{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T21:55:49Z","timestamp":1790286949159,"version":"4.1.0"},"reference-count":10,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T00:00:00Z","timestamp":1720483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Chimeric antigen receptor (CAR) T\u2010cell therapy has demonstrated remarkable success in treating various B\u2010cell malignancies, redirecting T\u2010cell cytotoxicity toward cancer cells. Despite its efficacy, CAR\u2010T therapy is associated with potential risks, including cytokine release syndrome (CRS) and cytopenia. We present a case of a 69\u2010year\u2010old man with diffuse large B\u2010cell lymphoma treated with axicabtagene\u2010ciloleucel CAR\u2010T therapy, who developed a rare and severe cutaneous toxicity resembling toxic epidermal necrolysis (TEN). The patient exhibited persistent fevers, CRS, and subsequent development of a widespread erythematous macular eruption, progressing to vesiculation with bullae. Notably, allopurinol\u2010induced TEN was considered with the patient's recent exposure to allopurinol, although the onset and minimal mucosal involvement did not align with typical presentations of allopurinol\u2010induced cases. The cutaneous reaction, distinct from typical SJS\/TEN, showed minimal mucosal involvement and coincided with the cytokine release storm, differing from allopurinol\u2010induced TEN. Despite the absence of guidelines, the patient was managed with systemic steroids, achieving significant improvement. This case expands the spectrum of CAR\u2010T therapy\u2010related cutaneous toxicities, highlighting the need for early recognition of histopathology and tailored management by dermatologists. Further understanding of these reactions is crucial for optimizing the safety profile of this groundbreaking immunotherapy.<\/jats:p>","DOI":"10.1111\/cup.14687","type":"journal-article","created":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T06:10:40Z","timestamp":1720591840000},"page":"767-772","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Toxic epidermal necrolysis\u2010like cutaneous toxicity following chimeric antigen receptor T\u2010cell therapy in recurrent large B\u2010cell lymphoma"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0177-2996","authenticated-orcid":false,"given":"Puneet K.","family":"Bhullar","sequence":"first","affiliation":[{"name":"Department of Dermatology Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0562-0826","authenticated-orcid":false,"given":"Kiran","family":"Motaparthi","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel P.","family":"Zieman","sequence":"additional","affiliation":[{"name":"Department of Dermatology Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassandra","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja","family":"Gurnani","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8060-4311","authenticated-orcid":false,"given":"Olayemi","family":"Sokumbi","sequence":"additional","affiliation":[{"name":"Department of Dermatology Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,9]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2016.06.062"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-12-580068"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-04-703751"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/HS9.0000000000000186"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2020.0636"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.18892"},{"issue":"10","key":"e_1_2_6_8_1","article-title":"Linear immunoglobulin A (IgA) bullous dermatosis mimicking Stevens\u2010Johnson syndrome","volume":"14","author":"Park JS","year":"2022","journal-title":"Cureus"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hemonc.2018.09.001"},{"issue":"4","key":"e_1_2_6_10_1","article-title":"Stevens Johnson syndrome in a patient with giant cell arteritis during short term tocilizumab therapy","volume":"12","author":"Venkateswaran N","year":"2020","journal-title":"Cureus"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1191\/0961203304lu2037sa"}],"container-title":["Journal of Cutaneous Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cup.14687","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,17]],"date-time":"2024-11-17T12:09:24Z","timestamp":1731845364000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cup.14687"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,9]]},"references-count":10,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1111\/cup.14687"],"URL":"https:\/\/doi.org\/10.1111\/cup.14687","archive":["Portico"],"relation":{},"ISSN":["0303-6987","1600-0560"],"issn-type":[{"value":"0303-6987","type":"print"},{"value":"1600-0560","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,9]]},"assertion":[{"value":"2024-02-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}