Korean J Dermatol.  2022 Mar;60(3):182-185.

A Drug-Induced Sarcoidosis-Like Reaction in Lung Cancer Patient Treated with Nivolumab and Ipilimumab: A Case Report and Literature Review

• Kim SH
• Lee SG
• Kim JY
• Ju HJ
• Kim GM
• Lee JH

Abstract

Immune checkpoint inhibitor (ICI), including programmed cell death protein 1 and cytotoxic T-lymphocyte-associated protein 4 inhibitors, has emerged as a pillar in the management of advanced malignancies. A drug-induced sarcoidosis-like reaction (DISR) is a rare cutaneous adverse event of ICI. A 47-year-old male presented with one-month history of a solitary erythematous nodule on his forehead. He had been diagnosed with metastatic adenocarcinoma of the lung and was treated with nivolumab and ipilimumab for three months. Histological findings revealed multinucleated giant cells forming non-caseating granulomas with moderate peripheral lymphocyte infiltration in the dermis. Also, new hilar lymphadenopathy of the lung was identified in a systemic evaluation. Given the temporal relationship with ICI treatment, the final diagnosis was ICI-induced sarcoidosis-like reaction. To our knowledge, this is the first report of a case of DISR that developed following ICI treatment in the dermatologic literature in Korea.

Keyword

Adverse event; Immune checkpoint inhibitor; Ipilimumab; Nivolumab; Sarcoidosis