{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T20:40:48Z","timestamp":1792269648798,"version":"4.4.0"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Camrelizumab-associated reactive cutaneous capillary endothelial proliferation (RCCEP) predominantly involves cutaneous surfaces. Mucosal involvement is exceptional, with no prior reports of conjunctival lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 64-year-old man with metastatic esophageal squamous cell carcinoma developed typical cutaneous RCCEP following initial camrelizumab exposure. Upon completion of three treatment cycles, he presented with bilateral conjunctival hyperemia, foreign body sensation, and purulent discharge. Slit-lamp examination revealed multiple vascular papules on the palpebral conjunctivae (Grade 3 RCCEP) with secondary bacterial infection. Unlike previously reported eyelid lesions requiring excision, conservative management with topical levofloxacin resulted in complete lesion resolution within four weeks without discontinuation of systemic therapy (Naranjo score: 7).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This represents the first documented case of RCCEP affecting the conjunctival mucosa. It underscores the necessity of ophthalmologic surveillance in patients receiving camrelizumab and demonstrates that topical antimicrobial therapy constitutes an effective therapeutic strategy for complicated ocular RCCEP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1847562","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T05:31:50Z","timestamp":1789104710000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Conjunctival reactive cutaneous capillary endothelial proliferation induced by camrelizumab in an esophageal cancer patient: a case report and literature review"],"prefix":"10.3389","volume":"16","author":[{"given":"Yedong","family":"Wei","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Zibo Central Hospital","place":["Zibo, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Zibo Central Hospital","place":["Zibo, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Oncology, Zibo Central Hospital","place":["Zibo, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Zibo Central Hospital","place":["Zibo, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youwei","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Zibo Central Hospital","place":["Zibo, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jigang","family":"Si","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Zibo Central Hospital","place":["Zibo, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rundong","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, First Affiliated Hospital of Nanjing Medical University","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2023.106369","article-title":"An epulis-like camrelizumab related reactive cutaneous capillary endothelial proliferation (rccep) in the oral cavity: a case report","volume":"140","author":"Hua","year":"2023","journal-title":"Oral Oncol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-018-0100-3","article-title":"Safety, anti-tumour activity, and pharmacokinetics of fixed-dose shr-1210, an anti-pd-1 antibody in advanced solid tumours: a dose-escalation, phase 1 study","volume":"119","author":"Mo","year":"2018","journal-title":"Br J Cancer"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1703481","article-title":"Immune-related adverse events associated with immune checkpoint blockade","volume":"378","author":"Postow","year":"2018","journal-title":"N Engl J Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1186\/s13045-020-00886-2","article-title":"Reactive cutaneous capillary endothelial proliferation in advanced hepatocellular carcinoma patients treated with camrelizumab: data derived from a multicenter phase 2 trial","volume":"13","author":"Wang","year":"2020","journal-title":"J Hematol Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.21037\/jgo-23-336","article-title":"Nasal alar metastasis of advanced hepatocellular carcinoma misdiagnosed as reactive cutaneous capillary endothelial proliferation in a patient treated with camrelizumab and apatinib: a case report","volume":"14","author":"Liu","year":"2023","journal-title":"J Gastrointest Oncol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1280208","article-title":"A case report and literature review on reactive cutaneous capillary endothelial proliferation induced by camrelizumab in a nasopharyngeal carcinoma patient","volume":"13","author":"Lin","year":"2023","journal-title":"Front Oncol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"53","DOI":"10.3892\/br.2024.1743","article-title":"Reactive cutaneous capillary endothelial proliferations of the eyelids induced by camrelizumab: a case report","volume":"20","author":"Zhou","year":"2024","journal-title":"BioMed Rep"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.13735\/j.cjdv.1001-7089.202110004","article-title":"Systemic reactive cutaneous capillary endothelial hyperplasia induced by camrelizumab:a case report","volume":"36","author":"Wang","year":"2022","journal-title":"Chin J Dermatovenereology"},{"key":"B9","doi-asserted-by":"publisher","first-page":"49","DOI":"10.19542\/j.cnki.1006-5180.2212-300","article-title":"Two cases of reactive cutaneous capillary endothelial proliferation caused by camrelizumab and literatures analysis","volume":"30","author":"Yu","year":"2023","journal-title":"Chin Rural Med"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14071710","article-title":"Immunomodulatory properties of immune checkpoint inhibitors\u2014more than boosting