PD-1 Blockade for Disseminated Kaposi Sarcoma in a Patient with Atopic Dermatitis and Chronic CD8 Lymphopenia

Abstract

We describe a 53-year-old male patient with a history of long-standing atopic dermatitis (AD) who presented with disseminated Kaposi sarcoma (KS). Although he never had received long-term immunosuppressive treatment for his AD, he had a 16-year history of CD8 lymphopenia. Because of his heavily pretreated progressive KS in lymph nodes and soft tissues, we treated the patient using pembrolizumab 2 mg/kg body weight 3-weekly. On PET-computed tomography 3-months after the initiation of pembrolizumab therapy, a solid treatment response was detected in all tumor sites – 6-months later a mixed response was observed. Pembrolizumab therapy for further 10 months resulted in stable disease. Notably, his AD also improved during the pembrolizumab treatment period. This report highlights a rare association between AD and KS that was complicated by chronic CD8 lymphopenia of unknown origin. Even though our patient was immunocompromised, he showed an overall good response to pembrolizumab treatment.

Keywords::

• atopic dermatitis
• CD8 lymphopenia
• idiopathic lymphopenia
• immunotherapy
• Kaposi sarcoma
• PD-1
• pembrolizumab

Author contributions

T Gambichler and L Susok treated the patient, reviewed the literature, prepared the data and drafted the manuscript. Both authors read and approved the final submitted manuscript.

Acknowledgments

The authors would like to thank the patient giving us informed consent for publishing his interesting case.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participant involved.

Informed consent disclosure

The authors state that they have obtained verbal and written informed consent from their patient for the inclusion of his medical and treatment history within this case report.