Margaret A. Kaszycki1*, Jonathan Leventhal2
1Frank H. Netter MD School of Medicine
2Yale School of Medicine
Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy, and their use in combination with radiation therapy (RT) has become increasingly utilized to optimize positive outcomes. The cutaneous adverse reactions from RT as well as ICIs are both well documented; however, in combination these cutaneous toxicities can be exacerbated. ICIs and RT may work synergistically to create an enhanced immune response against the tumor cells. This synergistic effect has been reported to occur both locally at the site of RT, as well as systemically via an abscopal effect. Fortunately, this combination of treatment does not increase the incidence of cutaneous reactions, although several cases have reported enhanced skin toxicity at the site of RT. RT is thought to create an ‘immunocompromised skin district’ or localized immune dysregulation in irradiated skin. This review summarizes previously published case reports and discusses the cutaneous adverse reactions from ICI and RT combination therapy. Properly identifying ICI and RT induced skin reactions depends on several factors including patient history, sequence of therapies, timing of reaction, and histological findings. Skin reactions from combination therapy can range in severity and include ICI-induced radiation recall dermatitis, as well as uncommon presentations of Stevens-Johnson syndrome, lichen planus, and bullous pemphigoid which are localized to or enhanced within areas of prior radiation exposure. It is important for oncologists and dermatologists alike to be aware of the spectrum of reactions associated with ICI and RT.View / Download Pdf
DOI: 10.29245/2767-5092/2021/3.1138 View / Download Pdf
Kelly Atherton BS1*, Latiffa Smith BS2, Alan Snyder MD MSCR3, John Plante MD MSCR3, Dirk Elston MD3
1College of Medicine, Medical University of South Carolina, Charleston, South Carolina; College of Graduate Studies, Medical University of South Carolina, Charleston, South Carolina, USA
2College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
3Department of Dermatology and Dermatologic Surgery, Medical University South Carolina, Charleston, South Carolina, USA
Jose Salgado Borges1,2*, C. Vergés2, J. Lima1, March de Ribot F2,3
1Clinsborges. Porto, Portugal
2Department of Ophthalmology. Hospital Universitario Dexeus. Area Oftalmológica Avanzada. Universidad Politécnica de Cataluña. Barcelona, Spain.
3Department of Ophthalmology. Girona Hospital, Girona University. Girona, Spain.
Intense pulsed light (IPL) are medical-esthetical procedures that emit light at a wavelength of 500 – 1200 nm, interacting with epidermal and dermal tissues. IPL is a relatively new treatment of growing popularity thanks to its versatility and efficacy, mainly in dermatology and recently also in ophthalmology. These devices are used to treat dry eye disease, meibomian gland dysfunction, rosacea, and periocular lesions with outstanding results.View / Download Pdf