台耳醫誌

Immunotherapy has become an essential therapy for head and neck cancer, but the incidence of accompanying severe cutaneous adverse events has also increased. Among these, anti-PD1 antibody-nivolumab-induced Stevens-Johnson syndrome is uncommon. We describe a 38-year-old man with recurrent/metastatic cancer of the oral cavity after a series of conventional treatments. Eventually, he received immunotherapy with nivolumab. Two weeks after the first dose, general skin rash, severe skin peeling, and multiple mucosal hemorrhages developed, which were later confirmed to be Stevens- Johnson syndrome. After receiving high-dose steroid infusion, preventive endotracheal intubation, and ventilator support, he steadily recovered during the following month with his symptoms gradually subsided. Eventually, he died of distant metastases to the lung, liver, bone, and spinal cord two months after the onset of Stevens-Johnson syndrome. Our case is the second known report of Stevens-Johnson syndrome induced by nivolumab in head and neck cancer. We highlight the importance of early recognition of this complication and prompt discontinuation of the culprit drug.(J Taiwan Otolaryngol Head Neck Surg 2020; 55:110-115)