Five cases of malignant melanoma during fingolimod treatment in Dutch patients with MS.

Several case reports suggest an association between the use of fingolimod in multiple sclerosis (MS) and the occurrence of malignant melanoma.1–4 There are also data, however, to suggest a role of fingolimod in eliminating melanoma cells.5,6 The most recent European Medicines Agency report on melanoma (among other skin cancers) in patients with MS using fingolimod states that “the number of skin cancer (potential risk) to date and the duration of follow-up, remain relatively limited and do not permit to draw definitive conclusions on any potential long-term risk for this type of malignancy.”7Acknowledgment: The authors thank C.A. Seldenrijk, MD, PhD, Pathology DNA, Department of Pathology, St. Antonius Hospital Nieuwegein, the Netherlands, for diagnosing superficial spreading malignant melanoma and critically reading the first draft of the manuscript.