Prevalence, Incidence, and Risk of Cancer in Patients With Psoriasis and Psoriatic Arthritis | Dermatology | JN Learning | AMA Ed Hub [Skip to Content]
[Skip to Content Landing]

Prevalence, Incidence, and Risk of Cancer in Patients With Psoriasis and Psoriatic ArthritisA Systematic Review and Meta-analysis

Educational Objective
To evaluate the association between cancer and psoriasis or psoriatic arthritis
1 Credit CME
Key Points

Question  Is psoriasis or psoriatic arthritis associated with an increased risk of cancer?

Findings  In a systematic review and meta-analysis of 112 studies including more than 2 million patients, the risk of cancer overall was slightly increased in patients with psoriasis, particularly the risks of keratinocyte cancer and lymphomas. No increase in cancer was seen among patients with psoriasis treated with biologic agents, and psoriatic arthritis was not associated with an increased risk of cancer.

Meaning  Patients with psoriasis appear to have a slightly increased risk of developing cancers.

Abstract

Importance  The association between psoriasis and risk of cancer remains debatable.

Objective  To evaluate the association and risk of cancer in patients with psoriasis or psoriatic arthritis, including risk of specific cancer subtypes.

Data Sources  Two databases (PubMed and Embase) were screened from inception to January 1, 2019, using the search string psoriasis or psoriatic and neoplasms or malignancy or cancer. The search was filtered to only include human participants and publications in English.

Study Selection  Observational cohort studies with a population of patients with psoriasis or psoriatic arthritis were included. Studies had to be original and report the incidence or prevalence of cancer within this population. Studies evaluating pediatric populations and cancer types not included in the protocol were excluded.

Data Extraction and Synthesis  This study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The search string, objectives, and study protocol methods were defined before the study was initiated. A total of 365 studies were included for full-text assessment. Owing to the heterogeneity of the included studies, a random-effects model was used.

Main Outcomes and Measures  Main outcome was cancer (overall and specific subtypes) and measures were prevalence, incidence, and risk estimate for cancer in patients with psoriasis or psoriatic arthritis.

Results  Of the 365 studies assessed, 112 were included in the analysis (N = 2 053 932 patients). The overall prevalence of cancer in patients with psoriasis was 4.78% (95% CI, 4.02%-5.59%), with an incidence rate of 11.75 per 1000 person-years (95% CI, 8.66-15.31) and a risk ratio (RR) of 1.21 (95% CI, 1.11-1.33). There was an increased risk of several cancers, including keratinocyte cancer (RR, 2.28; 95% CI, 1.73-3.01), lymphomas (RR, 1.56; 95% CI, 1.37-1.78), lung cancer (RR, 1.26; 95% CI, 1.13-1.40), and bladder cancer (RR, 1.12; 95% CI, 1.04-1.19). No increased risk of cancer for patients with psoriasis treated with biologic agents was found (RR, 0.97; 95% CI, 0.85-1.10). Psoriatic arthritis was not associated with increased risk of cancer overall (RR, 1.02; 95% CI, 0.97-1.08).

Conclusions and Relevance  Patients with psoriasis appear to have a slightly increased risk of cancer, particularly keratinocyte cancer and lymphomas. Data on treatment with biologic agents did not show an increased risk of cancer. Data on cancer in patients with psoriatic arthritis remain scarce, and further research is warranted in this area.

Sign in to take quiz and track your certificates

Buy This Activity

JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 CME Credit™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC

Article Information

Accepted for Publication: January 3, 2020.

Corresponding Author: Sofie Vaengebjerg, MD, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte Hospitalsvej 1, 2900 Hellerup, Denmark (sofie@vaengebjerg.dk).

Published Online: February 19, 2020. doi:10.1001/jamadermatol.2020.0024

Author Contributions: Dr Vaengebjerg had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Skov, Egeberg, Loft.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Vaengebjerg, Loft.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Egeberg.

Administrative, technical, or material support: All authors.

Supervision: Skov, Egeberg, Loft.

Conflict of Interest Disclosures: Dr Egeberg reported receiving grants, personal fees, and nonfinancial support from Eli Lilly, AbbVie, and Almirall; grants and personal fees from Pfizer and Janssen; personal fees from Novartis; and personal fees from Bristol-Myers Squibb, Samsung Bioepis, and UCB outside the submitted work. Dr Skov reported receiving personal fees from AbbVie, Janssen Cilag, Novartis, Eli Lilly, LEO Pharma, UCB, Almirall, and Sanofi; and has received grants from Pfizer, AbbVie, Novartis, Sanofi, Janssen Cilag, and LEO Pharma outside the submitted work; was a paid speaker for AbbVie, Eli Lilly, Novartis, and LEO Pharma; has been a paid consultant or has served on advisory boards of AbbVie, Janssen Cilag, Novartis, Eli Lilly, LEO Pharma, UCB, Almirall, and Sanofi; has served as an investigator for AbbVie, Janssen Cilag, Boehringer Ingelheim, AstraZeneca, Eli Lilly, Novartis, Regeneron, and LEO Pharma; and has received research and educational grants from Pfizer, AbbVie, Novartis, Sanofi, Janssen Cilag, and LEO Pharma. Dr Loft reported receiving personal fees from Eli Lilly outside the submitted work. No other disclosures were reported.

References
1.
Armstrong  AW , Harskamp  CT , Dhillon  JS , Armstrong  EJ .  Psoriasis and smoking: a systematic review and meta-analysis.   Br J Dermatol. 2014;170(2):304-314. doi:10.1111/bjd.12670 PubMedGoogle ScholarCrossref
2.
Brenaut  E , Horreau  C , Pouplard  C ,  et al.  Alcohol consumption and psoriasis: a systematic literature review.   J Eur Acad Dermatol Venereol. 2013;27(suppl 3):30-35. doi:10.1111/jdv.12164 PubMedGoogle ScholarCrossref
3.
Lan  C-CE , Ko  Y-C , Yu  H-S ,  et al.  Psoriatic patients with diabetes are prone to develop digestive organ cancers: a population-based study in Taiwan.   J Dermatol Sci. 2012;68(2):82-88. doi:10.1016/j.jdermsci.2012.08.004 PubMedGoogle ScholarCrossref
4.
Lee  JH , Kim  HJ , Han  KD ,  et al.  Cancer risk in 892 089 patients with psoriasis in Korea: a nationwide population-based cohort study.   J Dermatol. 2019;46(2):95-102. doi:10.1111/1346-8138.14698 PubMedGoogle ScholarCrossref
5.
Dai  H , Li  W-Q , Qureshi  AA , Han  J .  Personal history of psoriasis and risk of nonmelanoma skin cancer (NMSC) among women in the United States: a population-based cohort study.   J Am Acad Dermatol. 2016;75(4):731-735. doi:10.1016/j.jaad.2016.05.021 PubMedGoogle ScholarCrossref
6.
Egeberg  A , Thyssen  JP , Gislason  GH , Skov  L .  Skin cancer in patients with psoriasis.   J Eur Acad Dermatol Venereol. 2016;30(8):1349-1353. doi:10.1111/jdv.13619 PubMedGoogle ScholarCrossref
7.
Avina-Zubieta  JA , Dominique  A , Simon  TA . Risk of cancer in patients with psoriasis/psoriatic arthritis: a population-based study in the province of British Columbia [abstract 1588]. https://acrabstracts.org/abstract/risk-of-cancer-in-patients-with-psoriasis-psoriatic-arthritis-a-population-based-study-in-the-province-of-british-columbia/. Published 2018. Accessed January 17, 2020.
8.
Kamstrup  MR , Skov  L , Zachariae  C , Thyssen  JP , Egeberg  A .  Psoriasis and risk of malignant lymphoma: a population-based cohort study.   Br J Dermatol. 2018;178(6):1435-1436. doi:10.1111/bjd.16245 PubMedGoogle ScholarCrossref
9.
Alinaghi  F , Calov  M , Kristensen  LE ,  et al.  Prevalence of psoriatic arthritis in patients with psoriasis: a systematic review and meta-analysis of observational and clinical studies.   J Am Acad Dermatol. 2019;80(1):251-265.e19. doi:10.1016/j.jaad.2018.06.027 PubMedGoogle ScholarCrossref
10.
Hagberg  KW , Li  L , Peng  M , Paris  M , Shah  K , Jick  SS .  Rates of cancers and opportunistic infections in patients with psoriatic arthritis compared with patients without psoriatic arthritis.   J Clin Rheumatol. 2016;22(5):241-247. doi:10.1097/RHU.0000000000000364 PubMedGoogle ScholarCrossref
11.
Pouplard  C , Brenaut  E , Horreau  C ,  et al.  Risk of cancer in psoriasis: a systematic review and meta-analysis of epidemiological studies.   J Eur Acad Dermatol Venereol. 2013;27(suppl 3):36-46. doi:10.1111/jdv.12165 PubMedGoogle ScholarCrossref
12.
Chiesa Fuxench  ZC , Shin  DB , Ogdie Beatty  A , Gelfand  JM .  The risk of cancer in patients with psoriasis: a population-based cohort study in the health improvement network.   JAMA Dermatol. 2016;152(3):282-290. doi:10.1001/jamadermatol.2015.4847 PubMedGoogle ScholarCrossref
13.
Rønholt  K , Iversen  L .  Old and new biological therapies for psoriasis.   Int J Mol Sci. 2017;18(11):E2297. doi:10.3390/ijms18112297 PubMedGoogle Scholar
14.
Moher  D , Liberati  A , Tetzlaff  J , Altman  DG ; PRISMA Group.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.   BMJ. 2009;339(7716):b2535. doi:10.1136/bmj.b2535PubMedGoogle ScholarCrossref
15.
DerSimonian  R , Laird  N .  Meta-analysis in clinical trials.   Control Clin Trials. 1986;7(3):177-188. doi:10.1016/0197-2456(86)90046-2PubMedGoogle ScholarCrossref
16.
Wells G, Shea B, O’Connell D, Peterson J. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed January 17, 2020.
17.
Hemminki  K , Liu  X , Ji  J , Sundquist  J , Sundquist  K .  Autoimmune disease and subsequent digestive tract cancer by histology.   Ann Oncol. 2012;23(4):927-933. doi:10.1093/annonc/mdr333 PubMedGoogle ScholarCrossref
18.
Spehr  C , Reich  K , Mrowietz  U , Radtke  MA , Thaci  D , Rustenbach  SJ .  PsoBest: drug safety in systemic treatments for psoriasis and psoriatic arthritis.   J Invest Dermatol. 2015;135(suppl 3):S19.Google ScholarCrossref
19.
Frentz  G , Olsen  JH .  Malignant tumours and psoriasis: a follow-up study.   Br J Dermatol. 1999;140(2):237-242. doi:10.1046/j.1365-2133.1999.02655.x PubMedGoogle ScholarCrossref
20.
Frentz  G , Olsen  JH , Avrach  WW .  Malignant tumours and psoriasis: climatotherapy at the Dead Sea.   Br J Dermatol. 1999;141(6):1088-1091. doi:10.1046/j.1365-2133.1999.03161.x PubMedGoogle ScholarCrossref
21.
Hannuksela-Svahn  A , Pukkala  E , Läärä  E , Poikolainen  K , Karvonen  J .  Psoriasis, its treatment, and cancer in a cohort of Finnish patients.   J Invest Dermatol. 2000;114(3):587-590. doi:10.1046/j.1523-1747.2000.00898.x PubMedGoogle ScholarCrossref
22.
Margolis  D , Bilker  W , Hennessy  S , Vittorio  C , Santanna  J , Strom  BL .  The risk of malignancy associated with psoriasis.   Arch Dermatol. 2001;137(6):778-783. https://www.ncbi.nlm.nih.gov/pubmed/11405770.PubMedGoogle Scholar
23.
Paul  CF , Ho  VC , McGeown  C ,  et al.  Risk of malignancies in psoriasis patients treated with cyclosporine: a 5 y cohort study.   J Invest Dermatol. 2003;120(2):211-216. doi:10.1046/j.1523-1747.2003.12040.x PubMedGoogle ScholarCrossref
24.
Feldman  SR , Zhao  Y , Shi  L , Tran  MH .  Economic and comorbidity burden among patients with moderate-to-severe psoriasis.   J Manag Care Spec Pharm. 2015;21(10):874-888. doi:10.18553/jmcp.2015.21.10.874 PubMedGoogle Scholar
25.
Nyfors  A , Jensen  H .  Frequency of malignant neoplasms in 248 long-term methotrexate-treated psoriatics: a preliminary study.   Dermatologica. 1983;167(5):260-261. doi:10.1159/000249793 PubMedGoogle ScholarCrossref
26.
Halprin  KM , Comerford  M , Taylor  JR .  Cancer in patients with psoriasis.   J Am Acad Dermatol. 1982;7(5):633-638. doi:10.1016/S0190-9622(82)70144-6PubMedGoogle ScholarCrossref
27.
Alderson  MR , Clarke  JA .  Cancer incidence in patients with psoriasis.   Br J Cancer. 1983;47(6):857-859. doi:10.1038/bjc.1983.142 PubMedGoogle ScholarCrossref
28.
Jones  SK , Mackie  RM , Hole  DJ , Gillis  CR .  Further evidence of the safety of tar in the management of psoriasis.   Br J Dermatol. 1985;113(1):97-101. doi:10.1111/j.1365-2133.1985.tb02048.x PubMedGoogle ScholarCrossref
29.
Hannuksela-Svahn  A , Pukkala  E , Koulu  L , Jansén  CT , Karvonen  J .  Cancer incidence among Finnish psoriasis patients treated with 8-methoxypsoralen bath PUVA.   J Am Acad Dermatol. 1999;40(5, pt 1):694-696. doi:10.1016/S0190-9622(99)70148-9PubMedGoogle ScholarCrossref
30.
Stern  RS , Fitzgerald  E , Ellis  CN , Lowe  N , Goldfarb  MT , Baughman  RD .  The safety of etretinate as long-term therapy for psoriasis: results of the etretinate follow-up study.   J Am Acad Dermatol. 1995;33(1):44-52. doi:10.1016/0190-9622(95)90008-X PubMedGoogle ScholarCrossref
31.
Lindelöf  B , Sigurgeirsson  B , Tegner  E ,  et al.  PUVA and cancer risk: the Swedish follow-up study.   Br J Dermatol. 1999;141(1):108-112. doi:10.1046/j.1365-2133.1999.02928.x PubMedGoogle ScholarCrossref
32.
Brauchli  YB , Jick  SS , Miret  M , Meier  CR .  Psoriasis and risk of incident cancer: an inception cohort study with a nested case-control analysis.   J Invest Dermatol. 2009;129(11):2604-2612. doi:10.1038/jid.2009.113 PubMedGoogle ScholarCrossref
33.
Ji  J , Shu  X , Sundquist  K , Sundquist  J , Hemminki  K .  Cancer risk in hospitalised psoriasis patients: a follow-up study in Sweden.   Br J Cancer. 2009;100(9):1499-1502. doi:10.1038/sj.bjc.6605027 PubMedGoogle ScholarCrossref
34.
Prizment  AE , Alonso  A , Folsom  AR ,  et al.  Association between psoriasis and incident cancer: the Iowa’s Women’s Health Study.   Cancer Causes Control. 2011;22(7):1003-1010. doi:10.1007/s10552-011-9773-0 PubMedGoogle ScholarCrossref
35.
Lindelöf  B , Eklund  G , Lidén  S , Stern  RS .  The prevalence of malignant tumors in patients with psoriasis.   J Am Acad Dermatol. 1990;22(6, pt 1):1056-1060. doi:10.1016/0190-9622(90)70152-8 PubMedGoogle ScholarCrossref
36.
Hannuksela-Svahn  A , Sigurgeirsson  B , Pukkala  E ,  et al.  Trioxsalen bath PUVA did not increase the risk of squamous cell skin carcinoma and cutaneous malignant melanoma in a joint analysis of 944 Swedish and Finnish patients with psoriasis.   Br J Dermatol. 1999;141(3):497-501. doi:10.1046/j.1365-2133.1999.03044.x PubMedGoogle ScholarCrossref
37.
Väkevä  L , Reitamo  S , Pukkala  E , Sarna  S , Ranki  A .  Long-term follow-up of cancer risk in patients treated with short-term cyclosporine.   Acta Derm Venereol. 2008;88(2):117-120. doi:10.2340/00015555-0360 PubMedGoogle ScholarCrossref
38.
Kimball  AB , Rothman  KJ , Kricorian  G ,  et al.  OBSERVE-5: observational postmarketing safety surveillance registry of etanercept for the treatment of psoriasis final 5-year results.   J Am Acad Dermatol. 2015;72(1):115-122. doi:10.1016/j.jaad.2014.08.050 PubMedGoogle ScholarCrossref
39.
Li  WQ , Han  J , Cho  E ,  et al.  Personal history of psoriasis and risk of incident cancer among women: a population-based cohort study.   Br J Dermatol. 2016;174(5):1108-1111. doi:10.1111/bjd.14301 PubMedGoogle ScholarCrossref
40.
Lin  TL , Wu  CY , Chang  YT ,  et al.  Risk of skin cancer in psoriasis patients receiving long-term narrowband ultraviolet phototherapy: results from a Taiwanese population-based cohort study.   Photodermatol Photoimmunol Photomed. 2019;35(3):164-171. doi:10.1111/phpp.12443PubMedGoogle ScholarCrossref
41.
Stern  RS ; PUVA Follow-Up Study.  The risk of squamous cell and basal cell cancer associated with psoralen and ultraviolet A therapy: a 30-year prospective study.   J Am Acad Dermatol. 2012;66(4):553-562. doi:10.1016/j.jaad.2011.04.004 PubMedGoogle ScholarCrossref
42.
Lee  MS , Lin  RY , Chang  YT , Lai  MS .  The risk of developing non-melanoma skin cancer, lymphoma and melanoma in patients with psoriasis in Taiwan: a 10-year, population-based cohort study.   Int J Dermatol. 2012;51(12):1454-1460. doi:10.1111/j.1365-4632.2011.05310.x PubMedGoogle ScholarCrossref
43.
van Lümig  PPM , Menting  SP , van den Reek  JMPA ,  et al.  An increased risk of non-melanoma skin cancer during TNF-inhibitor treatment in psoriasis patients compared to rheumatoid arthritis patients probably relates to disease-related factors.   J Eur Acad Dermatol Venereol. 2015;29(4):752-760. doi:10.1111/jdv.12675 PubMedGoogle ScholarCrossref
44.
Mali-Gerrits  MGH , Gaasbeek  D , Boezeman  J , van de Kerkhof  PCM .  Psoriasis therapy and the risk of skin cancers.   Clin Exp Dermatol. 1991;16(2):85-89. doi:10.1111/j.1365-2230.1991.tb00314.x PubMedGoogle ScholarCrossref
45.
Raone  B , Patrizi  A , Gurioli  C , Gazzola  A , Ravaioli  GM .  Cutaneous carcinogenic risk evaluation in 375 patients treated with narrowband-UVB phototherapy: a 15-year experience from our institute.   Photodermatol Photoimmunol Photomed. 2018;34(5):302-306. doi:10.1111/phpp.12382 PubMedGoogle ScholarCrossref
46.
Hearn  RMR , Kerr  AC , Rahim  KF , Ferguson  J , Dawe  RS .  Incidence of skin cancers in 3867 patients treated with narrow-band ultraviolet B phototherapy.   Br J Dermatol. 2008;159(4):931-935. doi:10.1111/j.1365-2133.2008.08776.x PubMedGoogle ScholarCrossref
47.
Reddy  SP , Martires  K , Wu  JJ .  The risk of melanoma and hematologic cancers in patients with psoriasis.   J Am Acad Dermatol. 2017;76(4):639-647.e2. doi:10.1016/j.jaad.2016.09.047 PubMedGoogle ScholarCrossref
48.
Gelfand  JM , Berlin  J , Van Voorhees  A , Margolis  DJ .  Lymphoma rates are low but increased in patients with psoriasis: results from a population-based cohort study in the United Kingdom.   Arch Dermatol. 2003;139(11):1425-1429. doi:10.1001/archderm.139.11.1425 PubMedGoogle ScholarCrossref
49.
Gelfand  JM , Shin  DB , Neimann  AL , Wang  X , Margolis  DJ , Troxel  AB .  The risk of lymphoma in patients with psoriasis.   J Invest Dermatol. 2006;126(10):2194-2201. doi:10.1038/sj.jid.5700410 PubMedGoogle ScholarCrossref
50.
Fallah  M , Liu  X , Ji  J , Försti  A , Sundquist  K , Hemminki  K .  Autoimmune diseases associated with non-Hodgkin lymphoma: a nationwide cohort study.   Ann Oncol. 2014;25(10):2025-2030. doi:10.1093/annonc/mdu365 PubMedGoogle ScholarCrossref
51.
Fallah  M , Liu  X , Ji  J , Försti  A , Sundquist  K , Hemminki  K .  Hodgkin lymphoma after autoimmune diseases by age at diagnosis and histological subtype.   Ann Oncol. 2014;25(7):1397-1404. doi:10.1093/annonc/mdu144 PubMedGoogle ScholarCrossref
52.
Stern  RS .  Lymphoma risk in psoriasis: results of the PUVA follow-up study.   Arch Dermatol. 2006;142(9):1132-1135. doi:10.1001/archderm.142.9.1132 PubMedGoogle Scholar
53.
Roelofzen  JHJ , Aben  KKH , Oldenhof  UTH ,  et al.  No increased risk of cancer after coal tar treatment in patients with psoriasis or eczema.   J Invest Dermatol. 2010;130(4):953-961. doi:10.1038/jid.2009.389 PubMedGoogle ScholarCrossref
54.
Hemminki  K , Liu  X , Ji  J , Försti  A , Sundquist  J , Sundquist  K .  Effect of autoimmune diseases on risk and survival in female cancers.   Gynecol Oncol. 2012;127(1):180-185. doi:10.1016/j.ygyno.2012.07.100 PubMedGoogle ScholarCrossref
55.
Stern  RS , Lange  R ; Members of the Photochemotherapy Follow-up Study.  Cardiovascular disease, cancer, and cause of death in patients with psoriasis: 10 years prospective experience in a cohort of 1,380 patients.   J Invest Dermatol. 1988;91(3):197-201. doi:10.1111/1523-1747.ep12464847 PubMedGoogle ScholarCrossref
56.
Liu  X , Ji  J , Forsti  A , Sundquist  K , Sundquist  J , Hemminki  K .  Autoimmune disease and subsequent urological cancer.   J Urol. 2013;189(6):2262-2268. doi:10.1016/j.juro.2012.12.014 PubMedGoogle ScholarCrossref
57.
Asgari  MM , Ray  GT , Geier  JL , Quesenberry  CP .  Malignancy rates in a large cohort of patients with systemically treated psoriasis in a managed care population.   J Am Acad Dermatol. 2017;76(4):632-638. doi:10.1016/j.jaad.2016.10.006 PubMedGoogle ScholarCrossref
58.
Wu  JJ , Armstrong  A , Singh  R ,  et al.  Adverse medical conditions across treatment options in patients with psoriasis: a claims-based analysis.   J Drugs Dermatol. 2018;17(11):1211-1218. https://www.ncbi.nlm.nih.gov/pubmed/30500143.PubMedGoogle Scholar
59.
Papp  K , Gottlieb  AB , Naldi  L ,  et al.  Safety surveillance for ustekinumab and other psoriasis treatments from the Psoriasis Longitudinal Assessment and Registry (PSOLAR).   J Drugs Dermatol. 2015;14(7):706-714. https://www.ncbi.nlm.nih.gov/pubmed/26151787.PubMedGoogle Scholar
60.
Magnano  M , Loi  C , Sechi  A ,  et al.  Risk of malignancy in psoriatic patients: our clinical experience.   Dermatol Ther. 2017;30(4):e12476. doi:10.1111/dth.12476 PubMedGoogle Scholar
