Sunlight and psoralen and ultraviolet A (PUVA) are risk factors for the development of squamous cell carcinoma (SCC) and, to a lesser extent, basal cell carcinoma (BCC). Ultraviolet B (UVB) therapy, used for the treat...Sunlight and psoralen and ultraviolet A (PUVA) are risk factors for the development of squamous cell carcinoma (SCC) and, to a lesser extent, basal cell carcinoma (BCC). Ultraviolet B (UVB) therapy, used for the treatment of psoriasis, might also increase the risk of these tumors. We studied the relation of skin cancer incidence to UVB use among 1380 adult subjects enrolled in a long- term safety trial of PUVA therapy. We used negative binomial regression models to quantify the association between UVB and the development of non- melanoma skin cancer (NMSC), controlling for known confounders. High UVB exposure(≥ 300treatmentsvs<300 treatments) was associated with a modest but significant increase in SCC (adjusted incidence rate ratio (IRR)=1.37, 95% confidence interval (CI)=1.03- 1.83) and BCC (adjusted IRR=1.45, 95% CI=1.071.96) risk. Among patients with<100 PUVA treatments, high UVB exposure was significantly associated with the development of SCC (adjusted IRR=2.75, 95% CI=1.11- 6.84) and BCC (adjusted IRR=3.00, 95% CI=1.30- 6.91) on body sites typically exposed to UVB therapy but not on chronically sun- exposed sites typically covered during therapy. For adults with high UVB exposure levels, UVB confers a modest increase in NMSC risk, much less than that observed with PUVA. Therefore, UVB remains a relatively low- risk treatment for psoriasis.展开更多
Psoriasis is a common disease with substantial effects on quality of life. Few quality of life studies have been performed in psoriasis patients from the general US population. To describe the determinants of quality ...Psoriasis is a common disease with substantial effects on quality of life. Few quality of life studies have been performed in psoriasis patients from the general US population. To describe the determinants of quality of life in psoriasis patients from the US population. Patients were randomly selected from the US population. Patients who identified themselves as having been diagnosed with psoriasis by a physician were invited to complete a more detailed survey about quality of life. Two hundred sixty-six psoriasis patients from the US population completed the detailed survey. Body surface area showed the strongest association with decrements in quality of life (Spearman 0.50, P < . 0001). Younger patients and female patients also had statistically significant reductions in quality of life. Increasing psoriasis severity was associated with seeking care from multiple physicians and having decrements in income. Patients with more extensive skin involvement have great erreductions in quality of life. Female patients and young patients are affected to a greater extent.展开更多
文摘Sunlight and psoralen and ultraviolet A (PUVA) are risk factors for the development of squamous cell carcinoma (SCC) and, to a lesser extent, basal cell carcinoma (BCC). Ultraviolet B (UVB) therapy, used for the treatment of psoriasis, might also increase the risk of these tumors. We studied the relation of skin cancer incidence to UVB use among 1380 adult subjects enrolled in a long- term safety trial of PUVA therapy. We used negative binomial regression models to quantify the association between UVB and the development of non- melanoma skin cancer (NMSC), controlling for known confounders. High UVB exposure(≥ 300treatmentsvs<300 treatments) was associated with a modest but significant increase in SCC (adjusted incidence rate ratio (IRR)=1.37, 95% confidence interval (CI)=1.03- 1.83) and BCC (adjusted IRR=1.45, 95% CI=1.071.96) risk. Among patients with<100 PUVA treatments, high UVB exposure was significantly associated with the development of SCC (adjusted IRR=2.75, 95% CI=1.11- 6.84) and BCC (adjusted IRR=3.00, 95% CI=1.30- 6.91) on body sites typically exposed to UVB therapy but not on chronically sun- exposed sites typically covered during therapy. For adults with high UVB exposure levels, UVB confers a modest increase in NMSC risk, much less than that observed with PUVA. Therefore, UVB remains a relatively low- risk treatment for psoriasis.
文摘Psoriasis is a common disease with substantial effects on quality of life. Few quality of life studies have been performed in psoriasis patients from the general US population. To describe the determinants of quality of life in psoriasis patients from the US population. Patients were randomly selected from the US population. Patients who identified themselves as having been diagnosed with psoriasis by a physician were invited to complete a more detailed survey about quality of life. Two hundred sixty-six psoriasis patients from the US population completed the detailed survey. Body surface area showed the strongest association with decrements in quality of life (Spearman 0.50, P < . 0001). Younger patients and female patients also had statistically significant reductions in quality of life. Increasing psoriasis severity was associated with seeking care from multiple physicians and having decrements in income. Patients with more extensive skin involvement have great erreductions in quality of life. Female patients and young patients are affected to a greater extent.
