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

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.

MiR‐126 correlates with increased disease severity and promotes keratinocytes proliferation and inflammation while suppresses cells' apoptosis in psoriasis

“…Patient with psoriasis has a higher risk of developing multiple complications, including psoriatic arthritis, cardiovascular diseases, Crohn's disease, anxiety, and depression, all of them substantially contributing to increased morbidity and mortality . Although the application of topical therapy, physiotherapy, systemic therapy, and novel biological agents (such as tumor necrosis factor alpha [TNF‐α] inhibitor, interleukin [IL]‐12/23 inhibitor and IL‐17 inhibitor) have achieved a certain effect, the low response rate and high recurrence rate remain critical issues to clinicians . Therefore, it is of great importance to investigate the underlying mechanism of psoriasis and explore novel treatment target.…”

“…4,5 Although the application of topical therapy, physiotherapy, systemic therapy, and novel biological agents (such as tumor necrosis factor alpha [TNFα] inhibitor, interleukin [IL]-12/23 inhibitor and IL-17 inhibitor) have achieved a certain effect, the low response rate and high recurrence rate remain critical issues to clinicians. 1,[6][7][8] Therefore, it is of great importance to investigate the underlying mechanism of psoriasis and explore novel treatment target.…”

Depression Symptoms Predict Worse Clinical Response to Etanercept Treatment in Psoriasis Patients

“…Psoriasis is a chronic, inflammatory, multisystem disorder that predominantly affects the skin or joints or both, with approximately 125 million people affected worldwide [1, 2]. Symptoms regularly reported by psoriasis patients include pain, itching, bleeding, or scaling, and patients may be awkward about the visible disfiguration of their skin, which has a substantial negative influence on psychological well-being [3, 4].…”

Practical recommendations for systemic treatment in psoriasis in case of coexisting inflammatory, neurologic, infectious or malignant disorders (BETA‐PSO: Belgian Evidence‐based Treatment Advice in Psoriasis; part 2)

“…8 In general, both conventional and newer treatments for psoriasis do not seem to result in a marked increased rate of malignancy. 9 Nonetheless, in cancer patients the preservation of an effective antitumoral response is crucial and in general exceeds the importance of clearing the skin disease. Similarly in hepatitis or HIV, systemic treatments may worsen the infectious load and cause drug-drug interactions with antiviral treatments.…”