Bullous drug reaction after pembrolizumab administration: two case reports

Severe, blistering, adverse drug reactions involving the skin include Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Allopurinol, anticonvulsants, sulphonamide antibiotics and non-steroidal anti-inflammatory drugs in the oxicam class have been repeatedly described as triggers. Increasingly, immunotherapies are also coming into focus as triggers of severe skin reactions. Two patients with bullous skin symptoms after administration of the checkpoint inhibitor pembrolizumab are presented. As the clinical picture does not always allow an unequivocal classification, a histological assessment is often indispensable.

Automated summary

Severe adverse drug reactions involving the skin, such as Stevens-Johnson syndrome and toxic epidermal necrolysis, can be triggered by allopurinol, anticonvulsants, sulphonamide antibiotics, non-steroidal anti-inflammatory drugs, and immunotherapies. This study presents two cases of bullous skin symptoms after administration of the checkpoint inhibitor pembrolizumab. Histological assessment is often necessary due to the difficulty of unequivocal classification based on clinical symptoms.