Malignant Melanoma and Other Second Cutaneous Mali

Authors: Anita Goodrich Licata Lynn D Wilson Irwin M Braverman Andrea M Feldman Barry M Kacinski

Publish Date: 1995/04/01

Volume: 131, Issue: 4, Pages: 432-435

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Abstract

Background  Previous large studies have shown that patients with cutaneous Tcell lymphoma are at increased risk for basal cell carcinoma and squamous cell carcinoma and anecdotal case reports have suggested an association with malignant melanoma It has been postulated that the exposure of cutaneous structures to potentially carcinogenic therapies such as ionizing radiation or alkylating agents might be causally associated with the development of these second cutaneous malignancies but to date no study has directly addressed this issue The purpose of this study was to evaluate the occurrence of second cutaneous malignancies in a group of patients with cutaneous Tcell lymphoma treated with total skin electron beam therapy and to examine the additional effects of oral psoralen with UVA phototherapy topical mechlorethamine hydrochloride therapy and further radiation therapy One hundred sixtyfour patients with cutaneous Tcell lymphoma who had received total skin electron beam therapy between 1974 and 1990 were identified and information was abstracted from their recordsResults  Six patients developed malignant melanoma 12 to 95 months after total skin electron beam therapy Of the six patients three had received oral psoralen with UVA as additional therapy and two had received topical mechlorethamine None had received additional radiation therapy Twentyfour patients developed more than 37 basal cell carcinomas and 34 squamous cell carcinomas from 11 months to more than 10 years after total skin electron beam therapy Of the 24 patients 15 had received oral psoralen with UVA and 12 had received mechlorethamine as additional therapy Additional radiation therapy had been administered to nine patients During a median followup of 6 years no patients died of any second cutaneous malignancyConclusion  We found a high rate of both melanoma and nonmelanoma skin cancer The additional use of mechlorethamine or oral psoralen plus UVA but not radiation was significantly associated with the development of basal cell carcinoma and squamous cell carcinoma but not malignant melanomaArch Dermatol 1995131432435Licata AG Wilson LD Braverman IM Feldman AM Kacinski BM Malignant Melanoma and Other Second Cutaneous Malignancies in Cutaneous TCell Lymphoma The Influence of Additional Therapy After Total Skin Electron Beam Radiation Arch Dermatol 19951314432–435 doi101001/archderm199501690160060009

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