{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:30:42Z","timestamp":1760189442855,"version":"3.41.2"},"reference-count":17,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2015,9,15]],"date-time":"2015-09-15T00:00:00Z","timestamp":1442275200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Increased rates of <jats:styled-content style=\"fixed-case\">NMSC<\/jats:styled-content> (nonmelanoma skin cancer) have recently been reported in people with <jats:styled-content style=\"fixed-case\">MG<\/jats:styled-content> (myasthenia gravis) receiving azathioprine treatment. Guidelines on azathioprine for patients with dermatological and gastrointestinal disorders stress the importance of <jats:styled-content style=\"fixed-case\">NMSC<\/jats:styled-content> risk awareness and prevention. The aim of this study is to assess whether <jats:styled-content style=\"fixed-case\">MG<\/jats:styled-content> patients are being informed of this risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical records of patients with <jats:styled-content style=\"fixed-case\">MG<\/jats:styled-content> attending a university hospital neurology clinic were reviewed. Data on patient demographics, clinical presentation, diagnostic tests, azathioprine treatment, development of <jats:styled-content style=\"fixed-case\">NMSC<\/jats:styled-content>, and counseling regarding <jats:styled-content style=\"fixed-case\">NMSC<\/jats:styled-content> risk were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010nine <jats:styled-content style=\"fixed-case\">MG<\/jats:styled-content> cases were identified, median age 58\u00a0years (range 20\u201390). Forty\u2010two (60.9%) had received azathioprine at some point with a mean cumulative dose of 235.5\u00a0g (range 9.1\u2013972.8\u00a0g). Skin cancer risk and prevention advice provision was documented in 3 (7.1%) azathioprine\u2010treated patients. Five patients developed histologically confirmed <jats:styled-content style=\"fixed-case\">NMSC<\/jats:styled-content> of whom all were treated with azathioprine (incidence rate of 24.9 per 1000, 16 times higher than expected). Documented advice on other safety issues such as regular blood test monitoring was found in 33 (78.8%) azathioprine\u2010treated cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Preventative measures such as daily sunscreen use have been shown to reduce the incidence of <jats:styled-content style=\"fixed-case\">NMSC<\/jats:styled-content> in the general population. The results of this study demonstrate a very low rate of advice provision about <jats:styled-content style=\"fixed-case\">NMSC<\/jats:styled-content> risk in azathioprine\u2010treated <jats:styled-content style=\"fixed-case\">MG<\/jats:styled-content> patients and the need for increased awareness among treating neurologists and patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/brb3.396","type":"journal-article","created":{"date-parts":[[2015,9,15]],"date-time":"2015-09-15T05:42:09Z","timestamp":1442295729000},"source":"Crossref","is-referenced-by-count":17,"title":["Nonmelanoma skin cancer risk awareness in azathioprine\u2010treated myasthenia gravis patients"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8457-1748","authenticated-orcid":false,"given":"Iain J.","family":"McGurgan","sequence":"first","affiliation":[{"name":"Department of Neurology St. Vincent's University Hospital Elm Park Dublin 4 Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"McGuigan","sequence":"additional","affiliation":[{"name":"Department of Neurology St. Vincent's University Hospital Elm Park Dublin 4 Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,9,15]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2001.01023.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1177\/014107689208501213","article-title":"Pancytopenia related to azathioprine \u2013 an enzyme deficiency caused by a common genetic polymorphism: a review","volume":"85","author":"Anstey A.","year":"1992","journal-title":"J. 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