Original Article

Journal of Investigative Dermatology (1988) 91, 120–124; doi:10.1111/1523-1747.ep12464137

Non-Melanoma Skin Cancer Occurring in Patients Treated With PUVA Five to Ten Years After First Treatment

Robert S Stern1,2,3,4,5,6 and Rudee Lange2

  1. 1Department of Cell Biology, New York University Medical Center, New York, New York, U.S.A
  2. 2Photochemotherapy Follow-up Study and Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, U.S.A.
  3. 3Beth Isrel Hospital, Boston, Massachusetts, U.S.A.
  4. 4Harvard Medical School, Boston, Massachusetts, U.S.A.
  5. 5the Charles A. Dana Research Institute, Beth Israel Hospital, Boston, Massachusetts, U.S.A.
  6. 6the Center for Analysis of Health Practices, Harvard School of Public Health, Boston, Massachusetts, U.S.A.

Received 20 October 1988; Accepted 19 February 1988.

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Abstract

Continued prospective study of the 1,380 patients enrolled in the PUVA study for 10 years after first exposure to PUVA demonstrates a strong association between cumulative exposure to PUVA and an increased risk of squamous cell carcinoma of the skin. For tumors occurring at least 58 months after first treatment, after adjustment for age, sex, and area of residence, we observed that patients with more than 260 treatments had an 11-fold increase in risk compared to patients who had received 160 or fewer treatments during the same interval (P <0.01). Comparable increases in relative risk were noted in patients of all skin types, irrespective of prior ionizing radiation exposure. We also noted a modest dose-dependent increase in the risk for the development of basal cell carcinoma for patients who received an excess of 200 treatments compared to those who had received fewer than 160 treatments within the same time period (P <0.05). Tumors detected in our cohort exhibit biologic behavior similar to non-melanoma skin cancers associated with sun exposure. Careful monitoring and early detection should limit the morbidity associated with these tumors.

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References

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