Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain.
Servicio de Dermatología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Instituto de Investigación Sanitaria (IIS) La Fe, Valencia, Spain.
Actas Dermosifiliogr. 2024 Sep;115(8):T781-T790. doi: 10.1016/j.ad.2024.07.007. Epub 2024 Jul 5.
The use of disease-modifying therapies (DMT) has led to a paradigm shift in the management of multiple sclerosis. A comprehensive narrative review was conducted through an extensive literature search including Medline and Google Scholar to elucidate the link between DMT and the propensity of cutaneous malignancies. Sphingosine-1-phosphate receptor modulators, such as fingolimod and siponimod are associated with a higher risk of basal cell carcinoma (BCC), but not squamous cell carcinoma, or melanoma. The associated physiopathological mechanisms are not fully understood. Alemtuzumab and cladribine show isolated associations with skin cancer. Regarding other DMT, no increased risk has ever been found. Given the evidence currently available, it is of paramount importance to advocate for necessary dermatological assessments that should be individualized to the risk profile of each patient. Nonetheless, additional prospective studies are still needed to establish efficient dermatological follow-up protocols.
使用疾病修正疗法（DMT）已经在多发性硬化症的治疗管理方面引发了范式转变。通过广泛的文献检索，包括 Medline 和 Google Scholar，进行了全面的叙述性综述，以阐明 DMT 与皮肤恶性肿瘤易感性之间的联系。鞘氨醇-1-磷酸受体调节剂，如芬戈莫德和西尼莫德，与基底细胞癌（BCC）的风险增加相关，但与鳞状细胞癌或黑色素瘤无关。相关的生理病理机制尚未完全理解。阿仑单抗和克拉屈滨与皮肤癌有孤立的关联。关于其他 DMT，从未发现有增加的风险。鉴于目前的证据，倡导对每位患者的风险状况进行必要的皮肤科评估至关重要。尽管如此，仍需要进一步的前瞻性研究来建立有效的皮肤科随访方案。
