Becquart O, Guillot B, Bourrain J-L, Duflos C, Du-Thanh A
Département de dermatologie, Hôpital Saint-Eloi, 34295 Montpellier cedex 5, France.
Département de dermatologie, Hôpital Saint-Eloi, 34295 Montpellier cedex 5, France.
Rev Med Interne. 2019 Sep;40(9):617-622. doi: 10.1016/j.revmed.2019.04.008. Epub 2019 May 14.
The risk of skin cancer induced by photosensiting drugs is well known. An association between hydrochlorothiazide use and skin cancer has been recently published in some epidemiological studies. A systematic review of case-control or prospectives cohorts showed an increased risk of cutaneous squamous cell carcinoma even if some confusing factors such as tobacco smoking was not analysed. Results are more conflicting for basal cell carcinoma or melanoma. These results do not modify the benefit/risk ratio but should lead to propose preventive mesures: identification of high risk population, avoidance of this drug if possible in immunocompromised patients or with previous skin cancer, regular skin examination in case of long term use of hydrochlorothiazide.
由光敏药物诱发皮肤癌的风险是众所周知的。近期一些流行病学研究发表了使用氢氯噻嗪与皮肤癌之间的关联。一项对病例对照研究或前瞻性队列研究的系统评价显示，即使未分析诸如吸烟等一些混淆因素，皮肤鳞状细胞癌的风险也有所增加。对于基底细胞癌或黑色素瘤，结果则更具争议性。这些结果并未改变获益/风险比，但应促使提出预防措施：识别高危人群，对于免疫功能低下患者或既往有皮肤癌的患者尽可能避免使用此药物，长期使用氢氯噻嗪时要定期进行皮肤检查。
