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These cutaneous adverse reactions on photodamaged skin appear in more than one-third of patients treated with immune checkpoint inhibitors; they are often the first clinical manifestation, but may occur months after the start of therapy. Patients with significant cutaneous actinic injury suffered cutaneous immunotoxicity problems earlier and in a more serious manner, out of 19 patients being treated for metastatic melanoma.
Low-grade squamoproliferative skin tumors can be resistant to developing low-grade squamoproliferative skin tumors. Patients with eruptive keratoacanthoma lesions were recruited from the Melanoma Institute Australia, a tertiary referral center dedicated to melanoma treatment center from January 2015 to August 2017. Four patients with eruptive KAlike and lichenoid lesions were recruited 2–7 months after commencing penetinobac for AJCC stage IV melanoma. Low PDL1 expressions of both squamous tumor cells and the TME immune cells was seen in both cases and controls, as well as controls. Tcells were more prevalent in the cases than the controls, although the CD4:CD8 ratio was similar, but the CD4:CD8 ratio was similar. Patients treated with anti-PD1 immunotherapy may be uncovered in patients with chronically impaired keratinocytes linked to lichennoid eruptions that may have been contributing to by a local cutaneous immunosuppressed TME.
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