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

Naveed Sami, MD, a board-certified dermatologist and Professor of Medicine at the UCF College of Medicine, spoke at the 2025 New Wave Dermatology Conference in a session titled “Cutaneous Effects of Immunotherapy.”

The HCPLive 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.

“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.