Cyclosporine |
Immunosuppressant |
Reduces UVB-induced DNA damage repair and inhibits apoptosis by inhibiting nuclear factor of activated T-cells (NFAT) [140] |
Sirolimus and everolimus [95,96,97,149,150,151,152] |
Induces the expression of ATF3, which downregulates p53 and increases CSCC formation [141] |
Enhances AKT activation by suppressing PTEN and promotes tumor growth [142,143] |
Enhances epithelial-to-mesenchymal transition involving the upregulation of TGFβ signaling [144] |
Azathioprine |
Immunosuppressant |
Photosensitizes the skin to ultraviolet radiation (UVR) by changing the absorption interval of DNA upon incorporation of 6-thioguanine and induces the formation of reactive oxygen species [159,160,161] |
Mycophenolate mofetil [146,162,163] |
Voriconazole |
Antifungal |
The primary metabolite, voriconazole N-oxide, absorbs UVA and UVB wavelengths and causes photosensitivity [166,167,168] |
Photoprotection |
Inhibits terminal epithelial differentiation pathways resulting in poor formation of epithelial layers that are important for photoprotection [169] |
Inhibits catalase, raising intracellular levels of UV-associated oxidative stress and DNA damage [170] |
Vismodegib (Sonic-hedgehog inhibitor) |
Basal cell carcinoma |
Activates RAS-MAPK pathway [179] |
Close follow-up |
Vemurafenib and dabrafenib (BRAF inhibitors) |
Melanoma |
Activate, paradoxically, MAPK pathway and induce RAS mutations [51,190,191,192,197] |
BRAF inhibitors + MEK inhibitors [193,194,195,196] or BRAF inhibitors + cyclooxygenase (COX)-2 inhibitors [200,202] |