Eosinophilic Folliculitis of the Scalp Associated with PD-1/PDL1 Inhibitors

April 2020 in “ Journal of Cosmetic Dermatology ”

Alfredo Rossi, Francesca Magri, Gemma Caro, Alessandro Federico, Maria Caterina Fortuna, G. Soda, Ludovica De Vincentiis, Marta Carlesimo

eosinophilic folliculitis PD-1 inhibitors PDL1 inhibitors nivolumab immune checkpoint inhibitors lichen planopilaris topical steroids fusidic acid hair follicle antigens immuno-privilege lichenoid reaction Opdivo steroid cream antibiotic cream

Studysummary This case report describes the first instance of eosinophilic folliculitis of the scalp occurring during nivolumab therapy, which responded partially to topical steroids and cream but did not require stopping the treatment. Our plain-language summary of this paper — not a Tressless recommendation.

The document reported a case of eosinophilic folliculitis of the scalp that occurred during nivolumab therapy, an immune checkpoint inhibitor. This condition initially appeared as lichen planopilaris and was managed with topical steroids and fusidic acid cream, resulting in partial benefit and a scarring outcome without discontinuing nivolumab. The study concluded that immune checkpoint inhibitors could induce an inflammatory response, exposing hair follicle antigens and leading to a loss of immuno-privilege. The authors hypothesized that steroids might shift a primarily lichenoid reaction towards folliculitis.

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