The Risk of Cancer in Patients With Psoriasis

Fuxench, Zelma C. Chiesa; Shin, Daniel B.; Beatty, Alexis Ogdie; Gelfand, Joel M.

doi:10.1001/jamadermatol.2015.4847

Cited by 151 publications

(93 citation statements)

References 32 publications

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“…Although the development of CTCLs in patients with pre-existing dermatitis has been the subject largely of case reports [41–48], other studies investigating the relationship between BIDs and cancer including lymphoma have shown contradictory results [49–58]. However, in a recent population-based cohort study, patients with psoriasis were 3.82 times more likely to develop CTCL, compared to 1.34 for any type of lymphoma [59]. The “mild psoriasis” group was 3.51 times more likely, while patients with “moderate-to-severe” disease showed a 9.25 times increased risk of CTCL.…”

Section: Discussionmentioning

confidence: 99%

c-CBL E3 Ubiquitin Ligase Expression Increases Across the Spectrum of Benign and Malignant T-Cell Skin Diseases

Salva

Reeder

Lloyd³

et al. 2017

The American Journal of Dermatopathology

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Prolonged survival of lesional T cells plays a central role in the pathogenesis of T-cell-mediated dermatoses. We have recently shown that the ubiquitin ligase c-CBL is highly expressed in cutaneous T-cell lymphoma (CTCL) and that its knockdown increases activation-induced cell death, a key pathway for T-cell apoptosis. Here, we extend our work on c-CBL expression in malignant T cells to their non-neoplastic counterparts in benign inflammatory dermatoses. Immunohistochemical staining with anti-c-CBL antibody was performed on lesional biopsies from a total of 65 patients with atopic dermatitis, allergic contact dermatitis, pityriasis rosea, psoriasis vulgaris, lichen planus, mycosis fungoides (MF)/Sézary syndrome (SS) as well as on tonsil tissue from 5 individuals and on 5 human cutaneous T-cell lymphoma cell lines. Protein levels were measured in situ using multispectral image analysis, a quantitative method that is 5x more sensitive than standard immunohistology for antigen detection. There was a significant (p < 0.05) and progressive increase of mean c-CBL expression across the spectrum of inflammatory dermatoses (2-fold), MF/SS (3-fold) and lymphoma cell lines (4-fold) as compared to tonsillar T lymphocytes. A subset of MF/SS cases expressed mean c-CBL levels above the ranges observed in inflammatory dermatoses. Given our prior finding that c-CBL inhibits activation-induced cell death, c-CBL might play a role in the pathogenesis of inflammatory dermatoses and CTCL.

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Section: Discussionmentioning

confidence: 99%

c-CBL E3 Ubiquitin Ligase Expression Increases Across the Spectrum of Benign and Malignant T-Cell Skin Diseases

Salva

Reeder

Lloyd³

et al. 2017

The American Journal of Dermatopathology

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“…A subsequent cohort study of cancer risk among patients with psoriasis in the U.K. that included information on BMI, smoking, and drinking also found increased risks of lung cancer, NMSC, and lymphoma, supporting some of Pouplard, et al’s findings. 109 The greatest risks of cancer were among those receiving treatments for severe psoriasis. The association between psoriasis and lung cancer was lost, however, after stratification by smoking status.…”

Section: Malignancymentioning

confidence: 99%

“…Of the specific lymphoma types, the association between psoriasis and cutaneous T cell lymphoma (CTCL) was suggested to be the strongest. 109,112 It remains unclear what role psoriasis therapies and/or misdiagnosis of CTCL as psoriasis may play in explaining this observation.…”

Section: Malignancymentioning

confidence: 99%

Psoriasis and comorbid diseases

Takeshita

Grewal

Langan

et al. 2017

Journal of the American Academy of Dermatology

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869

703

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Psoriasis is a common chronic inflammatory disease of the skin that is increasingly being recognized as a systemic inflammatory disorder. Psoriatic arthritis is a well-known comorbidity of psoriasis. A rapidly expanding body of literature in various populations and settings supports additional associations between psoriasis and cardiometabolic disease, gastrointestinal disease, kidney disease, malignancies, infections, and mood disorders. The pathogenesis of comorbid disease in psoriasis patients remains unknown; however, shared inflammatory pathways, cellular mediators, genetic susceptibility, and common risk factors are hypothesized to be contributing elements. As additional psoriasis comorbidities continue to emerge, education of healthcare providers is essential to ensuring comprehensive medical care for patients with psoriasis.

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“…Patients with psoriasis and/or receiving treatment for psoriasis have an increased risk of cancer . Inhibitors of IL‐12/23 and IL‐23 are effective treatment approaches for psoriasis .…”

Section: Discussionmentioning

confidence: 99%

“…An increased risk of cancer has been observed among patients with psoriasis compared with the general population . Cohort studies have shown that patients with psoriasis have an increased risk of specific cancers regardless of their treatment, including non‐melanoma skin cancers (NMSCs), lymphohematopoietic cancers and cancers of the respiratory and digestive tracts . The interleukin‐12 (IL‐12)/23 inhibitor ustekinumab is an established treatment for psoriasis, and IL‐23–specific inhibitors are among the newest therapies, with promising efficacy and safety profiles (Table ; Figure ) .…”

Section: Introductionmentioning

confidence: 99%

Inhibition of interleukin‐12 and/or interleukin‐23 for the treatment of psoriasis: What is the evidence for an effect on malignancy?

Ergen

Yusuf

2018

Experimental Dermatology

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Immune cells and cytokines play an important role in the pathogenesis of psoriasis. Interleukin 12 (IL-12) and IL-23 promote cellular responses mediated by T cells, which contribute to an inflammatory loop responsible for the induction and maintenance of psoriatic plaques. Antibodies that inhibit IL-12/23 or IL-23 are key treatment options for patients with psoriasis. IL-12 and IL-23 also play a key role in immune responses to infections and tumors. A growing body of information from clinical trials, cohort studies, postmarketing reports, genetic studies, and animal models provides insights into the potential biological relationships between IL-12/23 inhibition and malignancies. We summarize this information in tables and provide some context for interpretation of these data with the goal of informing dermatologists who are using IL-12/23 or IL-23 inhibitors to treat patients with psoriasis.

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The Risk of Cancer in Patients With Psoriasis

Cited by 151 publications

References 32 publications

c-CBL E3 Ubiquitin Ligase Expression Increases Across the Spectrum of Benign and Malignant T-Cell Skin Diseases

c-CBL E3 Ubiquitin Ligase Expression Increases Across the Spectrum of Benign and Malignant T-Cell Skin Diseases

Psoriasis and comorbid diseases

Inhibition of interleukin‐12 and/or interleukin‐23 for the treatment of psoriasis: What is the evidence for an effect on malignancy?

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