Background: Unlicensed use of melanotan-II (MT-II) to promote skin pigmentation has become prevalent amongst young people attending fitness centres. We present a case where the melanocyte stimulation of MT-II in combination with the use of sun tanning beds coincided with cutaneous melanoma. Observation: A 20-year-old woman with Fitzpatrick skin type II was referred to a dermatology clinic. Clinical examination revealed a suspicious black melanocytic lesion in her left gluteal region. Furthermore, her skin was universally intensely pigmented. The melanocytic lesion was excised, and histology confirmed the diagnosis of melanoma. Three months prior to the excision the patient had conducted a 3- to 4-week course of self-injections with MT-II, intending an augmentation of sunbed tanning. Conclusions and Relevance: This observation brings attention to the potential risks related to the use of the cyclic α-melanocyte-stimulating hormone analogue MT-II. There are several hazardous aspects of the possible widespread use of MT-II. As the drug is unlicensed and incompletely tested, the extent and types of adverse effects are unknown. Clinicians are advised to be aware of the problem, and counsel their at-risk patients regarding the potential hazards related to the use of MT-II.

Keywords:
Melanoma, Melanotan-II, Skin pigmentation
1.
Sawyer TK, Sanfilippo PJ, Hruby VJ, Engel MH, Heward CB, Burnett JB, Hadley ME: 4-Norleucine, 7-D-phenylalanine-alpha-melanocyte-stimulating hormone: a highly potent alpha-melanotropin with ultralong biological activity. Proc Natl Acad Sci USA 1980;77:5754-5758.
2.
Grimes PE, Hamzavi I, Lebwohl M, Ortonne JP, Lim HW: The efficacy of afamelanotide and narrowband UV-B phototherapy for repigmentation of vitiligo. JAMA Dermatol 2013;149:68-73.
3.
Dorr RT, Lines R, Levine N, Brooks C, Xiang L, Hruby VJ, Hadley ME: Evaluation of melanotan-II, a superpotent cyclic melanotropic peptide in a pilot phase-I clinical study. Life Sci 1996;58:1777-1784.
4.
Hadley ME, Dorr RT: Melanocortin peptide therapeutics: historical milestones, clinical studies and commercialization. Peptides 2006;27:921-930.
5.
Evans-Brown M, Dawson RT, Chandler M, McVeigh J: Use of melanotan I and II in the general population. BMJ 2009;338:b566.
6.
Danish Health and Medicines Authority: Warning against the product melanotan [Internet]. Copenhagen, Denmark; 2008 Aug 11. Available from: http://sundhedsstyrelsen.dk/en/news/2008/warning-against-the-product-melanotan.
7.
Cousen P, Colver G, Helbling I: Eruptive melanocytic naevi following melanotan injection. Br J Dermatol 2009;161:707-708.
8.
Mang R, Krahl D, Assmann T: Dermoscopic changes in melanocytic nevi during use of melanotan II (in German). Hautarzt 2012;63:880-884.
9.
Paurobally D, Jason F, Dezfoulian B, Nikkels AF: Melanotan-associated melanoma. Br J Dermatol 2011;164:1403-1405.
10.
Paurobally D, El Hayderi L, Richert B, Andre J, Nikkels AF: Melanotan-associated transverse melanonychia. J Eur Acad Dermatol Venereol 2013;27:128-129.
11.
Nelson ME, Bryant SM, Aks SE: Melanotan II injection resulting in systemic toxicity and rhabdomyolysis. Clin Toxicol (Phila) 2012;50:1169-1173.
12.
Veierod MB, Adami HO, Lund E, Armstrong BK, Weiderpass E: Sun and solarium exposure and melanoma risk: effects of age, pigmentary characteristics, and nevi. Cancer Epidemiol Biomarkers Prev 2010;19:111-120.
13.
Eves PC, MacNeil S, Haycock JW: Alpha-melanocyte stimulating hormone, inflammation and human melanoma. Peptides 2006;27:444-452.
© 2013 S. Karger AG, Basel
2013
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