Melanocytic nevus count and dermoscopic features do not differ in psoriatic patients undergoing biological agent versus conventional drug therapy.
BACKGROUND
Psoriasis is a chronic immune-mediated disease and treatment of psoriasis includes conventional immunosuppressive agents and biological agents. There are a few data on the relationship between psoriasis and melanocytic lesions. Either benign or malignant proliferations may be seen with immunosuppressive treatment. Eruptive nevi and malignant melanoma (MM) have been reported also associated with biological agents There is raising link biological treatment and malignancies. The objective of this paper is to examine the effects of biological agents versus conventional drugs on melanocytic nevi count and dermoscopical features.


METHODS
Sixty-seven patients receiving TNF-α antagonists (etanercept, infliximab and adalimumab) and 62 patients receiving methotrexate and cyclosporin included to the trial. Duration of treatment with biological agents ranged from 6 months to 4 years, and between 6 months to 3 years for conventional drugs. Total and regional nevi count and structurel changes of biological treatment was evaluated. All melanocytic lesions checked for dermoscopic features by using Dermogenius Ultra (Linos Photonics GmbH & Co, Munich, Germany). Diagnosis of atypical nevi and doubtful lesions for melanoma was made by using ABCD clinically and, by three point check list (asymmetry, atypical pigment network and blue whitish structures) dermoscopically.


RESULTS
There were no significant changes in number of total and regional nevi count and in the dermoscopic features of nevi between biological and conventional treatment groups. We observed dermoscopical changes in only one nevus of a patient receiving etanercept. Histopathological examination of this nevi confirmed the diagnosis of dysplastic nevi. There were no MM and non-melanoma skin cancers in both groups.


CONCLUSIONS
We did not observe significant changes in biological and conventional treatment groups there is a need for further studies to determine long-term effects of biological agents on the melanocytic lesions in patients with psoriasis.
Dermatology and Venereology Unit, Lepra Deri ve Zührevi Hastalıklar Hospital, İstanbul, Turkey - serpilpirmit@gmail.com.
Serpil
S
Pirmit
Department of Dermatology and Venereology, Faculty of Medicine, Bezmialem Vakif University Hospital, İstanbul, Turkey.
Nahide
N
Onsun
Department of Dermatology and Venereology, Faculty of Medicine, Bezmialem Vakif University Hospital, İstanbul, Turkey.
Ozlem
O
Su
Department of Dermatology and Venereology, Faculty of Medicine, Bezmialem Vakif University Hospital, İstanbul, Turkey.
Dilek B
DB
Ozkaya
D000068879:Adalimumab / Q000009:adverse effects / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003879:Dermatologic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D046169:Dermoscopy / Q000379:methods*; D000068800:Etanercept / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000069285:Infliximab / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008544:Melanocytes / Q000473:pathology; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000473:pathology*; D011446:Prospective Studies; D011565:Psoriasis / Q000188:drug therapy* / Q000473:pathology; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D055815:Young Adult
D003879:Dermatologic Agents; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept