[Digital ischaemia with fingertip ulcers during ipilimumab therapy].
Ischémie digitale avec ulcération pulpaire sous ipilimumab.
Acrosyndrome
Bloqueur de point de contrôle immunitaire
Drug toxicity
Finger ulcer
Immune checkpoint inhibitor
Ipilimumab
Melanoma
Mélanome
Toxicité médicamenteuse
Ulcère digital
Journal
Annales de dermatologie et de venereologie
ISSN: 0151-9638
Titre abrégé: Ann Dermatol Venereol
Pays: France
ID NLM: 7702013
Informations de publication
Date de publication:
Mar 2020
Mar 2020
Historique:
received:
29
01
2019
revised:
17
04
2019
accepted:
05
09
2019
pubmed:
23
12
2019
medline:
25
11
2020
entrez:
23
12
2019
Statut:
ppublish
Résumé
Anti-cancer drugs have many adverse effects including vascular side effects. Herein we present the case of a patient presenting digital ischaemia with high imputability of ipilimumab. A 47-year-old male patient was treated for popliteal melanoma, initially stage IIIA but which subsequently became metastatic (stage IV), and for which ipilimumab was given after the failure of two lines of chemotherapy. During the 4th course of ipilimumab, the patient developed autoimmune hepatitis. Ipilimumab was suspended. Three months later, he developed a drug-like neuropathy followed one month later by ulceration of the right index finger. Causes of embolic, autoimmune and occupational origin (thrombotic microangiopathy, thrombosed aneurysm) were rapidly ruled out. Although a paraneoplastic origin could not be formally excluded, drug-induced immune disorder remained the most plausible origin. This is the first reported case of digital ulceration under ipilimumab.
Sections du résumé
BACKGROUND
BACKGROUND
Anti-cancer drugs have many adverse effects including vascular side effects. Herein we present the case of a patient presenting digital ischaemia with high imputability of ipilimumab.
OBSERVATION
METHODS
A 47-year-old male patient was treated for popliteal melanoma, initially stage IIIA but which subsequently became metastatic (stage IV), and for which ipilimumab was given after the failure of two lines of chemotherapy. During the 4th course of ipilimumab, the patient developed autoimmune hepatitis. Ipilimumab was suspended. Three months later, he developed a drug-like neuropathy followed one month later by ulceration of the right index finger. Causes of embolic, autoimmune and occupational origin (thrombotic microangiopathy, thrombosed aneurysm) were rapidly ruled out. Although a paraneoplastic origin could not be formally excluded, drug-induced immune disorder remained the most plausible origin.
DISCUSSION
CONCLUSIONS
This is the first reported case of digital ulceration under ipilimumab.
Identifiants
pubmed: 31864764
pii: S0151-9638(19)31025-7
doi: 10.1016/j.annder.2019.09.606
pii:
doi:
Substances chimiques
Antineoplastic Agents, Immunological
0
Ipilimumab
0
Types de publication
Case Reports
Langues
fre
Sous-ensembles de citation
IM
Pagination
212-216Informations de copyright
Copyright © 2019 Elsevier Masson SAS. All rights reserved.