Squamous Cell Neoplasm of the Ocular Surface in a Patient With Psoriasis Treated With Tumor Necrosis Factor-Alpha Inhibitors

Cornea. 2015 Jul;34(7):833-4. doi: 10.1097/ICO.0000000000000465.


Purpose: To report a case of conjunctival squamous cell carcinoma in a patient with psoriasis treated with tumor necrosis factor-alpha inhibitors.

Methods: Case report and review of the literature.

Results: A 44-year-old white woman presented to our hospital 1 year after developing a rapidly growing nodular lesion with papillomatous characteristics on the bulbar conjunctiva. The patient had a medical history of psoriasis since childhood and psoriatic arthritis since 2009. She had received several immunosuppressive medications such as leflunomide, adalimumab, methotrexate, and etanercept. The lesion appeared a few months after commencing treatment with etanercept and methotrexate. A histological examination revealed a squamous intraepithelial neoplasm of the conjunctiva that was negative for human papillomavirus infection.

Conclusions: Several case reports have described squamous cell carcinoma in different parts of the body in patients taking tumor necrosis factor-alpha inhibitors. Squamous cell neoplasm of the ocular surface should be considered during differential diagnosis of new conjunctival lesions in such patients.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Administration, Topical
  • Adult
  • Arthritis, Psoriatic / pathology*
  • Carcinoma in Situ / drug therapy
  • Carcinoma in Situ / pathology*
  • Conjunctival Neoplasms / drug therapy
  • Conjunctival Neoplasms / pathology*
  • Female
  • Humans
  • Immunologic Factors / therapeutic use*
  • Interferon alpha-2
  • Interferon-alpha / therapeutic use*
  • Psoriasis / pathology*
  • Recombinant Proteins / therapeutic use
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*


  • Immunologic Factors
  • Interferon alpha-2
  • Interferon-alpha
  • Recombinant Proteins
  • Tumor Necrosis Factor-alpha