PMC7303977_01
Chest computed tomography scan images and photographs of the skin rash. At the time of the lung cancer diagnosis, a tumor was found in the right lower lobe (A), and a new central metastasis to the lung was discovered after first-line chemotherapy (B). After the subsequent use of nivolumab, the tumor began to shrink (C), but pruritic eruptions appeared on the patient's extremities and trunk (D, E).
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On computed tomography, a tumor 36 mm in diameter was found in the right lower lobe S6 and was diagnosed as squamous cell carcinoma with no EGFR (epidermal growth factor receptor) mutations or the ALK (anaplastic lymphoma kinase) fusion oncogene by bronchoscopic examination (Fig. 1A). He started first-line treatment with carboplatin and nab-paclitaxel, after which he was determined to have progressive disease due to the appearance of an intrapulmonary metastasis after four courses of treatment (Fig. 1B). Around the start of the fifth course, the erythema spread to the proximal part of his limbs in addition to the trunk and was accompanied by a strong itching sensation, but pustules, blisters, erosion, and epidermal necrosis were not consistently observed (Fig. 1D and E). In addition, his lung tumors have been shrinking and maintaining partial response at 4 months after the last dose of nivolumab (Fig. 1C).