Verrucous Keratoses Associated with Checkpoint Inhibitor Immunotherapy

Main Article Content

Joshua L Owen
Cory Kosche
Jennifer N Choi

Keywords

immunotherapy, verrucous keratosis, VK, checkpoint inhibitor, PD-1, PD1, nivolumab, irAE, squamoproliferative

Abstract

Introduction:

Checkpoint inhibitor immunotherapy is associated with numerous adverse events, including eruptive keratoacanthomas and squamous cell carcinomas. However, no cases of immunotherapy-associated verrucous keratoses (VKs) have been reported. VKs are proliferative lesions generally considered benign, although they have been suggested to represent premalignant lesions.

Cases:

We present the first case series of three patients with immunotherapy-associated VKs. The patients were receiving nivolumab for renal cell carcinoma, combination ipilimumab/nivolumab for non-small cell lung carcinoma, and pembrolizumab for malignant melanoma. The VKs appeared 3-7 months after initiation of immunotherapy. Lesions were treated with shave removal or cryosurgery without recurrence. This report adds to the spectrum of cutaneous squamoproliferative lesions induced by checkpoint inhibitor immunotherapy.

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