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Soo Park, MD
Soo Park, MD
Posted: Monday, July 22, 2024
Patients with psoriasis who underwent phototherapy vs anti–tumor necrosis factor–alpha (TNF-α) therapy may have an increased risk of developing non-melanoma skin cancers, according to Laura Calabrese, MD, of the University of Siena, Italy, and colleagues. The results of a single-center retrospective study, which were published in the Journal of Clinical Medicine, also suggest that those with scalp psoriasis may require closer follow-up.
“Multiple factors may contribute to the development of non-melanoma skin cancers in psoriatic patients, ranging from immunosuppression induced by biologic agents to previous phototherapy,” the investigators explained. “However, the extent to which each factor may impact this risk has not been entirely assessed.”
The investigators focused on patients with psoriasis who were treated with either narrowband ultraviolet B phototherapy (n = 100) or anti–TNF-α agents (n = 100) at Siena University Hospital; they must have been naive to other systemic treatments or phototherapy. For 5 years, the study population underwent both observation and annual dermatologic examinations.
A total of 34 patients given phototherapy developed at least one basal or squamous cell carcinoma. Of this population, 10 developed two non-melanoma skin cancers (basal and squamous cell carcinoma [one of each]: n = 5; two basal cell carcinomas: n = 5). Of note, a higher frequency of non-melanoma skin cancers was documented in patients with psoriasis on the scalp vs other anatomic sites, irrespective of the treatment modality (hazard ratio = 0.51; P = .023).
“Our study represents an important contribution to the evolving narrative on non-melanoma skin cancer risk associated with dermatologic interventions,” the investigators concluded. “The intersection of treatment modalities, age-related vulnerabilities, and anatomical location forms a picture of complexity that encourages a more complete and precise understanding of this delicate subject.”
Disclosure: The study authors reported no conflicts of interest.
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