Fingolimod is used to treat
relapsing-remitting multiple sclerosis. It has an immunosuppressive effect that predisposes to skin
malignancies. The Summary of Product Characteristics recommends that persons receiving
Fingolimod be educated regarding photoprotection and vigilance of skin lesions and should undergo a dermatological evaluation at initiation of treatment and 6-12 monthly thereafter. The incidence of keratinocytic
carcinomas in those on long-term immunosuppression following solid
organ transplantation is declining. This trend coincided with temporal changes in immunosuppressive protocols and the introduction of
skin cancer prevention programmes suggesting that the risk of developing these
malignancies may be mitigated by the provision of education to patients amongst other measures. The aim of our study was to assess if health care professionals are explaining skin advice and documenting the discussion when prescribing
Fingolimod in a University Hospital outpatient setting. Clinical records of consecutive patients on
Fingolimod were reviewed. Data on demographics, documented provision of advice on skin protection and who provided the advice was collected. Fifty patients with
multiple sclerosis were identified. Median age was 40.5 years (range 25-63). Forty-two were female (42/50, 84%). Provision of advice regarding skin protection was documented in 20% (10/50). This was provided by nurse specialists in 14% (7/50), doctors in 10% (5/50) and both in 4% (2/50). The risk of developing
skin cancers can be reduced by the adoption of simple preventative measures; patients on
Fingolimod are at an increased risk of developing these
cancers. This study demonstrates a need for improvement in the documentation of advice around skin protection.