Clinical features, treatment, and outcomes of nivolumab induced psoriasis

Psoriasis is an uncommon immune-mediated adverse event linked to nivolumab, and its clinical characteristics remain inadequately defined. This study aims to investigate the clinical features and patterns of nivolumab-induced psoriasis, providing insights for the identification and management of this condition. Case reports and case series of nivolumab related psoriasis were gathered by searching Chinese and English databases for retrospective analysis until June 30, 2024. A total of fifty-five patients (80.0% male) were included, with a median age of 65 years (range 41, 89). Among these, thirty-eight (69.1%) patients experienced new-onset psoriasis, while 17 (30.9%) patients exhibited exacerbation of pre-existing psoriasis. The median time to onset of psoriasis was 28 days (range 3, 360). The predominant clinical types identified were plaque psoriasis (65.5%), psoriatic arthritis (20.0%) and palmoplantar psoriasis (16.4%). Twenty-five (45.5%) patients discontinued nivolumab, whereas 19 (34.5%) patients continued the treatment. Following clinical intervention, 52 (94.5%) patients reported symptom improvement. It is crucial to closely monitor patients receiving nivolumab for the emergence of psoriasis to ensure timely identification and diagnosis. Those diagnosed with psoriasis should be provided with appropriate treatment, whether topical or systemic, tailored to their specific clinical circumstances.