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Malignancy Risk and Recurrence with Psoriasis and its Treatments: A Concise Update

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Abstract

Psoriasis is a common inflammatory cutaneous disease that affects approximately 120 million people worldwide. Systemic treatments have significantly improved disease burden, but concerns persist regarding their association with increased risk of malignancy. Patients with psoriasis have a slightly elevated baseline risk of lymphoproliferative diseases. Studies on methotrexate and cyclosporine, as well as older biological agents such as tumor necrosis factor inhibitors, have found no increased risk of non-cutaneous solid tumors; however, positive associations between cutaneous squamous cell carcinomas and certain therapies have been found. There is conflicting evidence regarding the risk of lymphoma and melanoma. Further studies are needed to determine the long-term safety of newer psoriasis treatments (interleukin [IL]-12/23, IL-17, Janus kinase 1/3, and phosphodiesterase-4 inhibitors), specifically their safety in patients with a history of cancer. This review summarizes the most recent studies on malignancy risk from psoriasis, and its treatments in patients and cancer survivors, with the highest available level of evidence.

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Author notes

  1. Shamir Geller and Haoming Xu contributed equally to this work.

Authors and Affiliations

  1. Dermatology Service, Memorial Sloan Kettering Cancer Center, 16 East 60th Street, New York, NY, 10022, USA

    Shamir Geller, Haoming Xu, Mario E. Lacouture & Meenal Kheterpal

  2. Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Mark Lebwohl

  3. Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Beatrice Nardone

Authors
  1. Shamir Geller
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  2. Haoming Xu
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Correspondence to Shamir Geller.

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This article was exempt from IRB review.

Funding

This research was funded in part through the National Institutes of Health/National Cancer Institute (NIH/NCI) Cancer Center Support Grant P30 CA008748.

Conflict of interest

Dr. Lebwohl is an employee of the Icahn School of Medicine at Mount Sinai, which receives research funds from Abbvie, Amgen, Boehringer Ingelheim, Celgene, Eli Lilly, Janssen, Kadmon, Medimmune/AstraZeneca, Novartis, and Pfizer. Dr. Lacouture has consulting agreements with Quintiles, Boehringer Ingelheim, AstraZeneca Pharmaceuticals, Legacy Healthcare, Foamix, Adgero Biopharmaceuticals, Janssen R&D, Novartis and Novocure, and receives research grants from Berg and Bristol-Myers Squibb. Dr. Geller, Mr Xu, Dr. Nardone and Dr. Kheterpal have no conflicts of interest to declare.

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Geller, S., Xu, H., Lebwohl, M. et al. Malignancy Risk and Recurrence with Psoriasis and its Treatments: A Concise Update. Am J Clin Dermatol 19, 363–375 (2018). https://doi.org/10.1007/s40257-017-0337-2

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