title: Squamous Cell Neoplasm of the Ocular Surface in a Patient With Psoriasis Treated With Tumor Necrosis Factor-Alpha Inhibitors.
abstract: OBJECTIVE
  To report a case of conjunctival squamous cell carcinoma in a patient with psoriasis treated with tumor necrosis factor-alpha inhibitors.
  
  
  METHODS
  Case report and review of the literature.
  
  
  RESULTS
  A 44-year-old white woman presented to our hospital 1 year after developing a rapidly growing nodular lesion with papillomatous characteristics on the bulbar conjunctiva. The patient had a medical history of psoriasis since childhood and psoriatic arthritis since 2009. She had received several immunosuppressive medications such as leflunomide, adalimumab, methotrexate, and etanercept. The lesion appeared a few months after commencing treatment with etanercept and methotrexate. A histological examination revealed a squamous intraepithelial neoplasm of the conjunctiva that was negative for human papillomavirus infection.
  
  
  CONCLUSIONS
  Several case reports have described squamous cell carcinoma in different parts of the body in patients taking tumor necrosis factor-alpha inhibitors. Squamous cell neoplasm of the ocular surface should be considered during differential diagnosis of new conjunctival lesions in such patients.
authors.affiliation: Servicio de Oftalmología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Viviana Patricia
authors.initials: VP
authors.lastname: Lezcano Carduz
authors.forename: David
authors.initials: D
authors.lastname: Mingo Botín
authors.forename: Sonia Pilar
authors.initials: SP
authors.lastname: Durán Poveda
mesh_terms: D000287:Administration, Topical; D000328:Adult; D015535:Arthritis, Psoriatic / Q000473:pathology*; D002278:Carcinoma in Situ / Q000188:drug therapy / Q000473:pathology*; D003230:Conjunctival Neoplasms / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D011565:Psoriasis / Q000473:pathology*; D011994:Recombinant Proteins / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D007155:Immunologic Factors; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D014409:Tumor Necrosis Factor-alpha