PMC6206568_01
Skin lesions and skin biopsy with hematoxylin-eosin stain. (a) After 6 cycles of nivolumab and before ASCT: scaly erythematous annular plaque on the right tibia. (b) Twelve months after ASCT: skin lesions completely disappeared. (c) Skin biopsy: epidermis lesions showing hyperkeratosis. (d) Skin biopsy: lesions showing acanthosis (white arrow) and perivascular infiltration of mononuclear cells indicating chronic inflammation (black arrow).
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However, after the sixth infusion of nivolumab, he presented with raised nonitchy, erythematous scaly papules with silver-white coating and some annular plaques with collarettes of scales of different sizes involving the anterolateral aspects of shins and dorsa of hands, distal forearms, and both tibias (Figure 1). The epidermis findings revealed hyperkeratosis and irregular acanthosis with regular elongation of rete ridges and suprapapillary thinning (Figures 1 and 1). The upper dermis showed mild perivascular lymphocytic infiltration (Figure 1). Currently, one year after ASCT, the patient was alive in complete metabolic remission regarding his primary disease and without any evidence of residual skin lesions (Figure 1).