Drug-Induced Melanoma: Irbesartan Induced Cutaneous Melanoma! First Description in the World Literature!

Authors

  • Georgi Tchernev Medical Institute of the Ministry of Interior, Department of Dermatology, Venereology and Dermatologic Surgery, General Skobelev Nr 79, Sofia, Bulgaria; Onkoderma, Policlinic for Dermatology and Dermatologic Surgery, General Skobelev 26, Sofia, Bulgaria
  • Ivanka Temelkova Onkoderma, Policlinic for Dermatology and Dermatologic Surgery, General Skobelev 26, Sofia, Bulgaria

DOI:

https://doi.org/10.3889/oamjms.2019.042

Keywords:

Losartan, Valsartan, Melanoma, Surgery procarcinogenic effect

Abstract

BACKGROUND: Melanoma appears to be a malignant disease, whose development can be potentiated by different drug groups. More and more data are in favour of the claim that commonly used antihypertensive drugs also contain the risk of developing melanoma. The most evidence is that angiotensin receptor blockers may be carcinogenic. Two representatives from this group, valsartan and irbesartan, produced by certain pharmaceutical companies are being withdrawn from the market due to finding content of NDMA and NDEA, which are believed to be potent carcinogens. Another representative of this group, losartan, according to in vitro data, potentiates cell adhesion and invasion of human melanoma cells.

CASE REPORT: We present a 45-year-old man with arterial hypertension. For year and a half/two years, the patient is on systemic therapy with Aspirin and Irbesartan/Hydrochlorothiazide. The patient also reported about the presence of a pigmented lesion in the abdominal area, which occurred 5-6 years ago, before the onset of cardiac therapy. According to him, there was a change in the colour and size of the lesion within the framework of cardiac therapy (from 1.5-2 years). Innovative one step melanoma surgery was performed, and the lesion was radically removed with a 1 cm operational safety margin in all directions within one operative session. The subsequent histological verification found the presence of thin melanoma.

CONCLUSION: Drug-induced melanoma turned out to be a problem of significant importance. The group of angiotensin receptor blockers should be investigated more thoroughly and in detail on the probability of potentiating carcinogenesis. We describe an interesting case showing the progression of pigment lesion to melanoma as a possible result of irbesartan therapy, i.e. we share a theory that differs from that of drug-induced de novo melanomas. It should not be overlooked the fact that another widely used drug-Aspirin, is also likely to potentiate the development of melanoma. Furthermore, the case is indicative of the use of one step melanoma surgery in a melanoma patient with a thickness less than 1 mm.

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References

Tang H, Zhai S, Song Y, Han J. Use of Antihypertensive Drugs and Risk of Malignant Melanoma: A Meta-analysis of Observational Studies. Drug Saf. 2018; 41(2):161-169. https://doi.org/10.1007/s40264-017-0599-x PMid:28905299 DOI: https://doi.org/10.1007/s40264-017-0599-x

Nardone B, Orrell K, Vakharia P, West D. Skin cancer associated with commonly prescribed drugs: tumor necrosis factor alpha inhibitors (TNF-αIs), angiotensin-receptor blockers (ARBs), phosphodiesterase type 5 inhibitors (PDE5Is) and statins -weighing the evidence. Expert Opin Drug Saf. 2018; 17(2):139-147. https://doi.org/10.1080/14740338.2018.1400530 PMid:29103328 DOI: https://doi.org/10.1080/14740338.2018.1400530

Olschewski D, Hofschröer V, Nielsen N, Seidler D, Schwab A, Stock C. The Angiotensin II Type 1 Receptor Antagonist Losartan Affects NHE1-Dependent Melanoma Cell Behavior. Cell Physiol Biochem. 2018; 45:2560-2576. https://doi.org/10.1159/000488274 PMid:29558744 DOI: https://doi.org/10.1159/000488274

Sipahi I, Debanne S, Rowland D, Simon D, Fang J. Angiotensin-receptor blockade and risk of cancer: meta-analysis of randomised controlled trials. Lancet Oncol. 2010; 11(7):627-36. https://doi.org/10.1016/S1470-2045(10)70106-6 DOI: https://doi.org/10.1016/S1470-2045(10)70106-6

Schmidt S, Schmidt M, Mehnert F, Lemeshow S, Sørensen H. Use of antihypertensive drugs and risk of skin cancer. J Eur Acad Dermatol Venereol. 2015; 29(8):1545-54. https://doi.org/10.1111/jdv.12921 PMid:25640031 DOI: https://doi.org/10.1111/jdv.12921

D'Arrigo T. FDA issues statement as valsartan recalls grow. AphA, September 4, 2018. Retrieved from https://www.pharmacist.com/article/fda-issues-statement-valsartan-recalls-grow

Christensen J. FDA expands recall of blood pressure drug valsartan due to cancer concern. CNN, August 10, 2018. Retrieved from https://edition.cnn.com/2018/08/08/health/valsartan-recall-fda-expanded/index.html

WJZ, CBS Baltimore. FDA Recalls Common Blood Pressure Medicine Due To Cancer Concerns. July 17, 2018.

Wendling P. More Drug Makers Tagged as Valsartan Recall Grows. WebMD, August 13, 2018. Retrieved from https://www.webmd.com/heart-disease/news/20180813/more-drug-makers-tagged-as-valsartan-recall-grows

Howard J. Valsartan recall: 4 things patients should know. CNN, August 28, 2018. Retrieved from https://edition.cnn.com/2018/07/19/health/valsartan-recall-explainer/index.html

Herman A. Another Potential Carcinogen Found in Valsartan. NEJM Journal Watch, September 17, 2018. Retrieved from https://www.jwatch.org/fw114583/2018/09/17/another-potential-carcinogen-found-valsartan

Brooks M. FDA Issues Alert on Irbesartan Due to Contamination. Medscape Medical News, November 01, 2018. Retrieved from https://www.medscape.com/viewarticle/904270

Liu L, Fan X, Li H, An X, Yang R. Angiotensin II promotes melanogenesis via angiotensin II type 1 receptors in human melanocytes. Mol Med Rep. 2015; 12(1):651-6. https://doi.org/10.3892/mmr.2015.3438 PMid:25760379 DOI: https://doi.org/10.3892/mmr.2015.3438

Published

2019-01-09

How to Cite

1.
Tchernev G, Temelkova I. Drug-Induced Melanoma: Irbesartan Induced Cutaneous Melanoma! First Description in the World Literature!. Open Access Maced J Med Sci [Internet]. 2019 Jan. 9 [cited 2024 Jul. 23];7(1):114-6. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2019.042

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Section

C- Case Reports

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