Mucous membrane pemphigoid and lichenoid reactions after immune checkpoint inhibitors: common pathomechanisms.

Immune checkpoint inhibitor (ICI) therapy has demonstrated impressive antitumor activity. However, it causes adverse effects, including lichenoid reactions. Cases of ICI-triggered bullous pemphigoid (BP) and anecdotally mucous membrane pemphigoid (MMP) have also been reported. We describe two new cases of pembrolizumab-triggered MMP, one of which was associated with cutaneous lichenoid lesions

The biogeochemistry of insectivorous cave guano: a case study from insular Southeast Asia

Cave guano derived from insectivorous bats and birds contain unique geochemical and mineralogical signatures. We investigated the mineralogy, pH, C, N and metal abundance patterns of cave guano spatially and temporally (with depth) along a W–E transect in Malaysia and Palawan from five remote cave sites, each housing large populations of bats and Aerodramus spp.(cave swiftlets). Guano deposits were rich in phosphate and/or sulphate minerals (e.g., gypsum, bassanite) with leucophosphite, spheniscidite, and variscite present in most profiles. Metal abundances measured from modern and ancient bat guano revealed high concentrations of transition metals relative to the local environment. Highly enriched metals, however, were associated with phosphate rather than sulphate minerals. Copper and Zn were enriched in all profiles, whereas other metals were associated with specific caves consistent with known local mineral resources. For example, Sn, Pb, and Rb were particularly enriched in Batu Cave, located in the Peninsular Malaysian granitic tin belt, whereas Ni and Cr were high in regions associated with ultramafic ophiolites and Ni-laterites found on Palawan