Nivolumab-induced systemic vasculitis

Nivolumab is a fully human IgG4 monoclonal immune checkpoint inhibitor antibody that inhibits programmed cell death-1 receptor (PD-1), augmenting the host antitumor response.1 Nivolumab has been associated with immune-related adverse events (irAEs)2 such as colitis. In addition, various cutaneous adverse events have been reported and the 3 most common findings included lichenoid eruptions, eczema, and vitiligo.3 We report a patient with squamous cell carcinoma of the right maxillary sinus on nivolumab who had vasculitis of the jejunum and leukocytoclastic vasculitis of the skin successfully treated with high-dose systemic steroids and plasma exchange.