Cutaneous Hypersensitivity Reactions to Immune Checkpoint Inhibitors

The introduction of immune checkpoint inhibitors (ICIs) has transformed the management of various malignancies. Alongside their therapeutic success, the widespread application of ICIs has unveiled a spectrum of immune-related adverse events (irAE), most often affecting the skin. Cutaneous irAEs (cirAE) encompass a range from common morbilliform and lichenoid rashes to more severe conditions such as bullous dermatoses and psoriasiform eruptions, each presenting distinct clinical challenges. Moreover, less common but clinically severe cutaneous reactions like toxic epidermal necrolysis have also been observed. Cutaneous irAEs are frequently observed, with an incidence ranging from 37% to 70% for anti-CTLA-4 antibodies and 17% to 40% for anti-PD1/anti-PDL1 antibodies. Recognizing the critical need for effective therapeutic strategies, this review carefully examines current approaches and guidelines for managing cirAEs.