{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T14:14:41Z","timestamp":1740147281023,"version":"3.37.3"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,4,23]],"date-time":"2021-04-23T00:00:00Z","timestamp":1619136000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,4,23]],"date-time":"2021-04-23T00:00:00Z","timestamp":1619136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Dermatologic toxicity is a very common immune-related adverse event (irAE) for patients with melanoma who are receiving immune checkpoint inhibitor therapy (ICI). Concurrent skin infection, such as in the case of pityriasis versicolor reported here, can mimic and\/or exacerbate dermatologic toxicity from irAE.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 58-year-old Caucasian man with a history of pityriasis versicolor infection and metastatic melanoma received ICI therapy. He developed progressively worsening pruritic maculopapular lesions 22 weeks into his treatment that ultimately covered 40% of his body. He was diagnosed with dermatologic toxicity due to ICI therapy with concurrent pityriasis versicolor. He was initially started on topical steroid and topical antifungal cream but achieved minimum improvement. His treatment was then escalated to oral prednisone, but it only achieved modest control of his dermatitis. All subsequent attempts to wean him from oral prednisone resulted in worsening of his dermatitis. Eventually he was started on oral fluconazole in combination with prednisone, which led to rapid resolution of his dermatitis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>We report a case of dermatological toxicity due to an irAE with concurrent pityriasis versicolor. The steroid treatment for irAE was likely exacerbating the underlying fungal infection, and the fungal infection was in term mimicking the symptoms of irAE. This patient\u2019s severe dermatitis was only brought under control after receiving a more potent antifungal therapy in combination with a steroid. It is vital to look beyond the irAE when managing dermatitis in patients receiving ICI therapy.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-021-02818-1","type":"journal-article","created":{"date-parts":[[2021,4,22]],"date-time":"2021-04-22T23:10:31Z","timestamp":1619133031000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Refractory dermatitis contributed by pityriasis versicolor: a case report"],"prefix":"10.1186","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3910-4179","authenticated-orcid":false,"given":"Mingjia","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie","family":"Spaccarelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kari","family":"Kendra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard C.","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Verschraegen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,4,23]]},"reference":[{"issue":"4","key":"2818_CR1","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1093\/annonc\/mdz011","volume":"30","author":"O Hamid","year":"2019","unstructured":"Hamid O, Robert C, Daud A, Hodi FS, Hwu WJ, Kefford R, et al. Five-year survival outcomes for patients with advanced melanoma treated with pembrolizumab in KEYNOTE-001. Ann Oncol. 2019;30(4):582\u20138.","journal-title":"Ann Oncol"},{"key":"2818_CR2","doi-asserted-by":"crossref","unstructured":"Topalian SL, Hodi FS, Brahmer JR, Gettinger SN, Smith DC, McDermott DF, et al. Five-year survival and correlates among patients with advanced melanoma, renal cell carcinoma, or non-small cell lung cancer treated with nivolumab. JAMA Oncol. 2019.","DOI":"10.1001\/jamaoncol.2019.2187"},{"issue":"3","key":"2818_CR3","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1007\/s40257-017-0336-3","volume":"19","author":"V Sibaud","year":"2018","unstructured":"Sibaud V. Dermatologic reactions to immune checkpoint inhibitors\u202f: skin toxicities and immunotherapy. Am J Clin Dermatol. 2018;19(3):345\u201361.","journal-title":"Am J Clin Dermatol."},{"issue":"2","key":"2818_CR4","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1067\/S0190-9622(03)00861-2","volume":"49","author":"AT Gulec","year":"2003","unstructured":"Gulec AT, Demirbilek M, Seckin D, Can F, Saray Y, Sarifakioglu E, et al. Superficial fungal infections in 102 renal transplant recipients: a case-control study. J Am Acad Dermatol. 2003;49(2):187\u201392.","journal-title":"J Am Acad Dermatol."},{"issue":"12","key":"2818_CR5","doi-asserted-by":"publisher","first-page":"2375","DOI":"10.1093\/annonc\/mdv383","volume":"26","author":"J Naidoo","year":"2015","unstructured":"Naidoo J, Page DB, Li BT, Connell LC, Schindler K, Lacouture ME, et al. Toxicities of the anti-PD-1 and anti-PD-L1 immune checkpoint antibodies. Ann Oncol. 2015;26(12):2375\u201391.","journal-title":"Ann Oncol"},{"key":"2818_CR6","unstructured":"U.S. Department of Health and Human Services. Common terminology criteria for adverse events (CTCAE) version 5.0. 2017. https:\/\/ctep.cancer.gov\/protocoldevelopment\/electronic_applications\/docs\/ctcae_v5_quick_reference_5x7.pdf."},{"issue":"17","key":"2818_CR7","doi-asserted-by":"publisher","first-page":"1714","DOI":"10.1200\/JCO.2017.77.6385","volume":"36","author":"JR Brahmer","year":"2018","unstructured":"Brahmer JR, Lacchetti C, Schneider BJ, Atkins MB, Brassil KJ, Caterino JM, et al. Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: american society of clinical oncology clinical practice guideline. J Clin Oncol. 2018;36(17):1714\u201368.","journal-title":"J Clin Oncol"},{"issue":"1","key":"2818_CR8","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1046\/j.1468-3083.2002.00378.x","volume":"16","author":"AK Gupta","year":"2002","unstructured":"Gupta AK, Bluhm R, Summerbell R. Pityriasis versicolor. J Eur Acad Dermatol Venereol. 2002;16(1):19\u201333.","journal-title":"J Eur Acad Dermatol Venereol."},{"issue":"10","key":"2818_CR9","doi-asserted-by":"publisher","first-page":"1132","DOI":"10.1001\/archdermatol.2010.259","volume":"146","author":"SW Hu","year":"2010","unstructured":"Hu SW, Bigby M. Pityriasis versicolor: a systematic review of interventions. Arch Dermatol. 2010;146(10):1132\u201340.","journal-title":"Arch Dermatol."},{"key":"2818_CR10","doi-asserted-by":"publisher","first-page":"66","DOI":"10.12659\/AOT.906164","volume":"23","author":"ET Van Matre","year":"2018","unstructured":"Van Matre ET, Satyanarayana G, Page RL 2nd, Levi ME, Lindenfeld J, Mueller SW. Pharmacokinetic drug-drug interactions between immunosuppressant and anti-infective agents: antimetabolites and corticosteroids. Ann Transplant. 2018;23:66\u201374.","journal-title":"Ann Transplant."}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-021-02818-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-021-02818-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-021-02818-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,22]],"date-time":"2021-04-22T23:37:28Z","timestamp":1619134648000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-021-02818-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,23]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["2818"],"URL":"https:\/\/doi.org\/10.1186\/s13256-021-02818-1","relation":{},"ISSN":["1752-1947"],"issn-type":[{"type":"electronic","value":"1752-1947"}],"subject":[],"published":{"date-parts":[[2021,4,23]]},"assertion":[{"value":"10 August 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 March 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 April 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no financial or nonfinancial competing interests to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"212"}}