“Skin rashes” and immunotherapy in melanoma: distinct dermatologic adverse events and implications for therapeutic management

ABSTRACT

Immune checkpoint inhibitors have shown efficacy in the treatment of different cancers by stimulating the antitumoral activity of the patient’s immune system, representing a major breakthrough in the field of cancer therapy. Monoclonal antibodies including anti-cytotoxic T-lymphocyte–associated protein 4, anti–programmed cell death protein 1 and its ligand inhibitors have been approved for advanced melanoma among other solid cancers. Although immunotherapy demonstrated a good safety profile, a new spectrum of multisystemic immune-related adverse events has been recently reported due to their use. Cutaneous reactions represent one of the leading adverse events, often reported in literature as “skin rash”, and rarely further characterized in distinct dermatologic entities. Herein we describe the distinctive cutaneous rashes occurring during immunotherapies for advanced melanoma, discussing implications in the treatment management.

KEYWORDS:

• Advanced melanoma
• cutaneous adverse events
• immune checkpoint inhibitors
• PD-1 inhibitors
• CTLA-4 inhibitors
• skin rash

Acknowledgments

We sincerely thank the patients and their families for granting permission to publish this information. Alessandro Di Stefani, MD (Istituto di Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy), for his contribution to examine histopathology. These contributors were not financially supported.

Declaration of Interest

The authors declare that the scientific paper was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest