부산대학교 도서관

A 72-year-old male patient exhibited ptosis in both eyelids. Ptosis developed in the left eye 57 days after the administration of 240 mg of nivolumab for Stage IV (T4bN1bM1c (0)) malignant melanoma on his right heel. Ptosis developed in both eyes from the 71st day. The patient had difficulty opening both eyes, but no abnormality was observed in the movement of the eyeballs. Blood fractionation revealed an increase in CK, but anti-acetylcholine antibodies and anti-musclespecific kinase antibodies were absent. Based on the clinical course and test results, the administration of nivolumab was considered to have caused myasthenia gravis in the muscles around the eyes. Therefore, 30 mg per day of prednisolone was administered on the 71st day. At present,the dose of prednisolone has been reduced to 5 mg per day with no apparent worsening of the condition. In this case, rapid improvement was achieved without an increase in severity because treatment with steroids was started at the outset. Furthermore, combination with steroid treatment made it possible to continue the administration of nivolumab. As reports of ptosis following nivolumab administration are rare, this is an important case. Skin Research, 20 : 309-313, 2021