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Current Dermatology Reports
Erschienen in: Current Dermatology Reports 3/2023

17.07.2023 | REVIEW

Clinical Features and Management of Dermatologic Immune-Related Adverse Events for the Inpatient Dermatologist

verfasst von: Christopher J. Fay, Christopher Iriarte, Blair S. Allais, Catherine E. Pisano, Abdulhadi Jfri, Cecilia A. Larocca, Nicole R. LeBoeuf

Erschienen in: Current Dermatology Reports | Ausgabe 3/2023

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Abstract

Purpose of Review

Immune checkpoint inhibitors (ICIs) have become a mainstay of oncologic treatment over the past decade. There are currently 11 ICIs approved by the U.S. Food and Drug Administration in the treatment of over a dozen malignancies. ICIs are associated with immune-related adverse events that can affect virtually any organ system. In some instances, these toxicities may lead to inpatient hospitalization and/or discontinuation of the ICI. This review highlights the clinical features and management of cutaneous toxicities most relevant to the inpatient dermatologist, including morbilliform eruptions, severe mucocutaneous reactions including lichenoid eruptions and Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN)-like reactions, drug reaction with eosinophilia and systemic symptoms, acute generalized exanthematous pustulosis, and autoimmune bullous disease. We also review other systemic toxicities that present with skin findings that are relevant to the inpatient dermatologist.

Recent Findings

A distinct ICI-induced mucocutaneous eruption mimicking SJS/TEN but with a delayed presentation and more favorable prognosis has been reported. Biologic therapy for ICI-induced bullous pemphigoid is effective and does not impair survival compared with other systemic regimens. Early exposure to and higher doses of systemic corticosteroids have been shown to result in reduced progression-free and overall survival among patients on immunotherapy.

Summary

Given the increasing number of patients receiving ICIs alone and in combination with other anti-cancer regimens, as well as the complicated and varied clinical appearance of immune related adverse events, it is vital to promptly diagnose and treat these toxicities to provide optimal patient care while minimizing interruptions in oncologic treatment.
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Metadaten
Titel
Clinical Features and Management of Dermatologic Immune-Related Adverse Events for the Inpatient Dermatologist
verfasst von
Christopher J. Fay
Christopher Iriarte
Blair S. Allais
Catherine E. Pisano
Abdulhadi Jfri
Cecilia A. Larocca
Nicole R. LeBoeuf
Publikationsdatum
17.07.2023
Verlag
Springer US
Erschienen in
Current Dermatology Reports / Ausgabe 3/2023
Elektronische ISSN: 2162-4933
DOI
https://doi.org/10.1007/s13671-023-00395-8

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Riesenzellarteriitis: 15% der Patienten sind von okkulter Form betroffen

16.05.2024 Riesenzellarteriitis Nachrichten

In einer retrospektiven Untersuchung haben Forschende aus Belgien und den Niederlanden die okkulte Form der Riesenzellarteriitis genauer unter die Lupe genommen. In puncto Therapie und Rezidivraten stellten sie keinen sehr großen Unterschied zu Erkrankten mit kranialen Symptomen fest.

Betalaktam-Allergie: praxisnahes Vorgehen beim Delabeling

16.05.2024 Pädiatrische Allergologie Nachrichten

Die große Mehrheit der vermeintlichen Penicillinallergien sind keine. Da das „Etikett“ Betalaktam-Allergie oft schon in der Kindheit erworben wird, kann ein frühzeitiges Delabeling lebenslange Vorteile bringen. Ein Team von Pädiaterinnen und Pädiatern aus Kanada stellt vor, wie sie dabei vorgehen.

Isotretinoin: Risiko für schwere Laboranomalien „marginal erhöht“

08.05.2024 Akne Nachrichten

Die Aknetherapie mit Isotretinoin kann einen Anstieg von Leberenzymen und Blutfetten verursachen. Das Risiko für schwere Störungen ist laut einer Forschungsgruppe der Universität Lübeck aber nur marginal erhöht und auf einen engen Zeitraum konzentriert.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Update Dermatologie

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