A 66-year-old man with history of malignant melanoma presented with pain and weakness in the upper limbs; dysphagia; heliotrope rash on the head, face, and chest; and purplish-red scaly maculopapules and poikiloderma on the scapular region, upper arm extension, and dorsal hands, with occasional pruritus. These symptoms developed after 2 cycles of immunotherapy with toripalimab, a newly approved inhibitor of programmed cell death protein 1. |
Laboratory evaluations indicated elevated levels of creatine kinase (654 U/L), cretine kinase-MB (6.11 μg/L), and lactic dehydrogenase (259 U/L), and positive antinuclear antibodies (titier of 1:100), with a speckled pattern. Electroneuromyography revealed myogenic involvement of the deltoid muscle. |
The patient was diagnosed with dermatomyositis. Treatment with toripalimab was discontinued, and the dermatomyositis was successfully treated with methylprednisolone at a once-daily dose of 1 mg/kg body weight. |
This is the first case report of dermatomyositis as an immune-related adverse event induced by toripalimab. It should serve as a warning to clinicians that they need to be aware of the potential for immunotherapy-induced dermatomyositis and prompt early recognition of the entity. |
Open Access 22.05.2020 | Case Report
Toripalimab-Induced Dermatomyositis in a Patient with Metastatic Melanoma
Erschienen in: Dermatology and Therapy | Ausgabe 4/2020