Jørgensen Mads Gustaf, Toyserkani Navid Mohamadpour, Egeberg Alexander, Sørensen Jens Ahm
Research Unit for Plastic Surgery, Odense University Hospital, Odense, Denmark.
University of Southern Denmark, Odense, Denmark.
JAAD Int. 2020 May 23;1(1):31-38. doi: 10.1016/j.jdin.2020.03.004. eCollection 2020 Jul.
Vitiligo is a depigmentation disorder associated with genetic loss of melanocytes and decreased melanin synthesis. The current literature is conflicting in regard to vitiligo patients' risk of cutaneous malignant melanoma and keratinocyte cancer.
To investigate the risk of cutaneous malignant melanoma and keratinocyte cancer in vitiligo patients.
We conducted a population-based study, including 2,339 subjects with a first-time vitiligo diagnosis between 1994 and 2017 and 23,293 age- and sex-matched (1:10) controls. To address surveillance bias, we included 12,380 subjects with a first-time diagnosis of lichen planus.
Age was the only significant factor for cutaneous malignant melanoma in comparison of vitiligo with controls and lichen planus (hazard ratio 1.04, 95% confidence interval [CI] 1.03-1.05; and hazard ratio 1.02, 95% CI 1.01-1.04, respectively). Similarly, age was a significant factor for keratinocyte cancer in comparison of vitiligo with controls and lichen planus (hazard ratio 1.07, 95% CI 1.06-1.07; and hazard ratio 1.06, 95% CI 1.05-1.07). Male sex was an additional factor for keratinocyte cancer in comparison of vitiligo with lichen planus (hazard ratio 1.38; 95% CI 1.09-1.75). Phototherapy did not increase the risk of receiving a diagnosis of cutaneous malignant melanoma or keratinocyte cancer in the vitiligo cohort.
We observed no significant difference in cutaneous malignant melanoma or keratinocyte cancer risk among vitiligo subjects. Phototherapy use was not associated with a higher skin cancer risk in vitiligo compared with other skin diseases.
白癜风是一种与黑素细胞遗传丧失和黑色素合成减少相关的色素脱失性疾病。目前的文献对于白癜风患者患皮肤恶性黑色素瘤和角质形成细胞癌的风险存在矛盾观点。
调查白癜风患者患皮肤恶性黑色素瘤和角质形成细胞癌的风险。
我们开展了一项基于人群的研究，纳入了1994年至2017年间首次诊断为白癜风的2339名受试者以及23293名年龄和性别匹配（1:10）的对照。为解决监测偏倚问题，我们纳入了12380名首次诊断为扁平苔藓的受试者。
与对照组和扁平苔藓组相比，年龄是白癜风患者发生皮肤恶性黑色素瘤的唯一显著因素（风险比1.04，95%置信区间[CI] 1.03 - 1.05；以及风险比1.02，95% CI 1.01 - 1.04）。同样，与对照组和扁平苔藓组相比，年龄是白癜风患者发生角质形成细胞癌的显著因素（风险比1.07，95% CI 1.06 - 1.07；以及风险比1.06，95% CI 1.05 - 1.07）。与扁平苔藓组相比，男性性别是白癜风患者发生角质形成细胞癌的另一个因素（风险比1.38；95% CI 1.09 - 1.75）。光疗并未增加白癜风队列中被诊断为皮肤恶性黑色素瘤或角质形成细胞癌的风险。
我们观察到白癜风患者在皮肤恶性黑色素瘤或角质形成细胞癌风险方面无显著差异。与其他皮肤病相比，白癜风患者使用光疗与更高的皮肤癌风险无关。
