ArticleInternational journal of dermatology2026
Clinicopathologic and Immunohistochemical Features of Enfortumab Vedotin-Induced Cutaneous Toxicity.
Article in International journal of dermatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Toxicity attribution during enfortumab vedotin plus pembrolizumab therapy in urothelial carcinoma: a practical framework.The oncologist · 2026Review
- Enfortumab vedotin-induced cutaneous toxicities and their association with survival in urothelial carcinoma.medRxiv : the preprint server for health sciences · 2026Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEnfortumab vedotin (EV) frequently causes cutaneous eruptions that can mimic erythema multiforme and Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), complicating management decisions.
objectiveThe aim of this study was to define reproducible clinicopathologic patterns and evaluate immunohistochemical markers that distinguish EV-induced cutaneous toxicity (EVICT) eruptions from histologic mimics.
methodsThis retrospective case series included nineteen patients receiving EV (twenty-four biopsies), compared with ten controls (erythema multiforme or SJS/TEN). Blinded review assessed histologic patterns and immunohistochemistry for immunoglobulin G (IgG), Nectin-4, and cytotoxic T-cells.
resultsAll cases showed interface dermatitis fitting one of four patterns: classic vacuolar, cytotoxic with epidermal dysmaturation, necrolytic SJS/TEN-like, or spongiotic interface. Epidermal "ring" mitoses were frequent in EV-related biopsies and absent in controls. Intercellular IgG staining occurred in 83% of EV cases versus 20% of controls, yielding an area under the curve of 0.86; any intercellular staining provided 82% sensitivity and 80% specificity, while moderate or strong staining achieved 100% specificity. Cytotoxic T-cell density and Nectin-4 expression did not reliably discriminate groups. LIMITATIONS: Retrospective design, modest sample size, and potential confounding by concomitant therapies.
conclusionIntercellular IgG on routine immunohistochemistry, together with characteristic "ring" mitoses, provides a practical framework to identify enfortumab vedotin-associated eruptions and differentiate them from erythema multiforme and SJS/TEN.
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