Incidence and profile of skin cancers in patients following ultraviolet phototherapy without psoralens: A retrospective cohort study.
J Am Acad Dermatol
; 90(4): 759-766, 2024 Apr.
Article
em En
| MEDLINE
| ID: mdl-38070541
ABSTRACT
BACKGROUND:
Psoralen + ultraviolet-A (PUVA) is associated with photocarcinogenesis. However, carcinogenic risk with other ultraviolet phototherapies remains unclear.OBJECTIVE:
Evaluate whether phototherapy without psoralens increases skin cancer risk.METHODS:
Retrospective cohort study of patients treated at a teaching-hospital phototherapy center (1977-2018). Skin cancer records were validated against pathology reports. Age-standardized incidence rates (ASIRs) of skin cancer were evaluated for gender, skin phototype, diagnosis, ultraviolet modality, anatomical site; and compared to provincial population incidence rates (2003).RESULTS:
In total, 3506 patients treated with broadband-ultraviolet-B, narrowband-UVB and/or combined UVAB were assessed with a mean follow-up of 7.3 years. Majority of patients had psoriasis (60.9%) or eczema (26.4%). Median number of treatments was 43 (1-3598). Overall, 170 skin cancers (17 melanoma, 33 squamous cell carcinoma and 120 basal cell carcinoma) occurred in 79 patients. Patient-based and tumor-based ASIR of skin cancer was 149 (95% CI 112-187)/100,000 and 264 (219-309)/100,000 person-years, respectively. There was no significant difference between tumor-based ASIRs for melanoma, squamous cell carcinoma, and basal cell carcinoma compared to the general population; or in phototherapy patients with-psoriasis or eczema; or immunosuppressants. No cumulative dose-response correlation between UVB and skin cancer was seen.LIMITATIONS:
Treatment and follow-up duration.CONCLUSION:
No increased risk of melanoma and keratinocyte cancer was found with phototherapy.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Furocumarinas
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Psoríase
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Neoplasias Cutâneas
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Terapia Ultravioleta
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Carcinoma Basocelular
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Carcinoma de Células Escamosas
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Eczema
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Melanoma
Limite:
Humans
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article