{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T01:07:02Z","timestamp":1782954422522,"version":"3.54.5"},"reference-count":25,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2019,12,6]],"date-time":"2019-12-06T00:00:00Z","timestamp":1575590400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Oncol Pharm Pract"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Stevens-Johnson syndrome and toxic epidermal necrolysis are severe cutaneous drug eruptions characterized by epidermal detachment. Pembrolizumab is a monoclonal antibody that binds to the programmed death-1 receptor, and it has been associated with numerous cutaneous adverse side-effects, including Stevens-Johnson syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case report<\/jats:title>\n                    <jats:p>We describe a 63-year-old male with metastatic lung adenocarcinoma who developed a rapidly progressing maculopapular rash three days after a first dose of pembrolizumab. On day 16, the rash affected more than 80% of body surface area with detachment of large sheets of necrolytic epidermis in 30\u201340% of body surface area. However, the patient only presented with mild mucosal involvement. Histopathologic examination of a skin biopsy showed a subepidermal blister with overlying prominent full thickness epidermal keratinocytic necrosis and a superficial perivascular infiltrate of lymphocytes. A toxic epidermal necrolysis secondary to pembrolizumab was then diagnosed. Management and outcome: In addition to supportive cares, the patient received corticosteroids and cyclosporine. The patient responded rapidly to the immunosuppressant therapy, and nearly complete re-epithelialization was achieved 24\u2009days after the start of the reaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In our review of the literature, 15 other cases of Stevens-Johnson syndrome\/toxic epidermal necrolysis were reported with programmed death-1\/programmed cell death ligand-1 inhibitors. To our knowledge, this is the first case of toxic epidermal necrolysis secondary to pembrolizumab published in the literature. The American Society of Clinical Oncology guidelines suggest that cyclosporine, in addition to corticosteroids, be initiated when toxic epidermal necrolysis is suspected. Clinicians should be aware of this rare dermatological emergency with the increasing use of pembrolizumab in oncology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1078155219890659","type":"journal-article","created":{"date-parts":[[2019,12,6]],"date-time":"2019-12-06T23:06:27Z","timestamp":1575673587000},"page":"1259-1265","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":32,"title":["Toxic epidermal necrolysis associated with pembrolizumab"],"prefix":"10.1177","volume":"26","author":[{"given":"Zhuo Ran","family":"Cai","sequence":"first","affiliation":[{"name":"Department of Dermatology, Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Lecours","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7938-0944","authenticated-orcid":false,"given":"Jean-Philippe","family":"Adam","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al, Qu\u00e9bec, Canada"},{"name":"Centre de Recherche du Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Marcil","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Normand","family":"Blais","sequence":"additional","affiliation":[{"name":"Centre de Recherche du Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al, Qu\u00e9bec, Canada"},{"name":"Department of Medicine, Service of Hematology, Oncology and Blood Bank, Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Dallaire","sequence":"additional","affiliation":[{"name":"Department of Medicine, Centre int\u00e9gr\u00e9 de sant\u00e9 et des services sociaux de l'Outaouais, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie","family":"Belisle","sequence":"additional","affiliation":[{"name":"Department of Pathology, Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4224-8552","authenticated-orcid":false,"given":"Alexandre","family":"Mathieu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al, Qu\u00e9bec, Canada"},{"name":"Centre de Recherche du Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,12,6]]},"reference":[{"key":"bibr1-1078155219890659","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-017-0336-3"},{"key":"bibr2-1078155219890659","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2015.11.016"},{"key":"bibr3-1078155219890659","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.77.6385"},{"key":"bibr4-1078155219890659","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx225"},{"key":"bibr5-1078155219890659","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1747.2000.00061.x"},{"key":"bibr6-1078155219890659","doi-asserted-by":"crossref","unstructured":"Noe MH, Rosenbach M, Hubbard RA, et al. Development and validation of a risk prediction model for in-hospital mortality among patients with Stevens-Johnson syndrome\/toxic epidermal necrolysis\u2013ABCD-10.\n                      JAMA Dermatol\n                      2019; 155: 448-454.","DOI":"10.1001\/jamadermatol.2019.0998"},{"key":"bibr7-1078155219890659","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-017-8654-z"},{"key":"bibr8-1078155219890659","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.14530"},{"key":"bibr9-1078155219890659","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp080603"},{"key":"bibr10-1078155219890659","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1981.154"},{"key":"bibr11-1078155219890659","doi-asserted-by":"publisher","DOI":"10.1159\/000492172"},{"key":"bibr12-1078155219890659","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2014.06.005"},{"key":"bibr13-1078155219890659","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2016.5668"},{"key":"bibr14-1078155219890659","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2017.03.026"},{"key":"bibr15-1078155219890659","doi-asserted-by":"crossref","unstructured":"Demirtas S, Aridi LEl, Acquitter M, et\u00a0al. Toxic epidermal necrolysis due to anti-PD1 treatment with fatal outcome.\n                      Ann Dermatol Venereol\n                      2017; 144: 65\u201366.","DOI":"10.1016\/j.annder.2016.11.012"},{"key":"bibr16-1078155219890659","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2018.05.031"},{"key":"bibr17-1078155219890659","doi-asserted-by":"crossref","unstructured":"Hwang A, Iskandar A and Dasanu CA. Stevens-Johnson syndrome manifesting late in the course of pembrolizumab therapy.\n                      J Oncol Pharm Pract\n                      2019; 25: 1520-1522.","DOI":"10.1177\/1078155218791314"},{"key":"bibr18-1078155219890659","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2016.02.025"},{"key":"bibr19-1078155219890659","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdcr.2017.09.028"},{"key":"bibr20-1078155219890659","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx640"},{"key":"bibr21-1078155219890659","doi-asserted-by":"crossref","unstructured":"Dasanu CA. Late-onset Stevens-Johnson syndrome due to nivolumab use for hepatocellular carcinoma.\n                      J Oncol Pharm Pract\n                      2019; 25: 2052-2055.","DOI":"10.1177\/1078155219830166"},{"key":"bibr22-1078155219890659","doi-asserted-by":"publisher","DOI":"10.1111\/cup.12876"},{"key":"bibr23-1078155219890659","doi-asserted-by":"publisher","DOI":"10.1684\/ejd.2018.3295"},{"key":"bibr24-1078155219890659","doi-asserted-by":"crossref","unstructured":"Shah KM, Rancour EA, Al-Omari A, et al. Striking enhancement at the site of radiation for nivolumab-induced Stevens-Johnson syndrome.\n                      Dermatol Online J\n                      2018; 24.","DOI":"10.5070\/D3246040713"},{"key":"bibr25-1078155219890659","doi-asserted-by":"publisher","DOI":"10.1097\/CJI.0000000000000112"}],"container-title":["Journal of Oncology Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1078155219890659","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1078155219890659","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1078155219890659","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T02:22:11Z","timestamp":1777688531000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1078155219890659"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,6]]},"references-count":25,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2020,7]]}},"alternative-id":["10.1177\/1078155219890659"],"URL":"https:\/\/doi.org\/10.1177\/1078155219890659","relation":{},"ISSN":["1078-1552","1477-092X"],"issn-type":[{"value":"1078-1552","type":"print"},{"value":"1477-092X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,6]]}}}