case_images: PMC10682071_01
case_images: Treatment timeline of the patient. (A-F) The chest CT images at each time point. The red circle indicated the tumor lesion. (G) Flow diagram of the clinical course of the patient. Osi, osimertinib; PR, partial response; PD, progressive disease; SD, stable disease; PFS, progression-free survival. The red triangle indicates the SJS onset on day 12 since treatment with toripalimab plus docetaxel.
case_images: fphar-14-1131703-g001.jpg
case_images: PMC10682071_01_fphar-14-1131703-g001.jpg
case_images: F1
case_images: The enhanced computerized tomography (CT) scan of the chest and lumbar spine revealed multiple nodules in both the lungs and spinal lesions (Figure 1A). Partial response (PR) was achieved with 3 months' treatment based on the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 (Figure 1B), and the PFS was 16 m. New lesions were seen in the left lower lobe (Figure 1C), and gefitinib was discontinued. The spine magnetic resonance imaging (MRI) revealed more spinal lesions, and the chest CT scan showed the lung nodules were stable (Figure 1D). The combination of gefitinib and osimertinib was administered between October 2021 and May 2022, and SD was achieved with a PFS of 8 m (Figure 1E). A CT scan showed the shrinkage of the lung tumors (Figure 1F) and stable lesions of the spine after 2 months. The clinical course is shown in Figure 1G.
case_images: Diagnosis and treatment of Stevens-Johnson syndrome. (A) Erosions were seen on the mouth, face, and body trunk after 24 days of toripalimab treatment. (B) Hematoxylin and eosin staining of skin biopsy. Original magnifications, the upper panel x 40 and the lower panel x 100. (C) Reduction in diffuse erythema at 6 weeks of steroid therapy.
case_images: fphar-14-1131703-g002.jpg
case_images: PMC10682071_01_fphar-14-1131703-g002.jpg
case_images: F2
case_images: He presented with multiple macules and vesicles, and detachment of the epidermis on the mucous membranes of the mouth, face, and body trunk (Figure 2A). Skin biopsy showed a sub-epidermal cell poor blister and perivascular infiltrate of lymphocytes (Figure 2B). The patient recovered from SJS after steroid therapy (Figure 2C).