61.
Napolitano  M , Megna  M , Patrì  A ,  et al.  Systemic treatment for psoriasis and malignancies: a real risk?   Dermatol Ther. 2017;30(4):e12508. doi:10.1111/dth.12508 PubMedGoogle Scholar
62.
Mason  KJ .  The risk of keratinocyte carcinoma (KC) in psoriasis patients receiving biologic therapy compared with conventional systemic therapy: results from the British Association of Dermatologists Biologic Interventions Register (BADBIR).   Pharmacoepidemiol Drug Saf. 2018;27(5)(suppl 1):17. doi:10.1016/j.jid.2018.03.244 Google Scholar
63.
Rohekar  S , Tom  BDMM , Hassa  A , Schentag  CT , Farewell  VT , Gladman  DD .  Prevalence of malignancy in psoriatic arthritis.   Arthritis Rheum. 2008;58(1):82-87. doi:10.1002/art.23185 PubMedGoogle ScholarCrossref
64.
Gross  RL , Schwartzman-Morris  JS , Krathen  M ,  et al.  A comparison of the malignancy incidence among patients with psoriatic arthritis and patients with rheumatoid arthritis in a large US cohort.   Arthritis Rheumatol. 2014;66(6):1472-1481. doi:10.1002/art.38385 PubMedGoogle ScholarCrossref
65.
Fagerli  KM , Mercer  LK , Watson  K , Packham  J , Symmons  DPM , Hyrich  KL .  Risk of cancer in patients with severe psoriatic arthritis requiring tumour necrosis factor alpha inhibition.   Rheumatology. 2015;54(suppl 1):i135. doi:10.1093/rheumatology/kev089.108Google Scholar
66.
Hellgren  K , Dreyer  L , Arkema  EV ,  et al; ARTIS Study Group; DANBIO Study Group.  Cancer risk in patients with spondyloarthritis treated with TNF inhibitors: a collaborative study from the ARTIS and DANBIO registers.   Ann Rheum Dis. 2017;76(1):105-111. doi:10.1136/annrheumdis-2016-209270 PubMedGoogle ScholarCrossref
67.
Wilton  KM , Crowson  CS , Matteson  EL .  Malignancy incidence in patients with psoriatic arthritis: a comparison cohort-based incidence study.   Clin Rheumatol. 2016;35(10):2603-2607. doi:10.1007/s10067-016-3396-5 PubMedGoogle ScholarCrossref
68.
Didona  D , Paolino  G , Bottoni  U , Cantisani  C .  Non melanoma skin cancer pathogenesis overview.   Biomedicines. 2018;6(1):6. doi:10.3390/biomedicines6010006PubMedGoogle ScholarCrossref
69.
Melnikova  VO , Ananthaswamy  HN .  Cellular and molecular events leading to the development of skin cancer.   Mutat Res. 2005;571(1-2):91-106. doi:10.1016/j.mrfmmm.2004.11.015PubMedGoogle ScholarCrossref
70.
Moustafa  GA , Xanthopoulou  E , Riza  E , Linos  A .  Skin disease after occupational dermal exposure to coal tar: a review of the scientific literature.   Int J Dermatol. 2015;54(8):868-879. doi:10.1111/ijd.12903PubMedGoogle ScholarCrossref
71.
Nikolaou  V , Marinos  L , Moustou  E ,  et al.  Psoriasis in patients with mycosis fungoides: a clinicopathological study of 25 patients.   J Eur Acad Dermatol Venereol. 2017;31(11):1848-1852. doi:10.1111/jdv.14365 PubMedGoogle ScholarCrossref
72.
Stein  CJ , Colditz  GA .  Modifiable risk factors for cancer.   Br J Cancer. 2004;90(2):299-303. doi:10.1038/sj.bjc.6601509 PubMedGoogle ScholarCrossref
If you are not a JN Learning subscriber, you can either:
Subscribe to JN Learning for one year
Buy this activity
jn-learning_Modal_Multimedia_LoginSubscribe_Purchase
Close
If you are not a JN Learning subscriber, you can either:
Subscribe to JN Learning for one year
Buy this activity
jn-learning_Modal_Multimedia_LoginSubscribe_Purchase
Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close

Name Your Search

Save Search
Close
With a personal account, you can:
  • Track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
jn-learning_Modal_SaveSearch_NoAccess_Purchase
Close

Lookup An Activity

or

Close

My Saved Searches

You currently have no searches saved.

Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close