The treatment landscape for cutaneous squamous cell carcinoma (CSCC) is evolving, with immunotherapy transforming care across all stages of disease and expanding the role of dermatologists. While surgery and radiotherapy remain cornerstones for localized CSCC, immune checkpoint inhibitors (ICIs) offer durable responses and survival benefits in advanced cases. Emerging approaches, including neoadjuvant, adjuvant, and intralesional ICIs, provide dermatologists with opportunities to integrate these therapies into practice, potentially enhancing surgical outcomes and preserving function in high-risk, resectable CSCC. Preliminary data on anti-PD-1 therapy as a preventive strategy for actinic neoplasia syndrome introduces new avenues for long-term management, though further evidence is needed. As systemic immunotherapy becomes increasingly relevant in dermatology, addressing immunotherapy-related adverse events requires interdisciplinary collaboration and specialized training. These advancements emphasize the expanding responsibilities of dermatologists in CSCC management while highlighting the importance of continued research and thoughtful application of these therapies.
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