肝细胞癌（肝癌）是全球主要恶性肿瘤之一，靶向治疗和免疫治疗已成为中晚期肝癌重要治疗选择，但相关皮肤并发症的高发严重影响患者治疗依从性和生活质量。靶向治疗常见皮肤毒性包括手足皮肤反应、皮疹和皮肤干燥等，其中手足皮肤反应发生率高达45%~73%；免疫治疗相关皮肤毒性发生率约30%~40%，主要表现为瘙痒、斑丘疹和免疫相关皮炎。本综述对两类治疗相关皮肤毒性的发生机制、临床表现、分级标准进行了系统比较，并基于最新临床研究结果提出了分级化、循证化的管理策略。规范化的皮肤毒性管理包括治疗前评估、预防性处理、早期识别、分级处理和随访管理等环节，可有效降低皮肤毒性发生率和严重程度，提高患者生活质量。针对肝癌患者的特殊性，本文强调了肝功能状态评估与药物个体化调整的重要性。实施“预防为主、早期识别、分级处理、多学科协作”的皮肤毒性管理原则，可为肝癌患者提供更加安全、有效的靶免治疗保障。

Hepatocellular carcinoma (HCC) is one of the major malignant tumors worldwide. Targeted therapy and immunotherapy have become important treatment options for advanced HCC. However, high incidence of skin complications severely affects the treatment compliance and quality of life of patients. Targeted therapy-related skin toxicities mainly include hand-foot skin reaction, rash and dry skin, among which the incidence of hand-foot skin reaction is as high as 45%-73%. The incidence of immunotherapy-related skin toxicities is approximately 30%-40%, mainly manifested as itching, maculopapular rash and immune-related dermatitis. In this review, the mechanism, clinical manifestations and grading criteria between two types of treatment-related skin toxicities were systematically compared, and the grading-and evidence-based management strategies were proposed based on the latest clinical research results. Standardized skin toxicity management includes pre-treatment evaluation, preventive treatment, early identification, grading treatment and follow-up management, which can effectively reduce the incidence and severity of skin toxicity and improve the quality of life of patients. Considering the characteristics of patients with liver cancer, the importance of liver function evaluation and individualized adjustment of drugs was emphasized. Implementing the skin toxicity management principle of "prevention first, early identification, grading treatment and multidisciplinary team cooperation" can provide safer and more effective targeted treatment for patients with liver cancer.