Bernice Kwong, M.D., is Clinical Associate Professor of Dermatology and Director of the Inpatient Dermatology Consult Service. She has a special interest in the management of cutaneous complications that arise in cancer patients and currently runs the Supportive Dermato-Oncology Program at the Stanford Cancer Center, where she manages skin side effects of cancer therapies including chemotherapy related skin reactions, radiation dermatitis, and graft-versus-host disease. Dr. Kwong completed medical school at Yale University, and completed her dermatology residency at Stanford University in 2012.

Clinical Focus

  • Cancer > Cutaneous (Dermatologic) Oncology
  • Dermatology
  • Inpatient Dermatology Consultation
  • Cutaneous complications of cancer therapy and hematopoietic stem cell transplantation

Academic Appointments

Administrative Appointments

  • Associate Program Director, Stanford Dermatology (2016 - Present)
  • Director, Inpatient Dermatology Consultation Service, Stanford Dermatology (2012 - Present)

Professional Education

  • Internship:Yale University Traditional Internal Medicine Residency (2008) CT
  • Medical Education:Yale School Of Medicine Office of Student Affairs (2007) CT
  • Residency:Stanford University - Dept of Dermatology (2012) CA
  • Chief Resident, Stanford Dermatology, Dermatology (2012)
  • Board Certification: Dermatology, American Board of Dermatology (2012)

Research & Scholarship

Clinical Trials

  • A Study of Vismodegib (GDC-0449) in Patients Treated With Vismodegib in a Previous Genentech-sponsored Phase I or II Cancer Study Not Recruiting

    This was a multicenter, open-label extension study. Patients who received vismodegib (GDC-0449) in a Genentech-sponsored study and who had completed the parent study or who continued to receive vismodegib at the time the parent study closed were eligible for continued treatment in this protocol.

    Stanford is currently not accepting patients for this trial. For more information, please contact Shruthi Rangaraj, (650) 721 - 7159.

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  • A Trial of Intratumoral Injections of SD-101 in Combination With Pembrolizumab in Patients With Metastatic Melanoma or Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma Recruiting

    This is a phase 1b/2, open-label, multicenter trial designed to evaluate the safety, tolerability, biologic activity, and preliminary efficacy of intratumoral SD 101 injections in combination with intravenous pembrolizumab in patients with metastatic melanoma or recurrent or metastatic head and neck squamous cell carcinoma (HNSCC). Phase 1 of this trial is a modified 3+3 dose escalation study evaluating escalating or intermediate dose levels of SD-101 given with a fixed dose of pembrolizumab in patients with metastatic melanoma. Phase 2 of this study will consist of 4 expansion cohorts to further evaluate the efficacy and safety of SD-101 given in combination with pembrolizumab in specific melanoma and HNSCC populations: For each of the indications in melanoma and HNSCC 2 separate cohorts will be recruited, those who are anti-programmed death receptor-1/ligand 1 (anti-PD-1/L1) therapy naïve and those who have progressive disease (PD) while receiving anti-PD-1/L1 therapy.

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  • An Investigational Immuno-therapy Study to Determine the Safety of Urelumab Given in Combination With Nivolumab in Solid Tumors and B-cell Non-Hodgkin's Lymphoma Not Recruiting

    The purpose of this study is to determine which doses of Urelumab and Nivolumab are safe and tolerable when they are given together.

    Stanford is currently not accepting patients for this trial. For more information, please contact Kristine McGlennen, 650-723-3589.

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  • Modified Dakin's Solution in Reducing Radiation-Induced Dermatitis in Patients With Head and Neck Cancer Undergoing Radiation Therapy Recruiting

    This randomized phase III trial studies how well modified Dakin's solution works in reducing radiation-induced dermatitis, a common skin reaction to radiation therapy, in patients with head and neck cancer undergoing radiation therapy. Modified Dakin's solution may reduce inflammation in the body, which may prevent or reduce dermatitis after radiation therapy.

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2017-18 Courses


All Publications

  • Eruptive Keratoacanthomas Associated With Pembrolizumab Therapy. JAMA dermatology Freites-Martinez, A., Kwong, B. Y., Rieger, K. E., Coit, D. G., Colevas, A. D., Lacouture, M. E. 2017


    To our knowledge, there have been no previous reports of eruptive keratoacanthomas (KAs) in patients receiving pembrolizumab.To report the cases of 3 consecutive patients with pembrolizumab-induced eruptive KAs and their management.Case report study of 3 patients from 2 centers with pembrolizumab-treated cancer who all developed eruptive KAs.All 3 patients had AK treatment with clobetasol ointment and intralesional triamcinolone; 2 patients also underwent open superficial cryosurgery.Three consecutive patients with cancer, 2 men and 1 woman (median age, 83 years; range 77-91 years), experienced pembrolizumab-associated eruptive KAs. All patients presented with a sudden onset of multiple lesions on sun-exposed areas of their extremities after a median of 13 months (range, 4-18 months) of pembrolizumab therapy. On lesional biopsy, a lichenoid infiltrate was observed in the underlying dermis, predominantly composed of CD3+ T cells, scattered CD20+ B cells, and relatively few PD-1+ (programmed cell death 1-positive) T cells, an immunophenotypic pattern also observed in other cases of anti-PD-1-induced lichenoid dermatitis. Patients were treated with clobetasol ointment and intralesional triamcinolone, alone or in combination with open superficial cryosurgery. All KAs resolved in all patients, and no new lesions occurred during close follow-up. Pembrolizumab treatment was continued without disruption in all 3 cases, and all patients had complete responses of their primary cancers.Pembrolizumab is used in advanced melanoma, advanced non-small-cell lung cancer, and in head and neck cancer. A variety of dermatologic immune-related adverse events including maculopapular eruption, lichenoid reactions, pruritus, and vitiligo have been described. This case series demonstrates that pembrolizumab therapy may also be associated with eruptive KAs with characteristic dermal inflammation, which improved with corticosteroid treatment (topical and intralesional) alone or in combination with cryosurgery, allowing patients to continue therapy with pembrolizumab.

    View details for DOI 10.1001/jamadermatol.2017.0989

    View details for PubMedID 28467522

  • Mitigation of epidermal growth factor receptor inhibitor-induced side effects utilizing melanin and vascular-specific lasers: A case report series. Journal of cosmetic and laser therapy Kuo, K. Y., Kwong, B., Rahman, Z. 2017: 1-3


    The advent of targeted chemotherapy has led to the emergence of new dermatologic toxicities. We sought to use lasers and light devices to treat recalcitrant cutaneous adverse effects related to cancer treatment. Three stage III or IV cancer patients with cutaneous complications due to epidermal growth factor receptor (EGFR) inhibitors were treated with melanin and vascular-specific laser and light technologies. Two patients reported reduction in papulopustular eruption following pulse dye laser (PDL) treatment. Two patients noted reduction in hair growth following intense pulsed light (IPL) and/or Alexandrite laser treatments. One patient was treated with both the PDL and IPL and reported improvement of both EGFR-induced hypertrichosis and papulopustular eruption. Laser and light devices targeting melanin and hemoglobin can be utilized to mitigate the cutaneous adverse effects associated with EGFR inhibitors in patients who have failed traditional therapies. This represents a new option for the cancer patient who is suffering from chemotherapy-induced side effects.

    View details for DOI 10.1080/14764172.2017.1299187

    View details for PubMedID 28463045

  • Reversible cutaneous side effects of vismodegib treatment. Cutis Kwong, B., Danial, C., Liu, A., Chun, K. A., Chang, A. L. 2017; 99 (3): E19–E20

    View details for PubMedID 28398426

  • General management strategy for epidermal growth factor receptor inhibitor-associated papulopustular eruption. Journal of the American Academy of Dermatology Farahnik, B., Kwong, B., Murase, J. 2016; 75 (5)

    View details for DOI 10.1016/j.jaad.2016.07.036

    View details for PubMedID 27745649

  • Cutaneous Complications of Targeted Melanoma Therapy. Current treatment options in oncology de Golian, E., Kwong, B. Y., Swetter, S. M., Pugliese, S. B. 2016; 17 (11): 57-?


    The landscape of advanced and metastatic melanoma therapy has shifted dramatically in recent years. Since 2011, eight drugs (ipilimumab, vemurafenib, dabrafenib, trametinib, cometinib, pembrolizumab, nivolumab, and talimogene laherparepvec) have received FDA approval for the treatment of advanced or metastatic melanoma, including combination regimens of both small molecule kinase and immune checkpoint inhibitors. These therapies have revolutionized the management of unresectable regional nodal and distant melanoma, providing hope of extended survival to patients. As the use of novel agents has increased, so have the cutaneous toxicities associated with these medications. While most skin reactions are low-grade and can be managed conservatively with topical therapies, malignant lesions and more serious or life-threatening drug reactions can arise during therapy, requiring prompt dermatologic recognition and treatment in order to improve patient outcome. Given the survival benefit attributed to these new agents, treating skin toxicity and maintaining patient quality of life is of paramount importance. Oncologists should be aware of the common cutaneous toxicities associated with these medications and should be encouraged to involve dermatologists in the collaborative care of advanced melanoma patients. Close communication between oncologists and dermatologists can help to avoid unnecessary dose reduction or treatment discontinuation and identify situations when treatment cessation is truly warranted.

    View details for DOI 10.1007/s11864-016-0434-0

    View details for PubMedID 27645330

  • Eosinophil-Rich Acute Febrile Neutrophilic Dermatosis in a Patient With Enteropathy-Associated T-cell Lymphoma, Type 1. American Journal of dermatopathology Soon, C. W., Kirsch, I. R., Connolly, A. J., Kwong, B. Y., Kim, J. 2016; 38 (9): 704-708


    The presence of eosinophils within the neutrophilic infiltrates of acute febrile neutrophilic dermatosis (Sweet syndrome) is documented in the literature. Here, the authors describe a case of eosinophil-rich acute febrile neutrophilic dermatosis in the setting of new onset enteropathy-associated T-cell lymphoma (EATL), type 1. Histopathologic evaluation of the skin biopsies demonstrated a mixed superficial perivascular and inflammatory infiltrate composed of neutrophils, lymphocytes, and abundant eosinophils. EATL, type 1 is an aggressive although rare primary intestinal lymphoma that may be associated with celiac disease. This lymphoma is associated with a poor prognosis due to treatment resistance or bowel perforation. To the authors' knowledge, Sweet syndrome has not been reported in a patient with EATL.

    View details for DOI 10.1097/DAD.0000000000000549

    View details for PubMedID 27097333

  • Epidermotropic metastasis of primary lung adenocarcinoma. Journal of cutaneous pathology Scott, G. D., Kwong, B. Y., Novoa, R. A. 2016; 43 (9): 798-801


    Cutaneous metastasis of lung cancer is a rare event and usually portends a grim prognosis. Several cases of lung cancer with cutaneous metastasis have been reported, but these have been largely limited to the dermis. Here we describe a unique case of cutaneous metastatic lung adenocarcinoma largely limited to the epidermis, mimicking Paget's disease or a cutaneous adnexal tumor.

