Immune checkpoint inhibitor-associated linear IgA bullous dermatosis with recalcitrant ocular involvement: a rare presentation.

Abstract

Programmed death-1 (PD-1) and programmed death ligand-1 (PD-L1) receptor inhibitors have become imperative in the treatment of advanced solid organ malignancies such as metastatic melanoma. With this disinhibition of certain immune responses to induce an antitumour response, numerous adverse events have been reported, many of which affect the skin. While rare, PD-1/PD-L1 inhibitor-associated severe cutaneous adverse reactions (SCARs) can cause significant morbidity and/or mortality. New SCARs are reported with increasing frequency as immune checkpoint inhibitors become more widely used. Here, we present a rare case of recalcitrant ocular linear IgA bullous dermatosis associated with a PD-1 inhibitor. Awareness of this entity will allow more rapid recognition and initiation of appropriate management and treatment, which would reduce the morbidity and/or mortality associated with these serious adverse reactions.