115 The clinical and immunological features of immune checkpoint inhibitors-related psoriasis

Background: Cutaneous immune-related adverse event (irAE) is one of the common side effects in cancer patients receiving immune checkpoint inhibitors. Exacerbation psoriasis, and new-onset de novo psoriasis have been reported after use inhibitors (ICI). The detailed pathomechanism therapeutic still unclear. Methods: We enrolled suffering from irAE with exacerbation during 2018-2022 Chang Gung Memorial Hospital. reviewed clinical information, treatment response, performed transcriptomic expression skin lesions, cytokine assays flow cytometric studies peripheral blood for these comparison tolerant controls. Results: included 18 ICI related psoriasis. Fourteen were male (77.8%), mean age 65.6±11.2 years. Only three (16.7%) had history manifestations plaque (66.7%), guttate (16.7%), pustular (11.1%) eczematous (5.6%). Topical steroid or calcipotriol (100%), acitretin (38.9%), cyclosporin (5.6%) administered. Lesional profiles by NanoString showed significant upregulated IL-8, S100A7, S100A8, LCN2, CXCL1, LTF, CD79A, IL-1B(P<0.05). Pathway analysis revealed an IL-17A/17F IL-17RA interaction. Cytokine multiplex assay a increased IP10, CD27, TIM3(P<0.05). Flow cytometry demonstrated IL-17A IL-17F CD4 T cell populations ICI-psoriasis (P<0.01). Four refractory to topical systemic agents further treated blockade brodalumab, satisfactory response. Conclusions: presented as distinct immunological profile. Transcriptomic phenotyping predominant Th17 inflammatory A targeting pathway may be optional ICI-psoriasis.