CUTANEOUS ADVERSE EFFECTS ASSOCIATED WITH IMMUNOTHERAPY IN PATIENTS WITH MELANOMA
DOI:
https://doi.org/10.56238/levv17n56-023Keywords:
Melanoma, Immunotherapy, Immune Checkpoint Inhibitors, Adverse Skin Events, Dermatological ToxicityAbstract
Introduction: Immunotherapy with immune checkpoint inhibitors has transformed the treatment of melanoma, leading to significant improvements in patient survival. However, immune system activation is associated with the development of immune-related adverse events, among which cutaneous manifestations are the most frequent and clinically relevant. Methods: A systematized literature review was conducted to identify and analyze the main cutaneous adverse events associated with immunotherapy in patients with melanoma. Studies evaluating the use of PD-1, PD-L1, and CTLA-4 inhibitors, administered as monotherapy or in combination, were included. Data were analyzed descriptively and qualitatively, considering the methodological heterogeneity of the included studies. Cutaneous manifestations were categorized into clinical groups to facilitate interpretation of the findings. Results: Cutaneous adverse events were the most commonly reported immune-related toxicities. Most reactions were mild to moderate in severity, allowing continuation of oncologic treatment with appropriate dermatologic management. Inflammatory reactions, such as rash, pruritus, eczematous dermatitis, and lichenoid eruptions, were the most prevalent. Pigmentary alterations, particularly vitiligo-like depigmentation, were mainly observed in patients treated with PD-1 inhibitors, while autoimmune bullous dermatoses, although rare, were associated with greater clinical severity. Conclusion: Cutaneous manifestations associated with immunotherapy in melanoma are frequent and heterogeneous, with variable clinical impact. Early recognition and appropriate management are essential to ensure patient safety and maintain treatment continuity, highlighting the importance of a multidisciplinary approach.
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