    View details for DOI 10.1111/cup.12741

    View details for PubMedID 27234927

  • Enhanced radiation dermatitis associated with concurrent palliative radiation and vemurafenib therapy. Cutis Kuo, K. Y., Jiang, W., Swetter, S. M. 2016; 97 (2): E4-6

    View details for PubMedID 27622267

  • Immunohistochemical analysis of lichenoid reactions in patients treated with anti-PD-L1 and anti-PD-1 therapy. Journal of cutaneous pathology Schaberg, K. B., Novoa, R. A., Wakelee, H. A., Kim, J., Cheung, C., Srinivas, S., Kwong, B. Y. 2016; 43 (4): 339-346


    Recent advances in the immunotherapeutic treatment of cancer have led to the development of multiple new directed therapies including monoclonal antibodies that block the immune checkpoint T-cell receptor programmed death 1 (PD-1) and the PD-1 ligand, programmed death ligand 1 (PD-L1). Various immune-related toxicities have been associated with these drugs including, most commonly, skin rashes.Five cases of lichenoid dermatitis, including one case of lichenoid mucositis and one case of lichen sclerosus, associated with anti-PD-L1 and anti-PD1 therapy were compared with three biopsies of non-drug-related lichen planus (LP) and three lichen planus-like keratoses (LPLK) used as controls.Histopathologic and immunophenotypic analysis of these lichenoid lesions demonstrated significantly greater histiocytic infiltrates than observed in control lichenoid reactions (p = 0.0134). We also observed increased spongiosis and epidermal necrosis. No significant differences were seen in expression of CD3, CD4:CD8, CD20, PD-1, CD25, Foxp3, CXCL13 and PD-L1 expression.These findings expand the literature of immune-related toxicities of PD-L1 and PD-1 blockade to include lichenoid dermatitis and lichenoid mucositis. Of note, these cutaneous side effects were amenable to topical treatment, without the need for medication dose reduction or discontinuation.

    View details for DOI 10.1111/cup.12666

    View details for PubMedID 26762844

  • Acral verruca-like presentation of chronic graft-vs.-host disease JOURNAL OF CUTANEOUS PATHOLOGY Park, J. H., Lester, L., Kim, J., Kwong, B. Y. 2016; 43 (3): 236-241

    View details for DOI 10.1111/cup.12640

    View details for Web of Science ID 000372901600006

  • Acral verruca-like presentation of chronic graft-vs.-host disease. Journal of cutaneous pathology Park, J. H., Lester, L., Kim, J., Kwong, B. Y. 2016; 43 (3): 236-241


    Chronic graft-vs.-host disease (GVHD) is a severe and potentially fatal complication in patients after undergoing allogeneic stem cell transplant. This disease may be hard to diagnose as it has numerous cutaneous presentations.We report four cases of patients seen at Stanford Hospital between January 2013 to December 2014 with hematologic malignancy who developed hyperkeratotic papules and plaques on the palms and soles after allogeneic hematopoietic stem cell transplant.In all four cases, standard treatments for verruca vulgaris failed. Histopathology uniformly showed basal vacuolar alteration at the dermal-epidermal junction and necrotic keratinocytes around the eccrine glands, consistent with GVHD. Interestingly, all four patients responded to topical immunosuppression.Acral verrucous lesions represent an underrecognized presentation of chronic GVHD. We describe four patients with verruca-like lesions on the palms and soles following allogeneic HSCT. Histopathology confirmed GVHD, and lesions improved with immunosuppression. It is important for dermatologists and dermatopathologists to recognize this rare presentation of cutaneous GVHD.

    View details for DOI 10.1111/cup.12640

    View details for PubMedID 26449730

  • Recurrent Subepidermal Blistering Dermatosis Heralding Disease Relapse in IgA Kappa Multiple Myeloma: Report of a Case and a Review of the Literature. Clinical lymphoma, myeloma & leukemia Leatham, H. W., Novoa, R., Liedtke, M., Kwong, B. Y. 2016; 16 (1): e1-5

    View details for DOI 10.1016/j.clml.2015.11.007

    View details for PubMedID 26708980

  • Ibrutinib-associated rash: a single-centre experience of clinicopathological features and management. British journal of haematology 2016

    View details for DOI 10.1111/bjh.14302

    View details for PubMedID 27539794

  • JAK2-positive cutaneous myelofibrosis presenting as sclerosing extramedullary hematopoietic tumors on the scalp: case presentation and review of the literature. Journal of cutaneous pathology LeBlanc, R. E., Lester, L., Kwong, B., Rieger, K. E. 2015; 42 (11): 858-862


