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Immune checkpoint inhibitors (ICIs) have been widely used in the contemporary anticancer armamentarium. However, new side effects due to these agents have continued to emerge.

We describe herein a 71-year-old patient who received nivolumab as adjuvant therapy for malignant melanoma of the skin. He developed eosinophilia starting at 4 weeks of therapy. Eosinophilia increased progressively during the first six nivolumab cycles, then stabilized. Cycle-dependent increments were observed. Subsequently, the patient experienced well-known side effects of ICIs such as grade 1 diarrhea, arthralgias, and erythematous papular rash.

Nivolumab was continued, and absolute eosinophil counts were monitored. Prednisone 10 mg PO daily was required for moderate gastroenteritis, dermatitis, and arthritis, which all subsequently improved. Eosinophil levels gradually …