Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SE-41345 Gothenburg, Sweden.
Acta Derm Venereol. 2021 Jan 5;101(1):adv00365. doi: 10.2340/00015555-3725.
An association between methotrexate use and risk of cutaneous squamous cell carcinoma has been reported in patients with rheumatoid and psoriatic arthritis. A nested case-control study was performed to investigate if methotrexate use among patients with psoriasis was associated with increased risk of cutaneous squamous cell carcinoma. Data were obtained from Swedish registers and included 623 patients with psoriasis and a first cutaneous squamous cell carcinoma from 2010 to 2016. Ten randomly selected patients with psoriasis were matched on age and sex to each case. Among cases, 160 (26%) were ever-users of metho-trexate. The corresponding number among the controls was 1,370 (22%), yielding an unadjusted odds ratio (OR) of 1.23 (95% confidence interval (95% CI) 1.02-1.49); p = 0.034. After adjusting for use of other immunosuppressive drugs the association was close to unity (OR 1.09; 95% CI 0.89-1.34); p = 0.39. The slightly increased risk of cutaneous squamous cell carcinoma associated with methotrexate-exposure in patients with psoriasis does not seem to be associated with metho-trexate, but rather with disease severity, other anti-psoriatic treatments, and ultraviolet exposure.
在类风湿关节炎和银屑病关节炎患者中，已有报道称甲氨蝶呤的使用与皮肤鳞状细胞癌的风险相关。本研究进行了一项巢式病例对照研究，以调查银屑病患者中甲氨蝶呤的使用是否与皮肤鳞状细胞癌风险增加相关。数据来自瑞典登记处，包括 2010 年至 2016 年间的 623 例银屑病患者和首次发生皮肤鳞状细胞癌的患者。随机选择了 10 名年龄和性别与病例相匹配的银屑病患者作为对照。在病例中，有 160 名（26%）曾使用过甲氨蝶呤。对照组中相应的数字为 1370 名（22%），未经调整的比值比（OR）为 1.23（95%置信区间（95%CI）为 1.02-1.49）；p=0.034。在调整了其他免疫抑制剂的使用后，相关性接近一致（OR 1.09；95%CI 0.89-1.34）；p=0.39。与银屑病患者中甲氨蝶呤暴露相关的皮肤鳞状细胞癌风险略有增加似乎与甲氨蝶呤无关，而与疾病严重程度、其他抗银屑病治疗和紫外线暴露有关。