t-cell responses","volume":"14","author":"Kuske","year":"2022","journal-title":"Cancers (Basel)"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1080\/0284186x.2019.1567935","article-title":"Reactive capillary hemangiomas induced by camrelizumab (shr-1210), an anti-pd-1 agent","volume":"58","author":"Teng","year":"2019","journal-title":"Acta Oncol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1080\/19420862.2018.1550321","article-title":"Anti-pd1 \u2018shr-1210' aberrantly targets pro-angiogenic receptors and this polyspecificity can be ablated by paratope refinement","volume":"11","author":"Finlay","year":"2018","journal-title":"Mabs"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1007\/s10456-017-9574-5","article-title":"Frizzled-5: a high affinity receptor for secreted frizzled-related protein-2 activation of nuclear factor of activated t-cells c3 signaling to promote angiogenesis","volume":"20","author":"Peterson","year":"2017","journal-title":"Angiogenesis"},{"key":"B14","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.ejca.2016.02.010","article-title":"Characterisation and management of dermatologic adverse events to agents targeting the pd-1 receptor","volume":"60","author":"Belum","year":"2016","journal-title":"Eur J Cancer"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(20)30011-5","article-title":"Camrelizumab in patients with previously treated advanced hepatocellular carcinoma: a multicentre, open-label, parallel-group, randomised, phase 2 trial","volume":"21","author":"Qin","year":"2020","journal-title":"Lancet Oncol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(20)30110-8","article-title":"Camrelizumab versus investigator's choice of chemotherapy as second-line therapy for advanced or metastatic oesophageal squamous cell carcinoma (escort): a multicentre, randomised, open-label, phase 3 study","volume":"21","author":"Huang","year":"2020","journal-title":"Lancet Oncol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.ccr-20-2571","article-title":"Camrelizumab in combination with apatinib in patients with advanced hepatocellular carcinoma (rescue): a nonrandomized, open-label, phase ii trial","volume":"27","author":"Xu","year":"2021","journal-title":"Clin Cancer Res"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2015.10.029","article-title":"Cutaneous adverse events (aes) of anti-programmed cell death (pd)-1 therapy in patients with metastatic melanoma: a single-institution cohort","volume":"74","author":"Hwang","year":"2016","journal-title":"J Am Acad Dermatol"},{"key":"B19","article-title":"Expert consensus on the clinical diagnosis and management of reactive cutaneous capillary endothelial proliferation induced by camrelizumab","volume":"25","author":"Qin","year":"2020","journal-title":"Chin Clin Oncol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.2147\/ott.s279004","article-title":"A partial response of pulmonary pleomorphic carcinoma to camrelizumab (pd1 monoclonal antibody) monotherapy: a case report","volume":"13","author":"Chen","year":"2020","journal-title":"Onco Targets Ther"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v8.i3.624","article-title":"Camrelizumab (shr-1210) leading to reactive capillary hemangioma in the gingiva: a case report","volume":"8","author":"Yu","year":"2020","journal-title":"World J Clin cases"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.12144\/zgmfskin202004219","article-title":"Reactive capillary hemangiomas caused by pd-1 inhibitor(calerizumab):a report of three cases and literature review","volume":"36","author":"Long","year":"2020","journal-title":"China J Leprosy Skin Dis"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.35541\/cjd.20190821","article-title":"Reactive cutaneous capillary endothelial proliferation caused by the pd-1 inhibitor camrelizumab during the treatment of Malignant tumors: two case reports","volume":"54","author":"Wei","year":"2021","journal-title":"Chin J Dermatol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.35541\/cjd.20200002","article-title":"A case of reactive capillary hemangiomas induced by camrelizumab","volume":"54","author":"Liang","year":"2021","journal-title":"Chin J Dermatol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1672-8157.2021.01.018","article-title":"A case of reactive cutaneous capillary endothelial proliferation caused by camrelizumab","volume":"18","author":"Yu","year":"2021","journal-title":"Chin J Drug Appl Monit"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1000-8179.2021.13.419","article-title":"A case of reactive capillary hemangioma induced by camrelizumab","volume":"48","author":"Zeng","year":"2021","journal-title":"Chin J Clin Oncol"},{"key":"B27","first-page":"31","article-title":"Reactive cutaneous capillary endothelial proliferation caused by immune checkpoint inhibitor camrelizumab: a case report","volume":"30","author":"Gao","year":"2021","journal-title":"Pharm Weekly"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1008-049X.2021.04.024","article-title":"Cutaneous capillary endothelial proliferation caused by camrelizumab: a case report","volume":"24","author":"Wei","year":"2021","journal-title":"China Pharmacist"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.21037\/tcr-22-426","article-title":"Anlotinib improved the reactive cutaneous capillary endothelial proliferation induced by camrelizumab: a case report","volume":"11","author":"Wu","year":"2022","journal-title":"Transl Cancer Res"},{"key":"B30","article-title":"A case of reactive cutaneous capillary endothelial proliferation induced by pd-1 