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- Levodopa and melanoma: practical recommendations for Parkinson's disease—international Parkinson and movement disorder society scientific issues committee viewpointPublication . Sciacca, Giorgia; Elsayed, Inas; Perez‐Lloret, Santiago; Outeiro, Tiago; Unni, Vivek K.; Kordower, Jeffery H.; Berg, Daniela; Kalia, Lorraine V.The potential association between Parkinson's disease (PD), melanoma, and levodopa (l-dopa) use can be a source of uncertainty and concern in clinical practice. Several etiopathological hypotheses have been proposed, including a possible role of the protein α-synuclein that, in addition to being a major component of Lewy bodies in PD, is expressed in melanocytes.1 However, a definitive mechanistic link between PD and melanoma has yet to be defined. Epidemiological data examining whether l-dopa treatment increases melanoma risk in PD patients have been contradictory, and a causal connection has not been established. Nonetheless, product monographs for l-dopa-containing medications continue to cite a history of melanoma as a contraindication and list malignant melanoma as a potential adverse effect. This discrepancy between regulatory language and the available evidence can create uncertainty for both clinicians and people with PD when initiating or continuing l-dopa therapy. The aim of this article is to provide practical recommendations for clinicians based on current evidence regarding the (1) risk of melanoma in PD independent of l-dopa treatment based on epidemiological evidence and shared pathobiological mechanisms, (2) potential risk of developing melanoma with l-dopa use in PD, and (3) safety of l-dopa treatment in PD patients with a history of melanoma