Search

Taking into consideration that the immune system plays a very important role in the development of melanoma and non-melanoma skin cancers, which have a high prevalence in immunosuppressed patients and after prolonged ultraviolet radiation, the interest in developing novel therapies, in particular targeting the inflammation in cancer, has increased in the past years. The latest data suggest that therapies such as imiquimod (IMQ), ingenol mebutate (IM), 5-fluorouracil (5-FU), retinoids, and nonsteroidal anti-inflammatory drugs (NSAIDs) have been used with success in the topical treatment of some cancers. Herein, we review the topical treatment targeting the inflammation in skin cancer and the mechanisms involved in these processes. Currently, various associations have shown a superior success rate than monotherapy, such as systemic acitretin and topical IMQ, topical 5-FU with tretinoin cream, or IMQ with checkpoint inhibitor cytotoxic T lymphocyte antigen 4. Novel therapies targeting Toll-like receptor-7 (TLR-7) with higher selectivity than IMQ are also of great interest.

Multiple autoimmune syndrome is a rare condition, defined by the association of at least three autoimmune disorders in the same patient, and first described by Humbert and Dupond in 1988. Psoriasis, vitiligo, and oral lichen planus are all common dermatological disorders in the general population, and the coexistence of these three diseases in these exact clinical variants has never been reported in the literature before. Herein, we describe an unusual case of co-occurrence of psoriasis vulgaris, vitiligo, and oral lichen planus. A 67-yearold Romanian female patient with a history of both vitiligo and psoriasis presented with white, shiny striae, organized in a reticular pattern on the mucosa of the cheek and whitish homogeneous irregularities similar to leukoplakia involving the dorsal side of the tongue. Histology examination confirmed oral lichen planus. The rarity of this case is highlighted by the coexistence of psoriasis, vitiligo, and oral lichen planus in the absence of cutaneous lichen planus lesions, an association which may be a newly described variant of multiple autoimmune syndrome.

An important function of the immune system is its ability to differentiate between healthy cells in the organism and “foreign” cells, allowing the latest to be attacked and the first ones to be conserved. The most important molecules in this process are considered to be checkpoint inhibitors. This review is focused on the association between cancer and inflammation, underlying the mechanisms of action of monoclonal antibodies that are targeting checkpoint inhibitors: ipilimumab against cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and pembrolizumab and nivolumab against programmed cell death protein 1 (PD-1), their indications for treatment, and side effects. Presence of antibodies against checkpoint inhibitors shows promising results in the clinical trials in patients with types of cancer difficult to treat until now such as melanoma, non-small-cell lung cancer (NSCLC), and renal cell carcinoma, offering an increase in the overall survival rate, response rate, and progression-free rate. Resistance is now observed to emerge in patients treated with this therapy, showing the need for more studies in order to design a biomarker that will predict the type of response to immunotherapy.