R. Davenport1, P. Foley1, M.S. Goh1, S. Brennand1, S. Prakash2, A.H. Chong1
Merkel cell carcinoma (MCC) is a rare and aggressive malignant tumour of neuroendocrine differentiation. Immunosuppressive therapy is a well-recognised risk factor for developing MCC. The role of TNF-a blockers as promotors of tumorigenesis is unclear, although MCC has been described in seven patients on TNF-a blockers in the literature. We report the case of a 51-year old woman with Crohn’s colitis on long term infliximab and concomitant mercaptopurine who developed MCC. She presented with a slow growing, asymptomatic subcutaneous nodule to her right lower limb. The primary lesion was treated with definitive radiation therapy and the patient remains disease free on follow up at six months. This case is the second published report of MCC associated with infliximab therapy and serves as a reminder to dermatologists to be vigilant for this tumour in patients on TNF-a inhibitors.