[Long term treatment of psoriasis with TNF-alpha antagonists. Occurrence of malignant melanoma].
A 51-year-old white man developed de novo a cutaneous malignant melanoma (Stage Ia) after a 30-month treatment period with TNF-alpha-antagonists, consecutively using infliximab, adalimumab and etanercept because of a recalcitrant moderate to severe plaque psoriasis. The patient previously had been treated fumarates for 4 years, cyclosporine A for 2 months and methotrexate for 5 weeks. He also received cycles of cream PUVA and UVB before and then between systemic medications. A possible causal connection between development of melanoma and immunosuppressive treatment is discussed in the light of recent literature. The termination of TNF-alpha-antagonist therapy following development of melanoma is recommended.
Kowalzick
L
L
Klinik für Hautkrankheiten und Allergologie, HELIOS Vogtland-Klinikum Plauen GmbH, 100153, 08505 Plauen. lutz.kowalzick@helios-kliniken.de
Eickenscheidt
L
L
Komar
M
M
Schaarschmidt
E
E
D003879:Dermatologic Agents / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008297:Male; D008545:Melanoma / Q000139:chemically induced* / Q000175:diagnosis* / Q000517:prevention & control; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy*; D012878:Skin Neoplasms / Q000139:chemically induced* / Q000175:diagnosis* / Q000517:prevention & control; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D003879:Dermatologic Agents; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha