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Malignancy Risks of Dermatologic Therapies

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Dermato-Oncology Study Guide

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Abstract

Patients with inflammatory skin diseases such as psoriasis and atopic dermatitis may have higher risks of malignancies compared to healthy individuals regardless of their treatments. Many of the therapies used to treat inflammatory skin diseases modulate the immune system. It is important to determine whether dermatologic therapies influence the risk of malignancies in patients with psoriasis and atopic dermatitis. However, assessing the association between dermatologic therapies and malignancies is challenging because clinical trials lack adequate population sizes and long-term follow-up needed to detect clinically important differences in malignancy rates in those receiving the medication compared to placebo. This chapter synthesizes and interprets the literature on the malignancy risks of dermatologic therapies with a focus on long-term follow-up data. Dermatologic therapies discussed in this chapter include oral systemic therapies, phototherapies, and biologic therapies. This chapter will also discuss malignancy risk in special immunosuppressed populations such as organ transplant and HIV patients.

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Abbreviations

AIDS:

Acquired immunodeficiency syndrome

BB-UVB:

Broad-band ultraviolet B

BCC:

Basal cell carcinoma

CD:

Cluster of differentiation

CI:

Confidence interval

CMM:

Cutaneous malignant melanoma

CsA:

Cyclosporine

CTCL:

Cutaneous T-cell lymphoma

EBV:

Ebstein-Barr virus

ECG:

Electrocardiogram

FDA:

Food and Drug Administration

HAART:

Highly active antiretroviral therapy

HHV:

Human Herpesvirus

HIV:

Human immunodeficiency virus

HPV:

Human papilloma virus

HR:

Hazard ratio

IARC:

International Agency for Research on Cancer

IBD:

Inflammatory bowel disease

Ig:

Immunoglobulin

IL:

Interleukin

IRR:

Incidence rate ratio

IVIG:

Intravenous immunoglobulin

MTX:

Methotrexate

nbDMARDs:

Nonbiologic disease modifying antirheumatic drugs

NB-UVB:

Narrow-band ultraviolet B

NHL:

Non-Hodgkin’s lymphoma

NIH:

National Institutes of Health

NMSC:

Nonmelanoma skin cancer

OR:

Odds ratio

PDE:

Phosphodiesterase

PSOLAR:

Psoriasis Longitudinal Assessment and Registry

PUVA:

Psoralen-ultraviolet A

PY:

Person years

RA:

Rheumatoid arthritis

RCT:

Randomized clinical trial

RR:

Risk ratio

SCC:

Squamous cell carcinoma

SEER:

Surveillance, Epidemiology, and End Results Program

SIR:

Standardized incidence rate

SLE:

Systemic lupus erythematosus

TNF:

Tumor necrosis factor

UVA:

Ultraviolet A

UVB:

Ultraviolet B

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Authors and Affiliations

  1. Department of Medicine, University of California, Irvine, Orange, CA, USA

    Kevin K. Wu

  2. Department of Dermatology, University of Southern California Keck School of Medicine, Los Angeles, CA, USA

    April W. Armstrong

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  1. Kevin K. Wu
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  2. April W. Armstrong
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Editors and Affiliations

  1. Department of Dermatology, University of Iowa Health Care, Iowa, IA, USA

    Vincent Liu

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Wu, K.K., Armstrong, A.W. (2021). Malignancy Risks of Dermatologic Therapies. In: Liu, V. (eds) Dermato-Oncology Study Guide. Springer, Cham. https://doi.org/10.1007/978-3-030-53437-0_6

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  • DOI: https://doi.org/10.1007/978-3-030-53437-0_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-53436-3

  • Online ISBN: 978-3-030-53437-0

  • eBook Packages: MedicineMedicine (R0)

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