Clinicopathologic and Immunohistochemical Features of Enfortumab Vedotin-Induced Cutaneous Toxicity.

Cohort studyInternational journal of dermatology· Sep 2026

Clinicopathologic and Immunohistochemical Features of Enfortumab Vedotin-Induced Cutaneous Toxicity.

Federico Repetto, Soma Jobbagy, Eudora Lee … Rosalynn M Nazarian

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DermatopathologyCohort studyDiagnosisQ1IF 1.4

Intercellular immunoglobulin G staining distinguishes enfortumab vedotin skin eruptions from erythema multiforme/SJS/TEN mimics

Clinicopathologic and Immunohistochemical Features of Enfortumab Vedotin-Induced Cutaneous Toxicity.

Federico Repetto … Rosalynn M Nazarian

International journal of dermatology · Sep 2026

Background

Enfortumab vedotin (enfortumab vedotin) frequently causes cutaneous eruptions that can mimic erythema multiforme and Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), complicating management decisions.

Purpose

The aim of this study was to define reproducible clinicopathologic patterns and evaluate immunohistochemical markers that distinguish enfortumab vedotin-induced cutaneous toxicity (EV-induced cutaneous toxicity) eruptions from histologic mimics.

Methods

This retrospective case series included nineteen patients receiving enfortumab vedotin (twenty-four biopsies), compared with ten controls (erythema multiforme or SJS/TEN).

Results

intercellular immunoglobulin G staining was far more common in enfortumab vedotin eruptions than mimics

EV cases

83%

Controls

20%

More results

Epidermal "ring" mitoses were frequent in enfortumab vedotin-related biopsies and absent in controls.

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.

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Conclusion

Intercellular immunoglobulin G 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.

Clinicopathologic and Immunohistochemical Features of Enfortumab Vedotin-Induced Cutaneous Toxicity.

Clinicopathologic and Immunohistochemical Features of Enfortumab Vedotin-Induced Cutaneous Toxicity.

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