{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:16:31Z","timestamp":1790144191183,"version":"4.0.1"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T00:00:00Z","timestamp":1663891200000},"content-version":"vor","delay-in-days":265,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"NCI","doi-asserted-by":"publisher","award":["U54-CA225088"],"award-info":[{"award-number":["U54-CA225088"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Cutaneous immune-related adverse events (irAEs) are the most common irAEs caused by immune-checkpoint inhibitors (ICI). Psoriasiform eruptions, both de novo and flares, may occur. Evidence is lacking on inverse psoriasis subtype.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective study was conducted at Dana-Farber Cancer Institute\/Mass General Brigham through February 2020 using databases. Confirmed inverse psoriasis cases pre-\/post-ICI initiation either independently or in conjunction with other psoriasis subtypes were included. Known psoriasis cases without flare post-ICI were excluded.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 262 (3%) individuals with any ICI-mediated psoriasiform cutaneous irAE were identified out of the 8683 DFCI ICI-treated patients. Of these, 13 (5% of psoriasis patients) had inverse psoriasis (mean age 68.7 years; 7\/13 male sex). Median (range) time from ICI initiation to inverse psoriasis development or flare was 7 (4\u201312) and 3.5 (2\u20136) weeks, respectively. Pruritus occurred in 12\/13 (92.30%) cases. 11 (85%) had inguinal involvement; other sites included gluteal cleft (6; 46%), inframammary (3; 23%), perianal (2; 15%), axilla (2; 15%), umbilicus (2; 15%), and infra-abdominal folds (1; 8%). Most (9\/13) individuals had more than one site involved. The Common Terminology Criteria for Adverse Events severity was 1 in 10 (76.92%) individuals and 2 in 3 (15.38%) individuals. Six (46.15%) patients were treated initially by oncology with topical (nystatin, econazole, or clotrimazole) or systemic antifungals (fluconazole) for median (range) of 3.5 (1\u20137) months without improvement, for presumed candida intertrigo.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Patients on ICI may develop inverse psoriasis, which may be initially confused for fungal intertrigo. Delayed diagnosis can prolong symptoms, while patients are treated ineffectively with topical\/systemic antifungals for presumed candida infection. Oncologist and dermatologist awareness is important to improve diagnosis of ICI-mediated inverse psoriasis, its management and affected patients\u2019 quality of life.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/immadv\/ltac016","type":"journal-article","created":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T19:21:21Z","timestamp":1663960881000},"source":"Crossref","is-referenced-by-count":13,"title":["Prevalence of inverse psoriasis subtype with immune checkpoint inhibitors"],"prefix":"10.1093","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3866-1421","authenticated-orcid":false,"given":"Abdulhadi","family":"Jfri","sequence":"first","affiliation":[{"name":"Dermatology Department, Harvard Medical School , Boston, MA , USA"},{"name":"Department of Dermatology, Brigham and Women\u2019s Hospital , Boston, MA , USA"},{"name":"Center for Cutaneous Oncology, Dana-Farber Cancer Institute , Boston, MA , USA"},{"name":"Division of Dermatology, King Abdulaziz Medical City , Jeddah , Saudi Arabia"},{"name":"College of Medicine, King Saud Bin Abdulaziz University for Health Sciences , Jeddah , Saudi Arabia"},{"name":"King Abdullah International Medical Research Center , Jeddah , Saudi Arabia"},{"name":"Division of Dermatology, Department of Medicine, Ministry of the National Guard-Health Affairs , Jeddah , Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonnie","family":"Leung","sequence":"additional","affiliation":[{"name":"Center for Cutaneous Oncology, Dana-Farber Cancer Institute , Boston, MA , USA"},{"name":"Department of Dermatology, Massachusetts General Hospital , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan T","family":"Said","sequence":"additional","affiliation":[{"name":"Dermatology Department, Harvard Medical School , Boston, MA , USA"},{"name":"Department of Dermatology, Brigham and Women\u2019s Hospital , Boston, MA , USA"},{"name":"Center for Cutaneous Oncology, Dana-Farber Cancer Institute , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7387-3094","authenticated-orcid":false,"given":"Yevgeniy","family":"Semenov","sequence":"additional","affiliation":[{"name":"Dermatology Department, Harvard Medical School , Boston, MA , USA"},{"name":"Department of Dermatology, Massachusetts General Hospital , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole R","family":"LeBoeuf","sequence":"additional","affiliation":[{"name":"Dermatology Department, Harvard Medical School , Boston, MA , USA"},{"name":"Department of Dermatology, Brigham and Women\u2019s Hospital , Boston, MA , USA"},{"name":"Center for Cutaneous Oncology, Dana-Farber Cancer Institute , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,9,23]]},"reference":[{"issue":"4","key":"2022093018465545200_CIT0001","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/j.clindermatol.2015.04.007","article-title":"Psoriasis inversa: a separate identity or a variant of psoriasis vulgaris?.","volume":"33","author":"Omland","year":"2015","journal-title":"Clin Dermatol"},{"issue":"3","key":"2022093018465545200_CIT0002","first-page":"176","article-title":"Clinical analysis of 48 cases of inverse psoriasis: a hospital-based study.","volume":"15","author":"Wang","year":"2005","journal-title":"Eur J Dermatol"},{"issue":"6","key":"2022093018465545200_CIT0003","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1080\/09546630701341949","article-title":"Psoriasis of the face and flexures.","volume":"18","author":"Van de Kerkhof","year":"2007","journal-title":"J Dermatolog 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