Skip to main content

69-Year-Old with Psoriasis and a History of Skin Cancer

  • Chapter
  • First Online:
Clinical Cases in Psoriasis

Part of the book series: Clinical Cases in Dermatology ((CLIDADE))

  • 738 Accesses

Abstract

A 69-year-old female with a long history of psoriasis presented to the clinic for follow-up after undergoing electrodesiccation and curettage of nonmetastatic squamous cell carcinoma on the left knee. Her psoriasis and psoriatic arthritis have been managed with methotrexate for the past 5 months. She has no prior history of cancer, but multiple actinic keratoses and squamous cell carcinoma have been noted in previous visits. Two previous squamous cell carcinomas were found on the left forearm and left lateral shin and treated similarly with electrodesiccation and curettage. Follow-up visits have not shown signs of recurrence. The patient denies a history of smoking, exposure to radiation, and use of other immunosuppressant medications. She does admit to excessive ultraviolet light exposure and minimal use of sunscreen. The patient has a family history of psoriasis. However, she denies a family history of cancer, including skin cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 69.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Archier E, Devaux S, Castela E, Gallini A, Aubin F, Le Maître M, Aractingi S, Bachelez H, Cribier B, Joly P, Jullien D, Misery L, Paul C, Ortonne JP, Richard MA. Carcinogenic risks of psoralen UV-A therapy and narrowband UV-B therapy in chronic plaque psoriasis: a systematic literature review. J Eur Acad Dermatol Venereol. 2012;26(Suppl 3):22–31.

    Article  CAS  PubMed  Google Scholar 

  • Bettoli V, Zauli S, Virgili A. Retinoids in the chemoprevention of non-melanoma skin cancers: why, when and how. J Dermatolog Treat. 2013;24(3):235–7.

    Article  CAS  PubMed  Google Scholar 

  • Blauvelt A. Safety of secukinumab in the treatment of psoriasis. Expert Opin Drug Saf. 2016;15(10):1413–20. Epub 2016 Aug 22.

    Article  CAS  PubMed  Google Scholar 

  • Buchbinder R, Barber M, Heuzenroeder L, Wluka AE, Giles G, Hall S, Harkness A, Lewis D, Littlejohn G, Miller MH, Ryan PF, Jolley D. Incidence of melanoma and other malignancies among rheumatoid arthritis patients treated with methotrexate. Arthritis Rheum. 2008;59(6):794–9.

    Article  CAS  PubMed  Google Scholar 

  • Burmester GR, Panaccione R, Gordon KB, McIlraith MJ, Lacerda AP. Adalimumab: long-term safety in 23 458 patients from global clinical trials in rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, psoriatic arthritis, psoriasis and Crohn’s disease. Ann Rheum Dis. 2013;72(4):517–24.

    Article  CAS  PubMed  Google Scholar 

  • Chiesa Fuxench ZC, Shin DB, Ogdie Beatty A, Gelfand JM. The risk of cancer in patients with psoriasis: a population-based cohort study in the health improvement network. JAMA Dermatol. 2016;152(3):282–90.

    Article  PubMed  PubMed Central  Google Scholar 

  • Chimenti MS, Gramiccia T, Saraceno R, Bianchi L, Garofalo V, Buonomo O, Perricone R, Chimenti S, Chiricozzi A. Apremilast for the treatment of psoriasis. Expert Opin Pharmacother. 2015;16(13):2083–94.

    Article  PubMed  Google Scholar 

  • Gordon K, Papp K, Poulin Y, Gu Y, Rozzo S, Sasso EH. Long-term efficacy and safety of adalimumab in patients with moderate to severe psoriasis treated continuously over 3 years: results from an open-label extension study for patients from REVEAL. J Am Acad Dermatol. 2012;66(2):241–51.

    Article  CAS  PubMed  Google Scholar 

  • Hearn RM, Kerr AC, Rahim KF, Ferguson J, Dawe RS. Incidence of skin cancers in 3867 patients treated with narrow-band ultraviolet B phototherapy. Br J Dermatol. 2008;159(4):931–5.

    Article  CAS  PubMed  Google Scholar 

  • Kimball AB, Rothman KJ, Kricorian G, Pariser D, Yamauchi PS, Menter A, Teller CF, Aras G, Accortt NA, Hooper M, Rice KC, Gelfand JM. OBSERVE-5: observational postmarketing safety surveillance registry of etanercept for the treatment of psoriasis final 5-year results. J Am Acad Dermatol. 2015;72(1):115–22.

    Article  PubMed  Google Scholar 

  • Lain EL, Markus RF. Early and explosive development of nodular basal cell carcinoma and multiple keratoacanthomas in psoriasis patients treated with cyclosporine. J Drugs Dermatol. 2004;3(6):680–2.

    PubMed  Google Scholar 

  • Langley RG, Lebwohl M, Krueger GG, Szapary PO, Wasfi Y, Chan D, Hsu MC, You Y, Poulin Y, Korman N, Prinz JC, Reich K; PHOENIX 2 Investigators. Long-term efficacy and safety of ustekinumab, with and without dosing adjustment, in patients with moderate-to-severe psoriasis: results from the PHOENIX 2 study through 5 years of follow-up. Br J Dermatol. 2015;172(5):1371–83

    Google Scholar 

  • Lee E, Koo J, Berger T. UVB phototherapy and skin cancer risk: a review of the literature. Int J Dermatol. 2004;44(5):355–60.

