PD-1抑制剂致中毒性表皮坏死松解症2例并文献复习

Toxic Epidermal Necrolysis Induced by Anti-PD-1 Monoclonal Antibody:Two Cases Report and Literature Review

例1男,55岁,全身红斑大疱坏死伴发热1周。例2男,全身红斑大疱伴痒及发热2 d。2例诊断为中毒性表皮坏死松解症,SCORTEN评分为4分、7分。2例患者在发病前都使用了不止一种药物,经过ALDEN评分,例1卡瑞利珠单抗、例2信迪利单抗评分均为7分,在所有已使用过的药物中分数最高,2例患者最终诊断:PD-1抑制剂致中毒性表皮坏死松解症(TEN)。

Case 1,a 55-year-old male presented with erythema,bullae,necrosis and fever for one week.Case 2,a 69-year-old male with erythema,bullae accompanied by itching and fever for two days.All two cases were diagnosed as toxic epidermal necrolysis syndrome with SCORTEN scores of 4 and 7,respectively.Both patients used more than one drug before the onset of the disease.According to The ALDEN score,the scores of Carrelizumab in case one and Sintilizumab in case two were both 7 points,highest among all of the drugs.The diagnosis of toxic epidermal necrolysis caused by PD-1 inhibitor was made.