Multiple erosive lichen planus preceded by solitary lichen planus after combination therapy with nivolumab and radiation

Erosive lichen planus (ELP) is a rare type of LP, which is a T cell-mediated chronic inflammatory disease that develops in the skin and mucosa (1). ELP differs from common solitary LP in that it is accompanied by pain and erosive changes in the lesions (1). Nivolumab is a monoclonal antibody to the immune check point molecule programmed death 1 (PD-1). Nivolumab facilitates T cell activation by cancelling the suppressive effect of PD-1 signaling on T cells, and exerts anti-tumor effects in various cancers (2). The excess T cell activation induced by nivolumab, however, occasionally causes several T cell-mediated diseases, including LP as we have previously reported (3).

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