title: Lymphomatoid papulosis: A cutaneous lymphoproliferative disorder in a patient on fingolimod for multiple sclerosis.
abstract: BACKGROUND
  Fingolimod was the first oral disease-modifying treatment for relapsing-remitting multiple sclerosis. It has previously been associated with the development of lymphoma.
  
  
  OBJECTIVE
  To describe a case of lymphomatoid papulosis, a CD30+ cutaneous lymphoproliferative disorder, in a patient taking fingolimod.
  
  
  METHODS
  Case study.
  
  
  RESULTS
  Our patient developed lymphomatoid papulosis 2 months after starting fingolimod. Histology confirmed the diagnosis. The drug was withdrawn. Resolution began only 2 days later.
  
  
  CONCLUSIONS
  Lymphomatoid papulosis is a benign subtype of cutaneous T-cell lymphoma, but up to 20% of cases can transform to a malignant course. Patients on fingolimod and physicians caring for them should be mindful of the need to monitor the skin.
authors.affiliation: Division of Clinical Neuroscience, Queen's Medical Centre, University of Nottingham, UK.
authors.forename: Amal P R
authors.initials: AP
authors.lastname: Samaraweera
authors.affiliation: Nottingham University Hospitals NHS Trust, UK.
authors.forename: Stuart N
authors.initials: SN
authors.lastname: Cohen
authors.affiliation: Nottingham University Hospitals NHS Trust, UK.
authors.forename: Ela M
authors.initials: EM
authors.lastname: Akay
authors.affiliation: Division of Clinical Neuroscience, Queen's Medical Centre, University of Nottingham, UK/Nottingham University Hospitals NHS Trust, UK nikos.evangelou@nottingham.ac.uk.
authors.forename: Nikos
authors.initials: N
authors.lastname: Evangelou
mesh_terms: D000328:Adult; D005260:Female; D000068876:Fingolimod Hydrochloride / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D017731:Lymphomatoid Papulosis / Q000139:chemically induced*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy*; D012878:Skin Neoplasms / Q000139:chemically induced*
chemical_list: D007166:Immunosuppressive Agents; D000068876:Fingolimod Hydrochloride
keywords: Adverse effects; case study; fingolimod; lymphoma; lymphomatoid papulosis; multiple sclerosis; risk factor; skin