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Hueso-Gabriel, L. Mahiques Santos, L. Terrádez Mas, N. Santonja López" "autores" => array:4 [ 0 => array:4 [ "nombre" => "L." "apellidos" => "Hueso-Gabriel" "email" => array:1 [ 0 => "luishueso@msn.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "L." "apellidos" => "Mahiques Santos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "L." "apellidos" => "Terrádez Mas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "N." "apellidos" => "Santonja López" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital de Manises, Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital de Manises, Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Nevos displásicos eruptivos tras el consumo de Melanotan" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1448 "Ancho" => 951 "Tamanyo" => 574774 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A, Proliferation of melanocytes at the dermoepidermal junction and in the dermis (hematoxylin-eosin, original magnification ×40). B, Nests parallel to the skin surface; note their tendency to fuse. Focal cell atypia can be observed (hematoxylin-eosin, original magnification ×200).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Illegal use of Melanotan I and II has been reported and regulatory authorities have issued warnings in the United States and Europe.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Melatonin I and II are synthetic melanocortin analogs (α melanocyte-stimulating hormone) with greater potency and a longer half-life than endogenous α melanocyte-stimulating hormone. Melanotan I (afamelanotide) binds to the melanocortin I receptor (MC1R) to promote melanogenesis, both by proliferation of melanocytes and by regulation of tyrosinase activity. Melanotan II is less selective than its predecessor: it binds to MC2R, causing loss of appetite, and MC3R, initiating penile erections. This triple effect (tanning, loss of appetite, and increased sexual potency) has gained melatonin II the name “Barbie drug” and popularity among some sectors of the population.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Melanotan II can be administered subcutaneously or as a nasal spray.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Currently in the experimental stage, Melanotan I (afamelanotide) is a promising option in dermatology. Ongoing phase I and II clinical trials are examining the prevention and treatment of erythropoietic protoporphyria, congenital erythropoietic porphyria, solar urticaria, and polymorphous light eruption, as well as the prevention of actinic keratosis and epidermal carcinoma in transplant recipients. The US Food and Drug Administration recently approved a phase II clinical trial of afamelanotide (SCENESSE, Clinuvel Pharmacueticals Ltd) combined with narrowband UV-B therapy for the treatment of vitiligo.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">We report the case of a 25-year-old man who came to our department for the sudden eruption of multiple melanocytic nevi and rapid transformation of existing nevi. The changes occurred a few weeks after a 4-week course of subcutaneous Melanotan II. The patient (type II phototype) was a construction worker who regularly used a tanning bed. Examination revealed more than 100 melanocytic nevi, mainly on his back; many were clinically and dermatoscopically atypical (<a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1 and 2</a>). We removed the 10 most atypical lesions, some of which were suspected of being melanoma. Histopathology revealed the lesions to be dysplastic melanocytic nevi; in 3 the dysplasia was severe (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). A pigmented basal cell carcinoma on the right shoulder was also removed.