Skip to main content

Advertisement

SpringerLink
Log in

A cross-sectional analysis of skin cancer risk in patients receiving narrow-band ultraviolet B phototherapy: an evaluation of 100 patients

  • Original Paper
  • Published:
Archives of Dermatological Research Aims and scope Submit manuscript

Abstract

Narrow-band ultraviolet B (NB-UVB) phototherapy is an effective and widely used treatment modality for psoriasis and other inflammatory skin diseases. The carcinogenic effect of PUVA treatment has been investigated extensively, but there is very scarce data about the role of NB-UVB in the development of skin cancer. The aim of this study was to investigate the potential carcinogenic risk of NB-UVB therapy in various skin disorders. In this cross-sectional study, we evaluated 100 patients who had received whole-body NB-UVB treatment and 100 age- and sex-matched controls. Phototherapy unit database was used to identify patients. A total of 100 patients (53 males and 47 females) treated with NB-UVB and 100 controls were included in the study. The patient group revealed no cases of melanoma or non-melanoma skin cancer, while ten of them were found to have solar lentigines. Basal cell carcinoma in a patient and nine patients with solar lentigines were detected in the control group. There was no statistically significant difference between patient and control groups in terms of skin cancer and solar lentigines. This study does not provide evidence for an increased skin cancer risk in patients treated with NB-UVB phototherapy. However, we have detected the occurence of 10 cases of solar lentigines. Still, definitive prospective longitudinal studies with a greater number of patients and prolonged follow-up are required to specifically address skin cancer risk in relation to NB-UVB phototherapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Archier E, Devaux S, Castela E, Gallini A, Aubin F, Le Maitre M, Aractingi S, Bachelez H, Cribier B, Joly P, Jullien D, Misery L, Paul C, Ortonne JP, Richard MA (2012) Carcinogenic risks of psoralen UV-A therapy and narrowband UV-B therapy in chronic plaque psoriasis: a systematic literature review. J Eur Acad Dermatol Venereol 26(Suppl 3):22–31. https://doi.org/10.1111/j.1468-3083.2012.04520.x

    Article  CAS  PubMed  Google Scholar 

  2. Black RJ, Gavin AT (2006) Photocarcinogenic risk of narrowband ultraviolet B (TL-01) phototherapy: early follow-up data. Br J Dermatol 154:566–567. https://doi.org/10.1111/j.1365-2133.2005.07085.x

    Article  CAS  PubMed  Google Scholar 

  3. Chiesa Fuxench ZC, Shin DB, Ogdie Beatty A, Gelfand JM (2016) The risk of cancer in patients with psoriasis: a population-based cohort study in the health improvement network. JAMA Dermatol 152:282–290. https://doi.org/10.1001/jamadermatol.2015.4847

    Article  PubMed  PubMed Central  Google Scholar 

  4. Dawe RS (2003) A quantitative review of studies comparing the efficacy of narrow-band and broad-band ultraviolet B for psoriasis. Br J Dermatol 149:669–672

    Article  CAS  Google Scholar 

  5. Fisher GJ, Wang ZQ, Datta SC, Varani J, Kang S, Voorhees JJ (1997) Pathophysiology of premature skin aging induced by ultraviolet light. N Engl J Med 337:1419–1428. https://doi.org/10.1056/NEJM199711133372003

    Article  CAS  PubMed  Google Scholar 

  6. Gathers RC, Scherschun L, Malick F, Fivenson DP, Lim HW (2002) Narrowband UVB phototherapy for early-stage mycosis fungoides. J Am Acad Dermatol 47:191–197

    Article  Google Scholar 

  7. Hearn RM, Kerr AC, Rahim KF, Ferguson J, Dawe RS (2008) Incidence of skin cancers in 3867 patients treated with narrow-band ultraviolet B phototherapy. Br J Dermatol 159:931–935. https://doi.org/10.1111/j.1365-2133.2008.08776.x

    Article  CAS  PubMed  Google Scholar 

  8. Ichihashi M, Ueda M, Budiyanto A, Bito T, Oka M, Fukunaga M, Tsuru K, Horikawa T (2003) UV-induced skin damage. Toxicology 189:21–39

    Article  CAS  Google Scholar 

  9. Kilinc Karaarslan I, Teban L, Dawid M, Tanew A, Kittler H (2007) Changes in the dermoscopic appearance of melanocytic naevi after photochemotherapy or narrow-band ultraviolet B phototherapy. J Eur Acad Dermatol Venereol 21:526–531. https://doi.org/10.1111/j.1468-3083.2006.02020.x

