PDF(Pubmed)
Abstract：
Phototherapy is a standard treatment for moderate-to-severe psoriasis. However, concern remains regarding the associated cutaneous carcinogenic risk. Our objective is to conduct a systematic review of skin cancer risk for psoriasis patients treated with phototherapy. To achieve our goal, we searched Cochrane, PubMed, and Embase databases. We aimed to evaluate existing literature (from July 1, 2010, to December 31, 2020) on phototherapy for all Fitzpatrick skin phototypes (FSP) which includes 71 articles, and eight articles being categorized in this review. Five studies did not report an increased skin cancer risk with narrowband-ultraviolet blue (UVB) and unspecified UVB for FSP II through VI, with one study not reporting FSP. Three studies did report an increased risk of skin cancer with narrowband-UVB and broadband-UVB for FSP I-VI, with one study also not specifying skin phototypes or UVB phototherapy type. Additionally, a study with psoralen and ultraviolet A with and without narrowband-UVB demonstrated an increased risk of skin cancer in phototypes III and IV. The most commonly reported secondary outcomes with phototherapy were actinic keratosis (123) and solar lentigines (10). Numerous patients were also on additional therapies including methotrexate, acitretin, and biologics. Study limitations include publication bias due to limited number of studies published on this topic in the last ten years along with heterogeneity in reporting. The relationship between phototherapy, psoriasis, and cutaneous oncogenic risk remains contradictory. While phototherapy for psoriasis is an efficacious therapy, further studies are needed to understand the cutaneous oncogenic risk based on FSP to help clinicals tailor treatment recommendations based on skin phototypes.
摘要：
光疗是中度至重度银屑病的标准治疗方法。然而,相关的皮肤致癌风险仍然令人担忧。我们的目标是对接受光疗的牛皮癣患者的皮肤癌风险进行系统评价。为了实现我们的目标，我们搜查了Cochrane,PubMed,和Embase数据库。我们旨在评估现有文献（从2010年7月1日至2020年12月31日）对所有Fitzpatrick皮肤光疗（FSP），其中包括71篇文章，和八篇文章被分类在这篇评论中。五项研究未报告窄带紫外线（UVB）和未指明的UVB对FSPII至VI的皮肤癌风险增加，一项研究未报告FSP。三项研究确实报告了窄带UVB和宽带UVB对FSPI-VI的皮肤癌风险增加，一项研究也没有指定皮肤光疗类型或UVB光疗类型。此外,一项使用补骨脂素和紫外线A伴和不伴窄带UVB的研究表明，在III型和IV型中，患皮肤癌的风险增加。光疗最常见的次要结果是光化性角化病（123）和日光性角化病（10）。许多患者还接受了额外的治疗，包括甲氨蝶呤，阿维酮,和生物制品。研究限制包括由于过去十年中关于该主题的研究数量有限而导致的发表偏倚以及报告的异质性。光疗之间的关系，牛皮癣,和皮肤致癌风险仍然矛盾。虽然牛皮癣的光疗是一种有效的治疗方法，需要进一步的研究来了解基于FSP的皮肤致癌风险,以帮助临床医师根据皮肤照型制定治疗建议.
