Naveed Sami, MD, FAAD

 at the 2025 New Wave Dermatology Conference, Naveed Sami, MD, a board-certified dermatologist and professor of medicine for the UCF College of Medicine, discussed a variety of take-home messages from his “Cutaneous Effects of Immunotherapy” session.

In this particular interview segment, Sami was asked about ways to approach the diagnosis and differentiation of 

. Specifically, he was asked about differentiating them from other dermatologic conditions.

Differentiating Immunotherapy-Related Skin Reactions, with Naveed Sami, MD

“The approach is, number one, to have open communication with the oncologist, so that they have a patient and get them in as early as possible,” Sami explained. “...The second aspect is that we approach it the same as we would with any new dermatological condition that would present. A good history, was this present before, or have they had anything like this before? Then, even if they have, many conditions can look very similar at the very beginning. So a biopsy or using the tools that are necessary are crucial in terms of evaluating a patient [is important].”

Sami noted that such evaluations could include doing blood tests, especially if a patient has more of a hypersensitivity reaction, for example. If this is the case, Sami noted, then the appropriate blood tests for side effects, such as drug hypersensitivity syndrome, may be needed.

“There's a grading system, with grade one being mild, and it’s based on the body surface area involvement,” Sami said. “If it's less than 10%, it's grade one or mild. If it's between 10 and 30, it's moderate, and that's grade two. Anything greater than the body surface area of 30% is grade three, and grade four is life-threatening. So you're trying to first evaluate the grade of where the disease is presented, based on the symptoms and based on the grade.”

Sami noted that if a provider observes a grade 1 or early grade 2, as grade 2 has a wide range of 10% - 30%, then the treatment being used may be continued, potentially. Oral antihistamines over the counter and topical steroids, nonsteroidal ointments, can be used as much as possible to try to help with such symptoms, however.

“If that doesn't work for certain conditions where light treatment may be helpful, such as eczema, psoriasis, or lichen planus, we try to use non-systemic treatments, such as light treatment, to try to help prevent progression,” Sami explained. “If that is not beneficial, or if something is needed, it requires systemic treatment.”

To find out more about this session topic, view Sami’s full interview segment posted above.

The quotes used in this interview summary were edited for clarity.

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During his New Wave Dermatology interview, Naveed Sami, MD, spoke about additional takeaways from his session on the cutaneous effects of immunotherapies.

Naveed Sami, MD, a board-certified dermatologist and Professor of Medicine at the UCF College of Medicine, spoke at the 

 in a session titled “Cutaneous Effects of Immunotherapy.”

 editorial team asked Sami to summarize some of the most notable takeaways from this talk at the conference. Sami highlighted some of his session’s most significant points, noting them in order of their description during his talk.

Addressing the Cutaneous Effects of Immunotherapy, with Naveed Sami, MD

“The first [point] is really recognizing the fact that immunotherapies are becoming an increasing part in the treatment of cancers,” Sami explained. “Because they're increasing use, we probably will be seeing more side effects…because there are different targeted therapies, they have different side effects. So it's important to be aware when certain side effects come about in the skin…The second is focusing on three main immunotherapies from which we may see side effects. And the third is discussing their evaluation and [ways to] approach evaluating the patient who does present with a cutaneous side effect.”

Sami noted the importance of recognizing such an issue early on, adding that early recognition can help to prevent these side effects if treated appropriately. He was asked to go into greater depth about these takeaways.

“We focused on three of the major categories [of immunotherapies],” Sami said. “The first one is called immune checkpoint inhibitors…What happens with immune checkpoint inhibitors is it's the ‘brakes’ are removed, so there are immune cells that can go after a cancer cell. When that happens, the regulation is sometimes not as good, and when that happens is we see a lot of immune-mediated issues in the skin.”

Sami highlighted that conditions such as psoriasis, eczema, vitiligo, or bullous pemphigoid can appear in such cases. He added that more severe reactions can occur at any point from the outset, such as toxic epidermal necrolysis or drug hypersensitivity syndrome.

“The second [cateogry] is what I call the acneiform eruptors,” Sami said. “There are MEK inhibitors and [Epidermal Growth Factor Receptor] inhibitors. Those can cause an acne-like rash, which can be very painful at times but can also be prevented. So if a patient is about to go on those treatments, they can be put on some acne systemic treatments, such as doxycycline, to prevent that from happening.”

Sami highlighted that even if such patients are put on doxycycline, if it is not working, topical treatments or even isotretinoin can be implemented.

“The third is the BRAF inhibitors,” Sami explained. “The BRAF inhibitors have a side effect of skin cancer, or squamous cell carcinoma specifically. Fortunately, these are not very aggressive, so we can help in their treatment, but they can also be prevented by using the MEK inhibitors, potentially to prevent the side effects of BRAF inhibitors. We see, for many of the side effects that BRAF inhibitors cause, that if you have an adjuvant treatment with MEK inhibitors, you can minimize those kinds of side effects, and sometimes you can actually reverse them.”

For any additional information on the topics discussed in this interview, view the full video segment posted above.

The quotes used in this video summary were edited for the purposes of clarity.

In this interview at the New Wave Dermatology meeting, Naveed Sami, MD, highlights some of the notable takeaways from his talk on the impacts of immunotherapies.

Naveed Sami, MD, FAAD

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