Use of melanotan I and II in the general population
BMJ 2009; 338 doi: https://doi.org/10.1136/bmj.b566 (Published 18 February 2009) Cite this as: BMJ 2009;338:b566
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Melanotan usage seems to be on the increase in the North East, either
because of the recent poor summer and lack of sunshine, or of our slowly
increasing ability to identify patients who have been using the drug.
This is often first noticed, as stated before, by the discrepancy between
a patient’s deep tan and their reported poor tanning ability. Routine
questioning about the use of this drug is becoming a must in the
assessment of pigmented lesions, to put their evolution into perspective.
We have come across a number of patients recently who have had
pigmented lesions, removed because of a rapid change in size and colour
following Melanotan usage, that have been shown on histological
examination to be benign. Most interestingly, however, we have also
detected a melanoma in similar circumstances.
A 23 year old male presented to our department one month after
finishing a four week ‘course’ of Melanotan I, with a rapidly enlarging
pigmented lesion on his lower leg. He had noticed all of his moles
becoming darker almost immediately following his injections, which he had
been expecting. The lesion of in question also started increasing in size
as well and then more rapidly over the two weeks prior to presentation.
He was a regular sunbed user but had no other pertinent past medical or
family history. Surprisingly, he admitted that the he would probably have
watched the lesion for much longer before presenting to the GP if he had
not taken the Melanotan.
The lesion appeared clinically to be a banal melanocytic naevus,
measuring 10 x 12 mm, just palpable and deeply pigmented: an excision
biopsy was performed. A Specialist Dermatopathologist reported the lesion
to have junctional and nested dermal components of melanocytes, both
showing a reasonably substantial degree of cytological pleomorphism.
There were no dermal mitoses identified, but the degree of architectural
and cytological abnormality suggested that the lesion should be classified
as a melanoma, with a Breslow thickness of 1mm.
We cannot prove, nor do we suggest, a causative link between this
patient’s Melanotan usage and the development of his melanoma. At this
stage it merely highlights some of the problems to be faced by
Dermatologists in the future in assessing pigmented lesions in patients
who have been using á – melanocyte stimulating hormones.
Competing interests:
None declared
Editorial note
The patient whose case is described has given his signed informed consent to publication.
Competing interests: No competing interests
Usage of unlicensed drugs that are undergoing preclinical and clinical development: an unspecified risk
by the
general public of unlicensed drugs undergoing preclinical and clinical
development
those wishing to inform the medical community of such a trend and wishing
to warn the general public about the potential dangers of such usage
may want to spell out
the following
risk more clearly:
While using such unregulated and unlicensed drugs the potential exists that
previously
unrecognized health condition(s) could arise. Due to the very nature of these
types of
drugs in many cases their full effects are not fully documented (particularly
for
longer
periods of usage). What this means is that if a health condition should
present
itself
during (or even after) the period of usage of this type of drug an individual
(and their
doctors) can be left wondering what role if any such drugs played in the
development of
such condition(s)?
In the population of adults who use the Melanotan.org forums we have
witnessed this
issue in a handful of cases (since the forum's existence beginning
in January
2004) where members have presented reports of having encountered
previously
unrecognized health issues that developed during the course (or shortly
afterward) of
dosing with vials they were sold that ostensibly contained melanotan II. In the
majority
of these cases those reporting these issues have been left wondering if some
aspect of
their usage of what was in the vials they were sold led to their health
issue(s).
As is mentioned in this editorial letter there are many potential factors that
can lead to
health problems (ie: the drugs themselves, contaminated product, needle
sharing, etc.)
for those engaging in usage of relatively poorly sourced drugs like the
melanotan
peptides. The concern previously expressed in the BMJ by Ewan A Langan et
al. [1] regarding the usage of the melanotan peptides as, "a new
factor
complicating presentation and diagnosis of pigmented lesions" can in fact be
extended
relative to any health issues that users of such drugs may present with over
the course
of their usage (or even afterwards) that have possibly originated from some
aspect of
their usage regimens. Therefore, the previous advice given by Ewan A. Langan
et al. relative to the melanotan peptides with regards to, "unexpected tanning
providing a clue to such use" this recommendation should be extended to all
medical practitioners when evaluating the health of presenting
patients.
In correspondence with these concerns please be aware that we the operators
of the Melanotan.org site and forums do our best to fully inform the
community of individuals with interest in using one of the melanotan
peptides
of these risks so that they may be in a better position to evaluate the
potential benefits of usage vs.
such risks.
As a final note: We might also suggest that media
organizations
reporting on
the melanotan peptides do their best to properly inform themselves
completely
about these drugs so that they may be in a better position to fully inform the
public
about them.
1: Change in moles linked to use of
unlicensed "sun tan
jab" BMJ
2009;338:b277
Competing interests:
Author is the owner and
administrator
of the
aforementioned
informational website and
community of those with
interest in usage of one of the
melanotan
peptides:
Melanotan.org . Please see
this
related
forum discussion.
Competing interests: No competing interests