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July 2018

Cutaneous Eruption Secondary to Immunotherapy for Metastatic Melanoma Limited to Sites of Locoregional Melanoma Metastases: A Possible Variant of Locus Minoris Resistentiae

Author Affiliations
  • 1Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
  • 2Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois
JAMA Dermatol. 2018;154(7):846-847. doi:10.1001/jamadermatol.2018.0654

Immune checkpoint inhibitor therapies targeting PD-1 or CTLA-4 (programmed cell death 1 or cytotoxic T-lymphocyte–associated 4 protein) are increasingly used to treat metastatic melanoma.1 The most common adverse event from these classes of drugs is cutaneous toxic effects.1,2 The mechanism is incompletely understood but thought to be mediated by CD4-positive and CD8-positive T cells activated by immunotherapy.3 Immunotherapy-induced cutaneous eruptions include discrete or generalized papules without regional preference or, rarely, in inverse distribution. We report 2 cases of patients with metastatic melanoma who developed spongiotic cutaneous eruptions limited to the region of their melanoma locoregional metastases.

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