Cutaneous Adverse Reactions of Immunotherapy in Patients with Advanced Melanoma

SIMPLE SUMMARY: It is estimated that 30–50 percent of patients treated with Immune Checkpoint Blockers will eventually develop cutaneous immune-related adverse events. These toxicities are in, most of the time, low-grade reactions; however, they are characterized by a wide clinical spectrum. Clinicians who utilize these novel agents must have a thorough understanding of the pathogenesis, clinical characteristics, as well as the proper treatment of these toxicities. In this review, we analyze the treatment approaches as well as unique features observed in melanoma patients who develop cutaneous immune-related adverse events. ABSTRACT: Immune checkpoint blockers (ICBs) have been widely used during the last decade for the treatment of various tumors, including advanced and metastatic melanoma. While these agents have improved melanoma patients’ survival rates, they have also been associated with various autoimmune toxicities, with the skin being most commonly affected. The severity of cutaneous toxicity can not only negatively affect patients’ quality of life but can also limit the proper treatment of cancer. Thus, the role of the dermatologist is substantial in early detecting and promptly treating these adverse events. Maculopapular rash, psoriasiform, lichenoid dermatoses and bullous pemphigoid are the most frequent cutaneous adverse events that require immediate intervention. Other rare autoimmune toxicities, e.g., sarcoidosis, dermatomyositis or subacute lupus, have also been reported. In this review, we summarize the aspects of ICB-induced cutaneous toxicities in patients with melanoma, emphasizing their management and treatment options in clinical practice.