title: Metastatic melanoma in a young woman treated with TNF-α inhibitor for psoriatic arthritis: a case report.
abstract: BACKGROUND
  The risk of cancer with the use of biologic agents in rheumatic diseases is still a matter of debate. Published data suggest that the extent of cancer risk might differ according to the type of cancer, and there is recent clinical evidence for a significant increased risk for skin cancer, including melanoma. In contrast with the extensive literature on cancer risk in rheumatoid arthritis, little has been reported on the development of malignancies in spondyloarthroparthies.
  
  
  METHODS
  We report the case of an otherwise healthy 31-year-old Italian woman with psoriasic arthritis who developed a melanoma of left third toe with metastatic involvement of regional lymphnodes after a 3-year treatment with the TNF-alpha inhibitor adalimumab.
  
  
  CONCLUSIONS
  This case illustrates the possibility of a causal relationship between TNF-alpha inhibitors and melanoma. We believe that vigilance should continue in patients treated with TNF-alpha blocking agents, until the question on the increased incidence of cancers, including skin cancers, associated with these drugs will be defined.
authors: Rheumatology Unit, IRCCS Istituto Clinico Humanitas, via Manzoni 56, 20089 Rozzano, Milan, Italy. bianca.marasini@unimi.it
authors: Bianca
authors: B
authors: Marasini
authors: Luca
authors: L
authors: Cozzaglio
authors: Laura
authors: L
authors: Belloli
authors: Marco
authors: M
authors: Massarotti
authors: Nicola
authors: N
authors: Ughi
authors: Paolo
authors: P
authors: Pedrazzoli
mesh_terms: D000068879:Adalimumab; D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects* / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000276:immunology / Q000628:therapy*; D005260:Female; D006801:Humans; D008545:Melanoma / Q000276:immunology / Q000556:secondary* / Q000628:therapy*; D012878:Skin Neoplasms / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000502:physiology
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab