Department of Dermatology, Taichung Veterans General Hospital, Taichung, Taiwan.
Faculty of Medicine and Graduate Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
Photodermatol Photoimmunol Photomed. 2019 May;35(3):164-171. doi: 10.1111/phpp.12443. Epub 2019 Jan 8.
Narrowband ultraviolet B (NB-UVB) phototherapy is a widely used treatment for various dermatoses. The risk of skin cancer following long-term NB-UVB phototherapy has rarely been explored in skin phototypes III-V.
We conducted a nationwide-matched cohort study and identified a total of 22 891 psoriasis patients starting NB-UVB phototherapy from the Taiwan National Health Insurance Database during the period 2000-2013. Cumulative incidences of skin cancers were compared between subjects receiving less than 90 UVB treatments (S-cohort, N = 13 260) and age- as well as propensity score-matched subjects receiving more than or equal to 90 UVB treatments (L-cohort, N = 3315).
There were no significant differences in the overall cumulative incidences of skin cancers between the two cohorts (log-rank t test, P = 0.691) during the follow-up periods. The S-cohort had a significantly lower prevalence of actinic keratosis when compared with the L-cohort (0.54% vs 1.00%, P = 0.005).
Long-term NB-UVB phototherapy does not increase skin cancer risk compared with short-term NB-UVB phototherapy in psoriasis patients with skin phototypes III-V.
窄谱中波紫外线（NB-UVB）光疗是一种广泛应用于各种皮肤病的治疗方法。在皮肤类型为 III-V 的患者中，长期接受 NB-UVB 光疗后皮肤癌的风险很少被探讨。
我们进行了一项全国性的匹配队列研究，从 2000 年至 2013 年的台湾全民健康保险数据库中确定了 22891 例开始接受 NB-UVB 光疗的银屑病患者。在年龄和倾向评分匹配后，比较接受少于 90 次 UVB 治疗（S 队列，N=13260）和接受大于或等于 90 次 UVB 治疗（L 队列，N=3315）的患者的皮肤癌累积发生率。
在随访期间，两组之间的皮肤癌总累积发生率没有显著差异（对数秩检验，P=0.691）。与 L 队列相比，S 队列的光化性角化病发生率显著较低（0.54%比 1.00%，P=0.005）。
在皮肤类型为 III-V 的银屑病患者中，与短期 NB-UVB 光疗相比，长期 NB-UVB 光疗不会增加皮肤癌的风险。