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Other reports of illegal use of melanocortin analogs have appeared. Langan et al<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> reported the first cases of transformation of preexisting nevi in 2 women (aged 30 and 48 years, phototype I/II) after they had used Melanotan I and II. Histopathology revealed benign melanocytic nevi and a severely dysplastic melanocytic nevus. Cardones and Grichnik<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> subsequently reported the transformation of existing nevi and eruption of new melanocytic nevi with atypical clinical and histologic characteristics in a 40-year-old patient with a history of dysplastic nevi and melanoma. Cousen et al<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> reported the case of a 19-year-old woman who was a regular user of a tanning bed and who developed eruptive nevi after she had used Melanotan II. Ellis et al<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> reported a case of melanoma (Breslow depth of 1<span class="elsevierStyleHsp" style=""></span>mm) in a 23-year-old patient who consulted for an increase in size of a pigmented lesion on his leg after use of Melanotan I. The authors could not prove and did not suggest a causal relationship between the use of Melanotan I and development of melanoma. A second case of melanoma associated with this drug was recently reported by Paurobally et al,<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> who described the transformation of an existing nevus on the abdomen of a 42-year-old woman 3 months after she had received Melanotan injections; histopathology revealed a 0.3-mm melanoma. Of note, all of these patients had the following risk factors: phototype I or II, multiple melanocytic nevi, personal and family history of melanoma, regular use of tanning beds, and repeated exposure to sunlight. It may be that patients with these factors are more likely to suffer onset and transformation of melanocytic nevi after taking Melanotan, with a potentially increased risk of developing melanoma.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Eruptive melanocytic nevi have been described in the literature in combination with certain bullous dermatoses and compromised immune status (in AIDS, in chemotherapy, and after transplantation).<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> In all these cases, determining the potential risk of a new melanoma or transformation to melanoma is both difficult and open to debate. Nevertheless, close dermatoscopic and clinical monitoring is recommended in immunocompromised patients, and the most atypical lesions should be removed.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Easy access to these drugs on the Internet and their growing popularity will probably lead to reports of similar new cases. As dermatologists, we must suspect Melanotan use when faced with transformation of existing melanocytic nevi or the sudden eruption of new ones, especially in individuals with a suntan that is too intense for their skin type or for the time of year. The possibility that body dysmorphic disorder (tanorexia) may also be present should be taken into account in some cases.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Hueso-Gabriel L, et al. Nevos displásicos eruptivos tras el consumo de Melatonan. Actas Dermosifiliogr. 2012;103:329-42.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1390 "Ancho" => 1000 "Tamanyo" => 188805 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Multiple melanocytic nevi, some of which are atypical, on the patient's back.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 748 "Ancho" => 996 "Tamanyo" => 139787 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Detail of an atypical lesion that was later removed.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1448 "Ancho" => 951 "Tamanyo" => 574774 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A, Proliferation of melanocytes at the dermoepidermal junction and in the dermis (hematoxylin-eosin, original magnification ×40). B, Nests parallel to the skin surface; note their tendency to fuse. Focal cell atypia can be observed (hematoxylin-eosin, original magnification ×200).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:11 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "US Food and Drug Administration. FDA warns about unap-proved product, Melanotan II. 2007. 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Year/Month | Html | Total | |
