Dermatologic reactions are among the most common adverse events of antiprogrammed cell death-1 (anti-PD-1) monoclonal antibodies agents and include maculopapular rash, psoriasiform rash, lichenoid eruptions, autoimmune bullous disorders, and vitiligo. Here, we present a case of a 12-year-old African American male with metastatic spitzoid melanoma treated with nivolumab who developed a mild lichenoid eruption that progressed to a severe case of lichen planus pemphigoides (LPP). Management was complex given the patient's age and history and included hospitalization for intravenous steroids, an intensive topical steroid regimen, methotrexate, and discontinuation of nivolumab. This case illustrates a rare but dramatic progression from a mild LP-like eruption to severe bullous lichenoid eruption, most consistent with LPP, as well as the diagnostic and treatment challenges in the setting of a pediatric patient on nivolumab.

中文翻译：

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转移性黑色素瘤儿童重度纳武单抗诱发扁平苔藓一例

皮肤反应是抗程序性细胞死亡-1（抗 PD-1）单克隆抗体药物最常见的不良事件之一，包括斑丘疹、牛皮癣样皮疹、苔藓样疹、自身免疫性大疱性疾病和白斑。在这里，我们介绍了一名 12 岁的非洲裔美国男性，他患有转移性 spitzoid 黑色素瘤，接受了 nivolumab 治疗，出现轻度苔藓样皮疹，发展为严重的扁平苔藓类天疱疮 (LPP)。考虑到患者的年龄和病史，管理很复杂，包括因静脉注射类固醇、强化局部类固醇治疗、甲氨蝶呤和停用纳武单抗而住院。这个病例说明了从轻度 LP 样喷发到严重大疱性苔藓样喷发的罕见但戏剧性的进展，与 LPP 最一致，