An association between corticosteroid use and melanoma recurrence: a case report and review of the literature

The American Cancer Society estimates that melanoma accounts for less than 5% of skin cancer cases. Even so, it causes the majority of skin cancer deaths and its incidence continues to increase at an alarming rate [1]. Immunosuppression has also been linked to melanoma development in various populations, including patients with solid organ allografts, Hodgkin’s disease, and human immunodeficiency virus (HIV), which is presumably related to exogenous or endogenous suppression of the innate immune response [2–4]. Corticosteroids represent a class of widely used immunosuppressive agents whose precise mechanism of immune system suppression is incompletely understood. Nonetheless, various studies have highlighted its carcinogenic potential. Karagas et al. examined the potentials risks of developing squamous cell and basal cell carcinoma in non-transplant recipients who had used glucocorticoids and found that oral steroid use correlated with an increased risk of developing non-melanoma skin cancers [5]. Case reports of iatrogenically induced Kaposi’s sarcoma appearing in patients taking corticosteroids and remitting upon drug withdrawal further bolster the hypothesis that the immunosuppressive and carcinogenic properties of steroids may have a link [6, 7]. To our knowledge, there has been no description so far of the incidence of melanoma in patients using steroids in the non-transplant setting (Figs. 1, 2).