Table 1.

Therapy and Rash Characteristics

Patient	Demographics at Time of Rash Onset	Therapy Sequence [(Days to Rash Onset (RO)]	Clinical Course	Lab Abnormalities	CTCAE Rash Grade (G), Characterization Location Initial Diagnosis	Histopathology	Confounding Variables	Current Survival Status
1	54 year old Caucasian female	I/N ×1 - > N (Day − 315 to − 148) V/C (Day −12 to RO)	Hospitalized High grade fever Hypotension Oral mucositis	Hyponatremia Hypokalemia Elevated lactate (2.5XULN) Lymphocytopenia Elevated sIL-2R (20 X ULN) CRP 163	G-4, Diffuse morbilliform eruption of trunk and extremities DRESS vs SJS vs drug reaction	Papillary dermal edema, slight basal layer vacuolization, superficial dermal perivascular lymphocytic infiltration and eosinophils	Started allopurinol 14 days prior to rash onset	Deceased
2	60 year old Caucasian female	N (Day − 408 to −228) D/T (Day −214 to RO)	ICU High grade fever Hypotension AMS Lip swelling Difficulty swallowing	Transaminitis	G-4, Diffuse morbilliform eruption of trunk and extremities Drug reaction vs sepsis vs DRESS	Subepidermal vesicle formation with eosinophils; positive direct immunofluorescence with linear IgG and IgA at the basement membrane zone suggestive of bullous pemphigoid or linear IgA bullous dermatosis	On course of amoxicillin-clavulanic acid at rash onset	Alive
3	54 year old Caucasian male	D/T (Day − 331 to − 143) N (Day − 122 to − 24) V/C (Day − 16 to RO)	Hospitalized High grade fever	Hyponatremia Elevated creatinine Lymphocytopenia	G-4, Diffuse targetoid lesions involving trunk, extremities and face SJS vs drug eruption (including DRESS) vs viral exanthem	Papillary dermal edema, slight basal layer vacuolization, superficial dermal perivascular lymphocytic infiltration and eosinophils	Symptoms of upper respiratory tract infection present immediately prior to rash onset	Deceased
4	58 year old Caucasian female	N (Day − 344 to −43) V/C (Day −13 to RO)	Outpatient management	None	G-4 Diffuse morbilliform eruption of trunk and extremities Drug reaction	No biopsy performed	Started with full doses of V/C when had been instructed to start at a reduced dose of each	Deceased
5	59 year old Caucasian female	V/C (Day −75 to −11) P (Day −6 to RO)	ICU High grade fever Hypotension Tachycardia	Elevated creatinine Transaminitis Hyperbilirubinemia CRP 200	G-4 Diffuse morbilliform eruption of trunk and extremities Sepsis vs DRESS vs pembrolizumab induced reaction	Papillary dermal edema, slight basal layer vacuolization, superficial dermal perivascular lymphocytic infiltration and eosinophils; few plasma cells, neutrophils, and a rare focus of parakeratosis	Concern for sepsis from cellulitis (re-fevered after antibiotics narrowed)	Deceased
6	58 year old Caucasian female	P (Day −56) V/C (Day −21 to RO)	Outpatient management	Transaminitis Lymphocytopenia CRP 159	G-2 Discrete scattered erythematous edematous plaques on extremities Drug reaction vs Sweets Syndrome vs early SJS	Papillary dermal edema, slight basal layer vacuolization, superficial dermal perivascular lymphocytic infiltration and eosinophils	No apparent confounding variables	Alive

All days are calculated from rash occurrence (RO) being day 0, I Ipilimumab, N Nivolumab, P Pembrolizumab, V Vemurafenib, C Cobimetinib, D Dabrafenib, T Trametinib, sIL-2R Soluble interleukin-2 receptor, ULN Upper limit of normal, High grade fever= > 102, AMS Altered mental status, CRP C-reactive protein (reference range < 10.0 mg/L), SJS Stevens Johnson syndrome, DRESS Drug Reaction with Eosinophilia and Systemic Symptoms, CTCAE Common Terminology Criteria for Adverse Events (CTCAE 4.03)