Immune-related adverse events: A new great mimicker? A case of prurigo nodularis-like bullous pemphigoid due to anti-CTLA-1 and anti-PD-1 inhibitors responding to rituximab

A female in her forties with metastatic sacral chordoma was treated with ipilimumab and nivolumab, as part of the Dual Anti-CTLA-4 and Anti-PD-1 blockade in Rare Tumors trial. Shortly after starting treatment, she developed numerous pruritic excoriated papules and hypertrophic nodules on the trunk, arms and legs. This eruption persisted four months after discontinuing checkpoint inhibitor therapy. The presence of widespread hypertrophic excoriated papules and nodules, in the absence of bullae, initially appeared consistent with prurigo nodularis.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research