Dermatological toxicity associated with the use of immune checkpoint inhibitors

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Abstract

The article presents a review of immune-related cutaneous adverse events associated with checkpoint inhibitors. Pathogenetic mechanisms of immune-related complications associated with T cell hyperactivation and disruption of peripheral tolerance are considered. Clinical and pathomorphological characteristics of the most common skin reactions are described: maculopapular rash, itch, lichenoid and psoriasiform rashes, bullous pemphigoid, as well as rare and life-threatening syndromes such as drug reaction with eosinophilia and systemic symptoms (DRESS syndrome), Stevens–Johnson syndrome, toxic epidermal necrolysis. Special attention is paid to the analysis of psoriasiform rashes and exacerbation of psoriasis vulgaris which are associated with significant diagnostic difficulties and require differential approach to treatment. To demonstrate the importance of early involvement of a dermatologist for diagnosis verification (including skin biopsy) and prescription of pathogenetically justified steroid-sparing therapy, clinical cases are presented.

Multidisciplinary approach and personalized management of patients with immune-related cutaneous adverse events allow to control skin toxicity, minimize the necessity of checkpoint inhibitor cancellation, and preserve efficacy of antitumor treatment.

About the authors

A. Yu. Syryseva

S.S. Yudin City Clinical Hospital of Moscow Healthcare Department; Lomonosov Moscow State University

Email: Jezerovel@gmail.com
ORCID iD: 0000-0001-9585-8373

Oncological Center No. 1; Faculty of Fundamental Medicine, Medical Research and Educational Institute

Russian Federation, 4 Kolomenskiy Proezd, 115446 Moscow; Bld. 51, 1 Leninskie Gory, Moscow 119991

I. G. Shabanov

N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: Jezerovel@gmail.com
ORCID iD: 0009-0006-1072-7918

Institute of Continuing Education and Professional Development
Russian Federation, 1 Ostrovityanova St., Moscow 117513

E. A. Shatokhina

Lomonosov Moscow State University; Central State Medical Academy, Administrative Directorate of the President OF Russian Federation; MSU University Clinic

Email: Jezerovel@gmail.com
ORCID iD: 0000-0002-0238-6563

Faculty of Fundamental Medicine, Medical Research and Educational Institute

Russian Federation, Bld. 51, 1 Leninskie Gory, Moscow 119991; Bld. 1A, 19 Marshal Timoshenko St., Moscow 121359; Bld. 10, 27 Lomonosovsky Prospekt, Moscow 119992

N. V. Danilova

Lomonosov Moscow State University; MSU University Clinic

Email: Jezerovel@gmail.com
ORCID iD: 0000-0001-7848-6707

Faculty of Fundamental Medicine, Medical Research and Educational Institute; Medical Scientific and Educational Institute of Moscow State University

Russian Federation, Bld. 51, 1 Leninskie Gory, Moscow 119991; Bld. 10, 27 Lomonosovsky Prospekt, Moscow 119992

K. V. Orlova

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: Jezerovel@gmail.com
ORCID iD: 0000-0002-0442-5917
Russian Federation, 24 Kashirskoe Shosse, Moscow 115522, Russia

A. V. Michenko

Central State Medical Academy, Administrative Directorate of the President OF Russian Federation; MSU University Clinic

Email: Jezerovel@gmail.com
ORCID iD: 0000-0002-2985-5729

Medical Scientific and Educational Institute of Moscow State University

Russian Federation, Bld. 1A, 19 Marshal Timoshenko St., Moscow 121359; Bld. 10, 27 Lomonosovsky Prospekt, Moscow 119992

Z. R. Magomedova

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: Jezerovel@gmail.com
ORCID iD: 0009-0006-9145-0905
Russian Federation, 24 Kashirskoe Shosse, Moscow 115522

Valeria V. Nazarova

N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Author for correspondence.
Email: Jezerovel@gmail.com
ORCID iD: 0000-0003-0532-6061

Institute of Continuing Education and Professional Development

Russian Federation, 1 Ostrovityanova St., Moscow 117513, Russia; 24 Kashirskoe Shosse, Moscow 115522

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