Integrated Traditional Chinese and Western Medicine for Severe Tislelizumab-Induced Rash: A Case Report

Objective: To investigate the clinical efficacy and safety of integrated traditional Chinese and Western medicine in the treatment of severe cutaneous immune-related adverse events (irAEs) induced by tislelizumab, to describe the diagnosis and treatment process and the thinking of traditional Chinese medicine syndrome differentiation, and to provide clinical experience and research hypotheses for the clinical management of such severe adverse events.Methods: A 71-year-old male patient with squamous cell carcinoma of the right lung was diagnosed with severe tislelizumab-induced cutaneous irAE (syndrome of intermingled damp-heat, stasis, and toxin in TCM) and treated with modified TCM formulas (oral and external application) combined with comprehensive Western medicine (glucocorticoids, antihistamines, etc.). The clinical course, TCM syndrome differentiation, treatment plan, and follow-up data were systematically analyzed, and the potential synergistic mechanism was discussed. Results: After 12 days of hospitalization and 3 months of follow-up, the patient's severe rash, pain, and pruritus were completely relieved without recurrence. The duration of glucocorticoid use was shortened (7 days of intravenous administration followed by oral tapering), and no obvious adverse reactions were observed. Conclusion:Integrated traditional Chinese and Western medicine demonstrates synergistic efficacy in the treatment of severe tislelizumab-induced cutaneous immune-related adverse events (irAEs) by regulating immune balance and eliminating pathogenic factors. It provides a valuable therapeutic option for such patients and warrants further validation in larger sample studies.