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Cited by 480

The DOI matches its Crossref record; 21 of the 21 references it cites were found in a registry or an index.

Immune checkpoint inhibitor–related dermatologic adverse events

Open access
Geisler, Amaris N., Phillips, Gregory S., Barrios, Dulce M., Wu, Jennifer, Leung, Donald Y.M., Moy, Andrea P., Kern, Jeffrey A., Lacouture, Mario E.·2020·Journal of the American Academy of Dermatology
DOI 10.1016/j.jaad.2020.03.132
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Abstract

Immune checkpoint inhibitors have emerged as a pillar in the management of advanced malignancies. However, nonspecific immune activation may lead to immune-related adverse events, wherein the skin and its appendages are the most frequent targets. Cutaneous immune-related adverse events include a diverse group of inflammatory reactions, with maculopapular rash, pruritus, psoriasiform and lichenoid eruptions being the most prevalent subtypes. Cutaneous immune-related adverse events occur early, with maculopapular rash presenting within the first 6 weeks after the initial immune checkpoint inhibitor dose. Management involves the use of topical corticosteroids for mild to moderate (grades 1–2) rash, addition of systemic corticosteroids for severe (grade 3) rash, and discontinuation of immunotherapy with grade 4 rash. Bullous pemphigoid eruptions, vitiligo-like skin hypopigmentation/depigmentation, and psoriasiform rash are more often attributed to programmed cell death-1/programmed cell death ligand-1 inhibitors. The treatment of bullous pemphigoid eruptions is similar to the treatment of maculopapular rash and lichenoid eruptions, with the addition of rituximab in grade 3–4 rash. Skin hypopigmentation/depigmentation does not require specific dermatologic treatment aside from photoprotective measures. In addition to topical corticosteroids, psoriasiform rash may be managed with vitamin D3 analogues, narrowband ultraviolet B light phototherapy, retinoids, or immunomodulatory biologic agents. StevenseJohnson syndrome and other severe cutaneous immune-related adverse events, although rare, have also been associated with checkpoint blockade and require inpatient care as well as urgent dermatology consultation.

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Metadata

Authors
Geisler, A. N., Phillips, G. S., Barrios, D. M., Wu, J., Leung, D. Y. M., Moy, A. P., Kern, J. A., & Lacouture, M. E.
Venue
Journal of the American Academy of Dermatology
Publisher
Elsevier BV
Published
2020-11
Volume
83
Issue
5
Pages
1255-1268
ISSN
0190-9622 (ISSN-L)
DOI
10.1016/j.jaad.2020.03.132
OpenAlex
W3027845041
Cited by
480
References
21
FWCI
17.56
Type
journal article
Language
en
Open access
green

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