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Late-onset adverse events (AEs) of anti-programmed cell death 1 (anti-PD1) antibodies have not been systematically described.The purpose was to evaluate late-onset AEs in melanoma patients treated with anti-PD1 administered for at least 2 years in a real-life setting.Patients were screened from MelBase, a French multicentric biobank dedicated to the prospective follow up of unresectable stage III or IV melanoma. The study included 119 patients who received anti-PD1 during at least 2 years from January 2013 to November 2019. Median follow up was 41.7 months (range, 25.2-57.5 months). Fifty-three patients received nivolumab and 66 patients received pembrolizumab.AEs occurred in 99 patients (83%) with a median time of 13.3 months (range, 0-53.9 months), including severe AEs (grade 3 or 4) in 30 patients (30%). Late-onset AEs, mostly grades 1 or 2, occurred in 51 (43%) patients and led to 5 (4%) hospitalizations, of which 4 were severe. Factors associated with late-onset AEs in multivariate analysis were early-onset AEs (within the first 2 years of treatment) and treatment duration (P = .02 and P = .03, respectively).Our data demonstrate the possibility of late-onset AEs occurring after 2 years of anti-PD1 therapy. Late-onset AEs appear frequently and were mostly mild or moderate. Early-onset AEs and prolonged anti-PD1 treatment may increase the risk of late-onset AEs.

Background Dissecting cellulitis of the scalp (DCS), also known as Hoffmann disease or perifolliculitis capitis abscedens et suffodiens, is a rare disease characterized by chronic inflammation of the scalp. Treatment is difficult and often disappointing. Objectives To report our experience of TNF inhibitors in a series of patients with DCS. Materials & methods We conducted a monocentric retrospective study of nine patients with DCS treated with TNF blocker after failure of other conventional treatments. Results After a mean duration of treatment by TNF inhibitors of 17 ± 16 months, four patients (44% versus 0%) had a Physician's Global Assessment score of 0 or 1. We observed a 67% reduction in the number of inflammatory nodules, an 88% reduction in purulent drainage and a 45% improvement in Dermatology Life Quality Index. The mean treatment satisfaction index was 6.6 ± 1.6 out of 10. Conclusion Our study suggests that TNF inhibitors are effective against disease activity and may improve quality of life in the management of DCS refractory to conventional treatments.

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Introduction Les anti-PD1 sont associes a la survenue d’effets indesirables (EI) specifiques, en partie medies par l’immunite. Les patients atteints de melanomes avances inclus dans des essais cliniques ont ete traites par anti-PD1 pour une duree de deux ans ou moins et il n’existe pas de recommandation concernant la duree optimale de traitement. Il y a peu de donnees concernant les EIs tardifs des anti-PD1 (apres deux ans de traitement). L’objectif de cette etude etait de decrire les EIs (incluant les EIs tardifs) des anti-PD1 chez des patients atteints de melanomes avances traites en vie reelle pendant au moins deux ans. Materiel et methodes Les patients de la cohorte MELBASE (cohorte francaise multicentrique de suivi prospectif de patients atteints de melanomes de stades III non resecable ou IV de l’AJCC) traites par anti-PD1 pendant deux ans ou plus, entre janvier 2013 et novembre 2019, etaient inclus. Tous les EIs (dont les EIs tardifs, definis comme survenant au-dela de 2 ans de traitement) etaient colliges. Les facteurs potentiellement associes a la survenue d’EI etaient recherches. Resultats Parmi les 1849 patients atteints de melanomes avances inclus dans Melbase, 119 patients traites par anti-PD1 pendant au moins deux ans etaient inclus. La mediane de suivi de ces patients etait de 41,7 mois (25,2–57,5). Les principales caracteristiques initiales des patients etaient: sexe masculin (61 %), âge moyen 63 ans, antecedent de maladie auto-immune (11 %), mutation BRAF V600 (25 %), stade IV de l’AJCC (84 %), metastases cerebrales (22 %), ECOG 0-1 (88 %), et LDH eleves (18 %). Les patients avaient ete traites par nivolumab (n = 53, 45 %) ou pembrolizumab (n = 66, 55 %), et la maladie etait controlee par le traitement (reponse complete, partielle ou maladie stable dans 59 %, 34 % et 7 % des cas respectivement). La duree mediane de traitement etait de 35 mois (28,7–40,5). Des EIs etaient survenus chez 99 patients (83 %) apres une duree mediane de traitement de 13,3 mois (0–53,9) dont au moins un EI severe (grade 3–4) chez 30 patients (30 %). Les EIs tardifs, survenus au-dela de 2 ans de traitement par anti-PD1, etaient observes chez 51 patients (43 %). Ils etaient principalement de grade 1–2 mais severes chez 4 patients (3 %) et avaient conduit a l’hospitalisation de 5 patients (4 %). Parmi les patients ayant presente ces EIs tardifs, 45 (87 %) avaient deja presente un EI au cours des deux premieres annees de traitement et 29 (56 %) en avaient presente plusieurs. Les facteurs associes a la survenue d’EIs tardifs etaient les toxicites multiples avant 2 ans et la duree de traitement (p Discussion La poursuite du traitement par anti-PD1 au-dela de 2 ans s’accompagne frequemment d’EIs tardifs, le plus souvent benins. La survenue de plusieurs EIs au cours des 2 premieres annees etait un facteur de risque independant de survenue d’EIs tardifs.

Mycoplasma pneumoniae induced rash and mucositis (MIRM) is a distinct entity of erythema multiforma spectrum. Observation: we report a case of a 19-year-old man hospitalised for multiple mucosal eruptions and hyperthermia for three days, in context of a pro-T lymphoblastic leukemia in complete cytological and molecular remission. Discussion: MIRM is a skin split of 0% – 10% body surface area, at least two mucosal sites involved, few skins including vesiculobullous or atypical targets and evidence of atypical pneumonia. Identification of MP is essential for the correct diagnosis of MIRM and even more differentiation of EM associated with herpes simplex virus and drug-associated. Conclusion: MIRM has a good prognosis with rare recurrence and seldom complications.