中国麻风皮肤病杂志 ›› 2023, Vol. 39 ›› Issue (1): 31-34.doi: 10.12144/zgmfskin202301031

• 病例报告 • 上一篇    下一篇

免疫检查点抑制剂相关Stevens-Johnson综合征一例

胡紫馨1,2*,董慧静1,2*,李承旭3,俞仪萱1,2,薛崇祥1,2,李嘉1,2,鲁星妤1,2,翟烨4,崔慧娟2   

  1. 1北京中医药大学，北京，100029;2中日友好医院 中西医结合肿瘤内科，北京，100029;3中日友好医院 皮肤与性病科，北京，100029;4北京中医药大学东直门医院 皮肤科，北京，100700 *共同第一作者
  • 出版日期:2023-01-15 发布日期:2022-11-28

Stevens-Johnson syndrome induced by sequentially using of furmonertinib after immune checkpoint inhibitors: a case report

HU Zixin1,2*, DONG Huijing1,2*, LI Chengxu3, YU Yixuan1,2, XUE Chongxiang1,2, LI Jia1,2, LU Xingyu1,2, ZHAI Ye4, CUI Huijuan2   

  1. 1 Beijing University of Chinese Medicine, Beijing 100029, China; 2 Department of Oncology, China-Japan Friendship Hospital, Beijing 100029, China; 3 Department of Dermatology, China-Japan Friendship Hospital, Beijing 100029, China; 4 Department of Dermatology, Beijing University of Chinese Medicine Dongzhimen Hospital, Beijing 100700, China *Co-first author
  • Online:2023-01-15 Published:2022-11-28

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摘要： 本文报道1例经13程替雷利珠单抗治疗肺腺癌的37岁男性患者，使用伏美替尼1个月后出现Stevens-Johnson综合征 (SJS)，自行服用安罗替尼1天后加重，诊断为SJS，CTCAE分级3级，经激素冲击治疗后1个月内恢复。免疫检查点抑制剂 、表皮生长因子抑制剂、多激酶抑制剂均可以引起角质形成细胞凋亡，导致SJS/TEN，其中免疫治疗导致的SJS/TEN病情重、死亡率高，免疫治疗后使用靶向药物会提高严重皮肤不良事件的发生率。在免疫治疗后引入靶向治疗，脱敏可能是必要的。

关键词: 替雷利珠单抗, 伏美替尼, 安罗替尼, Stevens-Johnson综合征, 中毒性表皮坏死松解症

Abstract: We report a 37-year-old male with metastatic lung adenocarcinoma who developed Stevens-Johnson syndrome (SJS) after 13 doses of tislelizumab and one-month administration of furmonertinib. The rash erupted after one day of treatment of anlotinib. Immune checkpoint inhibitors, epidermal growth factor inhibitors, and multi-kinase inhibitors can cause keratinocytes apoptosis, leading to SJS/TEN. SJS/TEN caused by immunotherapy is characterized by severe conditions and high mortality. The consequential use of target therapy following immunotherapy increase the incidence of serious cutaneous adverse events. In this case, tislelizumab is the cornerstone of SJS/TEN, furmonertinib is an inducement, whereas anlotinib aggravated the rash. Anti-allergic before the introduction of target therapy following with immunotherapy may be necessary.

Key words: tislelizumab, furmonertinib, anlotinib, Stevens-Johnson syndrome, toxic epidermal necrolysis