Inflammatory vulvar dermatoses following immune checkpoint inhibitor therapy

Immune checkpoint inhibitors (ICIs) are associated with dermatologic adverse effects. We present 2 patients who developed inflammatory vulvar dermatoses after ICI therapy. The first patient—an 81-year-old with rectosigmoid adenocarcinoma—was treated initially with chemotherapy and radiation followed by pembrolizumab for local tumor regrowth. After her second dosage, she experienced vulvar pruritus with skin sloughing. An exam demonstrated bilateral hyperkeratotic white plaques on the labia majora (Figure, A).