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Usually, diarrhea, cutaneous rash, and pruritus are reported as the most common immune\u2010related adverse effects of nivolumab therapy. Oral lesions and secondary adrenal insufficiency sometimes occur but usually are rare events. We report a case of a patient treated with nivolumab who then showed persistent oral ulcerative and lichenoid lesions, which were refractory to topical corticosteroids. The oral lesions were concomitant to nivolumab\u2010induced adrenal insufficiency. These adverse events led to nivolumab discontinuation, which favored oral lesion healing and adrenal insufficiency remission. Through a brief review of the literature concerning nivolumab toxicity in the oral cavity, we discuss the clinical aspect and management of these lesions.<\/jats:p>","DOI":"10.1111\/scd.12660","type":"journal-article","created":{"date-parts":[[2021,10,30]],"date-time":"2021-10-30T16:54:31Z","timestamp":1635612871000},"page":"286-293","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Severe oral ulcerative and lichenoid lesions associated with adrenal insufficiency in a patient treated with nivolumab: Report of a case and review of literature"],"prefix":"10.1111","volume":"42","author":[{"given":"Marcella Ferreira","family":"Gobbi","sequence":"first","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo Brazil"},{"name":"Pathology Department School of Dentistry University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6939-988X","authenticated-orcid":false,"given":"Fernanda de Paula","family":"Eduardo","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leticia Mello","family":"Bezinelli","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle Lima Correa","family":"de Carvalho","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvana Kelly","family":"Mon\u00e7\u00e3o do Vale","sequence":"additional","affiliation":[{"name":"Hospital Paulistano  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luciana","family":"Corr\u00eaa","sequence":"additional","affiliation":[{"name":"Pathology Department School of Dentistry University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,10,30]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep13110"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0714.2011.01035.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-017-3629-4"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1758835918764628"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1517\/14740338.2013.795944"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2014.07.033"},{"key":"e_1_2_7_8_1","first-page":"560","article-title":"Immune checkpoint inhibitors in clinical practice: update on management of immune\u2010related toxicities","volume":"4","author":"Villadolid J","year":"2015","journal-title":"Transl. lung cancer Res."},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cllc.2017.02.001"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.2174\/1574886311207040289"},{"key":"e_1_2_7_11_1","article-title":"Association between immune\u2010related adverse events and prognosis in patients with metastatic renal cell carcinoma treated with nivolumab","volume":"000","author":"Ishihara H","year":"2019","journal-title":"Urol. 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