Acute Infusion Pain Reaction Due to Anti-PD-1 Antibodies for the Treatment of Cutaneous Squamous Cell Carcinoma in Recessive Dystrophic Epidermolysis Bullosa: A Case Report and Review of the Literature

Recessive dystrophic epidermolysis bullosa (RDEB) belongs to a rare group of inherited dermatoses, which are characterised by mucosal and cutaneous fragility. Cutaneous squamous cell carcinoma (CSCC) is a common complication of RDEB. In the severe subtype of RDEB (RDEB-S), CSCC is observed in 90% of...

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Main Authors: Vanessa Tran, Susan J. Robertson, Jamie Young, Malcolm Hogg, Alesha A. Thai, Vanessa Morgan
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Case Reports in Dermatological Medicine
Online Access:http://dx.doi.org/10.1155/crdm/4558623
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author Vanessa Tran
Susan J. Robertson
Jamie Young
Malcolm Hogg
Alesha A. Thai
Vanessa Morgan
author_facet Vanessa Tran
Susan J. Robertson
Jamie Young
Malcolm Hogg
Alesha A. Thai
Vanessa Morgan
author_sort Vanessa Tran
collection DOAJ
description Recessive dystrophic epidermolysis bullosa (RDEB) belongs to a rare group of inherited dermatoses, which are characterised by mucosal and cutaneous fragility. Cutaneous squamous cell carcinoma (CSCC) is a common complication of RDEB. In the severe subtype of RDEB (RDEB-S), CSCC is observed in 90% of the patients by 55 years. CSCC in patients with RDEB follows an aggressive course with the median survival rate of 2.4 years. We report the case of a 51-year-old female with RDEB with recurrent aggressive CSCC of the right lateral-back. She was commenced on cemiplimab, an anti-programmed death receptor-1 (PD-1) antibody, for the management of unresectable locally advanced CSCC; however, she experienced a severe infusion reaction, manifested as back pain, requiring treatment cessation. Despite three incomplete doses, the patient demonstrated a marked response with significant regression of her tumours. Therefore, further treatment was pursued. She was successfully administered cemiplimab under intravenous sedation. This was later complicated by immune-related colitis, necessitating treatment cessation. The patient was transitioned to best supportive care. The patient required inpatient admission for end-of-life care due to her complex analgesia requirements. This case report explores the pathophysiological mechanisms of pain in RDEB and anti-PD-1 antibody therapy and highlights the unique challenges of pain management in RDEB patients.
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spelling doaj-art-bfd244b40ff14c838eb72cc9e86063df2025-08-20T02:16:49ZengWileyCase Reports in Dermatological Medicine2090-64712025-01-01202510.1155/crdm/4558623Acute Infusion Pain Reaction Due to Anti-PD-1 Antibodies for the Treatment of Cutaneous Squamous Cell Carcinoma in Recessive Dystrophic Epidermolysis Bullosa: A Case Report and Review of the LiteratureVanessa Tran0Susan J. Robertson1Jamie Young2Malcolm Hogg3Alesha A. Thai4Vanessa Morgan5Department of DermatologyDepartment of DermatologyDepartment of Anaesthesia and Pain MedicineDepartment of Anaesthesia and Pain ManagementDepartment of OncologyDepartment of DermatologyRecessive dystrophic epidermolysis bullosa (RDEB) belongs to a rare group of inherited dermatoses, which are characterised by mucosal and cutaneous fragility. Cutaneous squamous cell carcinoma (CSCC) is a common complication of RDEB. In the severe subtype of RDEB (RDEB-S), CSCC is observed in 90% of the patients by 55 years. CSCC in patients with RDEB follows an aggressive course with the median survival rate of 2.4 years. We report the case of a 51-year-old female with RDEB with recurrent aggressive CSCC of the right lateral-back. She was commenced on cemiplimab, an anti-programmed death receptor-1 (PD-1) antibody, for the management of unresectable locally advanced CSCC; however, she experienced a severe infusion reaction, manifested as back pain, requiring treatment cessation. Despite three incomplete doses, the patient demonstrated a marked response with significant regression of her tumours. Therefore, further treatment was pursued. She was successfully administered cemiplimab under intravenous sedation. This was later complicated by immune-related colitis, necessitating treatment cessation. The patient was transitioned to best supportive care. The patient required inpatient admission for end-of-life care due to her complex analgesia requirements. This case report explores the pathophysiological mechanisms of pain in RDEB and anti-PD-1 antibody therapy and highlights the unique challenges of pain management in RDEB patients.http://dx.doi.org/10.1155/crdm/4558623
spellingShingle Vanessa Tran
Susan J. Robertson
Jamie Young
Malcolm Hogg
Alesha A. Thai
Vanessa Morgan
Acute Infusion Pain Reaction Due to Anti-PD-1 Antibodies for the Treatment of Cutaneous Squamous Cell Carcinoma in Recessive Dystrophic Epidermolysis Bullosa: A Case Report and Review of the Literature
Case Reports in Dermatological Medicine
title Acute Infusion Pain Reaction Due to Anti-PD-1 Antibodies for the Treatment of Cutaneous Squamous Cell Carcinoma in Recessive Dystrophic Epidermolysis Bullosa: A Case Report and Review of the Literature
title_full Acute Infusion Pain Reaction Due to Anti-PD-1 Antibodies for the Treatment of Cutaneous Squamous Cell Carcinoma in Recessive Dystrophic Epidermolysis Bullosa: A Case Report and Review of the Literature
title_fullStr Acute Infusion Pain Reaction Due to Anti-PD-1 Antibodies for the Treatment of Cutaneous Squamous Cell Carcinoma in Recessive Dystrophic Epidermolysis Bullosa: A Case Report and Review of the Literature
title_full_unstemmed Acute Infusion Pain Reaction Due to Anti-PD-1 Antibodies for the Treatment of Cutaneous Squamous Cell Carcinoma in Recessive Dystrophic Epidermolysis Bullosa: A Case Report and Review of the Literature
title_short Acute Infusion Pain Reaction Due to Anti-PD-1 Antibodies for the Treatment of Cutaneous Squamous Cell Carcinoma in Recessive Dystrophic Epidermolysis Bullosa: A Case Report and Review of the Literature
title_sort acute infusion pain reaction due to anti pd 1 antibodies for the treatment of cutaneous squamous cell carcinoma in recessive dystrophic epidermolysis bullosa a case report and review of the literature
url http://dx.doi.org/10.1155/crdm/4558623
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