[CDKN2A gene mutation and loss of p16 protein activity in a patient on levodopa presenting sporadic multiple primary melanoma].
BACKGROUND
Cutaneous melanoma is a complex disease involving genetic and environmental factors. Levodopa has been incriminated in the development and/or progression of melanoma.


METHODS
We report the case of a man treated with levodopa and a dopadecarboxylase inhibitor for Parkinson's disease and presenting 22 cutaneous melanomas over a 4-year period. The patient is of phototype II and presents multiple nevi. Genetic analysis of predisposing genes demonstrated a CDKN2A mutation with loss of p16 activity.


CONCLUSIONS
Multiple melanomas may be associated with genetic predisposition, and screening for the latter should be performed. The exceptionally high number of melanomas developed by our patient raised suspicions about levodopa, a precursor in melanin synthesis, as a potential inducer. Increased dermatologic controls and screening for predisposing genetic factors appear to us to be warranted in the event of melanoma development in patients on levodopa.
Templier
I
I
Dermatologie, Département Pluridisciplinaire de Médecine, CHU Albert Michallon, BP 217, 38043 Grenoble Cedex 9. ITemplier@chu-grenoble.fr
Charles
J
J
Combe
M-C
MC
Bressac de Paillerets
B
B
Leroux
D
D
Leccia
M-T
MT
D000978:Antiparkinson Agents / Q000009:adverse effects*; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000502:physiology*; D019942:Genes, p16; D006801:Humans; D007980:Levodopa / Q000009:adverse effects*; D008297:Male; D008545:Melanoma / Q000139:chemically induced* / Q000235:genetics*; D008875:Middle Aged; D009154:Mutation; D012878:Skin Neoplasms / Q000139:chemically induced* / Q000235:genetics*
D000978:Antiparkinson Agents; D019941:Cyclin-Dependent Kinase Inhibitor p16; D007980:Levodopa