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Do Topical Calcineurin Inhibitors Increase the Risk for Skin Cancer?

By: Lauren Harrison, MS
Posted: Monday, September 14, 2020

Topical calcineurin inhibitors, commonly used to treat atopic dermatitis, do not appear to be associated with an increased risk of keratinocyte, basal cell, or squamous cell carcinoma. These findings were based upon a postmarketing surveillance study performed by Maryam M. Asgari, MD, MPH, of Massachusetts General Hospital, Boston, and colleagues, and were published in JAMA Dermatology.

“We analyzed the data with multiple sensitivity analyses to explore the association of topical calcineurin inhibitors use and skin cancer risk in detail, which revealed no association each time, so that was very reassuring,” said Dr. Asgari in an institutional press release.

Researchers completed a retrospective cohort study using a comprehensive database maintained by Kaiser Permanente Northern California. They identified 93,746 adults older than 40 who had been diagnosed with atopic dermatitis or dermatitis between January 2002 and December 2013. The team then looked at which patients received topical calcineurin inhibitors or corticosteroids and compared that information with pathology-verified skin cancer diagnoses.

Overall, 7.5% of patients in the cohort were exposed to topical calcineurin inhibitors, 78.5% of patients were exposed to topical corticosteroids, and 4.8% of patients developed a keratinocyte carcinoma. There was no association found between exposure to topical calcineurin inhibitors and the risk of subsequent keratinocyte carcinoma when compared with corticosteroid use (hazard ratio = 1.02). Also, there seemed to be no significant difference in the number of patients who developed basal cell or squamous cell carcinoma when comparing topical calcineurin inhibitors with topical steroids (hazard ratio = 1.01 and 0.94, respectively). When the control group was changed from topical steroid users to patients who were not exposed to either topical calcineurin inhibitors or steroids, there was still no difference in the development of basal cell carcinoma (hazard ratio = 1.04).

Disclosure: For a full list of author disclosures, visit jamanetwork.com.



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