PMC10310403_01
Inflammatory parameters monitoring from day +1 to hospital discharge: interleukin 6 (IL 6), C-reactive protein (CRP), ferritin and D dimer. The red box highlights the CRS period, while the purple one shows the cutaneous adverse event period.
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CRS signs were followed by a sharp increase in inflammatory parameters as interleukin 6 (IL 6) C-creative protein (CRP), ferritin and D dimer ( Figure 1 ). Contextually, a strong CAR
(A) Day +6: development of erythematous itchy rash, spreading to malar regions to upper and lower limbs. (B) Erythematous-vesicular-bullous lesions affecting upper limbs with brownish hyperpigmented macules on day +8. (C) Initial re-epithelization on day +17. (D) Complete re-epithelialization 2 months after axi-cel infusion.
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On day 6, the patient developed an erythematous itchy rash, spreading to malar regions, chest and upper and lower limbs ( Figure 2A ). Cutaneous lesions rapidly evolved in the subsequent days: skin examination was notable for bullous erythema grade 4 affecting the malar regions and the whole limbs (including palms and soles), with coexisting erosions and brownish hyperpigmented macules ( Figure 2B ), involving about 75 percent of the body surface area. Beginning on the day after immunoglobulin infusion, no other skin lesion appeared whereas the remaining began to resolve. ( Figure 2C ). Her skin progressively improved and, on medical examination 2 months after axi-cel infusion, re-epithelialization was complete ( Figure 2D ).
Timeline of relevant clinical data of the patient during hospitalization.
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