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The life-threatening eruptions of immune checkpoint inhibitor therapy

Emily L Coleman1, Brianna Olamiju1, Jonathan S Leventhal1

  • 1Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA.

Clinics in Dermatology
|March 22, 2020
PubMed

Insights

Immune checkpoint inhibitors (ICPi) can cause frequent skin toxicities. This review details severe cutaneous adverse reactions (SCARs) like SJS, TEN, DRESS, and AGEP, crucial for dermatologists to manage.

Area of Science:

  • Oncology
  • Dermatology
  • Immunology

Background:

  • Immune checkpoint inhibitors (ICPi) targeting CTLA-4, PD-1, and PD-L1 are revolutionizing cancer therapy.
  • Dermatologic toxicities are frequent immune-related adverse events (irAE) associated with ICPi.
  • Effective management of irAE is critical for patients receiving ICPi therapy.

Purpose of the Study:

  • To provide an overview of severe cutaneous adverse reactions (SCARs) associated with ICPi therapy.
  • To discuss the recognition and management of various dermatologic toxicities.
  • To highlight the importance of dermatologists in managing ICPi-induced skin reactions.

Main Methods:

  • Review of literature on ICPi-related dermatologic toxicities.
  • Categorization and description of severe cutaneous adverse reactions (SCARs).
  • Discussion of immunobullous disorders, erythroderma, and neutrophilic dermatoses.

Main Results:

  • ICPi can lead to a spectrum of cutaneous toxicities, ranging from mild to life-threatening.
  • Severe reactions include Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), DRESS, and AGEP.
  • Other discussed reactions include immunobullous disorders, erythroderma, and neutrophilic dermatoses.

Conclusions:

  • Prompt recognition and management of ICPi-induced dermatologic toxicities are essential.
  • Dermatologists play a key role in managing these immune-related adverse events.
  • Understanding SCARs is vital for optimizing cancer patient care during ICPi treatment.

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