Auftreten eines genitalen Lichen sclerosus et atrophicus unter Pembrolizumab-Therapie eines metastasierten malignen Melanoms

Zusammenfassung

Pembrolizumab ist ein monoklonaler Antikörper, der an den PD-1-Rezeptor auf T-Zellen bindet und die Interaktion mit den Liganden PD-L1 und PD-L2 auf Krebszellen hemmt. Pembrolizumab wird für die Behandlung fortgeschrittener Tumorerkrankungen, v. a. für das metastasierte maligne Melanom angewendet. Zu den bekannten Nebenwirkungen dieser Therapie gehören neben kutanen Nebenwirkungen Müdigkeit, Dysfunktion der Schilddrüse und Kolitis. Diese sind durch die immunregulatorischen Eigenschaften des Medikaments bedingt. Hier berichten wir über den Fall einer 74-jährigen Patientin mit metastasiertem malignen Melanom, die unter einer Therapie mit Pembrolizumab zwar Stabilität des Tumorleidens zeigte, aber auch einen ausgedehnten Lichen sclerosus et atrophicus der Vulva entwickelte. Dieser Fall ergänzt die Kenntnisse über mögliche kutane Nebenwirkungen einer PD-1-Inhibitor-Therapie.

Abstract

Pembrolizumab is a monoclonal antibody that binds to the PD-1 receptor on T cells and inhibits the interaction with the PD-L1 and PD-L2 ligands on cancer cells. Pembrolizumab is indicated for the treatment of advanced tumor diseases, esp. for metastatic malignant melanoma. The known side effects of this therapy include beside cutaneous side effects fatigue, dysfunction of the thyroid gland and colitis. These are explained by the immunoregulatory action of the drug. Here we report on the case of a 74-year-old female patient with metastatic malignant melanoma, who developed a stable disease of the malignant disease but suffered from an extended lichen sclerosus et atrophicus of the vulva following pembrolizumab treatment. This case might extend the knowledge of possible cutaneous side effects of PD-1 inhibitor therapies.

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