Melanoma and non-melanoma skin cancer in psoriatic patients treated with high-dose phototherapy

Objectives: The carcinogenic effect of plus ultraviolet A (PUVA)-therapy in psoriatic patients has been widely demonstrated, while data on the safety of narrow band (311 nm) ultraviolet B (nb-UVB) are scarce. We investigated the occurrence of melanoma and non-melanoma skin cancer (NMSC) in psoriatic...

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Published in:The Journal of dermatological treatment Vol. 27; no. 5; pp. 443 - 447
Main Authors: Maiorino, Alessia, De Simone, Clara, Perino, Francesca, Caldarola, Giacomo, Peris, Ketty
Format: Journal Article
Language:English
Published: England Taylor & Francis 01.10.2016
Subjects:
Adult
Aged
Aged, 80 and over
Female
Humans
Male
melanoma
Middle Aged
Neoplasms, Radiation-Induced - epidemiology
non-melanoma skin cancer
phototherapy
Psoriasis
Psoriasis - drug therapy
Psoriasis - radiotherapy
PUVA Therapy - adverse effects
Retrospective Studies
Risk Assessment
Risk Factors
Skin Neoplasms - epidemiology
Ultraviolet Therapy - adverse effects
Young Adult
melanoma
phototherapy
Psoriasis
non-melanoma skin cancer
ISSN:0954-6634, 1471-1753
Online Access:Get full text
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Summary:Objectives: The carcinogenic effect of plus ultraviolet A (PUVA)-therapy in psoriatic patients has been widely demonstrated, while data on the safety of narrow band (311 nm) ultraviolet B (nb-UVB) are scarce. We investigated the occurrence of melanoma and non-melanoma skin cancer (NMSC) in psoriatic patients treated with nb-UVB or PUVA-therapy. Methods: This retrospective study included patients affected by psoriasis, who had been treated with nb-UVB or PUVA-therapy. Clinical data and phenotypic risk factors were collected and a total body examination was performed at a routine appointment during the study period. Results: We examined 92 patients (60 males and 32 females; mean age: 53.5 years, range: 20-83 years) treated with PUVA-therapy (42/92, 45%) or with nb-UVB (50/92, 55%) for 1-28 years (mean: 7.1 years). Among patients treated with PUVA, nine skin tumors (one melanoma, seven basal cell carcinoma (BCCs) and one squamous cell carcinoma (SCC)) were detected in 2/42 (4.7%) patients, while in the nb-UVB group, 14 skin tumors including two melanomas, four BCCs, and eight SCCs were diagnosed in 6/50 (12%) patients. Conclusions: A noteworthy number of NMSC were diagnosed in this Mediterranean population of patients exposed to high-dose UV treatment. A thorough risk-benefit evaluation should always be done before UV treatment and patients should be carefully monitored for skin cancer during and after treatment discontinuation.
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ISSN:0954-6634
1471-1753
DOI:10.3109/09546634.2015.1133882