Background
Clinicians are increasingly prescribing immune checkpoint inhibitors (ICIs) to treat cancer, but the real-world incidence, characteristics and risk factors of cutaneous immune-related adverse events (cirAEs) are unclear.
Objective
To determine the incidence, features and risk factors of cirAEs and measure their possible association with extracutaneous toxicity.
Methods
We conducted a prospective observational study in a Spanish tertiary care hospital, including people who started an ICI between March 2020 and May 2022. We used a survival analysis and a log-rank test to obtain and compare incidence rates, and a multivariate Cox model to detect risk factors of cirAEs.
Results
We included 189 patients, of whom 82 (43.4%) presented cutaneous toxicity. The incidence of cirAEs was 75.0 per 100 person-years, with a 50% probability of cirAE appearance at 10 months of follow-up. The most frequent cirAE category was inflammatory dermatoses, and the most frequent types were pruritus, eczema and maculopapular eruptions. ICI combination therapy, family history of psoriasis and rheumatologic and pulmonary irAEs increased the risk of cirAEs. Limitations: Single-center design.
Conclusion
We found a high incidence of cirAEs, and they occurred early in follow-up. Dermatologists should be involved in the management of cirAEs, especially in people with risk factors.