Immune checkpoint inhibitors (ICI) represent a new revolutionary weapon in the armamentarium of anti-cancer therapies. The side effects of these new agents represent a new challenge for oncologists; they are usually unpredictable and sometimes life threatening, if not managed rapidly and adequately. The most frequent side effects are the dermatologic, but they are usually low grade side effects and consequently easily manageable. Rash, pruritus and vitiligo are the most frequent dermatologic side effects. We aimed in this review to describe first all the dermatologic side effects of ICI according to the subtype of ICI and combination therapies in the clinical trials, then to report all the rare case reports dermatologic side effects, and finally to present the management algorithm of these side effects.

Toxic epidermal necrolysis (TEN) is a severe cutaneous adverse drug reaction leading to extensive sloughing of the skin. Late cutaneous complications such as pigmentation disorders are frequently reported. In this report, we present particular facial cutaneous sequelae with histological analysis after TEN. Two young patients who had survived TEN presented permanent multiple hypopigmented papules on the face affecting their quality of life. Histological analysis revealed areas of scarring, dystrophic microcalcifications and sebaceous hyperplasia. Late cutaneous sequelae are well documented; however, the physiopathological mechanisms leading to different clinical presentations remain unknown. We suggest that the destruction of the hair follicle by necrolysis leads to secondary dermal microcalcifications, scarring and sebaceous hyperplasia. Further studies are needed for a better understanding of these findings.

Grape seeds are a rich source of bioactive compounds, especially polyphenols, which are known for their antioxidant and anti-aging properties. The aim of this study was to extract phytochemicals from the Lebanese grape variety “Obeidi” and incorporate them into liposomes and hyalurosomes in order to select the most effective formulation for improving skin properties and protecting against oxidative damage. Grape seeds were extracted by a sustainable ethanol-water method, yielding a total phenolic content (TPC) of 376 ± 16 mg/g (gallic acid equivalents) and an antioxidant activity of 0.58 ± 0.04 µg/mL (trolox equivalents). HPLC analysis identified catechins (4.51 mg/g), gallic acid (3.2 mg/g) and epicatechins (0.88 mg/g) as the dominant phenolics. The extract was encapsulated in liposomes and hyalurosomes with a mean diameter of 148–159 nm, polydispersity index < 0.3, and zeta potentials of −47 to −44 mV, and remained stable for three months at 4 °C. In vitro studies showed that hyalurosomes significantly increased keratinocyte viability by up to 144% and provided better protection against oxidative stress compared to liposomes. A 12-week clinical study involving 40 volunteers was conducted to evaluate the efficacy of extract-loaded hyalurosomes as an “anti-aging serum” by assessing various skin parameters. This treatment resulted in improved skin hydration, a reduction in wrinkle depth, and a slight decrease in melanin and erythema levels as demonstrated by imaging. These results are promising for cosmeceutical applications using grape seed extract loaded in hyalurosomes.

Targeted anticancer therapies are an important weapon in the fight against cancer. Targeted therapies interfere with specific molecules necessary for tumor growth and cancer progression. They are divided mainly to either monoclonal antibodies or small molecules inhibitors. Their primary objective is to target directly and precisely the cancer cells leading to a minimal side-effects profile. The dermatologic adverse reactions of these targeted therapies is different from those seen with classical cytotoxic chemotherapy. Rashes, xerosis, hand-foot-skin reaction and mucositis are the most frequent side effects. In this paper, we aim to present a comprehensive review of the dermatologic side effects of targeted therapies including, specific side effects related to recently, approved targeted therapies.