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Treatment of severe cutaneous adverse reaction with tocilizumab

A 29-year-old Chinese male with recurrent alveolar soft part sarcoma of the tongue metastatic to lung presented with fever and rash (Figure 1a). He underwent glossectomy and adjuvant radiotherapy, complicated by recurrence and abscess with sinus tract formation on the right neck. Current therapy included ipilimumab 3mg/kg and nivolumab 1mg/kg (completed 9 cycles; last dose two days before admission), and cabozantinib 40mg daily (held for six weeks due to sinus tract in the neck).