Skin toxicities from cancer immunotherapy

Choi, 2020Haanen, 2017Hansen, 2018

Skin toxicities are the most common immune-related adverse events associated with the use of immunotherapy drugs, including anti-CTLA-4 therapies and PD-1/PD-L1 inhibitors. Most toxicities are mild to moderate in severity and take the form of a maculopapular rash, pruritus or vitiligo.

It may be possible to manage skin toxicities with a topical corticosteroid and an oral antihistamine while continuing the immunotherapy drug, as the appearance of the skin toxicities may be associated with immunotherapy response. However, severe reactions (blistering, ulceration, mucosal involvement) may require stopping the immunotherapy drug and starting treatment with a systemic corticosteroid or other immunosuppressants.