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Clinical, biological and histological characteristics of bullous pemphigoid associated with anti-PD-1/PD-L1 therapy: A national retrospective study Immune checkpoint inhibitors (ICI), most commonly anti-programmed cell death 1 (PD-1) and anti-programmed cell death ligand 1 (PD-L1) therapies, have revolutionized the treatment of many cancers. We thank Dr C-J. Clerc (Niort), Dr E. Funck-Brentano (Paris), Dr D. Giacchero (Nice), Pr L. Mortier (Lille), Dr M. Dinulescu (Rennes), Pr L. Boussemart (Nantes), Pr L. Machet (Tours), Dr S. Duvert-Lehembre (Dunkerque), Dr A. Viarnaud (Paris), Dr C. Joachim (Amiens), Dr C. Bara (Le Mans), Dr E. Baubion (Fort de France), Dr B. Bergeret (Nîmes), Dr F. Brunet-Possenti (Paris), Dr S. Debarbieux (Lyon), Dr V. Hebert (Rouen), Pr Grange (Reims), Dr M-P. Konstantinou (Toulouse), Dr A. Marzouki-Zerouali (Nancy), Dr J. Moreau-Huguen (Lorient), Dr C. Phan (Argenteuil), Dr I. Templier (Grenoble), Dr P. Celerier (la Rochelle), Pr F. Aubin (Besançon), P. Modiano (Lille), Dr L. Dousset (Bordeaux), Dr J. Bonini (Bordeaux) for providing us patient data and for their assistance in the preparation of the manuscript. [Extracted from the article]

Background Vemurafenib, a BRAF inhibitor, is commonly associated with skin toxicity. The impact of severe forms is unknown. Objective To determine the rate of permanent vemurafenib discontinuation due to grade 3-4 skin toxicity, features of these toxicities, their recurrence rate after a switch to dabrafenib and their impact on overall survival. Methods Retrospective cohort study of 131 patients treated with vemurafenib for melanoma between November 2010 and December 2014. Data on skin toxicities, the need for vemurafenib adjustment and the impact of switching to dabrafenib were collected. Regarding survival analysis, a conditional landmark analysis was performed to correct lead-time bias. Results Among the 131 vemurafenib-treated patients, 26% developed grade 3-4 skin toxicity. Forty-four percent of them permanently discontinued their treatment, mainly due to rash and classic skin adverse reactions (Steven-Johnson syndrome, Drug Reaction with Eosinophilia and Systemic Symptoms). Conversely, photosensitivity and carcinomas rarely required treatment adjustment. Grade 3-4 rashes were associated with clinical or biological abnormalities in 94% of patients. Among the 10 patients who subsequently switched to dabrafenib, skin toxicity recurred only in one patient. Overall survival was significantly prolonged in case of severe skin toxicity emerging within the first 4 ( P = 0.014) and 8 weeks ( P = 0.038) on vemurafenib, with only a trend at 12 weeks ( P = 0.052). Median overall survival was also prolonged in case of severe rash. Conclusion In this study, vemurafenib was continued in 56% of patients with grade 3-4 skin toxicity, which was associated with prolonged overall survival when emerging within the first 4 and 8 weeks of treatment. While developing severe skin adverse reactions permanently contraindicates vemurafenib use, other rashes should lead to retreatment attempts with dose reduction. In case of recurrence, dabrafenib seems to be an interesting option. For other skin toxicities, including photosensitivity and cutaneous carcinoma, treatment adjustment is usually not needed. [ABSTRACT FROM AUTHOR]

Background Basal cell carcinoma ( BCC) is the most common cancer in humans. Vismodegib, a Hedgehog pathway inhibitor, has proved its effectiveness in treating non-resectable advanced BCC. Aim However, its action on squamous cell carcinoma ( SCC) is unknown. We present three SCC cases developed into BCC in vismodegib-treated patients. Material and methods We have described three cases of patients developing SCC during treatment by vismodegib for BCC. Results Patient 1 was treated with vismodegib for five facial BCC. Due to the progression of one of the lesions at month 3 (M3), a biopsy was performed and showed SCC. Patient 2 was treated with vismodegib for a large facial BCC. A biopsy was performed at M2 on a BCC area not responding to treatment and showed SCC. Patient 3 was treated with vismodegib for a BCC on the nose. Due to vismodegib ineffectiveness, a biopsy was performed and showed SCC. Discussion Two similar cases have been described in the literature. This could be due to the appearance of the squamous contingent of a metatypical BCC or to the squamous differentiation of stem cells through inhibition of the hedgehog pathway. Conclusion In practice, any dissociated response of a BCC to vismodegib should be biopsied. [ABSTRACT FROM AUTHOR]

The article presents a case study of 61-year-old woman due to spontaneous hemorrhage from presternal spider angioma. It notes the use of trastuzumab emtansine (T-DM1), which is a monoclonal antibody for human epidermal growth factor receptor-2 (HER2), the T-DM1 second-line therapy for metastatic breast cancer.

The article discusses the case of a patient with epithelioid hemangioma presenting as acneiform rash. Topics discussed include the post-partum flareups of papulonodular dermatosis on the frontotemporal region, the results of histopathological and immunohistochemical examination, and management of the condition with phototherapy. Also mentioned is the patient's switch from progesterone intrauterine device (IUD) use to copper IUD due to a possible link between progesterone and the disease.

The article assesses the predictive value of T-cell clone and CD13 antigen in the prognosis for parapsoriasis (PP). Noted is the possibility that PP could progress to epidermotropic cutaneous T-cell lymphoma (CTCL), a condition that exhibits a specific loss of CD13 expression. The researchers claim that T-cell clone presence in the skin of PP patients at baseline was a significant predictor of progression to CTCL.

Background: Adverse pregnancy outcomes (APO) occur in 35% of patients with pemphigoid gestationis (PG). No biological predictor of APO has been established yet., Objectives: To assess a potential relationship between the occurrence of APO and the serum value of anti-BP180 antibodies at the time of PG diagnosis., Methods: Multicentre retrospective study conducted from January 2009 to December 2019 in 35 secondary and tertiary care centres., Inclusion Criteria: (i) diagnosis of PG according to clinical, histological and immunological criteria, (ii) ELISA measurement of anti-BP180 IgG antibodies determined at the time of PG diagnosis with the same commercial kit and (iii) obstetrical data available., Results: Of the 95 patients with PG included, 42 had one or more APO, which mainly corresponded to preterm birth (n = 26), intrauterine growth restriction (IUGR) (n = 18) and small weight for gestational age at birth (n = 16). From a ROC curve, we identified a threshold of 150 IU ELISA value as the most discriminating to differentiate between patients with or without IUGR, with 78% sensitivity, 55% specificity, 30% positive and 91% negative predictive value. The threshold >150 IU was confirmed using a cross-validation based on bootstrap resampling, which showed that the median threshold was 159 IU. Upon adjusting for oral corticosteroid intake and main clinical predictors of APO, an ELISA value of >150 IU was associated with the occurrence of IUGR (OR = 5.11; 95% CI: 1.48-22.30; p = 0.016) but not with any other APO. The combination of blisters and ELISA values higher than 150 IU led to a 2.4-fold higher risk of all-cause APO (OR: 10.90; 95% CI: 2.33-82.3) relative to patients with blisters but lower values of anti-BP180 antibodies (OR of 4.54; 95% CI 0.92-34.2)., Conclusion: These findings suggest that anti-BP180 antibody ELISA value in combination with clinical markers is helpful in managing the risk of APO, in particular IUGR, in patients with PG., (© 2023 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.)