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Levodopa/Melanoma (Closure) Today at the library I dug up 3 more of the references cited in Kathrynne Holden's PubMed search (10 Jan 99): Lieberman A, Shupack J; Neur 1974: Combining 3 of their own cases with 2 reported by others, they summarize recurrence of melanoma in 4 of them, within a few weeks or months after beginning levodopa treatment for PD. The quickest onset (3 weeks) was in a patient getting only 1000mg/day of levodopa. The other 3 patients were getting 2000, 3600, or 4500 mg/day of levodopa. Authors' diffident suggestion that it might be wise to monitor such patients evidently prompted inclusion of the notice in the PDR (My post 12 Jan 99). Fermaglich J, Delaney P, and reply; Sober A; JAMA 1979: They agree that no firm causal link between levodopa and melanoma is known, but for the sake of caution anyway, maybe substitution in patients with melanoma and PD of an agonist, such as bromocriptine, rather than levodopa, might be wise. Neither side sounds especially confident of their position. Rampen F and reply: Pfutzner W, Przybilla B; J Am Acad Derm 1998: Rampen pulls no punches: Studying the moles of PD patients on levodopa is a waste of time and money. The rather weak reply is that not all melanomas are related to sun exposure, and a relation to levodopa cannot be ruled out, since no carefully conducted and analyzed epidemiological study has been done. CONCLUSION: It certainly doesn't hurt to watch your melanoma for signs of change, whether you're a PD patient getting levodopa or not. But if you never had a melanoma, you probably needn't worry about getting one from levodopa alone. Of course, future research may show otherwise, but for now... Cheers, Joe -- J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks, CA 91403-5013