Article : Oral Corticosteroids Do Not Increase...

Oral Corticosteroids Do Not Increase the Incidence of Nonmelanoma Skin Cancers

Skin cancer is one of the few effects that physicians do not have to worry about in long-term systemic corticosteroid users.

Oral corticosteroids are potent anti-inflammatory and immunosuppressive agents that are effective for a wide variety of conditions. Other immunosuppressive agents, such as azathioprine and cyclosporine, have been found to augment risk for nonmelanoma skin cancers, particularly squamous cell carcinoma (SCC). Despite widespread use over decades, the extent to which long-term oral corticosteroid treatment increases skin cancer risk is uncertain. To examine this issue, researchers analyzed data from the Veterans Affairs Topical Tretinoin Chemoprevention Trial. Subjects were veterans at high risk for nonmelanoma skin cancers; organ transplant recipients were excluded. The authors compared development of new SCCs or basal cell carcinomas (BCCs) in 148 patients who filled prescriptions for prednisone and 903 who did not. The mean duration of prednisone therapy was 190.5 days, with a median of 21 days. The mean cumulative dose was 372 mg when prednisone was taken for less than 1 month and 4555 mg when treatment was longer than a month. Median follow up was 3.4 years.

Incidences of BCC, SCC, or the two combined did not differ significantly between groups. Further analysis showed that crude and adjusted BCC, SCC, and combined skin cancer hazard ratios were no different among prednisone nonusers, those who used prednisone for longer than 1 month, and those whose cumulative prednisone dose was larger than 1 g.

CITATION(S):

Baibergenova AT et al. Oral prednisone use and risk of keratinocyte carcinoma in non-transplant population. The VATTC trial. J Eur Acad Dermatol Venereol 2012 Sep; 26:1109.

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