Management of immune-related cutaneous adverse events associated with immune checkpoint inhibitors in patients with cancer: an evidence summary.

This study aims to systematically retrieve and synthesise the best available evidence on the management of immune-related cutaneous adverse events (ircAEs) associated with immune checkpoint inhibitors (ICIs) in patients with cancer, thereby providing evidence-based guidance for the development of assessment and management protocols in clinical practice. This study was conducted as an evidence summary following the evidence summary reporting standard of the Fudan University Center for Evidence-Based Nursing. Evidence was searched across clinical decision support resources, guideline repositories, professional society websites and bibliographic databases, including UpToDate, BMJ Best Practice, Joanna Briggs Institute (JBI), National Comprehensive Cancer Network, European Society for Medical Oncology, American Society of Clinical Oncology, Cochrane Library, Embase, PubMed, Web of Science and major Chinese databases. Searches were conducted up to 23 December 2025. Evidence sources concerning the assessment, prevention or management of ircAEs in adults aged ≥18 years receiving ICIs were eligible. Clinical practice guidelines, expert consensus statements, evidence summaries, systematic reviews, clinical decision support resources and relevant original studies, including observational and quasi-experimental studies, published in Chinese or English were considered for inclusion. Duplicate publications, superseded guidelines and evidence sources that did not meet the predefined methodological quality criteria were excluded. Two reviewers independently screened eligible evidence sources, extracted data and conducted methodological quality appraisal using design-appropriate tools, including the Appraisal of Guidelines for Research and Evaluation II and JBI critical appraisal instruments. Evidence was classified according to the JBI levels of evidence and evaluated for strength of recommendation using the feasibility, appropriateness, meaningfulness and effectiveness framework. Evidence with similar content was compared, integrated and synthesised into practice-oriented evidence statements, with disagreements resolved through discussion or consultation with a third reviewer. A total of 21 evidence sources were included, comprising nine clinical practice guidelines, five expert consensus statements, two systematic reviews, two evidence summaries, one observational study, one quasi-experimental study and one clinical decision support resource. 29 evidence statements were synthesised across seven domains: risk factor identification, assessment and diagnosis, severity-based treatment, supportive nursing care, follow-up management, patient education and healthcare professional training. The synthesised evidence emphasised baseline skin assessment and early recognition of ircAEs, standardised severity grading, severity-based treatment escalation, phenotype-oriented supportive skin care, structured follow-up, patient and caregiver education, and timely multidisciplinary referral for severe or complex cutaneous toxicities. The evidence provides a structured basis for standardising ircAEs screening, nursing assessment, symptom management, referral and follow-up in patients receiving ICIs. It may also support oncology nurses in strengthening patient and caregiver education, promoting timely symptom reporting and self-management and facilitating multidisciplinary referral for severe or atypical cutaneous toxicities.