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Igg4 Related and Inflammatory Diseases / Vascular Tumors and Angiosarcomas · Journal article
Frontiers in Oncology · September 11, 2026
Early or partial results. Treat as a signal, not a conclusion.
This is the first reported case of conjunctival reactive cutaneous capillary endothelial proliferation (RCCEP) in a patient treated with camrelizumab. The lesion was Grade 3 in severity, complicated by secondary bacterial infection, and resolved completely with topical antimicrobial therapy without discontinuation of systemic immunotherapy. The report raises awareness of a previously undocumented mucosal site of involvement for this adverse event but does not establish incidence, risk factors, or optimal management strategies.
Case report. One 64-year-old man with metastatic esophageal squamous cell carcinoma receiving camrelizumab immunotherapy. Intervention: Topical levofloxacin applied to conjunctival lesions. n = 1.
64-year-old man with metastatic esophageal squamous cell carcinoma developed bilateral conjunctival hyperemia with Grade 3 RCCEP after three cycles of camrelizumab Conjunctival lesions presented with foreign body sensation and purulent discharge secondary to bacterial infection Complete lesion resolution achieved within four weeks using topical levofloxacin without discontinuation of systemic therapy
Complete lesion resolution achieved within four weeks using topical levofloxacin without discontinuation of systemic therapy Naranjo score of 7 indicating probable drug-induced adverse event
Clinicians administering camrelizumab should maintain ophthalmologic awareness for mucosal manifestations of RCCEP beyond previously recognized cutaneous lesions. This case suggests that topical antimicrobial therapy may be effective for managing complicated ocular RCCEP without requiring systemic immunotherapy discontinuation, though confirmation in additional cases is needed.
A single case report describing a novel adverse event manifestation; raises awareness of a rare toxicity but provides no comparative data or epidemiological evidence.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians administering camrelizumab should maintain ophthalmologic awareness for mucosal manifestations of RCCEP beyond previously recognized cutaneous lesions. This case suggests that topical antimicrobial therapy may be effective for managing complicated ocular RCCEP without requiring systemic immunotherapy discontinuation, though confirmation in additional cases is needed.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background Camrelizumab-associated reactive cutaneous capillary endothelial proliferation (RCCEP) predominantly involves cutaneous surfaces. Mucosal involvement is exceptional, with no prior reports of conjunctival lesions. Case presentation A 64-year-old man with metastatic esophageal squamous cell carcinoma developed typical cutaneous RCCEP following initial camrelizumab exposure. Upon completion of three treatment cycles, he presented with bilateral conjunctival hyperemia, foreign body sensation, and purulent discharge. Slit-lamp examination revealed multiple vascular papules on the palpebral conjunctivae (Grade 3 RCCEP) with secondary bacterial infection. Unlike previously reported eyelid lesions requiring excision, conservative management with topical levofloxacin resulted in complete lesion resolution within four weeks without discontinuation of systemic therapy (Naranjo score: 7). Conclusion This represents the first documented case of RCCEP affecting the conjunctival mucosa. It underscores the necessity of ophthalmologic surveillance in patients receiving camrelizumab and demonstrates that topical antimicrobial therapy constitutes an effective therapeutic strategy for complicated ocular RCCEP.
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