Challenging Dermatologic Considerations Associated with Immune Checkpoint Inhibitors

Area of Science:

• Oncology
• Dermatology
• Immunology

Background:

• Immune checkpoint inhibitors (ICIs) are revolutionizing cancer treatment.
• Non-specific immune activation by ICIs can lead to immune-related adverse events (irAEs).
• Skin is a frequent target organ for irAEs, presenting diverse clinical challenges.

Purpose of the Study:

• To review challenging dermatologic considerations associated with ICI therapies.
• To highlight the importance of dermatologist collaboration in managing cutaneous irAEs.
• To provide approaches for complex clinical scenarios involving ICIs and skin toxicity.

Main Methods:

• Review of current literature and clinical guidelines.
• Discussion of complex management scenarios requiring multidisciplinary input.
• Emphasis on diagnostic and therapeutic strategies for cutaneous irAEs.

Main Results:

• Cutaneous irAEs encompass a broad spectrum of presentations.
• Referral to dermatology is crucial for diagnosis and management of irAEs.
• Collaboration is vital for managing corticosteroid-refractory irAEs, ICI rechallenge, and patients with pre-existing conditions.

Conclusions:

• Dermatologic consultation is essential for optimizing care in patients receiving ICIs.
• Multidisciplinary collaboration can mitigate morbidity and mortality associated with irAEs.
• Evidence-based approaches are needed for complex irAE management decisions.