CASE REPORT
J. Cutan. Immunol. Allergy
Case Report: Blister formation with transient drug hypersensitivity following CAR-T-cell therapy
- NW
Natsu Watanabe
- NK
Nobuo Kanazawa
- SY
Satoshi Yoshihara
Hyogo College of Medicine, Nishinomiya, Japan
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Abstract
We present a rare case of a 70-year-old male who developed multiple tense bullae with minimal inflammation after receiving CD19-directed chimeric antigen receptor (CAR)-T-cell therapy for diffuse large B-cell lymphoma. Although strong drug-induced lymphocyte stimulation test positivity was observed initially for multiple drugs, the reactions faded over time. Histopathology revealed subepidermal blistering with minimal inflammatory infiltration, including a mild perivascular infiltration of T lymphocytes, predominantly CD4+ cells rather than CD8+ cells. All of the previously-reported cases with CAR-T-related cutaneous eruptions involve marked inflammation. In contrast, this case may represent a unique blister formation with T-cell hyperreactivity associated with post-CART immune reconstitution. A comparative analysis of previously published cases is provided.
Summary
Keywords
car-t therapy, CRS, bullous eruption, DLST, drug hypersensitivity
Received
16 July 2025
Accepted
26 September 2025
Copyright
© 2025 Watanabe, Kanazawa and Yoshihara. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Nobuo Kanazawa, nkanazaw@hyo-med.ac.jp
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