ABSTRACT
A number of medications for short-term and long-term use have been linked to an increased risk for keratinocyte carcinoma (KC). Immunosuppressive medications are associated with an increased risk for KC and melanoma due to reduction of antitumor immune surveillance, and some immunosuppressive agents directly impact DNA replication and repair. Clinical and epidemiologic studies have shown an increased risk for KC in users of photosensitizing medications. Additional mechanisms include drug-induced modulation of DNA damage repair, enhancement of keratinocyte proliferation, and direct carcinogenic effect. Alternatively, some medications potentially decrease KC risk. This article reviews the literature on medications associated with KC risk.
Subject(s)
Carcinoma, Basal Cell/epidemiology , Carcinoma, Squamous Cell/epidemiology , Immunosuppressive Agents/therapeutic use , Skin Neoplasms/epidemiology , Anti-Infective Agents/therapeutic use , Antihypertensive Agents/therapeutic use , Calcineurin Inhibitors/therapeutic use , Humans , Keratinocytes/pathology , Molecular Targeted Therapy , Risk Factors , TOR Serine-Threonine Kinases/antagonists & inhibitors , Tumor Necrosis Factor-alpha/antagonists & inhibitorsABSTRACT
Amelanotic melanoma (AM) is a rare form of melanoma which lacks visible pigment. Due to the achromic manifestation of this atypical cutaneous malignancy, it has been difficult to establish clinical criteria for diagnosis. Thus, AM often progresses into an invasive disease due to delayed diagnosis. In this report, we describe the case of a 72-year-old Caucasian woman who had been diagnosed with AM after 3 years of failed treatments for what presented as a periorbital dermatitis. Her Clark's level 4, 1.30 mm thick melanoma required nine surgeries for successful resection and reconstruction. This case exemplifies the diagnostic pitfall of AM and the need for new criteria for early detection and management.
