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Outline
To explore the clinical and pathological characteristics, treatment measures and clinical outcome of programmed death 1/programmed death ligand 1 (PD-1/PD-L1) inhibitors-induced skin vasculitis.
Relevant domestic and foreign databases (up to November 30, 2020) were searched, case reports and clinical research papers on skin vasculitis caused by PD-1/PD-L1 inhibitors were collected, and the characteristics of PD-1/PD-L1 inhibitor-induced skin vasculitis was analyzed using descriptive statistics.
A total of 11 patients were included in the analysis. Patient medications included four cases of nivolumab, three cases of pembrolizumab, one case of duvaluzumab, one case of nivolumab combined with ipilimumab, and one case of pembrolizumab combined with ipilimumab. One patient did not provide the name of the drug. The time from the patients' start of using PD-1/PD-L1 inhibitor to the appearance of skin vasculitis was 1 to 28 weeks, with a median time of 8 weeks (3~13). The skin vasculitis manifested as skin purpura or skin necrosis, which may be accompanied by immune related adverse events of other systems, and skin biopsy showed perivascular neutrophil and lymphocyte infiltration with focal fibrinoid necrosis. Glucocorticoid therapy was the main treatment measure, and the prognosis was good. Most patients got remission. The recover time ranged from 2 to 60 days, with a median time of 30 (13~50) days.
Vasculitis is a rare adverse reaction of PD-1/PD-L1 inhibitors. Skin purpura is the main manifestation. Glucocorticoids can be used for treatment. The prognosis is good, but it may be combined with other serious adverse reactions, which should be paid attention to in clinical practice.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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