Lichen planus pemphigoides in a patient with metastatic lung cancer treated with combination tislelizumab and sitravatinib.

Abstract

Tislelizumab, a novel programmed cell death 1 (PD-1) receptor inhibitor, is in development for the potential treatment of both solid tumour and haematologic cancers. Nivolumab and pembrolizumab, other PD-1 inhibitors, have been associated with several cutaneous adverse events, including bullous lichenoid reactions. We report a 75-year-old woman with stage IV lung adenocarcinoma who developed a pruritic bullous eruption on the extremities and trunk. Biopsy of a lesion revealed a subepidermal bullous lichenoid dermatosis with positive immunofluorescence in a linear pattern along the basement membrane, consistent with lichen planus pemphigoides (LPP). The patient improved with oral prednisolone and cessation of tislelizumab. We find no previous report in the literature of LPP in association with tislelizumab.