title: Evolution of nevi during treatment with natalizumab: A prospective follow-up of patients treated with natalizumab for multiple sclerosis.
abstract: BACKGROUND
  Natalizumab is a monoclonal antibody directed against α₄ integrin used in the treatment of multiple sclerosis (MS). Four cases of melanomas occurring in patients prescribed natalizumab to treat MS were recently reported. Although some fundamental data suggested that α₄β1 integrin could be linked to the invasiveness of melanoma, none showed any relation with the transformation of melanocytes.
  
  
  METHODS
  We performed a prospective follow-up of a cohort of patients with MS treated with natalizumab to assess the evolution of nevi under treatment. Clinical dermatologic examination and videodermoscopy were performed every 6 months. Nevi were compared side-by-side with baseline photographs, and histologic analysis was proposed based on clinical and dermoscopic criteria. Forty-four patients were included, and 248 nevi were examined and followed up. The mean duration of follow-up was 14 months (range, 6-20 months). Seventeen lesions (6.8%) showed modifications over time. Only 12 (4.8%) presented substantial dermoscopic changes. Five lesions were removed. All of them were classified as benign after histologic examination.
  
  
  CONCLUSIONS
  Our results showed the same rate of clinical and dermoscopic changes of nevi during treatment with natalizumab compared with the spontaneous evolution of nevi reported in literature. In accordance with fundamental data, those results suggest that the inhibition of the α₄ integrin does not promote the transformation of melanocytic lesions.
authors.affiliation: Department of Dermatology, University Hospital of Nice, France.
authors.forename: Emeline
authors.initials: E
authors.lastname: Castela
authors.forename: Christine
authors.initials: C
authors.lastname: Lebrun-Frenay
authors.forename: Muriel
authors.initials: M
authors.lastname: Laffon
authors.forename: Fanny
authors.initials: F
authors.lastname: Rocher
authors.forename: Michael
authors.initials: M
authors.lastname: Cohen
authors.forename: Nathalie Cardot
authors.initials: NC
authors.lastname: Leccia
authors.forename: Philippe
authors.initials: P
authors.lastname: Bahadoran
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Lacour
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Ortonne
authors.forename: Thierry
authors.initials: T
authors.lastname: Passeron
mesh_terms: D000293:Adolescent; D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D046169:Dermoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D039441:Integrin alpha4 / Q000276:immunology*; D008297:Male; D008544:Melanocytes / Q000378:metabolism; D008545:Melanoma / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy*; D000069442:Natalizumab; D009508:Nevus, Pigmented / Q000473:pathology*; D010781:Photography; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000453:epidemiology / Q000209:etiology; D013997:Time Factors; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000069442:Natalizumab; D039441:Integrin alpha4