Drug-induced eruptive melanocytic nevi

ABSTRACT

Introduction: The sudden eruption of melanocytic nevi has been associated with a number of conditions, such as bullous skin diseases, immunodeficiency and immunosuppression. The exact mechanisms leading to the development of eruptive melanocytic nevi are unknown.

Areas covered: The aim of this article is to review the literature concerning eruptive melanocytic nevi following the administration of immunosuppressive drugs and other medications.

Expert opinion: The literature regarding the development of eruptive nevi in association with pharmacological therapies includes a relatively low number of reports. Prevalence of this phenomenon is likely to be underestimated, thus reporting should be encouraged in order to better define the actual significance and related clinical implications. The development of multiple melanocytic nevi during immunosuppressive treatments highlights the importance of immune system integrity in the regulation of nevi growth. The observation of eruptive nevi as an unexpected effect of targeted therapies for specific types of cancer, including melanoma, provided intriguing hints to understand the mechanisms underlying this paradoxical event. The synergistic role of additional triggers in the occurrence of drug-induced eruptive nevi has not been explored and may be an interesting area of research.

KEYWORDS:

• Drug-induced nevus changes
• biologicals
• BRAF inhibitors
• chemotherapy
• eruptive melanocytic nevi
• immunosuppressive medications
• nevus numbers

Article highlights

• The eruption of multiple melanocytic nevi has been reported in association with several conditions, including immunodeficiency and bullous skin disorders, and can also be drug-induced.

• The development of eruptive nevi has been repeatedly described in patients receiving immunosuppressive therapy for organ transplantation or immune-mediated disorders and chemotherapy for cancer.

• Thiopurines are included among the immunosuppressive drugs most commonly associated with eruptive nevi, and recent reports suggest the involvement of biological agents.

• Eruptive nevi have also been observed in the course of targeted cancer therapies with blockers of the MAPK pathway, including non-selective and selective BRAF inhibitors.

• Anecdotal reports documented the development of multiple nevi during administration of other agents, such as natalizumab, melanotan, octreotide, insulin, thyroid extract, and methamphetamine.

This box summarizes key points contained in the article.

Declaration of interest

GA Vena has been a speaker and/or a scientific consultant and/or an advisory board member for Astellas, Abbvie, Janssen-Cilag, Leo Pharma, Merck-Serono, Merck Sharp & Dohme, Novartis, Pfizer, and UCB Pharma (with no conflict of interest for the submitted paper).

N Cassano has been a speaker and/or a scientific consultant for Astellas, Abbvie, Leo Pharma, Merck-Serono, Merck Sharp & Dohme, Novartis, Pfizer, Rottapharm Madaus, and UCB Pharma (with no conflict of interest for the submitted paper). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was not funded.