    Article  CAS  PubMed  Google Scholar 

  10. Kripke ML (1981) Immunologic mechanisms in UV radiation carcinogenesis. Adv Cancer Res 34:69–106

    Article  CAS  Google Scholar 

  11. Kunisada M, Kumimoto H, Ishizaki K, Sakumi K, Nakabeppu Y, Nishigori C (2007) Narrow-band UVB induces more carcinogenic skin tumors than broad-band UVB through the formation of cyclobutane pyrimidine dimer. J Invest Dermatol 127:2865–2871. https://doi.org/10.1038/sj.jid.5701001

    Article  CAS  PubMed  Google Scholar 

  12. Lin TL, Wu CY, Chang YT, Juan CK, Chen CC, Yu SH, Chen YJ (2018) Risk of skin cancer in psoriasis patients receiving long-term narrowband ultraviolet phototherapy: results from a Taiwanese population-based cohort study. Photodermatol Photoimmunol Photomed. https://doi.org/10.1111/phpp.12443

    Article  Google Scholar 

  13. Maiorino A, De Simone C, Perino F, Caldarola G, Peris K (2016) Melanoma and non-melanoma skin cancer in psoriatic patients treated with high-dose phototherapy. J Dermatol Treat 27:443–447. https://doi.org/10.3109/09546634.2015.1133882

    Article  Google Scholar 

  14. Man I, Crombie IK, Dawe RS, Ibbotson SH, Ferguson J (2005) The photocarcinogenic risk of narrowband UVB (TL-01) phototherapy: early follow-up data. Br J Dermatol 152:755–757. https://doi.org/10.1111/j.1365-2133.2005.06537.x

    Article  CAS  PubMed  Google Scholar 

  15. Manganoni AM, Rossi MT, Sala R, Venturini M, Sereni E, Ungari M, Marocolo D, Lonardi S, Calzavara-Pinton P (2012) Dermoscopic, histological and immunohistochemical evaluation of cancerous features in acquired melanocytic nevi that have been repeatedly exposed to UVA or UVB. Exp Dermatol 21:86–90. https://doi.org/10.1111/j.1600-0625.2011.01397.x

    Article  PubMed  Google Scholar 

  16. Nardone B, Hammel JA, Raisch DW, Weaver LL, Schneider D, West DP (2014) Melanoma associated with tumour necrosis factor-alpha inhibitors: a research on adverse drug events and reports (RADAR) project. Br J Dermatol 170:1170–1172. https://doi.org/10.1111/bjd.12779

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Nijsten TE, Stern RS (2003) The increased risk of skin cancer is persistent after discontinuation of psoralen+ ultraviolet A: a cohort study. J Invest Dermatol 121:252–258. https://doi.org/10.1046/j.1523-1747.2003.12350.x

    Article  CAS  PubMed  Google Scholar 

  18. Pathak MA (1991) Ultraviolet radiation and the development of non-melanoma and melanoma skin cancer: clinical and experimental evidence. Skin Pharmacol 4(Suppl 1):85–94

    Article  Google Scholar 

  19. Paul CF, Ho VC, McGeown C, Christophers E, Schmidtmann B, Guillaume JC, Lamarque V, Dubertret L (2003) Risk of malignancies in psoriasis patients treated with cyclosporine: a 5 years cohort study. J Invest Dermatol 120:211–216. https://doi.org/10.1046/j.1523-1747.2003.12040.x

    Article  CAS  PubMed  Google Scholar 

  20. Scherschun L, Kim JJ, Lim HW (2001) Narrow-band ultraviolet B is a useful and well-tolerated treatment for vitiligo. J Am Acad Dermatol 44:999–1003. https://doi.org/10.1067/mjd.2001.114752

    Article  CAS  PubMed  Google Scholar 

  21. Schulman JM, Fisher DE (2009) Indoor ultraviolet tanning and skin cancer: health risks and opportunities. Curr Opin Oncol 21:144–149. https://doi.org/10.1097/CCO.0b013e3283252fc5

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Stern RS, Nichols KT, Vakeva LH (1997) Malignant melanoma in patients treated for psoriasis with methoxsalen (psoralen) and ultraviolet A radiation (PUVA). The PUVA Follow-Up Study. N Engl J Med 336:1041–1045. https://doi.org/10.1056/NEJM199704103361501

