Case Reports in Dermatological Medicine / 2019 / Article / Tab 1

Case Report

An Atypical Presentation of Lichen Planus-Like Reaction from Pembrolizumab

Table 1

Skin and subcutaneous tissue disorders management of different gradings based on CTCAE (Common Terminology Criteria for Adverse Events) [16].

Grading (CTCAE)General Cutaneous FeaturesSteroidsImmunosuppressivesManagement of ImmunotherapyOutpatient or Inpatient care

1Covers <10% BSA, limited, asymptomaticNot recommendedNot recommendedContinueOutpatient

2Covers 10-30% BSA, minimal to moderate symptomsTopical or systemic steroids oral 0.5-1 mg/kg/dNot recommendedContinueOutpatient

3Covers >30% BSA, moderate or severe symptoms, limiting self-care ADLsSystemic steroids oral or IV 1-2 mg/kg/d for 3 days then to 1mg/kg/dCan consider if unresolved after 3-5 days of steroidsSuspend, discuss risk/benefit with patientOutpatient or Inpatient for IV steroids

4>30% BSA and fluid/electrolyte abnormalitiesSystemic IV methylprednisolone 1-2mg/kg/d for 3 daysCan consider if unresolved after 3-5 days of steroidsDiscontinue permanentlyInpatient and possible ICU or burn unit

BSA: body surface area.

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