{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T22:46:31Z","timestamp":1782254791294,"version":"3.54.5"},"reference-count":19,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"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":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Immune checkpoint inhibitors (ICIs), such as pembrolizumab, are integral to cancer therapy but can cause severe immune-related adverse events (irAEs), including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). These rare, life-threatening reactions typically occur early in treatment, with delayed onset being less commonly reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Report<\/jats:title>\n                    <jats:p>We present a 67-year-old female with triple-negative breast cancer who developed a diffuse, painful rash five months after discontinuing pembrolizumab. Physical exam revealed \u223c15% body surface area involvement without mucosal lesions. Biopsy confirmed SJS\/TEN overlap. The patient had previously experienced pembrolizumab-induced Grade 2 pneumonitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Management &amp; Outcome<\/jats:title>\n                    <jats:p>Initial treatment with high-dose corticosteroids yielded minimal improvement. Intravenous immunoglobulin (IVIG) was added, resulting in clinical stabilization. The patient was discharged after 11 days with a steroid taper and showed gradual symptom improvement at one-month follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case highlights an exceptionally delayed onset of pembrolizumab-induced SJS\/TEN overlap, extending known timelines for irAE manifestation. Prior pneumonitis may have predisposed the patient to subsequent cutaneous toxicity. Despite a SCORTEN score predicting high mortality, aggressive immunosuppressive therapy led to a favorable outcome. This underscores the importance of prolonged vigilance and multidisciplinary management in patients with prior irAEs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10781552251409390","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T18:50:57Z","timestamp":1766170257000},"page":"960-964","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Delayed presentation of pembrolizumab-induced SJS-TEN overlap syndrome"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7466-7516","authenticated-orcid":false,"given":"Drew A.","family":"Wells","sequence":"first","affiliation":[{"name":"Methodist Le Bonheur Healthcare - University Hospital"},{"name":"Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center, Memphis, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Acton","sequence":"additional","affiliation":[{"name":"Union University College of Pharmacy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7032-0398","authenticated-orcid":false,"given":"Zachery","family":"Halford","sequence":"additional","affiliation":[{"name":"Union University College of Pharmacy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,19]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdv383"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2019.10.015"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","DOI":"10.1093\/oncolo\/oyaf143","article-title":"Clinical characteristics of Stevens-Johnson syndrome\/toxic epidermal necrolysis-like reactions induced by immune checkpoint inhibitors","volume":"30","author":"Zheng Z","year":"2025","unstructured":"Zheng Z, Shen Z. Clinical characteristics of Stevens-Johnson syndrome\/toxic epidermal necrolysis-like reactions induced by immune checkpoint inhibitors. Oncologist 2025; 30: oyaf143.","journal-title":"Oncologist"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1414136"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-017-0530-y"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdcr.2024.10.004"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.17039"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2020.03.029"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2409932"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2025.104473"},{"key":"e_1_3_2_12_2","doi-asserted-by":"crossref","DOI":"10.6004\/jnccn.2024.7148","article-title":"CRE25-044: a case series of immunotherapy-induced stevens-johnson syndrome\/toxic epidermal necrolysis","volume":"23","author":"Konopnicki A","year":"2025","unstructured":"Konopnicki A, Masuda K, Roy M, et al. CRE25-044: a case series of immunotherapy-induced stevens-johnson syndrome\/toxic epidermal necrolysis. J Natl Compr Cancer Network 2025; 23: CRE25-044.","journal-title":"J Natl Compr Cancer Network"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.17479"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdcr.2024.08.011"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2024.1399171"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1080\/2162402X.2023.2197358"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2021.03.204"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol30070498"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1747.2000.00061.x"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2024.0057"}],"container-title":["Journal of Oncology Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10781552251409390","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10781552251409390","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10781552251409390","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T21:50:57Z","timestamp":1782251457000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10781552251409390"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,19]]},"references-count":19,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1177\/10781552251409390"],"URL":"https:\/\/doi.org\/10.1177\/10781552251409390","relation":{},"ISSN":["1078-1552","1477-092X"],"issn-type":[{"value":"1078-1552","type":"print"},{"value":"1477-092X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,19]]}}}