Cargando…

Pyodermitis during Nivolumab Treatment for Non-Small Cell Lung Cancer: A Case Report and Review of the Literature

Immunotherapy in oncology is replacing traditional therapies due to it specific action and limited side effects. Despite the high efficacy of immunotherapy, side effects such as bacterial infection have been reported. Bacterial skin and soft tissue infections represent one of the most important diff...

Descripción completa

Detalles Bibliográficos
Autores principales: Cosio, Terenzio, Coniglione, Filadelfo, Flaminio, Valeria, Gaziano, Roberta, Coletta, Deborah, Petruccelli, Rosalba, Dika, Emi, Bianchi, Luca, Campione, Elena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10003408/
https://www.ncbi.nlm.nih.gov/pubmed/36902013
http://dx.doi.org/10.3390/ijms24054580
_version_ 1784904600404361216
author Cosio, Terenzio
Coniglione, Filadelfo
Flaminio, Valeria
Gaziano, Roberta
Coletta, Deborah
Petruccelli, Rosalba
Dika, Emi
Bianchi, Luca
Campione, Elena
author_facet Cosio, Terenzio
Coniglione, Filadelfo
Flaminio, Valeria
Gaziano, Roberta
Coletta, Deborah
Petruccelli, Rosalba
Dika, Emi
Bianchi, Luca
Campione, Elena
author_sort Cosio, Terenzio
collection PubMed
description Immunotherapy in oncology is replacing traditional therapies due to it specific action and limited side effects. Despite the high efficacy of immunotherapy, side effects such as bacterial infection have been reported. Bacterial skin and soft tissue infections represent one of the most important differential diagnoses in patients presenting with reddened and swollen skin and soft tissue. Among these infections, cellulitis (phlegmon) and abscesses are the most frequent. In most cases, these infections occur locally with possible contiguous spread, or as a multifocal manifestation, especially in immunocompromised patients. Herein, we report a case of pyodermitis in an immunocompromised district in a patient treated with nivolumab for non-small cell lung cancer. A 64-year-old, smoker male patient showed cutaneous lesions at a different evolution level in the left arm, all in a tattooed area, with one phlegmon and two ulcerated lesions. Microbiological cultures and gram staining revealed an infection caused by a methicillin-susceptible but erythromycin-resistant (ER-R), clindamycin-resistant (CL-R), and gentamicin-resistant (GE-R) Staphylococcus aureus strain. Despite immunotherapy becoming a milestone in oncologic treatment, more than the spectrum of immune-mediated toxicities of these agents needs to be investigated. This report highlights the importance of considering lifestyle and cutaneous background before starting immunotherapy for cancer treatment, with an emphasis on pharmacogenomics and the possibility of modified skin microbiota predisposing to cutaneous infections in patients treated with PD-1 inhibitors.
format Online
Article
Text
id pubmed-10003408
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-100034082023-03-11 Pyodermitis during Nivolumab Treatment for Non-Small Cell Lung Cancer: A Case Report and Review of the Literature Cosio, Terenzio Coniglione, Filadelfo Flaminio, Valeria Gaziano, Roberta Coletta, Deborah Petruccelli, Rosalba Dika, Emi Bianchi, Luca Campione, Elena Int J Mol Sci Case Report Immunotherapy in oncology is replacing traditional therapies due to it specific action and limited side effects. Despite the high efficacy of immunotherapy, side effects such as bacterial infection have been reported. Bacterial skin and soft tissue infections represent one of the most important differential diagnoses in patients presenting with reddened and swollen skin and soft tissue. Among these infections, cellulitis (phlegmon) and abscesses are the most frequent. In most cases, these infections occur locally with possible contiguous spread, or as a multifocal manifestation, especially in immunocompromised patients. Herein, we report a case of pyodermitis in an immunocompromised district in a patient treated with nivolumab for non-small cell lung cancer. A 64-year-old, smoker male patient showed cutaneous lesions at a different evolution level in the left arm, all in a tattooed area, with one phlegmon and two ulcerated lesions. Microbiological cultures and gram staining revealed an infection caused by a methicillin-susceptible but erythromycin-resistant (ER-R), clindamycin-resistant (CL-R), and gentamicin-resistant (GE-R) Staphylococcus aureus strain. Despite immunotherapy becoming a milestone in oncologic treatment, more than the spectrum of immune-mediated toxicities of these agents needs to be investigated. This report highlights the importance of considering lifestyle and cutaneous background before starting immunotherapy for cancer treatment, with an emphasis on pharmacogenomics and the possibility of modified skin microbiota predisposing to cutaneous infections in patients treated with PD-1 inhibitors. MDPI 2023-02-26 /pmc/articles/PMC10003408/ /pubmed/36902013 http://dx.doi.org/10.3390/ijms24054580 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Cosio, Terenzio
Coniglione, Filadelfo
Flaminio, Valeria
Gaziano, Roberta
Coletta, Deborah
Petruccelli, Rosalba
Dika, Emi
Bianchi, Luca
Campione, Elena
Pyodermitis during Nivolumab Treatment for Non-Small Cell Lung Cancer: A Case Report and Review of the Literature
title Pyodermitis during Nivolumab Treatment for Non-Small Cell Lung Cancer: A Case Report and Review of the Literature
title_full Pyodermitis during Nivolumab Treatment for Non-Small Cell Lung Cancer: A Case Report and Review of the Literature
title_fullStr Pyodermitis during Nivolumab Treatment for Non-Small Cell Lung Cancer: A Case Report and Review of the Literature
title_full_unstemmed Pyodermitis during Nivolumab Treatment for Non-Small Cell Lung Cancer: A Case Report and Review of the Literature
title_short Pyodermitis during Nivolumab Treatment for Non-Small Cell Lung Cancer: A Case Report and Review of the Literature
title_sort pyodermitis during nivolumab treatment for non-small cell lung cancer: a case report and review of the literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10003408/
https://www.ncbi.nlm.nih.gov/pubmed/36902013
http://dx.doi.org/10.3390/ijms24054580
work_keys_str_mv AT cosioterenzio pyodermitisduringnivolumabtreatmentfornonsmallcelllungcanceracasereportandreviewoftheliterature
AT coniglionefiladelfo pyodermitisduringnivolumabtreatmentfornonsmallcelllungcanceracasereportandreviewoftheliterature
AT flaminiovaleria pyodermitisduringnivolumabtreatmentfornonsmallcelllungcanceracasereportandreviewoftheliterature
AT gazianoroberta pyodermitisduringnivolumabtreatmentfornonsmallcelllungcanceracasereportandreviewoftheliterature
AT colettadeborah pyodermitisduringnivolumabtreatmentfornonsmallcelllungcanceracasereportandreviewoftheliterature
AT petruccellirosalba pyodermitisduringnivolumabtreatmentfornonsmallcelllungcanceracasereportandreviewoftheliterature
AT dikaemi pyodermitisduringnivolumabtreatmentfornonsmallcelllungcanceracasereportandreviewoftheliterature
AT bianchiluca pyodermitisduringnivolumabtreatmentfornonsmallcelllungcanceracasereportandreviewoftheliterature
AT campioneelena pyodermitisduringnivolumabtreatmentfornonsmallcelllungcanceracasereportandreviewoftheliterature