Care Step Pathway Tools for Immune-Related Adverse Event Assessment and Management

Abstract

Look: • Does the patient appear uncomfortable? • Does the patient appear unwell? • Is there an obvious rash? • Is the patient scratching during the visit? • Is skin integrity intact? • Are there skin changes? » Xerosis (dry skin) » Changes in skin pigment or color • Is there oral involvement of the rash? • Does the rash involve the genitalvaginal region? The scalp? Listen: • Does the patient have pruritus with or without rash? • Is there a rash with or without pruritus? • Are symptoms interfering with ADLs? • With sleep? • Have symptoms worsened? Recognize: • Is there a history of dermatitis, preexisting skin issues (psoriasis, eczema, wounds, prior radiation to region, etc.)? • Laboratory abnormalities consistent with other etiologies (e.g., eosinophils on complete blood count, liver function abnormalities) Appendix A. Care Step Pathway: Skin Toxicities