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Patients with dermatologic immune-related adverse events benefit from dermatology consult

Dermatology consultation may improve the long-term implications of hospitalization for suspected dermatologic immune-related adverse events, according to researchers in Journal of the American Academy of Dermatology.

“Current practice guidelines recommend consideration of systemic corticosteroids for the treatment of even mild dermatologic [immune-related adverse events],” Steven T. Chen, MD, MPH, of Harvard Medical School and departments of dermatology and medicine, Massachusetts General Hospital, and colleagues wrote. “This may be detrimental to oncologic outcomes, at least at high doses.”

The aim of the study was to determine the impact of dermatology consultation among a cohort of hospitalized patients with suspected dermatologic immune-related adverse events. Patients had received immune checkpoint inhibitors, and the analysis included only those who experienced a disruption to their oncologic management as a result of dermatologic immune-related adverse events.

Among 47 patients admitted to the hospital with a suspected dermatologic immune-related adverse event, 33 cases were confirmed after consult by a subspecialist, of which 15 patients were hospitalized primarily or exclusively for dermatologic immune-related adverse events. Six of the other 18 patients developed dermatologic immune-related adverse events during hospitalization.

Dermatology consultation was requested in 22 of the confirmed cases and all 14 cases that were deemed improbable. The confirmed patients that were evaluated were less likely to receive systemic immunosuppression when compared with patients who did not undergo dermatology consultation (18% vs. 55%, P = .049). Additionally, 0% of patients who underwent dermatologic consultation discontinued immune checkpoint inhibitors compared with 36% who did not undergo dermatology consultation (P = .014).

“Our finding that all improbable cases received dermatology consultation indicates that dermatologists may help rule out dermatologic [immune-related adverse events], thereby allowing providers to explore other etiologies and continue cancer treatments uninterrupted,” Chen and colleagues wrote.

Disclosures: The authors report no relevant financial disclosures.