Abstract:
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.
摘要:
疾病改善疗法(DMT)的使用导致了多发性硬化症管理的范式转变。通过包括Medline和GoogleScholar在内的广泛文献检索进行了全面的叙述性综述,以阐明DMT与皮肤恶性肿瘤倾向之间的联系。鞘氨醇-1-磷酸受体调节剂,例如芬戈莫德和西波莫德与基底细胞癌(BCC)的高风险相关,但不是鳞状细胞癌,或者黑色素瘤.相关的病理生理学机制尚未完全了解。阿仑单抗和克拉屈滨显示与皮肤癌的孤立关联。关于其他DMT,从未发现风险增加。鉴于现有的证据,最重要的是倡导必要的皮肤病学评估,这些评估应针对每位患者的风险状况进行个性化评估。尽管如此,仍然需要更多的前瞻性研究来建立有效的皮肤病学随访方案.