Integrating Oncology and Dermatology: Addressing ICI-Induced Psoriasis Risk

The integration of oncology and dermatology is increasingly important as immune checkpoint inhibitors (ICIs) transform cancer care and elevate psoriasis risk among survivors.

Clinicians now face an unexpected challenge: the introduction of immune checkpoint inhibitors (ICIs) in cancer therapy has been associated with an increased incidence of psoriasis, underscoring the emerging concern of ICI-induced psoriasis. This emergence highlights a new dimension of cancer treatment side effects, reframing how cutaneous toxicities influence patient quality of life and therapy adherence. This shift also reframes the evolving ICI safety profile, informing conversations on risk–benefit alongside oncologic efficacy.

Earlier findings noted that PD-1 and PD-L1 inhibitors are particularly prone to trigger psoriasis flares, complicating treatment courses across diverse tumor types. The selective blockade of these checkpoints not only unleashes antitumor immunity but also disrupts immunologic tolerance in the skin, unmasking or exacerbating psoriasis pathogenesis.

Further immunologic analyses highlight the pivotal contribution of Th1 and Th17 cell populations in ICI-induced psoriasis. By amplifying Th1-driven cytokine release and expanding Th17-mediated inflammation, checkpoint blockade creates a milieu conducive to keratinocyte hyperproliferation and psoriasiform lesions.

As multidisciplinary insights evolve, the importance of oncology-dermatology collaboration becomes clear. Early dermatologic evaluation, joint treatment planning, and shared monitoring protocols enable timely intervention—whether with topical agents, systemic immunomodulators, or ICI schedule adjustments—to preserve both cancer control and skin integrity.

Looking ahead, will refined risk stratification based on tumor subtype, ICI regimen, or patient immunogenetics guide personalized prophylactic strategies? Ongoing trials and registries promise to illuminate pathways for preemptive dermatologic care in patients poised to receive checkpoint therapy.

Key Takeaways:

• Immune checkpoint inhibitors significantly elevate the risk of psoriasis in cancer patients.
• PD-1 and PD-L1 inhibitors are particularly associated with heightened risk.
• Th1 and Th17 immune pathways are implicated in ICI-induced psoriasis pathogenesis.
• Oncology-dermatology collaboration is pivotal for early recognition and management.