Table III.

Schematic treatment algorithm for management of dermatological adverse events during anticancer immunotherapy.

Severity of symptoms	Description	Management and follow-up
Grade 1	Maculopapular rash <10% BSA, with/without symptoms (pruritus, burning, tightness)	Continue ICPI Supportive care: Anti-histamines and topical steroid
Grade 2	Maculopapular rash 10–30% BSA, with/without symptoms (pruritus, burning, tightness); limiting instrumental ADL	Delay ICPI Topical steroids If symptoms persist >7 days: Systemic steroids (such as methylprednisolone 0.5–1 mg/kg/day or PO equivalent)
Grade 3–4	Maculopapular rash >30% BSA, with/without symptoms (pruritus, burning, tightness); limiting self-care ADL; local or extensive superinfection	Delay or discontinue ICPI Methylprednisolone 1–2 mg/kg/day or PO equivalent Consider skin biopsy If symptoms persist: Consider alternative immunosuppressive therapy (such as mycophenolate mofetil or infliximab)

ICPI, immune checkpoint inhibitors; BSA, body surface area; ADL, activities of daily living; PO, per os.