Immune-related skin toxicity

Acute Oncology Guidelines
NHS Lothian

Abridged from: NHS Lothian Immunotherapy toxicity management guidelines v7.0. S Clive & C Barrie. Last reviewed: 22.11.2021.

Symptoms: rash, pruritus, vitiligo 

Others: alopecia areata, stomatitis, xerosis cutis, photosensitivity, exacerbation of psoriasis, psoriasiform or lichenoid skin reaction. 

Recent evidence suggests severe reactions such as Steven Johnson Syndrome and Toxic Epidermal Necrolysis are more common than initially thought. Consider these early in assessment of skin toxicity. 

Immune-related skin toxicity pathway

Editorial Information

Last reviewed: 13/08/2025

Next review date: 13/02/2026

Author(s): Edinburgh Cancer Centre.

Version: 1.0

Approved By: CTAC. Refer to Q-Pulse for approval details

Reviewer name(s): Stewart J.