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CASE REPORT article

Front. Pharmacol.
Sec. Pharmacology of Anti-Cancer Drugs
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1454015

Immune-related toxic epidermal necrolysis affecting trachea mucosal epithelium: A case report and literature review

Provisionally accepted
  • 1 Cancer Center, Renmin Hospital, Faculty of Medical Sciences, Wuhan University, Wuhan, Hubei Province, China
  • 2 Department of Oncology and Hematology, XiangYang Hospital of Traditional Chinese Medicine, Xiangyang, Hebei Province, China
  • 3 Shandong Provincial Qianfoshan Hospital, Jinan, Shandong Province, China

The final, formatted version of the article will be published soon.

    Background: monoclonal antibodies against pProgrammed cell death protein-1 (PD-1)/programmed death-ligand-1 (PD-L1) monoclonal antibodies have emerged as criticalcrucial tools in cancer treatmenttherapy. However, concerns regarding their potential cutaneous and mucosal toxicity, along with severe complications, have drawn clinical attention. Further research is warranted to explore investigate the adverse reactions and treatment strategies associated with PD-1 monoclonal antibodies.We present a detailed case report of a laryngeal cancer patient with laryngeal cancer who developed toxic epidermal necrolysis (TEN) following after treatment with PD-1 monoclonal antibody. By integrating clinical manifestations, pathological examinations, and literature reviews, we analyzed the etiology, diagnosis, and treatment approaches by integrating clinical manifestations, pathological examinations, and literature research.Results: After PD-1 monoclonal antibody therapy, Tthe patient exhibited systemic rash, bullae, and epidermal detachment after PD-1 monoclonal antibody therapy, which subsequently involved the tracheal and bronchial mucosa, leading toresulting in dyspnea. The patient recovered Following after treatments with steroids, macrolides, immunoglobulins, and etanercept, along with repeated removal of scabs under via bronchoscopy., the patient recovered. Literature reviewing suggests a potential association between PD-1 monoclonal antibodies and the pathogenesis of Steven Johnson's Syndrome(SJS) and /Toxic epidermal necrolysis(TEN), possibly related due to immune dysregulation. Treatment includes consists of immediate discontinuation of suspected suspicious drugs, essential supportive therapy, and systemic corticosteroid administration, with the addition of immunosuppressants and/or immunoglobulins when necessaryas needed. The mucocutaneous toxicity induced by PD-1 monoclonal antibodies is not limited to the surface of the skin but may also affect deeperin deep mucosal layers, potentially leading to lifethreatening complications. Therefore, when using PD-1 monoclonal antibodies, clinicians should closely monitor adverse events and promptly implement effectiveapply appropriate treatments as soon as possible to prevent severe complications when using PD-1 monoclonal antibodies.

    Keywords: PD-1, PD-L1, Immunotherapy, Immune-related adverse events, toxic epidermal necrolysis, Fiberoptic bronchoscopy

    Received: 24 Jun 2024; Accepted: 09 Oct 2024.

    Copyright: © 2024 Zhang, Fu, Song, Gao, Wang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Bicheng Zhang, Cancer Center, Renmin Hospital, Faculty of Medical Sciences, Wuhan University, Wuhan, 430060, Hubei Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.