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BackgroundImmune checkpoint inhibitors (ICIs) have revolutionized cancer treatment, yet they can induce immune-related adverse events (irAEs), including cutaneous toxicities such as lichenoid eruptions. Pembrolizumab, a PD-1 inhibitor, is known for its association with lichen-planus-like reactions, while the side effect profile of combining immunotherapy with MK-4830, a novel fully human IgG4 monoclonal antibody that targets ILT-4, remains limited.Case reportWe present a case of a 47-year-old female with metastatic breast cancer who developed a grade 2 Common Terminology Criteria for Adverse Events (CTCAE) lichenoid reaction after 9 months of MK-4830 and pembrolizumab use. Confluent, erythematous papules with Wickham’s striae appeared predominantly on the extremities. Initial therapy with high-potency topical corticosteroids proved insufficient, however prednisone 40 mg daily resulted in satisfactory remission of lichen-planus-like reaction, permitting continued immunotherapy without dosage adjustment.ConclusionThis case highlights the novel occurrence of lichenoid eruption induced by MK-4830 and pembrolizumab in breast cancer treatment. The patient was successfully treated with oral prednisone, which controlled the skin symptoms without interrupting ICI therapy. We emphasize that early diagnosis and treatment of low-grade lichenoid eruption can prevent the cessation of ICIs, thereby combining the benefits of managing irAEs and avoiding cancer progression, leading to a better long-term prognosis.

Antimicrobial peptides (AMPs) are natural components of the immune system of organisms from the prokaryotic and eukaryotic kingdoms. The human body is equipped with more than 100 antimicrobial peptides that are an integral part of innate immunity. The main AMP families in human skin are β-defensins and cathelicidins. They are produced in cells such as keratinocytes, sweat glands, neutrophils, monocytes, NK cells and mast cells. Their particular function is a broad spectrum of antibacterial as well as antifungal, antiviral and antiprotozoal activity. The ability to kill bacteria involves penetration and destruction of the cell membrane, as opposed to traditional antibiotics that act by binding to specific cell structure. The antimicrobial peptides are involved in the pathogenesis of various skin diseases, including atopic dermatitis, psoriasis, and rosacea. The lack of a specific molecular target in a bacterial cell minimizes the risk of resistance development; hence the AMPs have become the target of intensive research in the last two decades.

Introduction. Comèl-Netherton syndrome is a rare autosomal recessive genodermatosis characterized by congenital ichthyosiform erythroderma, ichthyosis linearis circumflexa, trichorrhexis invaginata, and atopic diathesis. Comèl-Netherton syndrome is caused by mutations of the SPINK5 gene, which encodes the serine protease inhibitor LEKTI. Objective. We present diagnostic and therapeutic difficulties in a patient with Comèl-Netherton syndrome. Case report. We present the case of a 3-year-old boy, in whom from the first day of life generalized ichthyosiform erythroderma and diffuse exfoliation of the skin were observed. The differential diagnosis included Omenn syndrome, and atopic and seborrheic dermatitis. Finally, based on the overall clinical picture and microscopic examination of the hair, which showed the presence of bamboo hair, Comèl-Netherton syndrome was diagnosed. Conclusions . Because of similarity to other erythroderma, diagnosis of Comèl-Netherton syndrome in the first months of life creates diagnostic problems. In older children, recurrent skin infections and atopic diathesis can cause therapeutic difficulties and require the cooperation of many specialists.

Staphylococcus aureus ( S. aureus ) is a Gram-positive bacterium capable of causing various diseases, from skin infections to life-threatening necrotizing pneumonia, bacteraemia, endocarditis and toxic shock syndrome. Methicillin-resistant Staphylococcus aureus (MRSA) is endemic in hospitals worldwide and is a major cause of human morbidity and mortality. Healthcare-associated MRSA (HA-MRSA) infections occur in individuals with a compromised immune system and people with prior surgery. Community-associated MRSA (CA-MRSA) infections often occur in healthy individuals and are epidemic in some countries, which may suggest that those strains are more virulent and transmissible than HA-MRSA. According to the Center for Disease Control and Prevention, a case of MRSA infection is community acquired when it is diagnosed in an outpatient or within 48 hours of hospitalization if the patient lacks the following traditional risk factors for MRSA infection: receipt of hemodialysis, surgery, residence in a long-term care facility, or hospitalization during the previous year; the presence of an indwelling catheter or a percutaneous device at the time culture samples were obtained. Although progress has been made toward understanding emergence of CA-MRSA, virulence factors and treatment options, our knowledge remains incomplete. The recent occurrence of CA-MRSA in addition to the widespread problem of MRSA in hospitals has underlined the high urgency to find novel treatment options for drug-resistant S. aureus .