ABSTRACT
A 51-year-old white man developed de novo a cutaneous malignant melanoma (Stage Ia) after a 30-month treatment period with TNF-alpha-antagonists, consecutively using infliximab, adalimumab and etanercept because of a recalcitrant moderate to severe plaque psoriasis. The patient previously had been treated fumarates for 4 years, cyclosporine A for 2 months and methotrexate for 5 weeks. He also received cycles of cream PUVA and UVB before and then between systemic medications. A possible causal connection between development of melanoma and immunosuppressive treatment is discussed in the light of recent literature. The termination of TNF-alpha-antagonist therapy following development of melanoma is recommended.
Subject(s)
Dermatologic Agents/adverse effects , Immunosuppressive Agents/adverse effects , Melanoma/chemically induced , Melanoma/diagnosis , Psoriasis/drug therapy , Skin Neoplasms/chemically induced , Skin Neoplasms/diagnosis , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Humans , Male , Melanoma/prevention & control , Middle Aged , Skin Neoplasms/prevention & controlABSTRACT
A case of keratosis palmoplantaris with drumstick fingers, hypotrichosis, hypohidrosis and dental dysplasia is presented. Classification of this case among the more familiar syndromes of palmoplantar keratoderma is problematic.