    We report the second case of cutaneous myelofibrosis with a documented JAK2 activating mutation involving the scalp of a 67-year-old woman with primary myelofibrosis in her marrow. In contrast to the previous case, the biopsy revealed extensive lesional collagen deposition and closely mimicked a fibrohistiocytic proliferation. Similar rare lesions occurring in the setting of myeloproliferative neoplasms have been called sclerosing extramedullary hematopoietic tumors. These entities appear histomorphologically and etiologically distinct from extramedullary hematopoiesis, and their diagnosis should prompt the workup for a myeloproliferative neoplasm in the absence of an antecedent diagnosis. The presence of the JAK2 mutation in our case confirmed that the lesions represented skin involvement by a neoplastic myeloid proliferation and not compensatory extramedullary hematopoiesis. Our patient died of disease several months following the appearance of her lesions, which is in keeping with other reports that suggest that cutaneous myelofibrosis may serve as an independent poor prognostic sign in otherwise advanced primary myelofibrosis. A review of the literature further emphasizes the importance of distinguishing this entity from mesenchymal neoplasms and acute myeloid leukemia involving the skin.

    View details for DOI 10.1111/cup.12553

    View details for PubMedID 26153565

  • JAK2-positive cutaneous myelofibrosis presenting as sclerosing extramedullary hematopoietic tumors on the scalp: case presentation and review of the literature JOURNAL OF CUTANEOUS PATHOLOGY LeBlanc, R. E., Lester, L., Kwong, B., Rieger, K. E. 2015; 42 (11): 858-862

    View details for DOI 10.1111/cup.12553

    View details for Web of Science ID 000368293300010

  • Pruritus as a Paraneoplastic Symptom of Thymoma JOURNAL OF THORACIC ONCOLOGY Padda, S. K., Shrager, J. B., Riess, J. W., Pagtama, J. Y., Tisch, A. J., Kwong, B. Y., Liang, Y., Schwartz, E. J., Loo, B. W., Neal, J. W., Hardy, R., Wakelee, H. A. 2015; 10 (11): E110-E112

    View details for DOI 10.1097/JTO.0000000000000623

    View details for Web of Science ID 000363312300001

    View details for PubMedID 26536199

  • Management of Dermatologic Complications of Lung Cancer Therapies. Current treatment options in oncology Pugliese, S. B., Neal, J. W., Kwong, B. Y. 2015; 16 (10): 50-?


    In recent years, oncogene-directed targeted agents and immunotherapies have expanded the treatment armamentarium for advanced lung cancer and, in particular, non-small cell lung cancer (NSCLC). Along with extended survival, these agents are accompanied by a host of cutaneous complications that affect the skin, hair, and nails. These skin complications range from the well-characterized papulopustular (acneiform) eruption of the epidermal growth factor receptor (EGFR) inhibitors to the emerging characterization of lichenoid skin eruptions seen during treatment with antibodies targeting the programmed cell death protein 1 (PD-1) and programmed cell death protein 1 ligand (PD-L1). When promptly recognized and accurately diagnosed, most cutaneous adverse events can be managed with supportive treatments, avoiding the need to interrupt antitumor therapy. Furthermore, preemptive management of skin problems can lead to significantly decreased severity of many cutaneous complications of these therapies. We encourage close collaboration between dermatologists and oncologists to better characterize cutaneous toxicity, select appropriate management, and avoid unnecessary dose reduction or discontinuation while simultaneously improving patient quality of life.

    View details for DOI 10.1007/s11864-015-0368-y

    View details for PubMedID 26338208

  • Management of Dermatologic Complications of Lung Cancer Therapies. Current treatment options in oncology Pugliese, S. B., Neal, J. W., Kwong, B. Y. 2015; 16 (10): 368-?

    View details for DOI 10.1007/s11864-015-0368-y

    View details for PubMedID 26338208