A case report of thalidomide in the treatment of camrelizumab-induced reactive cutaneous capillary hyperplasia

• Published in: Medicine (Baltimore) 2023-06, Vol.102 (26), p.e34120-e34120
• Main Authors: Fu, Shujuan, Li, Cunya, Wang, Zhiying, Zhong, Zhixian, Zhong, Yi
• Format: Article
• Language: English
• Subjects: Clinical Case Report
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000034120

Reactive cutaneous capillary endothelial proliferation (RCCEP) is the most prevalent immune-related adverse event observed in patients undergoing camrelizumab treatment, and there is a lack of effective therapeutic strategies. Thalidomide (THD) has anti-inflammatory, immunomodulatory, antiangiogenic, and antitumor properties, which have led to its use in various autoimmune diseases, hematological malignancies, solid tumors, and other disorders. A 52-year-old male patient with lung cancer developed vascular moles on his face, neck, and back after 3 cycles of chemotherapy comprising pemetrexed and carboplatin combined with camrelizumab immunotherapy. The moles ranged in size (0.1-1.2 cm) and were red or red-black, appearing on the skin's surface. The patient was advised to avoid scratching or friction, continue monitoring, and apply Yunnan Baiyao powder if a papule ruptured. After the third treatment cycle, papules on the patient's face, particularly an eyelid vascular mole, ulcerated, causing significant psychological distress. RCCEP induced by camrelizumab was considered. The patient received 50 mg of THD in the morning and 100 mg in the evening. The vascular nevus began to shrivel after 1 week and started disappearing after 2 weeks of THD treatment. After 3 THD treatment courses, RCCEP was alleviated without recurrence, allowing the patient to successfully complete camrelizumab treatment. During treatment with camrelizumab, if a patient develops moderate or severe RCCEP, and local therapy or anti-infective therapies prove insufficient, THD may be considered as a potential treatment option to improve RCCEP symptoms.