Objective: To summarise the key points in the diagnosis and management of reactive cutaneous capillary proliferation (RCCEP) induced by the combination of camrelizumab and regorafenib in the treatment of hepatocellular carcinoma, and to outline management strategies in light of the latest research advances. Methods: We reviewed the complete clinical, dermatoscopic and pathological data of a 56-year-old patient with hepatocellular carcinoma and diabetic nephropathy. Cutaneous immune-related adverse event grade was assessed in accordance with Multidisciplinary Expert Consensus on Cutaneous Adverse Reactions Induced by Immune Checkpoint Inhibitors (2025 Edition). The patient underwent surgical excision of large skin lesions and cryotherapy with liquid nitrogen for microscopic lesions, and was treated topically with mupirocin ointment, with a one-year follow-up. Results: Following four cycles of immunotherapy combined with anti-vascular therapy, the patient developed multiple, easily bleeding, red, pedunculated papules on the posterior neck and trunk; dermoscopy revealed characteristic vascular lacunae and the ‘white curtain’ sign, whilst histopathology demonstrated benign lobular capillary proliferation in the dermis. The lesion was graded as grade 2 RCCEP; after local treatment, there was no recurrence of the lesions at the one-year follow-up. Underlying diabetic microvascular damage exacerbated the haemorrhagic manifestations of the skin lesions. Conclusion: RCCEP is a characteristic cutaneous adverse reaction of camrelizumab; patients with concomitant diabetes present with more severe skin lesions. Localised lesions are best managed with minimally invasive topical treatment. Individualised local treatment plans developed under a tiered approach are in line with the recommendations of domestic guidelines. RCCEP indicates anti-tumour immune benefit; treatment need not be discontinued in the absence of severe infection.