Abstract
Immunotherapy with checkpoint inhibitors significantly improves the outcome for stage III and IV melanoma. Cutaneous adverse events during treatment are often reported. We herein aim to review the principal pigmentation changes induced by immune check-point inhibitors: the appearance of vitiligo, the Sutton phenomenon, melanosis and hair and nail toxicities.
Highlights
Immune checkpoint inhibitors have shown promise in enhancing the immune system to fight against cancer cells and in providing a higher response rates than chemotherapies used in the past [1,2]
Immune checkpoint inhibitors (ICI) are monoclonal antibodies which target two immune checkpoint pathways: (1) the cytotoxic T-lymphocyte antigen-4 (CTLA-4) that is expressed by activated T cells and transmits an inhibitory signal to T cells activation during immune response, and (2) programmed death-1 protein (PD-1)
We review the principal pigmentation changes induced by ICI: the appearance of vitiligo, the Sutton phenomenon, the melanosis and hair and nail toxicities
Summary
The function of the immune system in melanoma disease course is well established. Immune checkpoint inhibitors have shown promise in enhancing the immune system to fight against cancer cells and in providing a higher response rates than chemotherapies used in the past [1,2]. Tumor cells inactivate the process of immunosurveillance by expressing ligands of immune checkpoint pathways. Immune checkpoint inhibitors (ICI) are monoclonal antibodies which target two immune checkpoint pathways: (1) the cytotoxic T-lymphocyte antigen-4 (CTLA-4) that is expressed by activated T cells and transmits an inhibitory signal to T cells activation during immune response, and (2) programmed death-1 protein (PD-1). That promotes apoptosis of T cells in lymph nodes and reduces apoptosis in regulatory. This activation of T cells may be responsible for the occurrence of immune-related adverse effects (AE) affecting different organs and systems; in particular, skin-related AE are reported in up to 30–50% of patients treated with ICIs [3]. Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations
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