A 69-year-old male patient with hepatocellular carcinoma received  tislelizumab 200 mg anti-immunotherapy after transcatheter arterial chemoembolization. After 20 days of treatment, the patient began to develop erythema, papules on the abdomen, and white scales on some rashes accompanied by pruritis. Then the rash gradually expanded to the trunk and limbs, and pruritis aggravated and affected normal life. Skin biopsy revealed hyperkeratosis of the epidermis, slight thickening of the spinous layer, and perivascular lymphocyte infiltration in the superficial dermis. Methylprednisolone sodium succinate and symptomatic treatment were given. After 15 days, the original rash subsided without itching or new rash. The patient was retreated with tislelizumab 200 mg immunotherapy approximately 4 months later and was followed up without discomfort. The Naranjo’s Assessment Scale was used to evaluate the association between adverse reactions and tislelizumab, and the result was "probably relevant". Tislelizumab’s specification contains information on adverse skin reactions, which should be taken into account in clinical practice. An early differential diagnosis should be made to avoid severe consequences.

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