PMC4986338_01
Time axis. Line graph illustrating disease progression and therapeutic intervention from primary diagnosis in May 2015 to April 2016
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PMC4986338_01_40425_2016_151_Fig1_HTML.jpg
Fig1
The patient was treated with four cycles of ipilimumab (Yervoy ), administered at a dose of 3 mg/kg body weight every 3 weeks (Fig. 1).
Skin findings after the second course of ipilimumab treatment. a) Clinical presentation. Overview image showing the diffuse eruption of a papulovesicular rash on the patient's trunk (left). Detail image showing lesions of different stages ranging from early erythematous papules to crusty and scaly erosions (right). b Histopathological findings on skin biopsy (Hematoxylin-eosin stain). Overview image demonstrating circumscript acantholytic dyskeratosis and mild interface dermatitis with perivascular accentuation as an accompanying feature (left). Detail image showing Darier-like features with acatholytic and dyskeratotic keratinocytes present at all levels of the epidermis (right). Scale bars are indicated.
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PMC4986338_01_40425_2016_151_Fig2_HTML.jpg
Fig2
On physical examination, he had multiple erythematous, 2- to 7-mm scaly papules and fragile vesicles on his chest, abdomen, back, shoulders and proximal limbs, which quickly formed crusts and keratotic erosions (Fig. 2a). In addition, histological examination of the skin biopsy revealed a mild interface dermatitis and perivascular, lymphohistiocytic infiltrates with scattered eosinophils in the superficial dermis (Fig. 2b).