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August 24, 2026Current Opinion in Allergy and Clinical Immunology

Between hypersensitivity and toxicity: the complex spectrum of chemotherapy-induced skin reactions

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Authors

MYMona-Rita YacoubMCMaria CilonaENEustachio Nettis

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Overview

Narrative review reveals overlapping toxic and immune mechanisms in chemotherapy-induced skin reactions, suggesting multidisciplinary evaluation to prevent premature cancer treatment cessation.

Key Points

  • To examine the interplay between direct tissue toxicity and immune-mediated mechanisms responsible for chemotherapy-induced skin reactions.
  • Reviewed pathogenic pathways, clinical phenotypes, and management strategies for cutaneous adverse reactions caused by traditional chemotherapies, targeted agents, and immune checkpoint inhibitors.
  • Chemotherapy-induced skin reactions stem from dynamic interactions among direct keratinocyte injury, innate immune activation, cytokine-driven inflammation, and adaptive immune responses.
  • Clinical presentations reflect an overlapping spectrum encompassing toxic phenotypes (e.g., toxic erythema of chemotherapy, hand–foot syndrome) and immune-mediated hypersensitivities (e.g., urticaria, severe cutaneous adverse reactions, bullous pemphigoid).
  • Integrated allergologic workups and multidisciplinary collaboration enable precise phenotyping and safe drug rechallenge or desensitization, minimizing unnecessary anticancer treatment discontinuation.

Cite This Study

Yacoub et al. (2026) studied this question.

synapsesocial.com/papers/6a8c00c1bca056c88e6dfacahttps://doi.org/10.1097/aci.0000000000001196
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