“…Owing to the pharmacological profile of these molecules, other clinical features might be more frequent in anti-TNF-␣ -associated cutaneous SCC such as multiple tumors, rapid local growth and perhaps a higher metastatic potential, all characteristics featured by our patient. On the other hand, it is of interest to note that the use of efalizumab, another non-anti-TNF-␣ biological agent currently used in psoriasis, has not been linked to a significant increase in the patients' risk of developing skin malignancies [7] although the occurrence of multiple dermatofibromas, a cutaneous condition sometimes also related to immunodeficiency, has recently been reported in this therapeutic setting [8] . Although definitive conclusions cannot be drawn on so few cases, a very careful examination of the whole body surface including the genitals must be carried out on a regular basis in psoriasis patients receiving anti-TNF-␣ agents.…”