[Immunorelated Stevens-Johnson syndrome/toxic epidermolysis caused by programmed death receptor 1 inhibitors: a case report].

Abstract

Stevens-Johnson syndrome (SJS) and toxic epidermalnecrolysis (TEN) are acute, severe and fatal diseases involving the skin and mucous membranes, most commonly caused by pharmaceutical factors. These include various sensitizing antibiotics, non-steroidal anti-inflammatory drugs and so on. Immune-associated Stevens-Johnson syndrome/toxic epidermolysis caused by programmed death-1 (PD-1) inhibitors has not been reported. On April 11, 2024, a male patient with primary bronchial lung cancer (right lung squamous cell carcinoma T3N3M1b ⅣA phase driver gene KRAS G12S PD-L1 negative, PS 0 score) was admitted to the department of respiratory and critical care medicine of Bishan hospital affiliated to Chongqing medical university. On March 25, 2024, the patient underwent the 3rd cycle of anti-tumor therapy "Tirellizumab 200 mg+albumin paclitaxel 400 mg+carboplatin 450 mg", and on April 9, 2024, Stevens-Johnson syndrome and toxic epidermolysis occurred, and the epidermolysis area reached more than 95%. After permanent discontinuation of immunosuppressants, anti-infection, hormone, nutritional support, immunoglobulin and other comprehensive treatment, the patient was eventually cured and successfully discharged.