The incidence of dermatologic infections in patients receiving checkpoint inhibitors (CPIs) has not been systematically described.
Identify the incidence of dermatologic infections in patients who received CPIs and were evaluated by dermatologists.
Retrospective review of the incidence of dermatologic infections in patients who received CPIs 2005-2020 and were evaluated by dermatologists at Memorial Sloan Kettering Cancer Center.
Of 2061 patients, 1292 were identified as actively receiving CPIs (≤90 days since the last dose) versus 769 as previously been on CPIs (>90 days since the last dose). 226/1292 (17.5%) patients actively receiving CPI had dermatologic infections, significantly higher than that of patients without active treatment (8.2%; p<0.0001). In patients with infections on CPIs, 82 (36.2%), 78 (34.5%), and 48 (21.2%) were bacterial, fungal, and viral. Eighteen (8.0%) had polymicrobial infections. Anti-CTLA-4 monotherapy was associated with the highest risk (HR=2.93, 95% CI, 1.87 to 4.60; p<0.001).
Retrospective design and sample limited to patients referred to dermatology.
Patients actively receiving CPIs are more susceptible to dermatologic infections, with anti-CTLA-4 monotherapy carrying the highest risk, suggesting that the index of suspicion for infections should be increased in these patients to minimize morbidity and optimize care.

Copyright © 2021. Published by Elsevier Inc.

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