Would you switch azathioprine to a different immunosuppressant if a controlled patient with SLE develops melanoma and/or non-melanoma skin cancer?  

This is a difficult question with no definitive research-proven answer. Clearly, most of our drugs do enhance the chance of melanoma and nonmelanoma skin cancer. If one does a literature search the only one of our drugs that has not been reported to increase the chance for relapse of melanoma is Tac...

I would add to Dr. @Gary Gilkeson's excellent response with considering biologics as per the latest EULAR guidelines for SLE management. Belimumab has not had any cancer flags after being used now for well over a decade; anifrolumab has thus far had no red flags; rituximab is an option, but I try to...