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
- Journal Title
- Case Reports in Dermatological Medicine
- Publication Type
- Case report
- Abstract
- 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.
- Publisher
- Wiley
- Keywords
- cemiplimab; epidermolysis bullosa; immune checkpoint inhibitor; pain; squamous cell carcinoma
- Department(s)
- Anaesthetics; Medical Oncology
- Publisher's Version
- https://doi.org/10.1155/crdm/4558623
- Open Access at Publisher's Site
https://doi.org/10.1155/crdm/4558623- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2026-01-15 11:50:43
Last Modified: 2026-01-15 11:51:01