    Article  Google Scholar 

  • Marcil I, Stern RS. Squamous-cell cancer of the skin in patients given PUVA and ciclosporin: nested cohort crossover study. Lancet. 2001;358(9287):1042–5.

    Article  CAS  PubMed  Google Scholar 

  • Menter A, Tyring SK, Gordon K, Kimball AB, Leonardi CL, Langley RG, Strober BE, Kaul M, Gu Y, Okun M, Papp K. Adalimumab therapy for moderate to severe psoriasis: a randomized, controlled phase III trial. J Am Acad Dermatol. 2008;58(1):106–15.

    Article  PubMed  Google Scholar 

  • Menter A, Gordon KB, Leonardi CL, Gu Y, Goldblum OM. Efficacy and safety of adalimumab across subgroups of patients with moderate to severe psoriasis. J Am Acad Dermatol. 2010;63(3):448–56.

    Article  CAS  PubMed  Google Scholar 

  • Menter A, Thaçi D, Papp KA, Wu JJ, Bereswill M, Teixeira HD, Rubant S, Williams DA. Five-year analysis from the ESPRIT 10-year postmarketing surveillance registry of adalimumab treatment for moderate to severe psoriasis. J Am Acad Dermatol. 2015;73(3):410–9.e6.

    Article  PubMed  Google Scholar 

  • Papp KA, Griffiths CE, Gordon K, Lebwohl M, Szapary PO, Wasfi Y, Chan D, Hsu MC, Ho V, Ghislain PD, Strober B, Reich K, PHOENIX 1 Investigators, PHOENIX 2 Investigators, ACCEPT Investigators. Long-term safety of ustekinumab in patients with moderate-to-severe psoriasis: final results from 5 years of follow-up. Br J Dermatol. 2013;168(4):844–54.

    Article  CAS  PubMed  Google Scholar 

  • Papp K, Reich K, Leonardi CL, Kircik L, Chimenti S, Langley RG, Hu C, Stevens RM, Day RM, Gordon KB, Korman NJ, Griffiths CE. Apremilast, an oral phosphodiesterase 4 (PDE4) inhibitor, in patients with moderate to severe plaque psoriasis: results of a phase III, randomized, controlled trial (Efficacy and Safety Trial Evaluating the Effects of Apremilast in Psoriasis [ESTEEM] 1). J Am Acad Dermatol. 2015;73(1):37–49.

    Article  CAS  PubMed  Google Scholar 

  • Paul CF, Ho VC, McGeown C, Christophers E, Schmidtmann B, Guillaume JC, Lamarque V, Dubertret L. Risk of malignancies in psoriasis patients treated with cyclosporine: a 5 y cohort study. J Invest Dermatol. 2003;120(2):211–6.

    Article  CAS  PubMed  Google Scholar 

  • Paul C, Cather J, Gooderham M, Poulin Y, Mrowietz U, Ferrandiz C, Crowley J, Hu C, Stevens RM, Shah K, Day RM, Girolomoni G, Gottlieb AB. Efficacy and safety of apremilast, an oral phosphodiesterase 4 inhibitor, in patients with moderate-to-severe plaque psoriasis over 52 weeks: a phase III, randomized controlled trial (ESTEEM 2). Br J Dermatol. 2015;173(6):1387–99.

    Article  CAS  PubMed  Google Scholar 

  • Pouplard C, Brenaut E, Horreau C, Barnetche T, Misery L, Richard MA, Aractingi S, Aubin F, Cribier B, Joly P, Jullien D, Le Maître M, Ortonne JP, Paul C. Risk of cancer in psoriasis: a systematic review and meta-analysis of epidemiological studies. J Eur Acad Dermatol Venereol. 2013;27(Suppl 3):36–46.

    Article  PubMed  Google Scholar 

  • Reich K, Wozel G, Zheng H, van Hoogstraten HJ, Flint L, Barker J. Efficacy and safety of infliximab as continuous or intermittent therapy in patients with moderate-to-severe plaque psoriasis: results of a randomized, long-term extension trial (RESTORE2). Br J Dermatol. 2013;168(6):1325–34.

    Article  CAS  PubMed  Google Scholar 

  • Shear NH, Hartmann M, Toledo-Bahena M, Katsambas A, Connors L, Chang Q, Yao R, Nograles K, Popmihajlov Z, REALITY Investigators. Long-term efficacy and safety of infliximab maintenance therapy in patients with plaque-type psoriasis in real-world practice. Br J Dermatol. 2014;171(3):631–41.

    Article  CAS  PubMed  Google Scholar 

  • Stern RS, Laird N. The carcinogenic risk of treatments for severe psoriasis. Photochemotherapy Follow-up Study. Cancer. 1994;73(11):2759–64.

    Article  CAS  PubMed  Google Scholar 

  • Tessari G, Girolomoni G. Nonmelanoma skin cancer in solid organ transplant recipients: update on epidemiology, risk factors, and management. Dermatol Surg. 2012;38(10):1622–30.

    Article  CAS  PubMed  Google Scholar 

  • Ulrich C, Kanitakis J, Stockfleth E, Euvrard S. Skin cancer in organ transplant recipients—where do we stand today? Am J Transplant. 2008;8(11):2192–8.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jashin J. Wu .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

No, D.J., Amin, M., Darji, K., Wu, J.J. (2017). 69-Year-Old with Psoriasis and a History of Skin Cancer. In: Wu, J. (eds) Clinical Cases in Psoriasis. Clinical Cases in Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-319-52779-6_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-52779-6_16

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-52778-9

  • Online ISBN: 978-3-319-52779-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics