Andrea Paradisi1, Stefano Tabolli1, Biagio Didona2, Luciano Sobrino3, Nicoletta Russo4, Damiano Abeni1. 1. Health Services Research Unit; 2. First Dermatological Clinic. 3. Hospital Information System. 4. Medical Direction, Istituto Dermopatico dell'Immacolata, Istituto di Ricovero e Cura a Carattere Scientifico (IDI-IRCCS), Via dei Monti di Creta, 104 I-00167 Rome, Italy.
Abstract
BACKGROUND: Chronic inflammatory conditions such as psoriasis may pose an increased risk of cancer due to impaired immunosurveillance resulting from the chronic inflammation and immunosuppressive medications. However, the relationship between psoriasis and the risk of melanoma is still controversial. OBJECTIVE: To compare the occurrence of melanoma in a cohort of 72,739 psoriasis patients and in 25,956 non-dermatological patients. METHODS: A record-linkage was performed between records of hospitalizations and access to day-hospital and day-surgery clinics and outpatient clinics. The frequency of melanoma was compared between psoriasis patients and vascular surgery patients. Occurrence of melanoma was compared by computing the relative risk (RR) and modelled using multiple logistic regression. RESULTS: Overall, occurrence of melanoma was 1.8% (95% CI 1.5-2.2%) in psoriasis patients and 4.5% (95% CI 3.8-5.4%) in non-dermatological patients (RR = 0.40, 95% CI 0.31-0.51). The simultaneous adjustment for gender, age, and phototherapy yielded a RRadj = 0.54(95% CI 0.41-0.70. For patients who underwent phototherapy, vs. those who did not, the RRadj was 1.50 (95% CI 0.56-4.15). CONCLUSIONS: In this large retrospective study, patients with psoriasis had a significantly lower probability of having melanoma when compared to a group of non-dermatological patients. Further studies, preferably with a concurrent longitudinal design to estimate incidence with more complete information, are needed to corroborate our findings.
BACKGROUND: Chronic inflammatory conditions such as psoriasis may pose an increased risk of cancer due to impaired immunosurveillance resulting from the chronic inflammation and immunosuppressive medications. However, the relationship between psoriasis and the risk of melanoma is still controversial. OBJECTIVE: To compare the occurrence of melanoma in a cohort of 72,739 psoriasispatients and in 25,956 non-dermatological patients. METHODS: A record-linkage was performed between records of hospitalizations and access to day-hospital and day-surgery clinics and outpatient clinics. The frequency of melanoma was compared between psoriasispatients and vascular surgery patients. Occurrence of melanoma was compared by computing the relative risk (RR) and modelled using multiple logistic regression. RESULTS: Overall, occurrence of melanoma was 1.8% (95% CI 1.5-2.2%) in psoriasispatients and 4.5% (95% CI 3.8-5.4%) in non-dermatological patients (RR = 0.40, 95% CI 0.31-0.51). The simultaneous adjustment for gender, age, and phototherapy yielded a RRadj = 0.54(95% CI 0.41-0.70. For patients who underwent phototherapy, vs. those who did not, the RRadj was 1.50 (95% CI 0.56-4.15). CONCLUSIONS: In this large retrospective study, patients with psoriasis had a significantly lower probability of having melanoma when compared to a group of non-dermatological patients. Further studies, preferably with a concurrent longitudinal design to estimate incidence with more complete information, are needed to corroborate our findings.