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Bilateral anterior uveitis and unilateral facial palsy due to ipilimumab for metastatic melanoma in an individual with human leukocyte antigen DR4: A case report

CRP and IgG titer were normal, and his lesions disappeared gradually. Interstitial granulomatous dermatitis needs to be differentiated from interstitial granuloma annulare (IGA), palisaded neutrophilic granulomatous dermatitis (PNGD) and interstitial granulomatous drug reaction (IGDR). Mucin deposition is generally prominent in IGA. Unclear dust and vasculitis can be observed in PNGD. The key histological features of IGDR include prominent eosinophils and interface dermatitis. Thus, the histopathology of these entities help to distinguish them from IGD. In our case, the patient was diagnosed with IGD after 10-year abnormal liver function, which was finally diagnosed as PBC. Interestingly, when the liver function became normal after UDCA treatment, the skin lesions gradually disappeared. Thus, our case highlights a rare cutaneous presentation of PBC and increases the awareness of association between IGD and autoimmune diseases. Our case also indicates that IGD may be skin presentation of some autoimmune diseases, and the skin lesions may disappear when the systemic diseases are alleviated. CONFLICT OF INTEREST: None declared.