People with psoriasis, particularly those dealing with chronically severe forms of the skin disease, are at a higher risk of also having certain types of cancer.
Both the skin cancer known as squamous cell carcinoma and lymphoma, a cancer that affects the immune system, are health risks some psoriasis patients face, according to a 2008 study Journal of the American Academy of Dermatology (JAAD).
The risk of certain cancers has troubled the psoriasis community in recent years, said Dr. Ken Gordon, a dermatologist at Evanston Northwestern Healthcare in Skokie, Ill., and a former Psoriasis Foundation Medical Board member.
"The concern we all have is primarily lymphoma, and that's still controversial," Gordon said.
Controversial because, while studies like the one published in JAAD have linked a higher risk of lymphoma in patients with severe psoriasis, the actual cause of the cancer remains unclear.
Researchers suggest that the increased rate of particular cancers may be due to the following:
- Psoriasis leads to increased T-cell activity because it is a disease that affects the immune system. (T cells are white blood cells in the immune system that fight infections and foreign materials.)
- Newer treatments that suppress the immune system (immunosuppressants) may be independent risk factors for developing malignancies.
- Or the combination of immunosuppressants and the disease itself may lead to the increased rate.
"We don't know which one is exactly right," said Gordon, who believes long-term studies of psoriasis patients are needed before a definite determination can be made. "We need better information on the [disease]."
Even so, some psoriasis treatments have been linked to a higher risk for cancer. For example, PUVA—ultraviolet light A used with a light-sensitive drug called psoralen—is the most clear-cut psoriasis treatment associated with developing cancer, said Dr. Mark Lebwohl, dermatology chairman of the Mount Sinai School of Medicine in New York and the chairman of the National Psoriasis Foundation Medical Board.
There also are some studies showing biologics used to treat psoriasis might be linked to lymphoma and squamous cell carcinoma. It's been known for some time that TNF-alpha blockers are associated with an increase in certain kinds of lymphoma, Lebwohl said. (TNF-alpha blockers suppress a protein in the immune system called tumor necrosis factor-alpha, which is believed to play a role in the development of psoriasis.)
Talking openly with your dermatologist about your psoriasis and your overall health is an important first step in ensuring good health, experts said. Follow the recommended routine health screenings for cancers and avoid high-risk behaviors that increase the risk of developing some cancers, such as smoking, alcohol abuse and intentional sun exposure.
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