inhibitor","volume":"19","author":"Liu","year":"2022","journal-title":"Chin J Drug Appl Monit"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.13288\/j.11-2166\/r.2022.18.018","article-title":"Treatment of camrelizumab-induced atypical rcactive cutaneous capillary endothelial proliferation based on wei-qiying-blood theory: a case report","volume":"63","author":"Wei","year":"2022","journal-title":"J Tradit Chin Med"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.16833\/j.cnki.jbmc.2022.03.017","article-title":"A case of reactive cutaneous capillary endothelial proliferation induced by camrelizumab","volume":"38","author":"Zhang","year":"2022","journal-title":"J Baotou Med Coll"},{"key":"B33","article-title":"Reactive cutaneous capillary endothelial proliferation caused by pd-1 inhibitor camrelizumab: two cases report","volume":"38","author":"Zhang","year":"2022","journal-title":"China J Leprosy Skin Dis"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.13735\/j.cjdv.1001-7089.202107080","article-title":"A case of reactive capillary hemangiomas caused by calerizumab","volume":"36","author":"Hou","year":"2022","journal-title":"Chin J Dermatovenereology"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.12206\/j.issn.1006-0111.202109137","article-title":"A case of reactive cutaneous capillary endothelial proliferation induced by camrelizumab","volume":"40","author":"Wang","year":"2022","journal-title":"J Pharm Pract"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1002-2600.2022.02.071","article-title":"A case of capillary hyperplasia of whole colon caused by camrelizumab","volume":"44","author":"Lin","year":"2022","journal-title":"Fujian Med J"},{"key":"B37","doi-asserted-by":"publisher","first-page":"374","DOI":"10.3892\/etm.2023.12023","article-title":"Complete remission of reactive cutaneous capillary endothelial proliferation caused by the programmed cell death-1 inhibitor camrelizumab achieved through thalidomide monotherapy: a case report","volume":"26","author":"Wang","year":"2023","journal-title":"Exp Ther Med"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1177\/10668969231195032","article-title":"A 67-year-old man with grade 3 reactive cutaneous capillary endothelial proliferation induced by camrelizumab first manifested in the oral mucosa \u2013 a case report","volume":"32","author":"Liu","year":"2023","journal-title":"Int J Surg Pathol"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000034120","article-title":"A case report of thalidomide in the treatment of camrelizumab-induced reactive cutaneous capillary hyperplasia","volume":"102","author":"Fu","year":"2023","journal-title":"Med (Baltimore)"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.16761\/j.cnki.1000-4963.2023.02.001","article-title":"Reactive cutaneous capillary endothelial proliferation","volume":"52","author":"Yao","year":"2023","journal-title":"J Clin Dermatol"},{"key":"B41","article-title":"Lauromacrogol sclerotherapy for reactive cutaneous capillary endothelial proliferation induced by camrelizumab: a case report","volume":"40","author":"Xu","year":"2023","journal-title":"J Clin Internal Med"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.16761\/j.cnki.1000-4963.2023.09.011","article-title":"Camrelizumab leading to reactive cutaneous capillary endothelial hyperplasia:a case report","volume":"52","author":"Huang","year":"2023","journal-title":"J Clin Dermatol"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.15887\/j.cnki.13-1389\/r.2023.15.048","article-title":"A case report of grade 3 reactive cutaneous capillary endothelial proliferation induced by camrelizumab in the treatment of colorectal cancer","volume":"16","author":"Gu","year":"2023","journal-title":"Chin J Clin Rational Drug Use"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.12173\/j.issn.1004-5511.202210028","article-title":"A case report of immunotherapy-related breast reactive capillary endothelial proliferation","volume":"33","author":"Jie","year":"2023","journal-title":"New Med"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.16945","article-title":"Camrelizumab\u2010induced reactive cutaneous capillary endothelial proliferation followed by tislelizumab\u2010induced erythema multiforme in a patient with acute myeloid leukemia","volume":"63","author":"Hui","year":"2023","journal-title":"Int J Dermatol"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.16761\/j.cnki.1000-4963.2024.06.016","article-title":"Reactive cutaneous capillary endothelial proliferation caused by camrelizumab:a case report","volume":"53","author":"Zheng","year":"2024","journal-title":"J Clin Dermatol"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1006-4931.2025.14.027","article-title":"Pharmaceutical care practice for reactive colonic capillary hyperplasia induced by camrelizumab","volume":"34","author":"Tan","year":"2025","journal-title":"China Pharm"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn115330-20250114-00041","article-title":"Camrelizumab-induced intranasal reactive hemangiomas: a case series report","volume":"60","author":"Huang","year":"2025","journal-title":"Chin J Otorhinolaryngology Head Neck Surg"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1847562\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T05:32:11Z","timestamp":1789104731000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1847562\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,11]]},"references-count":48,"alternative-id":["10.3389\/fonc.2026.1847562"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1847562","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,11]]},"article-number":"1847562"}}