---|---|---|---|
2024 October | 163 | 71 | 234 |
2024 September | 207 | 52 | 259 |
2024 August | 267 | 74 | 341 |
2024 July | 349 | 72 | 421 |
2024 June | 309 | 87 | 396 |
2024 May | 283 | 63 | 346 |
2024 April | 229 | 64 | 293 |
2024 March | 245 | 70 | 315 |
2024 February | 172 | 50 | 222 |
2024 January | 169 | 62 | 231 |
2023 December | 182 | 68 | 250 |
2023 November | 225 | 48 | 273 |
2023 October | 177 | 67 | 244 |
2023 September | 164 | 75 | 239 |
2023 August | 190 | 58 | 248 |
2023 July | 218 | 108 | 326 |
2023 June | 231 | 74 | 305 |
2023 May | 269 | 84 | 353 |
2023 April | 264 | 51 | 315 |
2023 March | 228 | 56 | 284 |
2023 February | 169 | 44 | 213 |
2023 January | 136 | 52 | 188 |
2022 December | 169 | 65 | 234 |
2022 November | 125 | 64 | 189 |
2022 October | 103 | 61 | 164 |
2022 September | 134 | 52 | 186 |
2022 August | 88 | 71 | 159 |
2022 July | 112 | 51 | 163 |
2022 June | 160 | 55 | 215 |
2022 May | 230 | 106 | 336 |
2022 April | 217 | 63 | 280 |
2022 March | 197 | 78 | 275 |
2022 February | 220 | 61 | 281 |
2022 January | 226 | 72 | 298 |
2021 December | 121 | 61 | 182 |
2021 November | 144 | 68 | 212 |
2021 October | 127 | 89 | 216 |
2021 September | 137 | 77 | 214 |
2021 August | 127 | 74 | 201 |
2021 July | 115 | 76 | 191 |
2021 June | 85 | 56 | 141 |
2021 May | 81 | 58 | 139 |
2021 April | 143 | 86 | 229 |
2021 March | 112 | 66 | 178 |
2021 February | 78 | 58 | 136 |
2021 January | 49 | 53 | 102 |
2020 December | 54 | 47 | 101 |
2020 November | 43 | 45 | 88 |
2020 October | 59 | 41 | 100 |
2020 September | 42 | 39 | 81 |
2020 August | 42 | 38 | 80 |
2020 July | 36 | 24 | 60 |
2020 June | 50 | 48 | 98 |
2020 May | 37 | 32 | 69 |
2020 April | 44 | 34 | 78 |
2020 March | 58 | 27 | 85 |
2020 February | 4 | 9 | 13 |
2020 January | 4 | 13 | 17 |
2019 December | 8 | 9 | 17 |
2019 November | 4 | 6 | 10 |
2019 October | 0 | 13 | 13 |
2019 September | 8 | 10 | 18 |
2019 August | 4 | 9 | 13 |
2019 July | 4 | 29 | 33 |
2019 June | 4 | 11 | 15 |
2019 May | 6 | 22 | 28 |
2019 April | 2 | 27 | 29 |
2019 March | 2 | 9 | 11 |
2019 February | 2 | 3 | 5 |
2019 January | 0 | 4 | 4 |
2018 December | 2 | 5 | 7 |
2018 November | 3 | 3 | 6 |
2018 October | 1 | 0 | 1 |
2018 September | 2 | 0 | 2 |
2018 April | 0 | 6 | 6 |
2018 March | 2 | 2 | 4 |
2018 February | 187 | 4 | 191 |
2018 January | 224 | 8 | 232 |
2017 December | 305 | 10 | 315 |
2017 November | 255 | 8 | 263 |
2017 October | 242 | 8 | 250 |
2017 September | 210 | 18 | 228 |
2017 August | 190 | 27 | 217 |
2017 July | 142 | 8 | 150 |
2017 June | 194 | 22 | 216 |
2017 May | 88 | 16 | 104 |
2017 April | 80 | 21 | 101 |
2017 March | 81 | 15 | 96 |
2017 February | 65 | 15 | 80 |
2017 January | 130 | 18 | 148 |
2016 December | 158 | 17 | 175 |
2016 November | 195 | 16 | 211 |
2016 October | 266 | 21 | 287 |
2016 September | 299 | 8 | 307 |
2016 August | 270 | 16 | 286 |
2016 July | 158 | 8 | 166 |
2016 June | 9 | 18 | 27 |
2016 May | 6 | 9 | 15 |
2016 April | 8 | 11 | 19 |
2016 March | 11 | 11 | 22 |
2016 February | 15 | 12 | 27 |
2016 January | 18 | 2 | 20 |
2015 December | 7 | 1 | 8 |
2015 November | 14 | 16 | 30 |
2015 October | 17 | 1 | 18 |
2015 September | 13 | 1 | 14 |
2015 August | 22 | 7 | 29 |
2015 July | 373 | 14 | 387 |
2015 June | 334 | 6 | 340 |
2015 May | 416 | 20 | 436 |
2015 April | 361 | 9 | 370 |
2015 March | 406 | 11 | 417 |
2015 February | 304 | 15 | 319 |
2015 January | 306 | 17 | 323 |
2014 December | 202 | 13 | 215 |
2014 November | 182 | 16 | 198 |
2014 October | 192 | 22 | 214 |
2014 September | 179 | 19 | 198 |
2014 August | 213 | 14 | 227 |
2014 July | 239 | 31 | 270 |
2014 June | 245 | 18 | 263 |
2014 May | 269 | 28 | 297 |
2014 April | 133 | 7 | 140 |
2014 March | 108 | 15 | 123 |
2014 February | 89 | 13 | 102 |
2014 January | 124 | 14 | 138 |
2013 December | 63 | 13 | 76 |
2013 November | 110 | 19 | 129 |
2013 October | 42 | 8 | 50 |
2013 September | 40 | 9 | 49 |
2013 August | 53 | 23 | 76 |
2013 July | 49 | 34 | 83 |
2013 June | 19 | 51 | 70 |
2013 May | 16 | 83 | 99 |
2013 April | 13 | 46 | 59 |
2013 March | 26 | 41 | 67 |
2013 February | 45 | 29 | 74 |
2013 January | 102 | 13 | 115 |
2012 December | 59 | 11 | 70 |