case_images: PMC11759537_01
case_images: Upper and lower mucosal (A and B) lip with diffuse hemorrhagic oral erosions and crusting.
case_images: gr1.jpg
case_images: PMC11759537_01_gr1.jpg
case_images: fig1
case_images: She initiated single agent pembrolizumab and presented to our clinic 17 days after her first infusion with pembrolizumab monotherapy reporting a 10-day history of worsening painful erosions in the mouth and a 3-day history of an asymptomatic rash on the trunk and extremities (Figs 1 and 2).
case_images: Scattered atypical targetoid papules to thin plaques seen on trunk (A) thighs (B) bilaterally.
case_images: gr2.jpg
case_images: PMC11759537_01_gr2.jpg
case_images: fig2
case_images: She initiated single agent pembrolizumab and presented to our clinic 17 days after her first infusion with pembrolizumab monotherapy reporting a 10-day history of worsening painful erosions in the mouth and a 3-day history of an asymptomatic rash on the trunk and extremities (Figs 1 and 2).
case_images: Punch biopsies of oral mucosa from the lower lip (A) and right thigh (B) consistent with epidermal necrosis with a sub epidermal split, superficial perivascular lymphocytic infiltrate, and vacuolization of the basal cell layer.
case_images: gr3.jpg
case_images: PMC11759537_01_gr3.jpg
case_images: fig3
case_images: Punch biopsies of the lower mucosal lip and right thigh revealed epidermal necrosis and apoptosis with a superficial perivascular lymphocytic infiltrate, basal layer vacuolization and a subepidermal split (Fig 3).
case_images: Purple thin plaque with overlying scale and scattered red to purple linear plaques and papules on the lower extremities at time of rash recurrence.
case_images: gr4.jpg
case_images: PMC11759537_01_gr4.jpg
case_images: fig4
case_images: Six weeks after completing the prednisone taper, she developed recurrence of a scaly violaceous to erythematous rash on the extremities while not on anti-cancer therapy (Fig 4).