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Autoimmune and Inflammatory Disorders / Eosinophilic Disorders and Syndromes · Review
Anais Brasileiros De Dermatologia · August 10, 2026
Early or partial results. Treat as a signal, not a conclusion.
This systematic review synthesized 22 reported cases of eosinophilic fasciitis temporally associated with immune checkpoint inhibitor therapy, predominantly involving nivolumab and pembrolizumab, with onset ranging from weeks to months and most cases responding to systemic corticosteroids. The evidence base is limited to case reports and small case series, precluding incidence estimation, risk quantification, or definitive causal inference.
Systematic review of case reports and case series. Adult cancer patients who developed eosinophilic fasciitis temporally associated with immune checkpoint inhibitor therapy. Intervention: Immune checkpoint inhibitor therapy (predominantly nivolumab and pembrolizumab). n = 22.
22 unique patients with ICI-associated eosinophilic fasciitis identified across 18 included studies Nivolumab and pembrolizumab were the most frequently implicated agents EF onset ranged from several weeks to months after ICI initiation
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
This summary provides clinicians with recognition features of an emerging immune-related adverse event (early onset weeks to months post-ICI; extremity involvement) and corticosteroid-responsive management, supporting early recognition and multidisciplinary care to prevent morbidity. However, the rarity and case-report basis mean individual risk cannot be quantified and the evidence cannot guide ICI patient selection or monitoring protocols.
A systematic review of case reports and small case series with no comparative data, incidence estimates, or controlled outcomes—describes a rare adverse event but cannot quantify risk or establish causality rigorously.
As stated by the source record.
Quoted from the source exactly as published.
This summary provides clinicians with recognition features of an emerging immune-related adverse event (early onset weeks to months post-ICI; extremity involvement) and corticosteroid-responsive management, supporting early recognition and multidisciplinary care to prevent morbidity. However, the rarity and case-report basis mean individual risk cannot be quantified and the evidence cannot guide ICI patient selection or monitoring protocols.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background Eosinophilic Fasciitis (EF) is a rare immune-mediated fibrosing disorder of the fascia. Immune Checkpoint Inhibitors (ICIs) have transformed oncologic therapy but may precipitate immune-related Adverse Events (irAEs), including dermatologic and rheumatologic manifestations. ICI-associated EF has been increasingly reported, yet remains poorly characterized. Objective To systematically summarize the clinical features, diagnostic approaches, management strategies, and outcomes of ICI-associated EF. Methods A systematic review was conducted in accordance with PRISMA 2020. PubMed/MEDLINE, EMBASE, and Web of Science were searched from inception through January 2026. Eligible studies were case reports, case series, or observational studies describing adult cancer patients who developed EF temporally associated with ICI therapy. Two reviewers independently screened studies, extracted data, and assessed methodological quality using Joanna Briggs Institute tools. Results Among 148 records identified, 93 remained after removal of 55 duplicates; 28 full-text articles were assessed and 18 met inclusion criteria, representing 22 unique patients. Nivolumab and pembrolizumab were the most frequently implicated agents. EF onset ranged from several weeks to months after ICI initiation. The most commonly affected regions were the extremities. Diagnosis was confirmed by histopathology and/or imaging in most cases. Systemic corticosteroids were the main treatment, with additional immunosuppressive agents used in selected patients. Most cases showed partial or complete clinical improvement. Study limitations Evidence is limited to case reports and small case series, with heterogeneous reporting, precluding incidence estimation and limiting generalizability. Conclusions ICI-associated EF is a rare but clinically relevant irAE with dermatologic and connective tissue involvement. Early recognition and multidisciplinary management are essential to prevent long-term morbidity.
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