Cutaneous Adverse Events of Immune Checkpoint Inhibitors: A Literature Review

Zoe Apalla; Chryssoula Papageorgiou; Aimilios  Lallas; Florentina Delli; Christina Fotiadou; Christina Kemanetzi; Elizabeth Lazaridou

doi:10.5826/dpc.1101a155

Cutaneous Adverse Events of Immune Checkpoint Inhibitors: A Literature Review

Authors

Zoe Apalla Second Dermatology Department, School of Medicine, Aristotle University of Thessaloniki, Greece
Chryssoula Papageorgiou Second Dermatology Department, School of Medicine, Aristotle University of Thessaloniki, Greece
Aimilios Lallas First Dermatology Department, School of Medicine, Aristotle University of Thessaloniki, Greece
Florentina Delli State Dermatology Department, Hippokratio General Hospital of Thessaloniki, Greece
Christina Fotiadou Second Dermatology Department, School of Medicine, Aristotle University of Thessaloniki, Greece
Christina Kemanetzi Second Dermatology Department, School of Medicine, Aristotle University of Thessaloniki, Greece
Elizabeth Lazaridou Second Dermatology Department, School of Medicine, Aristotle University of Thessaloniki, Greece

Keywords:

immune checkpoint inhibitors, skin toxicity, adverse effects, nivolumab, pembrolizumab, ipilimumab

Abstract

Immune checkpoints assist with self-tolerance and minimize collateral tissue damage when immune responses are activated. Although immune checkpoint inhibitors (CPIs) are characterized by a favorable risk/benefit ratio, immune checkpoint blockade has been associated with a new subset of autoimmune-like toxicities, named immune-related adverse events (irAEs). Dermatologic reactions are among the most prevalent irAE triggered by CPIs. In a majority of cases they are self-limiting and readily manageable. However, it is not uncommon that they result in severe skin involvement and impairment of patients’ quality of life. Awareness of the spectrum of cutaneous irAEs is mandatory for every clinician involved in the management of oncologic patients. The role of the dermatologists is essential because early recognition and appropriate management of skin toxicity may prevent dose modifications and discontinuation of CPIs. The latter is particularly relevant, considering that recent data suggest favorable oncologic response in patients developing irAEs.

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