Melanoma in situ and phototoxic drug reaction appearing simultaneously after antihypertensives intake: photo nitroso carcinogenicity of drugs as possible risk factor for the development and progression of cutaneous melanoma
DOI:
https://doi.org/10.2478/AMB-2025-0080Keywords:
nitrosamines, drug related photoxicity, photocarcinogenicity, melanoma, telmisartan, hydrochlorothiazide, lisnopril, amlodipine, clinical case reportAbstract
Drug-mediated nitrosogenesis or oncopharmacogenesis of skin cancer in general and melanoma skin cancer development in particular could be pathogenetically determined/ explained by the presence of photocarcinogens in drugs. These photocarcinogens are also known as nitrosamines. A number of studies in the scientific literature have linked the intake of antihypertensive drugs from heterogeneous groups to the generation of phototoxicity and the subsequent development of cutaneous melanomas. However, these particular groups of antihypertensive drugs belong at the same time to those declared by regulatory authorities worldwide (FDA/EMA) as affected by contamination with photocarcinogens. According to the most recent literature, 1) the number of potentially nitrosamine-contaminated antihypertensive drugs taken and 2) exposure to ultraviolet radiation could correspond to the severity of the clinical picture. We report a patient who developed a phototoxic reaction and melanoma in situ in the context of a relatively short-term use of the four types of antihypertensive drugs: lisinopril/ amlodipine, followed by valsartan/ hydrochlorothiazide. An analysis of the possible
pathogenetic association is made, discussing recent literature concepts such as: drug-induced photo nitrosogenesis / carcinogenesis of cutaneous melanoma.
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Copyright (c) 2025 G. Tchernev, S. Kordeva (Author)
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Journal Acta Medica Bulgarica 
