A case of multiple skin cancers in a patient on combination immunosuppressive therapy for Behcet's disease

Skin cancer risk from the use of immunosuppressive medications used to treat inflammatory conditions is not well understood, though studies clearly establish an exaggerated risk of skin cancer in solid organ transplant recipients (SOTRs) receiving these medications. The authors report a patient with Behcet's disease treated with combination immunosuppressive therapy and common variable immunodeficiency developing multiple squamous cell carcinomas (SCCs) of the skin, necessitating adjustment of her immunosuppressive regimen. As more patients are treated with immunosuppressive medications for chronic inflammatory diseases, clinicians must be aware of the possible increased risk of skin cancers associated with these medications. Skin cancer risk assessment, screening for sub-clinical malignancies and frequent skin exams of high risk patients may represent strategies to improve the safety of these medications.