Systemic sarcoidosis first manifesting in a tattoo in the setting of immune checkpoint inhibition

BMJ Case Rep. 2016 Oct 26:2016:bcr2016216217. doi: 10.1136/bcr-2016-216217.

Abstract

The use of immune checkpoint inhibitors is revolutionising the treatment of cancer. However, their unique toxicity profile is substantially different from what has been observed with traditional chemotherapy, resulting in a novel learning curve for medical oncologists. Early recognition of these toxicities can make a substantial impact in ameliorating these side effects in the oncological and medical-surgical fields. Here, we present a case of Lofgren syndrome sarcoidosis, which first manifested in a tattoo in a patient with metastatic urothelial cancer on therapy with anti-CTLA-4 (ipilimumab) and anti-PD1 (nivolumab).

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal / adverse effects*
  • Antineoplastic Agents / adverse effects*
  • Fatal Outcome
  • Humans
  • Ipilimumab
  • Lymphadenopathy / diagnostic imaging
  • Lymphadenopathy / drug therapy
  • Male
  • Middle Aged
  • Nivolumab
  • Sarcoidosis / chemically induced*
  • Sarcoidosis / immunology*
  • Tattooing*
  • Urinary Bladder Neoplasms / drug therapy*

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents
  • Ipilimumab
  • Nivolumab