Department of Dermatology, University of Brescia and ASST-Spedali Civili, Brescia, Italy.
Department of Rheumatology, University of Brescia and ASST-Spedali Civili, Brescia, Italy.
Ital J Dermatol Venerol. 2024 Aug;159(4):436-443. doi: 10.23736/S2784-8671.24.07763-6.
The incidence of skin cancer in patients with systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) has only been investigated with retrospective studies enrolling a low number of patients. The aims of our study were to assess the incidence of skin cancer in two large cohorts of patients, one with SLE and the other with SSc and investigating possible risk factors.
Ninety SLE, 53 SSc patients and 392 control subjects were enrolled. A questionnaire including personal and medical details was fulfilled. The severity of photoaging, photosensitivity and sun exposure habits was assessed. Skin lesions were evaluated using a video-dermatoscope. Suspicious lesions were surgically removed.
The incidence of skin cancer was not different to those of controls. However, a decrease in the incidence of basal cell carcinoma was found in patients with SLE. This finding associated negatively with photosensitivity. SSc patients with skin malignancies did not report photosensitivity and did not adopt a careful photoprotection. A positive association was found between skin cancer and diffuse cutaneous sclerosis, pitting scars, severe photoaging and treatment with Iloprost.
Regular avoidance of sun exposure and photoprotection are effective in reducing the development of skin cancer in patients with autoimmune diseases.
患有系统性红斑狼疮 (SLE) 和系统性硬皮病 (SSc) 的患者的皮肤癌发病率仅通过纳入少数患者的回顾性研究进行了调查。我们研究的目的是评估两个大型患者队列（一个是 SLE，另一个是 SSc）中皮肤癌的发病率，并调查可能的危险因素。
共纳入 90 例 SLE 患者、53 例 SSc 患者和 392 例对照者。完成了一份包含个人和医疗详细信息的问卷。评估了光老化、光敏性和阳光暴露习惯的严重程度。使用视频皮肤镜评估皮肤病变。对可疑病变进行手术切除。
皮肤癌的发病率与对照组无差异。然而，发现 SLE 患者的基底细胞癌发病率降低。这一发现与光敏性呈负相关。患有皮肤恶性肿瘤的 SSc 患者没有报告光敏性，也没有采取谨慎的光保护措施。皮肤癌症与弥漫性皮肤硬化症、凹陷性瘢痕、严重光老化和 Iloprost 治疗之间存在正相关关系。
定期避免阳光照射和光保护可有效降低自身免疫性疾病患者皮肤癌的发生。
