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CASE REPORT
Year : 2019  |  Volume : 37  |  Issue : 3  |  Page : 157-161

Cyclosporine but not acitretin for psoriasis exacerbation and general Myalgia induced by Pembrolizumab in a patient with advanced esophageal cancer


Department of Dermatology, Chang Gung Memorial Hospital, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan

Correspondence Address:
Chih-Hung Lee
Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 123, Ta-Pei Road, Niao-Sung District, Kaohsiung 83301
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ds.ds_45_18

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Pembrolizumab is a checkpoint inhibitor to treat cancers by boosting overall immunity with T-cell disinhibition. However, this nonselectively enhanced immunity could trigger de novo or aggravate autoimmune diseases. Only a few reports showed exacerbation of psoriasis after pembrolizumab. We reported a psoriatic patient with esophageal cancer experiencing exacerbation of psoriasis and general myalgia soon after pembrolizumab induction. These adverse effects failed initially to acitretin but responded successfully and durably to cyclosporine subsequently, suggesting immune targeting regimen could be a treatment choice for pembrolizumab-induced psoriasis. We briefly reviewed and discussed the limited numbers of reports regarding this scenario.


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