10040 例白癜风非同期队列患者中黑色素瘤和非黑色素瘤皮肤癌发病率明显降低。

Markedly reduced incidence of melanoma and nonmelanoma skin cancer in a nonconcurrent cohort of 10,040 patients with vitiligo.

机构信息

Health Services Research Unit, Istituto Dermopatico dell'Immacolata, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy.

出版信息

J Am Acad Dermatol. 2014 Dec;71(6):1110-6. doi: 10.1016/j.jaad.2014.07.050. Epub 2014 Sep 19.

DOI:10.1016/j.jaad.2014.07.050

PMID:25242557

Abstract

BACKGROUND

Genetic findings suggesting a lower susceptibility to melanoma in patients with vitiligo are supported by recent clinical studies. Nonmelanoma skin cancer (NMSC) has also been studied, but mainly in small samples, and with conflicting results.

OBJECTIVE

We sought to study the relative risk (RR) of melanoma and NMSC in patients with vitiligo compared with that in patients seen for vascular surgery.

METHODS

The frequency of melanoma and NMSC was compared between patients with vitiligo and patients seen for vascular surgery. Occurrence of skin cancer was compared by computing RR and modeled using multiple logistic regression.

RESULTS

Overall, the crude RR for melanoma was 0.24 (95% confidence interval [CI] 0.13-0.45) in patients with vitiligo compared with those with a nondermatologic condition (occurrence 1.1‰, 95% CI 0.5‰-2.0‰ in patients with vitiligo and occurrence 4.5‰, 95% CI 3.8‰-5.4‰ in the control cohort). The crude RR for NMSC was 0.19 (95% CI 0.14-0.17) and the occurrence was 3.8‰ (95% CI 2.7‰-5.2‰) among patients with vitiligo and 19.6‰ (95% CI 18.0‰-21.4‰) in control subjects. Patients with vitiligo who underwent phototherapy had a markedly higher risk of both cancers.

CONCLUSIONS

In our large study, patients with vitiligo have a decreased risk of developing skin neoplasms, even considering that a larger proportion in this patient group is exposed to higher levels of ultraviolet radiation.

摘要

背景

遗传研究发现，白癜风患者罹患黑色素瘤的风险较低，这一结果得到了近期临床研究的支持。非黑素瘤皮肤癌（NMSC）也有相关研究，但主要集中在小样本中，且结果相互矛盾。

目的

我们旨在研究白癜风患者罹患黑色素瘤和 NMSC 的相对风险（RR）与血管外科患者的风险相比。

方法

比较白癜风患者和血管外科患者的黑色素瘤和 NMSC 发生率。通过计算 RR 并使用多因素逻辑回归模型来比较皮肤癌的发生情况。

结果

总体而言，与非皮肤科疾病患者相比，白癜风患者罹患黑色素瘤的粗 RR 为 0.24（95%置信区间 [CI] 0.13-0.45）（白癜风患者中黑色素瘤的发生率为 1.1‰，95%CI 0.5‰-2.0‰，对照组中的发生率为 4.5‰，95%CI 3.8‰-5.4‰）。NMSC 的粗 RR 为 0.19（95% CI 0.14-0.17），发生率为 3.8‰（95% CI 2.7‰-5.2‰），而对照组中的发生率为 19.6‰（95% CI 18.0‰-21.4‰）。接受光疗的白癜风患者罹患这两种癌症的风险明显更高。