Empowering Oncology Clinicians Through a Skin Toxicity Library
Summary
- Sylvester Comprehensive Cancer Center and the Oncology Nursing Society have launched the first public, image-based database of cancer treatment-related skin toxicities across a spectrum of skin tones.
- The database will help with early-detection efforts for skin cancer and identify treatment side effects more accurately.
- Precise clinical care demands being able to identify skin conditions across varying skin tones, which the database accommodates.
Breakthrough cancer treatments are saving lives. But some come with new challenges, such as widespread and often severe skin toxicities.
In response, the Oncology Nursing Society (ONS), with grant support from La Roche-Posay, is launching a groundbreaking national initiative: the first public, image-based database of cancer treatment-related skin toxicities across a spectrum of skin tones. Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, is the inaugural clinical collaborator in this project. This innovative clinical and educational resource helps nurses and health care professionals identify dermatologic side effects more accurately, closing critical gaps in care and improving outcomes.
“We’re using real images of real patients, across all skin types, to show what skin toxicities actually look like,” said Jessica MacIntyre, D.N.P., APRN, assistant vice president of advanced practice providers at Sylvester. “Our goal is to give nurses across the country the tools they need to identify side effects with clarity and confidence.”
Why It Matters
Up to 90% of cancer patients experience side effects from new therapies like immunotherapies and EGFR inhibitors. These toxicities can affect skin, hair and nails, disrupt treatment plans and take a toll on physical and emotional well-being.
“Nurses are often the first to recognize these symptoms,” said MacIntyre, who also serves as the Oncology Nursing Society’s president. “Early detection is critical to keeping patients safe and treatment on track.”
But these toxicities don’t present the same way on all skin. A rash that’s obvious on light skin may be missed on darker tones. Biological differences and other outside factors influence how symptoms appear and how they may be treated.
“If clinicians aren’t trained to recognize how skin conditions vary by skin tone, it can lead to delayed or incorrect diagnoses, seriously affecting patient outcomes, especially in oncology,” said Erica Fischer-Cartlidge, DNP, RN, AOCNS, EBP-C and chief clinical officer for ONS.
A Visual Database
The free, open-access database will serve as a dynamic, visual platform for nurses, students, researchers and even patients and their caregivers. The images, originally collected from Sylvester patients by oncology nurses and advanced practice providers (APPs), were carefully de-identified in full compliance with HIPAA standards. Each image is paired with essential clinical context, including cancer type, treatment, skin reaction and provider notes.
The result is a powerful, real-world resource clinicians can use to recognize and compare skin toxicities, particularly in settings without dedicated dermatology support.
This is how we transform cancer care — one image, one nurse, one patient at a time.
Jessica MacIntyre
“This tool helps nurses say, ‘I’ve seen this before,’ and act quickly and confidently,” said MacIntyre.
“This library provides a more standardized and updated approach to educating both patients and staff on what to observe during the assessment process. Most importantly, patients were eager to participate, demonstrating their willingness to be active partners in their care,” said Cynthia Bradley, DNP, nurse manager for the Miller School’s Department of Radiation Oncology.
A Scalable Solution
As cancer therapies become more advanced, nursing education must evolve just as rapidly. Nurses today manage complex side effects from CAR T-cell therapy, immunotherapy and other cutting-edge treatments, each with unique dermatologic challenges.
“When I started as an infusion nurse, skin toxicities were rare,” MacIntyre said. “Now they’re some of the most common and challenging issues we face.”
The growing database will offer a sustainable, scalable model for continuing education, one that cancer centers nationwide can adopt and help expand.
“Sylvester was excited to help build the foundation for this initiative,” MacIntyre said. “By defining the processes and standards early, we created a pathway for clinical collaborators everywhere to contribute to a resource that benefits the entire oncology community. Sylvester was the launchpad. Now, the platform is ready to grow nationwide, with input from across the oncology community.”
A Catalyst for Change
This initiative is more than a resource. It’s a turning point. By accurately documenting how toxicities appear on different skin tones, the platform aims to promote faster triage, better care and more inclusive treatment for all patients.
“ONS is thrilled to initiate this project with Sylvester as our first clinical collaborator,” Fischer-Cartlidge said. “Sylvester’s commitment to reducing the human burden of cancer aligns well with our aim to increase clinician proficiency, so that quality of life isn’t impacted by complex dermatologic symptoms of disease and side effects of treatment. The oncology nurse and advanced practice team is a critical driver to bring it to life.”
“The patients who shared their images know they’re part of something bigger,” MacIntyre added. “This is how we transform cancer care — one image, one nurse, one patient at a time.”
Tags: cancer research, Jessica MacIntyre, skin cancer, skin tumors, Sylvester Comprehensive Cancer Center