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Wu et al. J Cancer Metastasis Treat 2020;6:40 I http://dx.doi.org/10.20517/2394-4722.2020.77 Page 3 of 9
A B
C D
Figure 1. Clinical presentations. Multiple, grouped, large, tense haemorrhagic blisters were seen on the first clinical presentation, which
affected the chest, abdomen, inner thighs and upper arms (A, B and C); active blisters and erosions were seen on the roof of the mouth
(D)
A B
Figure 2. Haematoxylin and eosin staining of edge (A) and base (B) of blisters. Epidermal hyperplasia and subepidermal splitting were
seen with few eosinophils, scattered plasma cells, neutrophils and a subjacent chronic inflammation
down to 10 mg per day, requiring re-introduction of high-dose prednisolone. Consequently, nivolumab
had been permanently discontinued in view of refractory BP and further disease progression in his adrenal
metastatic disease.
