Table 1:

Grading of cutaneous adverse events according to the National Cancer Institute’s Common Terminology Criteria for Adverse Events (NCI-CTCAE)⁶

	Grade 1	Grade 2	Grade 3	Grade 4	Grade 5
Overall	Mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; intervention not indicated	Moderate; minimal, local or noninvasive intervention indicated; limiting age- appropriate instrumental activities of daily living (ADL)	Severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self-care ADL	Life-threatening consequences; urgent intervention indicated	Death related to adverse event
Pruritus	Mild or localized; topical intervention indicated	Widespread and intermittent; skin changes from scratching; oral intervention indicated; limiting instrumental ADL	Widespread and constant; limiting self-care ADL or sleep; systemic corticosteroid or immunosuppressive therapy indicated	X	X
Maculopapular Rash	Macules/papules covering <10% BSA with or without symptoms	Macules/papules covering 10–30% BSA with or without symptoms; limiting instrumental ADL; rash covering >30% BSA with or without mild symptoms	Macules/papules covering >30% BSA with moderate or severe symptoms; limiting self-care ADL	X	X
Lichenoid reactions	Covering < 10% BSA and no associated symptom	Covering 10–30% BSA and associated with erythema or pruritus; limiting instrumental ADL	Covering >30% BSA and associated with pruritus; limiting self-care ADL	X	X
Vitiligo-like depigmentation	Hypopigmentation or depigmentation covering <10% BSA; no psychosocial impact	Hypopigmentation or depigmentation covering >10% BSA; associated with psychosocial impact	x	X	X
Blistering adverse events	Asymptomatic; blisters covering < 10% BSA	Blisters covering 10–30% BSA;painful blisters; limiting instrumental ADL	Blisters covering >30% BSA; limiting self-care ADL	Blisters covering >30% BSA; associated with fluid or electrolyte abnormalities; ICU care or burn unit indicated	Death
Stevens-Johnson syndrome	X	X	Skin sloughing covering <10% BSA with associated signs (erythema, purpura, epidermal detachment, and mucous membrane detachment)	Skin sloughing covering 10-30% BSA with associated signs (like in grade 3)	Death
Toxic epidermal necrolysis	X	X	X	Skin sloughing covering >=30% BSA with associated symptoms (erythema, purpura or epidermal detachment)	Death
Alopecia	Hair loss less than 50% normal for that individual, not obvious from a distance	Hair loss >= 50% of normal, readily apparent to others and requiring a wig	X	X	X
Nail changes	Clinical or diagnostic observation of discoloration; asymptomatic separation of the nail bed from the nail plate or nail loss	Symptomatic separation of the nail bed; limiting instrumental ADL	X	X	X