【摘要】 目的 随着免疫治疗在临床的推广及使用，免疫相关不良反应的伴随发生获得越来越多的关注。控制免疫相关皮肤不良反应可有效改善治疗耐受性，提高疗效。方法 本文报道了近期1例严重免疫相关不良皮肤毒性患者的临床诊治经过，同时对同期本院应用帕博利珠单抗的44例患者进行皮肤毒性分析及相关文献复习。结果 44例应用帕博利珠单抗治疗患者中仅少数表现为皮肤瘙痒、皮疹，予激素对症治疗效果良好，不影响帕博利珠单抗的继续使用。1例严重剥脱性皮炎，积极治疗后好转，停用免疫治疗。结论 免疫相关皮肤不良反应发生率低，合理干预为临床诊治免疫相关不良反应提供了理论依据及实践策略。更多还原

【Abstract】 Objective Clinically, increasing immune-related adverse events cause concern with the promotion and application of immunotherapy. The tolerability profile could be effectively improved by controlling immune-related skin adverse reactions to enhance efficacy. Methods In this article regarding the diagnosis and treatment of severe immune-related adverse skin toxicity in a recent patient was reported. Meanwhile, a skin toxicity analysis were performed on 44 patients who received pembrolizumab in our hospital with a review of the related literature. Results Among 44 patients received pembrolizumab, only a few patients presented itchy skin and rash. The symptomatic treatment effect of hormone was good not affecting the continued use pembrolizumab. One case with severe exfoliative dermatitis withdrew immunotherapy although which resolved by active treatment. Conclusion Although the incidence of immune-related skin adverse reactions is low, it is essential to provide reasonable intervention theoretical basis and practical strategy regarding the diagnosis and treatment of immune-related adverse reactions.更多还原