Choi Seohee Deanne, D'Souza Mario I, Menzies Scott W, Weninger Wolfgang
Department of Dermatology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
Discipline of Dermatology, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
Australas J Dermatol. 2019 Feb;60(1):e14-e19. doi: 10.1111/ajd.12838. Epub 2018 May 23.
BACKGROUND/OBJECTIVES: Patients on biologic therapy are thought to be at increased risk of developing non-melanoma skin cancers and melanomas. It is unknown whether biologic therapy alters the natural history of melanocytic naevi. Therefore, a prospective observational study was conducted to determine whether psoriasis patients on biologic therapy develop changes in naevi.
Clinical and dermoscopic assessment of all melanocytic naevi was performed in 45 psoriasis patients on biologic therapy versus a control cohort of 43 subjects, using sequential digital dermoscopic imaging and total body photography. The mean follow-up period was 1.5 years.
The study and control patients had comparable age, gender, previous and family history of non-melanoma skin cancers and melanomas, as well as previous sun exposure and total number of naevi. The number of naevi with major dermoscopic changes was 3% in the study and 1.9% in the control group, with an adjusted incidence rate ratio of 1.45 (95% confidence interval 0.90-2.33; P = 0.125). The rate of minor changes was 15.9% in the study group versus 19.4% in the control (adjusted incidence rate ratio 0.77, 95% confidence interval 0.57-1.08; P = 0.14). There were six new dysplastic naevi in 4/45 biologic patients and four in 4/43 controls; however, the difference was not significant (relative risk 0.96, 95% confidence interval -0.12 to 0.12; P = 0.95). There were no melanomas in either group.
Over a mean follow-up period of 1.5 years there was no evidence of significantly different changes in naevi or development of new dysplastic naevi in psoriasis patients on biologic treatment compared to controls.
背景/目的：接受生物治疗的患者被认为发生非黑色素瘤皮肤癌和黑色素瘤的风险增加。生物治疗是否会改变黑素细胞痣的自然病程尚不清楚。因此，开展了一项前瞻性观察性研究，以确定接受生物治疗的银屑病患者的痣是否会发生变化。
对45例接受生物治疗的银屑病患者以及43名对照受试者的所有黑素细胞痣进行临床和皮肤镜评估，采用连续数字皮肤镜成像和全身摄影。平均随访期为1.5年。
研究组和对照组患者在年龄、性别、非黑色素瘤皮肤癌和黑色素瘤的既往史及家族史、既往日晒情况和痣的总数方面具有可比性。研究组中出现主要皮肤镜变化的痣的比例为3%，对照组为1.9%，调整后的发病率比为1.45（95%置信区间0.90-2.33；P = 0.125）。研究组微小变化的发生率为15.9%，对照组为19.4%（调整后的发病率比0.77，95%置信区间0.57-1.08；P = 0.14）。45例接受生物治疗的患者中有4例出现6个新发发育异常痣，43名对照中有4例出现4个新发发育异常痣；然而，差异无统计学意义（相对风险0.96，95%置信区间-0.12至0.12；P = 0.95）。两组均未出现黑色素瘤。
在平均1.5年的随访期内，与对照组相比，接受生物治疗的银屑病患者的痣没有明显不同的变化，也没有新发发育异常痣。
