Cutaneous adverse events of immune checkpoint inhibitor therapy: incidence and types of reactive dermatoses

J Dermatolog Treat. 2022 May;33(3):1691-1695. doi: 10.1080/09546634.2021.1898529. Epub 2021 Mar 23.

Abstract

Background: Dermatoses are common and potentially serious complications of programmed cell death receptor PD-1 immune checkpoint inhibitor (anti-PD-1 ICI) therapy. Understanding their incidence is necessary to support clinical awareness, diagnosis, and management.

Objective: To examine the incidence and odds of reported non-cancerous dermatoses in the setting of anti-PD-1 ICI therapy.

Methods: Cross-sectional study of anti-PD-1 (pembrolizumab or nivolumab) treated patients at a tertiary healthcare institution. Selected dermatologic events following immunotherapy were identified in the electronic medical record. Comparator arm were patients that developed these same dermatoses without receiving anti-PD-1 ICI therapy.

Results: There were 13.7% (254/1857) patients that developed one of 28 dermatoses. Compared with the general population, patients treated with anti-PD-1 had a greater risk for development of mucositis (OR 65.7, 95% CI 35.0-123.3), xerostomia (OR 11.9, 95% CI 8.4-16.8), pruritus (11.3, 95% CI 8.9-14.3), and lichen planus/lichenoid dermatitis (OR 10.7, 95% CI 5.6-20.7).

Conclusions: We report the frequency of dermatoses encountered in the setting of ICI therapy, both common (pruritus, rash, vitiligo) and uncommon (scleroderma, urticaria).

Keywords: Nivolumab; drug reaction; irAE; pembrolizumab.

MeSH terms

  • Cross-Sectional Studies
  • Exanthema*
  • Humans
  • Immune Checkpoint Inhibitors* / adverse effects
  • Incidence
  • Pruritus

Substances

  • Immune Checkpoint Inhibitors