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Objectives: Immune-mediated adverse events (irAEs) from immune checkpoint inhibitors (ICIs) often require high-dose glucocorticoids (GCs), which can promote cancer progression and counteract ICI benefits. This study evaluated the articular and oncologic clinical outcomes of ICI-induced arthritis treated with methotrexate (MTX) as a GC-sparing agent., Methods: Adult patients with ICI-induced arthritis in 2023 were included. Arthritis was assessed using the disease activity score on 28 joints by C-reactive protein (DAS28-CRP), with follow-ups every 3 months. All patients received subcutaneous MTX, and oncologic outcomes were evaluated using RECIST 1.1 criteria after one year., Results: Fourteen patients (median age 74.5 years) with melanoma (64.3%), colorectal cancer (14.3%), lung cancer (14.3%), or Hodgkin's lymphoma (7.1%) were treated with PD1 antagonists (92.9%) or combined with CTLA4 blockers (7.1%). Arthritis presentations included oligo-arthritis (36%), mono-arthritis (29%), polyarthritis (21%), and polymyalgia rheumatica-like syndrome (14.3%), with a mean onset of 4.7±3.7 months post-ICI. MTX was started for all at a mean dose of 9.5±1.5 mg weekly, beginning at the first rheumatology visit in 78.5% of patients. Over a mean follow-up of 12.8±4.6 months, DAS28-CRP scores improved significantly, and prednisone dosage was in all reduced (3.6 mg at V4 vs. 8.4 mg at V0, p=0.003). No major MTX-related toxicities were noted. Cancer responses at follow-up were complete (50%), partial (21.4%), stable disease (7.1%), and progression (21.5%)., Conclusions: The use of MTX in ICI-induced arthritis showed promising results in reducing GC dosages and managing the inflammatory articular activity, with no major toxicities observed over one year. These findings suggest that MTX may be a viable GC-sparing option in this context, but larger, controlled studies are needed to confirm these observations and better understand the impact on both articular and oncologic outcomes.

Objectives: Body mapping of normal values of skin thickness and hardness may be a useful aid in daily practice. By employing non-invasive techniques, our pilot study provides these values in healthy individuals using high frequency ultrasound (HFUS) and durometry in areas used to evaluate the modified Rodnan skin score (mRSS)., Methods: One-hundred-fifty-two healthy volunteers from Ghent and Genova University Hospitals (mean ages 31.2, 35.5, and 64.9 years), were evaluated to exclude rheumatologic diseases. HFUS and durometry were used to assess the dermal status in mRSS areas. Exploratory analyses were performed to assess the impact of demographic and anthropometric characteristics on intra-subject skin measurements. Statistical analysis was performed with Datatab®., Results: The upper and lower arms exhibited significantly higher durometry values and lower dermal thickness compared to the trunk regions, underscoring distinct variations across these areas (all p<0.05). The hardest skin was found on the finger, while the thickest dermal measurements were at the abdomen and thighs. Dermal thickness was higher in men in multiple areas in the three cohorts, albeit with relatively modest effect sizes (r coefficients ranging between 0.02 and 0.6). Despite the presence of significant inter-group differences in dermal thickness, HFUS mapping showed similar topographical distributions in both centres., Conclusions: Our study offers a comprehensive skin mapping status in healthy individuals. Key findings indicate lower dermal thickness in the upper arms, legs, and feet, and higher skin hardness in peripheral areas like fingers, compared to truncal regions.This skin mapping pilot study might provide the normal distribution values in outpatient clinics for physicians to be used when comparing the same areas in pathological conditions like systemic sclerosis-related fibrotic skin.