Thus, nivolumab has immunostimulatory properties. The known side effects of this therapy include fatigue, skin rash, dysfunction of the thyroid gland and colitis, which are explained by the immunoregulatory mechanisms of the drug. Here we report on the case of a 58-year-old man with metastatic base of tongue carcinoma who developed de novo psoriasis triggered by nivolumab. The patient was treated for months with the diagnosis of a generalized mycosis. This case highlights the importance of vigilance for unexpected cutaneous side effects during immune stimulating therapy with checkpoint inhibitors.
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S. Troyanova-Slavkova, L. Eickenscheidt, K. Dumann und L. Kowalzick geben an, dass kein Interessenkonflikt besteht.
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Troyanova-Slavkova, S., Eickenscheidt, L., Dumann, K. et al. Initial nicht erkannte De-novo-Psoriasis getriggert durch Nivolumab bei metastasiertem Zungengrundkarzinom. Hautarzt 69, 674–680 (2018). https://doi.org/10.1007/s00105-017-4109-y
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DOI: https://doi.org/10.1007/s00105-017-4109-y