No Evidence for Increased Skin Cancer Risk in Psoriasis Patients Treated with Broadband or Narrowband UVB Phototherapy: A First Retrospective Study

Abstract

Phototherapy of skin diseases such as psoriasis is an effective and safe treatment modality. However, increasing the risk of skin cancer by phototherapy is a serious concern. An increased skin cancer risk occurs after prolonged photochemotherapy (PUVA). In contrast, the role of broadband UVB or narrowband UVB therapy in skin carcinogenesis of humans with psoriasis is less clear. Therefore, we investigated the incidence of skin tumours in a total of 195 psoriasis patients, receiving broadband (n=69) or narrowband (n=126) UVB from 1994 to 2000 with follow-up until 2003. Data were raised from the regional interdisciplinary cancer centre of the University of Tuebingen, Germany and compared with the tumour incidences given for the German population. In this study, with 80% statistical power to detect a 6-7-fold increase in skin cancer with broadband UVB and 83% power to detect a 5-6-fold increase with narrow band UVB at p=0.05, only one patient developed skin cancer - an in situ melanoma. The tumour occurred within the same year that phototherapy was initiated. Thus, the present study does not provide evidence for an increased skin cancer risk for patients treated with either broadband or narrowband UVB phototherapy

Targeted therapy against EGFR and VEGFR using ZD6474 enhances the therapeutic potential of UV-B phototherapy in breast cancer cells

“…Thus, phototherapy utilizing the energy of photons in combination with photosensitizers can be used to direct the energy to generate ROS or DNA damage in the tissue specific manner seems to be a promising alternative for treatment of advanced breast cancer patients for whom the RT is limited due to prior therapies. There is a recent development of targeted phototherapy, photosensitizers [47,48] that further minimizes the toxicities associated with UV phototherapy. Ionizing radiation enhances both epithelial growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) expression, and similar results were obtained with UV radiation [23,49], which are a part of key pathways for tumor progression and radioresistance [16].…”

Excimer Laser versus Narrow-Band UVB (311 nm) in the Treatment of Psoriasis Vulgaris

“…These unnecessary exposures of uninvolved skin increase the risk of short- and long-term side effects such as blistering, pruritus and photoaging. In a retrospective study with a total of 195 psoriasis patients, no evidence for elevated carcinogenesis after narrow-band UVB phototherapy was found [15]. In several studies the efficacy of the excimer laser has been demonstrated [5, 8, 16].…”

A Short Cycle of Narrow-Band UVB Phototherapy in the Early Phase of Long-Term Efalizumab Can Provide a Quicker Remission of Moderate and Severe Psoriasis: A Pilot Study

“…However, the cumulative dose of NB-UVB light is very low, and the carcinogenic potential of these doses is likely to be negligible [2]. …”

“…In fact, NB-UVB is effective, well tolerated and does not present systemic toxicity, thus ensuring a remarkably low toxicity profile when used in combination with a systemic drug such as efalizumab. Indeed, when a short treatment cycle of NB-UVB phototherapy is used, the hazards of skin carcinogenesis and photoaging are negligible [2], and the inconvenience for the patient who must attend the photobiology unit is limited. The possible usefulness of this combination was previously demonstrated in a case report where a psoriatic flare during continuous treatment with efalizumab was reported to be successfully managed with NB-UVB [3].…”