National Skin Centre, Singapore, Singapore.
Photodermatol Photoimmunol Photomed. 2023 Jul;39(4):343-350. doi: 10.1111/phpp.12844. Epub 2022 Nov 23.
Previous studies regarding the risk of skin malignancy with NBUVB have been performed in Caucasian patients, but few studies have been conducted in Asians.
The aim of the study was to determine the risk of skin cancer in Asian patients with psoriasis and vitiligo receiving NBUVB phototherapy.
We performed a 9-year retrospective study including all patients with psoriasis and vitiligo receiving NBUVB (either 311 nm wavelength through cabin phototherapy or 308 nm through excimer lamp phototherapy) at the National Skin Centre. We matched the identification numbers of patients to the National Registry of Diseases Office database and collected data on all skin cancers diagnosed.
A total of 3730 patients were included. During the course of the study, 12 cases of skin cancer were diagnosed, of which 10 were basal cell carcinomas, and 2 were squamous cell carcinomas. No cases of melanoma were detected in the study. The age-standardized incidence of skin cancer in psoriasis and vitiligo patients who received phototherapy was 47.5 and 26.5, respectively, which is higher than the incidence of skin cancers in the general population. Risk of skin malignancy was positively correlated with the cumulative (p = .008) and maximum dose of phototherapy (p = .011) as well as previous systemic treatments (p = .006).
Limitations include a relatively short follow-up period as well as the lack of quantification of solar exposure.
NBUVB phototherapy in Asian skin increases the risk of skin malignancy. The risk of skin malignancy is higher with psoriasis patients, greater cumulative and maximal dose of phototherapy as well as the use of systemic therapy. Despite the increased risk, the absolute number of skin malignancies remains low, especially for vitiligo patients, with no cases of melanoma diagnosed-a reassuring finding that phototherapy remains a safe alternative in the treatment of psoriasis and vitiligo.
此前有关窄谱中波紫外线（NBUVB）治疗皮肤恶性肿瘤风险的研究均在白种人群中进行，而亚洲人群中的研究较少。
本研究旨在确定接受 NBUVB 光疗的银屑病和白癜风亚洲患者罹患皮肤癌的风险。
我们进行了一项为期 9 年的回顾性研究，纳入在新加坡国家皮肤中心接受 NBUVB（通过舱式光疗仪使用 311nm 波长或通过准分子光疗仪使用 308nm 波长）治疗的所有银屑病和白癜风患者。我们将患者的识别号与国家疾病登记处数据库进行匹配，并收集所有诊断出的皮肤癌数据。
共纳入 3730 例患者。在研究过程中，诊断出 12 例皮肤癌，其中 10 例为基底细胞癌，2 例为鳞状细胞癌。本研究未发现黑色素瘤病例。接受光疗的银屑病和白癜风患者的皮肤癌标准化发病率分别为 47.5 和 26.5，高于一般人群的发病率。皮肤恶性肿瘤风险与累积（p=0.008）和最大光疗剂量（p=0.011）以及既往全身治疗（p=0.006）呈正相关。
本研究的局限性包括随访时间相对较短以及缺乏对太阳暴露的量化。
亚洲人种接受 NBUVB 光疗会增加皮肤恶性肿瘤的风险。银屑病患者、累积和最大光疗剂量更大以及使用全身治疗的患者发生皮肤恶性肿瘤的风险更高。尽管风险增加，但皮肤恶性肿瘤的绝对数量仍然较低，特别是白癜风患者，未诊断出黑色素瘤——这一令人安心的发现表明，光疗仍然是治疗银屑病和白癜风的一种安全替代方法。
