TY  - JOUR
T1  - SKin reactions in a subset of patients with stage iv melanoma treated with anti–cytotoxic t-lymphocyte antigen 4 monoclonal antibody as a single agent
AU  - Jaber SH, Cowen EW, Haworth LR, et al
Y1  - 2006/02/01
N1  - 10.1001/archderm.142.2.166
JO  - Archives of Dermatology
SP  - 166
EP  - 172
VL  - 142
IS  - 2
N2  - Objective 
    To describe the clinical and histologic manifestations of skin reactions incidentally noted in patients with stage IV melanoma who were treated with up to 9 mg/kg of a humanized monoclonal antibody reactive against human cytotoxic T-lymphocyte antigen 4 (anti–CTLA-4) as a single agent every 3 weeks.Setting 
    Single-institution prospective study.Design 
    Patients treated with anti–CTLA-4 as a sole agent were prospectively referred for clinicopathologic characterization of skin reactions occurring during treatment.Main Outcome Measures 
    Specific clinicopathologic features were determined by means of a detailed history, a physical examination, conventional histologic analysis, antibody staining, and complete blood cell counts.Results 
    Nine (14%) of 63 consecutive patients treated with anti–CTLA-4 as a sole agent developed skin eruptions that were attributed to anti–CTLA-4 in 8 of them. Skin lesions consisted primarily of discrete, pruritic, erythematous, minimally scaly papules that typically coalesced into thin plaques on the trunk and extensor surfaces of the extremities. Extensive alopecia was also noted in 1 patient. Histologically, a superficial, perivascular CD4+-predominant T-cell infiltrate with eosinophils in the dermis, rare dyskeratotic cells, and mild epidermal spongiosis were present. An increase (compared with pretreatment values) in the peripheral blood eosinophil frequency was observed in patients at the time of skin eruptions (P = .006).Conclusions 
    Specific features of the skin eruption dermatitis with increased tissue and peripheral blood eosinophil levels in a subset of treated patients. Specific features of skin eruption associated with anti–CTLA-4 resemble those described for maculopapular reactions to medications.
SN  - 0003-987X
M3  - doi: 10.1001/archderm.142.2.166
UR  - http://dx.doi.org/10.1001/archderm.142.2.166
ER  -