Concurrent erythema multiforme and psoriasiform eruption during enfortumab vedotin plus pembrolizumab therapy for advanced urothelial carcinoma.
Year: 2026
Type: article
Study design: Case Report
Abstract: Enfortumab vedotin (EV) plus pembrolizumab is an effective first-line treatment for advanced urothelial carcinoma, but clinically significant cutaneous adverse events may require treatment interruption or discontinuation. We report a 74-year-old man with metastatic upper-tract urothelial carcinoma who achieved a complete metabolic and radiologic response after three cycles of EV plus pembrolizumab. After six cycles and before cycle 7, he developed painful plantar lesions that progressed to Common Terminology Criteria for Adverse Events (CTCAE) grade 3 cutaneous toxicity involving the lower limbs, trunk, and oral cavity. Clinicopathological assessment supported erythema multiforme, while a morphologically distinct psoriasiform eruption was identified on the upper limbs. EV plus pembrolizumab was discontinued, and systemic and topical corticosteroid-based treatment produced marked improvement within approximately one month. In view of the grade 3 toxicity and ongoing complete response, treatment was not restarted. This case highlights the uncommon coexistence of two clinically distinct cutaneous patterns during combination therapy and underscores the value of early dermatologic assessment, clinicopathological correlation, and multidisciplinary management when an eruption evolves or displays atypical morphology.
Source: PubMed
Authors: Rossella Di Trolio, Giuseppe Di Lorenzo
Language: English
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7225327687