Case Report: Immune-related eruptive keratoacanthoma with fungal coinfection under PD-1 inhibitor therapy: a diagnostic and therapeutic challenge
BackgroundIt has been reported that immunotherapy with programmed cell death protein 1 (PD-1) inhibitors (pembrolizumab or nivolumab) can induce multiple eruptive keratoacanthomas (KAs), representing an immune-related cutaneous adverse event (ircAE).MethodsThis case report describes a 63-year-old fe...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-08-01
|
| Series: | Frontiers in Pharmacology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2025.1619450/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849239941440077824 |
|---|---|
| author | Ying-Jie Su Zheng Wu Yan-Li Hou Meng-Xia Yan Meng-Xia Yan Xiu-Mei Ma Hou-Wen Lin |
| author_facet | Ying-Jie Su Zheng Wu Yan-Li Hou Meng-Xia Yan Meng-Xia Yan Xiu-Mei Ma Hou-Wen Lin |
| author_sort | Ying-Jie Su |
| collection | DOAJ |
| description | BackgroundIt has been reported that immunotherapy with programmed cell death protein 1 (PD-1) inhibitors (pembrolizumab or nivolumab) can induce multiple eruptive keratoacanthomas (KAs), representing an immune-related cutaneous adverse event (ircAE).MethodsThis case report describes a 63-year-old female with recurrent cervical adenocarcinoma who developed multiple eruptive KAs and a concurrent fungal infection following treatment with the PD-1 inhibitor zimberelimab. We analyzed the etiology, diagnosis, and treatment by integrating clinical manifestations, pathological examinations, previous treatment history, and a review of the literature.ResultsDespite an initial misdiagnosis as a fungal infection, multidisciplinary review identified KA as an ircAE. Topical corticosteroids led to resolution, and another PD-1 inhibitor was reintroduced without recurrence of cutaneous toxicity.ConclusionThis is the first documented case of eruptive KA linked to zimberelimab, expanding the spectrum of PD-1 inhibitor-associated ircAEs. A concurrent fungal infection obscured the diagnosis, delaying appropriate treatment and highlighting the importance of recognizing rare ircAEs and multidisciplinary collaboration. |
| format | Article |
| id | doaj-art-6d8c7d99dce54639864cc1f8c1a8f74b |
| institution | Kabale University |
| issn | 1663-9812 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj-art-6d8c7d99dce54639864cc1f8c1a8f74b2025-08-20T04:00:48ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-08-011610.3389/fphar.2025.16194501619450Case Report: Immune-related eruptive keratoacanthoma with fungal coinfection under PD-1 inhibitor therapy: a diagnostic and therapeutic challengeYing-Jie Su0Zheng Wu1Yan-Li Hou2Meng-Xia Yan3Meng-Xia Yan4Xiu-Mei Ma5Hou-Wen Lin6Department of Pharmacy, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, ChinaDepartment of Radiation Oncology, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, ChinaDepartment of Radiation Oncology, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, ChinaDepartment of Pharmacy, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, ChinaDepartment of Pharmacy, Ningbo Hangzhou Bay Hospital, Ningbo, Zhejiang, ChinaDepartment of Radiation Oncology, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, ChinaDepartment of Pharmacy, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, ChinaBackgroundIt has been reported that immunotherapy with programmed cell death protein 1 (PD-1) inhibitors (pembrolizumab or nivolumab) can induce multiple eruptive keratoacanthomas (KAs), representing an immune-related cutaneous adverse event (ircAE).MethodsThis case report describes a 63-year-old female with recurrent cervical adenocarcinoma who developed multiple eruptive KAs and a concurrent fungal infection following treatment with the PD-1 inhibitor zimberelimab. We analyzed the etiology, diagnosis, and treatment by integrating clinical manifestations, pathological examinations, previous treatment history, and a review of the literature.ResultsDespite an initial misdiagnosis as a fungal infection, multidisciplinary review identified KA as an ircAE. Topical corticosteroids led to resolution, and another PD-1 inhibitor was reintroduced without recurrence of cutaneous toxicity.ConclusionThis is the first documented case of eruptive KA linked to zimberelimab, expanding the spectrum of PD-1 inhibitor-associated ircAEs. A concurrent fungal infection obscured the diagnosis, delaying appropriate treatment and highlighting the importance of recognizing rare ircAEs and multidisciplinary collaboration.https://www.frontiersin.org/articles/10.3389/fphar.2025.1619450/fullimmune checkpoint inhibitorsprogrammed cell death protein 1immune-related adverse eventimmune-related cutaneous adverse eventeruptive keratoacanthomas |
| spellingShingle | Ying-Jie Su Zheng Wu Yan-Li Hou Meng-Xia Yan Meng-Xia Yan Xiu-Mei Ma Hou-Wen Lin Case Report: Immune-related eruptive keratoacanthoma with fungal coinfection under PD-1 inhibitor therapy: a diagnostic and therapeutic challenge Frontiers in Pharmacology immune checkpoint inhibitors programmed cell death protein 1 immune-related adverse event immune-related cutaneous adverse event eruptive keratoacanthomas |
| title | Case Report: Immune-related eruptive keratoacanthoma with fungal coinfection under PD-1 inhibitor therapy: a diagnostic and therapeutic challenge |
| title_full | Case Report: Immune-related eruptive keratoacanthoma with fungal coinfection under PD-1 inhibitor therapy: a diagnostic and therapeutic challenge |
| title_fullStr | Case Report: Immune-related eruptive keratoacanthoma with fungal coinfection under PD-1 inhibitor therapy: a diagnostic and therapeutic challenge |
| title_full_unstemmed | Case Report: Immune-related eruptive keratoacanthoma with fungal coinfection under PD-1 inhibitor therapy: a diagnostic and therapeutic challenge |
| title_short | Case Report: Immune-related eruptive keratoacanthoma with fungal coinfection under PD-1 inhibitor therapy: a diagnostic and therapeutic challenge |
| title_sort | case report immune related eruptive keratoacanthoma with fungal coinfection under pd 1 inhibitor therapy a diagnostic and therapeutic challenge |
| topic | immune checkpoint inhibitors programmed cell death protein 1 immune-related adverse event immune-related cutaneous adverse event eruptive keratoacanthomas |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2025.1619450/full |
| work_keys_str_mv | AT yingjiesu casereportimmunerelatederuptivekeratoacanthomawithfungalcoinfectionunderpd1inhibitortherapyadiagnosticandtherapeuticchallenge AT zhengwu casereportimmunerelatederuptivekeratoacanthomawithfungalcoinfectionunderpd1inhibitortherapyadiagnosticandtherapeuticchallenge AT yanlihou casereportimmunerelatederuptivekeratoacanthomawithfungalcoinfectionunderpd1inhibitortherapyadiagnosticandtherapeuticchallenge AT mengxiayan casereportimmunerelatederuptivekeratoacanthomawithfungalcoinfectionunderpd1inhibitortherapyadiagnosticandtherapeuticchallenge AT mengxiayan casereportimmunerelatederuptivekeratoacanthomawithfungalcoinfectionunderpd1inhibitortherapyadiagnosticandtherapeuticchallenge AT xiumeima casereportimmunerelatederuptivekeratoacanthomawithfungalcoinfectionunderpd1inhibitortherapyadiagnosticandtherapeuticchallenge AT houwenlin casereportimmunerelatederuptivekeratoacanthomawithfungalcoinfectionunderpd1inhibitortherapyadiagnosticandtherapeuticchallenge |