BI31 Pembrolizumab-induced scleroderma in a patient with nonsmall cell lung cancer

We present the case of a 59-year-old woman with locally advanced metastatic adenocarcinoma of the lung, who developed skin tightening and thickening following a course of treatment with pembrolizumab. She was commenced on pembrolizumab in September 2021, and in July 2023 she developed the skin changes in the neck, shoulders, stomach and thighs with associated pain, as well as areas of colour change and restriction of movement. Clinical presentation combined with subsequent histopathological confirmation led to a diagnosis of scleroderma. Following a failed trial of high-dose prednisolone, methotrexate was started with beneficial effect. This case highlights that scleroderma is a rare skin-related adverse event that can occur with immune checkpoint inhibitors.