Anti-Programmed Cell Death Protein 1-Induced Lichenoid Changes of the Nail Unit: Histopathologic Description

    March 2021 in “ JAAD Case Reports ”
    Claire van Damme, V. Sibaud, Josette André, Bertrand Richert, Evelyne Berlingin
    TLDR Nail changes from immunotherapy can be managed without stopping cancer treatment.
    The document described two cases of nail lichenoid changes in patients undergoing anti-PD-1 immunotherapy with nivolumab for lung cancer. These changes were confirmed through histopathology and included symptoms such as onycholysis and erythema of the lunula. The study highlighted that while skin-related immune-related adverse events (irAEs) were common with immunotherapy, nail changes were less frequently reported. The treatment involved the use of topical corticosteroids and intralesional triamcinolone acetonide, which led to significant improvement without discontinuing nivolumab. The findings suggested that while immunotherapy can cause lichenoid changes, these can be managed effectively without interrupting cancer treatment. Further studies were recommended to explore the relationship between immunotherapy and nail changes.
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