Potential Link Between Psoriasis and Risk of Non-Melanoma Skin Cancer
Posted: Thursday, January 23, 2020
Results from a study published in the Journal of Drugs in Dermatology may help clinicians to assess non-melanoma skin cancer risk and to monitor approaches among patients with psoriasis. Rosemary deShazo, MD, of the University of Utah, Salt Lake City, and colleagues found that although patients with psoriasis are an increased risk of developing non-melanoma skin cancer, including squamous cell and basal cell carcinomas, the risk is especially high among those who previously received phototherapy or systemic treatment, such as biologic therapies and methotrexate, due to immunosuppression.
Using data from a psoriasis registry called PSOLAR, the research team conducted an observational study among approximately 12,000 patients with psoriasis, focusing on the effects of biologic and methotrexate therapy exposure and the risk of non-melanoma skin cancer. Biologic therapies included tumor necrosis factor inhibitors and ustekinumab—an immunosuppressive agent used to treat psoriasis and psoriatic arthritis. Eligible patients did not have a history of basal cell or squamous cell carcinoma. A comparative group included patients with non-melanoma skin cancer who were not exposed to biologic therapies or methotrexate.
Among the overall population, exposure to biologic therapies combined did not cause a significant risk of basal cell carcinoma (P = .0843). However, when considered independently, the risk of basal cell carcinoma was significantly higher among patients exposed to tumor necrosis factor inhibitors (P = .0324) and methotrexate (P < .0001), but not those exposed to ustekinumab. Conversely, none of the exposures significantly increased the risk of squamous cell carcinoma. In fact, exposure to the biologic therapy ustekinumab significantly decreased the risk of squamous cell carcinoma.
Of note, the authors acknowledged the limitations of their study, including its observational design with associated biases and imbalances across cohorts that may not have been adequately adjusted for in the analysis. Further investigation is needed to confirm these findings.
Disclosure: For full disclosures of the study authors, visit jddonline.com.