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Table 1 Previously published and current case of Immune checkpoint inhibitor-related acral vasculitis. Patient characteristics

From: Immune checkpoint inhibitor-related acral vasculitis

  Age/Gender Cancer ICI Onset* Skin lesions Systemic symptoms Immunological findings CTCAE Treatment/outcome of the IRAE
Comont et al. 66/Male Urothelial bladder cancer Anti-CTLA4 (tremelimumab)
Anti-PDL1 (durvalumab)
8 Periungual skin necrosis of several digits of both hands None ANAs (titer 5200, speckled pattern) 3 ICI discontinuation; Prednisone Complete resolution of IRAE
Padda er al. 52/Male Melanoma Anti-CTLA4 (ipilimumab) 4 Subungual necrosis on several upper and lower limb digits, rash Myalgias, arthralgias, vision changes, jaw pain, interstitial pneumonia None 3 ICI discontinuation; Methylprednisolone, prednisone, calcium channel blockers, nitropaste, poprostenol, botulinum toxin, sildenafil, rituximab
Worsening of the IRAE requiring surgical amputation of multiple distal digits
Leburel et al. 60/Male Melanoma Anti-PDL1 (UKN)
BRAF and MEK inhibitors (UKN)
8 Necrosis of 3 fingers and the heels Arthralgia, dry mouth, paresthaesia of the feet and interstitial pneumonia ANAs (titer 160, speckled pattern), Anti-SSA Abs
Type III cryoglobulinemia
3 ICI discontinued; prednisone, calcium channel blockers, iloprost and acetylsalicylic acid
Partial resolution of th.e IRAE
Gambichler et al. 60/Male Melanoma Anti-PD1 (nivolumab)
Anti- CTLA4 (ipilimumab)
3 Subungual necrosis on the fingertips of both hands, severe gangrene None None 4 ICI discontinued after a second course of nivolumab;
Prostacyclin, methylprednisolone Worsening of the IRAE requiring surgical amputation of multiple distal digits
Progression of metastatic disease to multi-organ failure, leading to the death of the patient
  1. *Weeks between initiation of immunotherapy and the diagnosis of vasculitis
  2. Ab antibodies, ANA antinuclear antibody, CTCAE Common Terminology Criteria for Adverse Events, ICI immune checkpoint inhibitor, IRAE immune-related adverse event, UKN unknown