How would you approach the management of HLA-B27-associated recurrent uveitis and inflammatory back pain with a recent history of melanoma?  

This is a very practical question (and challenging to answer succinctly as well!). Like many scenarios seen in clinical practice, there is unfortunately less data in the literature than we would like to guide us here. While decent data exists on the risk of incident cancer following exposure to biol...

Drs. @Kolfenbach, @Gilkeson, and @Nowatzky have provided thoughtful and scholarly responses. I agree completely that most patients with recurrent B27-related AAU can be managed with topical therapy which can usually be started safely even before seeing the ophthalmologist - provided that the patient...

Dr. @Kolfenbach's answer is very much appreciated. In this specific case, the patient's history involves recent melanoma rather than other types of skin cancer. Nearly every biologic and immunosuppressant has associated case reports indicating melanoma recurrence post-immunosuppression or biolo...

As for isolated acute anterior HLA-B27-associated uveitis (AAU), I agree that topical therapy is the mainstay of uncomplicated cases of AAU that are not severe. However, patients with AAU that have more than 2+ cell grade on slit lamp exam in the anterior chamber (not a rare occurrence at all), impe...