    Article  CAS  PubMed  Google Scholar 

  23. Stern RS, Thibodeau LA, Kleinerman RA, Parrish JA, Fitzpatrick TB (1979) Risk of cutaneous carcinoma in patients treated with oral methoxsalen photochemotherapy for psoriasis. N Engl J Med 300:809–813. https://doi.org/10.1056/NEJM197904123001501

    Article  CAS  PubMed  Google Scholar 

  24. van Lumig PP, Menting SP, van den Reek JM, Spuls PI, van Riel PL, van de Kerkhof PC, Fransen J, Kievit W, de Jong EM (2015) An increased risk of non-melanoma skin cancer during TNF-inhibitor treatment in psoriasis patients compared to rheumatoid arthritis patients probably relates to disease-related factors. J Eur Acad Dermatol Venereol 29:752–760. https://doi.org/10.1111/jdv.12675

    Article  CAS  PubMed  Google Scholar 

  25. Van Weelden H, Baart de la Faille H, Young E, van der Leun JC (1990) Comparison of narrow-band UV-B phototherapy and PUVA photochemotherapy in the treatment of psoriasis. Acta Derm Venereol 70:212–215

    PubMed  Google Scholar 

  26. van Weelden H, De La Faille HB, Young E, van der Leun JC (1988) A new development in UVB phototherapy of psoriasis. Br J Dermatol 119:11–19

    Article  Google Scholar 

  27. Walker D, Jacobe H (2011) Phototherapy in the age of biologics. Semin Cutan Med Surg 30:190–198. https://doi.org/10.1016/j.sder.2011.08.004

    Article  CAS  PubMed  Google Scholar 

  28. Weischer M, Blum A, Eberhard F, Rocken M, Berneburg M (2004) No evidence for increased skin cancer risk in psoriasis patients treated with broadband or narrowband UVB phototherapy: a first retrospective study. Acta Derm Venereol 84:370–374. https://doi.org/10.1080/00015550410026948

    Article  PubMed  Google Scholar 

  29. Wulf HC, Hansen AB, Bech-Thomsen N (1994) Differences in narrow-band ultraviolet B and broad-spectrum ultraviolet photocarcinogenesis in lightly pigmented hairless mice. Photodermatol Photoimmunol Photomed 10:192–197

    CAS  PubMed  Google Scholar 

  30. Zaher H, Bassiouny D, Abdel Hay R, Samir N, Ragab N, Sayed S (2016) Dermoscopic and immunohistochemical changes in acquired melanocytic nevi following narrow-band ultraviolet B therapy. Dermatology 232:273–278. https://doi.org/10.1159/000445780

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors declare that there are no relationships that provided financial or editorial support for the study which may in potential cause competing interest for the submission.

Author information

Authors and Affiliations

  1. Dermatology and Venereology, Ankara Training and Research Hospital, Ankara, Turkey

    Nermin Karaosmanoglu, Işıl Göğem Imren, Esra Kiratli Nalbant & Meral Eksioglu

  2. Dermatology and Venereology, Nazilli State Hospital, Aydın, Turkey

    Pınar Ozdemir Cetinkaya

  3. Dermatology and Venereology, Develi Hatice Muammer Kocatürk State Hospital, Kayseri, Turkey

    Omer Kutlu

  4. Dermatology and Venereology, Nusaybin State Hospital, Mardin, Turkey

    Engin Karaaslan

Authors
  1. Nermin Karaosmanoglu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pınar Ozdemir Cetinkaya
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Omer Kutlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Engin Karaaslan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Işıl Göğem Imren
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Esra Kiratli Nalbant
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Meral Eksioglu
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by NK, EK, EKN, IGI, OK, ME and POC. The first draft of the manuscript was written by NK and POC and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Pınar Ozdemir Cetinkaya.

Ethics declarations

Conflict of interest

The authors declared they do not have anything to disclose regarding conflict of interest with respect to this manuscript.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Karaosmanoglu, N., Ozdemir Cetinkaya, P., Kutlu, O. et al. A cross-sectional analysis of skin cancer risk in patients receiving narrow-band ultraviolet B phototherapy: an evaluation of 100 patients. Arch Dermatol Res 312, 249–253 (2020). https://doi.org/10.1007/s00403-019-02007-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00403-019-02007-7

Keywords

Search

Navigation