Melanoma occurrence under long-term etanercept treatment for psoriasis: a case report.
Melanoma occurrence during treatment with anti-tumor necrosis factor is considered an incidental event, although very recent studies suggest a risk. Etanercept is a fusion protein that binds the tumor necrosis factor receptor and is included among TNF inhibitors, approved for the treatment of several autoimmune diseases, such as psoriasis.We described a 79-year-old man with psoriasis, being treated with etanercept, who presented with a new brown to black macule on his right shoulder; this was immediately surgically excised. Histology showed a superficial spreading melanoma, 1.2 mm Breslow thickness, one mitosis/hpf, with no vascular or neural invasion (stage T2b). Sentinel lymph node biopsy was negative. There were no apparent melanoma risk factors: normal total nevus count, photo type IV, no childhood sunburns, no family history of melanoma, and no previous immune suppressive drugs and/or phototherapies. Etanercept 50 mg/week had been administered continuously for 5 years before the melanoma occurrence. After etanercept withdrawal his psoriasis slowly, but progressively relapsed.
Dermatology Clinic, Department of Medical and Public Science, University of Cagliari, Italy Struttura Complessa di Dermatologia, Azienda Ospedaliero, University of Cagliari, Italy. atzoril@unica.it.
Laura
L
Atzori
Luca
L
Pilloni
Severino
S
Murgia
Cristina
C
Mugheddu
Monica
M
Pau
Franco
F
Rongioletti
D000368:Aged; D000068800:Etanercept / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007558:Italy; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000473:pathology; D011565:Psoriasis / Q000188:drug therapy*; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology
D007166:Immunosuppressive Agents; D000068800:Etanercept