%0 Journal Article
%T Incidence and profile of skin cancers in patients following ultraviolet phototherapy without psoralens: A retrospective cohort study.
%A Wang E
%A Ahad T
%A Liu YA
%A Lee TK
%A Lui H
%A Crawford RI
%A Kalia S
%J J Am Acad Dermatol
%V 90
%N 4
%D 2024 Apr 7
%M 38070541
%F 15.487
%R 10.1016/j.jaad.2023.11.053
%X <B>BACKGROUND: </B>Psoralen + ultraviolet-A (PUVA) is associated with photocarcinogenesis. However, carcinogenic risk with other ultraviolet phototherapies remains unclear.<BR><B>OBJECTIVE: </B>Evaluate whether phototherapy without psoralens increases skin cancer risk.<BR><B>METHODS: </B>Retrospective cohort study of patients treated at a teaching-hospital phototherapy center (1977-2018). Skin cancer records were validated against pathology reports. Age-standardized incidence rates (ASIRs) of skin cancer were evaluated for gender, skin phototype, diagnosis, ultraviolet modality, anatomical site; and compared to provincial population incidence rates (2003).<BR><B>RESULTS: </B>In total, 3506 patients treated with broadband-ultraviolet-B, narrowband-UVB and/or combined UVAB were assessed with a mean follow-up of 7.3 years. Majority of patients had psoriasis (60.9%) or eczema (26.4%). Median number of treatments was 43 (1-3598). Overall, 170 skin cancers (17 melanoma, 33 squamous cell carcinoma and 120 basal cell carcinoma) occurred in 79 patients. Patient-based and tumor-based ASIR of skin cancer was 149 (95% CI: 112-187)/100,000 and 264 (219-309)/100,000 person-years, respectively. There was no significant difference between tumor-based ASIRs for melanoma, squamous cell carcinoma, and basal cell carcinoma compared to the general population; or in phototherapy patients with-psoriasis or eczema; or immunosuppressants. No cumulative dose-response correlation between UVB and skin cancer was seen.<BR><B>CONCLUSIONS: </B>Treatment and follow-up duration.<BR><B>CONCLUSIONS: </B>No increased risk of melanoma and keratinocyte cancer was found with phototherapy.