Pyoderma gangrenosum secondary to chimeric antigen receptor T-cell therapy for diffuse large B-cell lymphoma.

IF 1.4 4区医学 Q3 DERMATOLOGY Wounds : a compendium of clinical research and practice Pub Date : 2025-01-01

Layna Mager, Jacob McFeeters, Jose A Plaza, Brittany Dulmage, Benjamin H Kaffenberger

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Abstract

Background: Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by rapidly progressive ulcers. PG manifests clinically as painful ulcers with undetermined violaceous borders. A case of diffuse large B-cell lymphoma with cutaneous involvement treated with chimeric antigen receptor T-cell (CAR T-cell) therapy with subsequent development of PG is presented.

Case report: Based on her clinical presentation, the patient was started on a prednisone taper with wound vacuum. Complete granulation and 90% reepithelialization were noted at 3-month follow-up. The wound was fully resolved within 4 months, without subsequent reactions.

Conclusion: The relationship between CAR T-cell therapy and PG remains unknown. In this case, excellent response was achieved using standard treatment for PG wounds, which included prednisone taper and appropriate wound care. The discovery of novel cutaneous manifestations resulting from immunotherapy treatment remains essential for targeted therapy and further management of post-radiation site reactions. More research is needed to determine the significance of CAR T-cell therapy on post-treatment reactions, including PG.

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背景：坏疽性脓皮病（PG）是一种罕见的嗜中性皮肤病，以快速进展性溃疡为特征。脓皮病临床表现为疼痛性溃疡，边界不清。本文介绍了一例经嵌合抗原受体 T 细胞（CAR T 细胞）治疗后出现皮肤受累的弥漫大 B 细胞淋巴瘤病例：根据其临床表现，患者开始使用泼尼松减量疗法，并进行伤口真空处理。在 3 个月的随访中，患者的伤口肉芽完全脱落，90% 重新上皮。伤口在 4 个月内完全愈合，没有出现后续反应：结论：CAR T 细胞疗法与 PG 之间的关系尚不清楚。结论：CAR T 细胞疗法与 PG 之间的关系尚不清楚，在本病例中，采用 PG 伤口的标准治疗方法（包括减少泼尼松用量和适当的伤口护理）取得了很好的疗效。发现免疫疗法治疗导致的新皮肤表现对于靶向治疗和进一步处理放疗后部位反应仍然至关重要。要确定 CAR T 细胞疗法对治疗后反应（包括 PG）的影响，还需要进行更多的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Wounds : a compendium of clinical research and practice 医学-皮肤病学

CiteScore

1.50

自引率

11.80%

发文量

审稿时长

6-12 weeks

期刊介绍： Wounds is the most widely read, peer-reviewed journal focusing on wound care and wound research. The information disseminated to our readers includes valuable research and commentaries on tissue repair and regeneration, biology and biochemistry of wound healing, and clinical management of various wound etiologies. Our multidisciplinary readership consists of dermatologists, general surgeons, plastic surgeons, vascular surgeons, internal medicine/family practitioners, podiatrists, gerontologists, researchers in industry or academia (PhDs), orthopedic surgeons, infectious disease physicians, nurse practitioners, and physician assistants. These practitioners must be well equipped to deal with a myriad of chronic wound conditions affecting their patients including vascular disease, diabetes, obesity, dermatological disorders, and more. Whether dealing with a traumatic wound, a surgical or non-skin wound, a burn injury, or a diabetic foot ulcer, wound care professionals turn to Wounds for the latest in research and practice in this ever-growing field of medicine.