Table I.
Main features of the 3 patients reported with moderate to severe immune induced/aggravated psoriasis
| Sex/age | Cancer/anti-PD-1 | Psoriasis type | Latency period | Past psoriatic treatment | Apremilast treatment period | Body sites affected | Initial psoriasis severity | Final psoriasis severity | Malignancy progression/ time to progression with apremilast | Estimated progression free survival mean time of anti-PD1 treatment/reference | Apremilast adverse effects |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Male/50 years | Stage IV Uveal melanoma/nivolumab | New onset plaque psoriasis with psoriatic arthritis | 5 months | –∗ | 12 months | Trunk, soles, upper and lower extremities Asymmetric oligoarthritic involvement |
PASI 12 BSA 15 % PGA 3 |
PASI 3.40 BSA 8% PGA 1 |
None/–∗ | 2.8 months12 | Auto limited diarrhea |
| Male/70 years | Stage IV laryngeal carcinoma/nivolumab | Exacerbated Plaque psoriasis with intertriginous psoriasis | 2 weeks | Acitretin 25 mg/day | 10 months | Trunk, upper and lower extremities, axillar and sub-mammary folds | PASI 13.80 BSA 15% PGA 3 |
PASI 3 BSA 4% PGA 1 |
Yes/10 months | 2 months13 | Mild headache |
| Male/60 years | Stage IV squamous lung cell carcinoma/nivolumab | Exacerbated plaque psoriasis with intertriginous psoriasis | 1 week | Mometasone furoate ointment | 10 months | Lower extremities, inguinal and genital folds | PASI 6.40 BSA 4% PGA 3 |
PASI 4 BSA 3% PGA 1 |
Yes/10 months | 3.5 months14 | None |
BSA, Body surface area; PASI, psoriasis area severity index; PD1, programmed cell death protein 1; PGA, physician's global assessment.
– = not applicable.