FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 310:1156-1161 May 3, 1984 Number 18 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

A 5.7-year prospective study of 1380 patients treated for psoriasis with oral methoxsalen (8-methoxypsoralen) and ultraviolet A photochemotherapy (PUVA) revealed that after adjustment for exposures to ionizing radiation and topical tar preparations, the risk that cutaneous squamous-cell carcinoma would develop at least 22 months after the first exposure to PUVA was 12.8 times higher in patients exposed to a high dose than in those exposed to a low dose (95 per cent confidence interval, 5.8 to 28.5). No substantial dose-related increase was noted for basal-cell carcinoma. The dose-dependent risk of cutaneous squamous-cell carcinoma suggests that PUVA can act as an independent carcinogen. In our study, morbidity associated with these tumors has been limited, but further follow-up is needed. Meanwhile, patients treated with PUVA should be followed closely for the possible development of cutaneous squamous-cell carcinoma.

This article has been cited by other articles:

• Prince, H. M., Whittaker, S., Hoppe, R. T. (2009). How I treat mycosis fungoides and Sezary syndrome. Blood 114: 4337-4353 [Abstract] [Full Text]  
• Derheimer, F. A., Hicks, J. K., Paulsen, M. T., Canman, C. E., Ljungman, M. (2009). Psoralen-Induced DNA Interstrand Cross-Links Block Transcription and Induce p53 in an Ataxia-Telangiectasia and Rad3-Related-Dependent Manner. Mol. Pharmacol. 75: 599-607 [Abstract] [Full Text]  
• Nijsten, T., Looman, C. W. N., Stern, R. S. (2007). Clinical Severity of Psoriasis in Last 20 Years of PUVA Study. Arch Dermatol 143: 1113-1121 [Abstract] [Full Text]  
• Gelfand, J. M. (2007). Long-term Treatment for Severe Psoriasis: We're Halfway There, With a Long Way to Go. Arch Dermatol 143: 1191-1193 [Full Text]  
• Stern, R. S. (2007). Psoralen and Ultraviolet A Light Therapy for Psoriasis. NEJM 357: 682-690 [Full Text]  
• Stern, R. S. (2006). Lymphoma Risk in Psoriasis: Results of the PUVA Follow-up Study.. Arch Dermatol 142: 1132-1135 [Abstract] [Full Text]  
• Parrish, J. A. (2005). Immunosuppression, Skin Cancer, and Ultraviolet A Radiation. NEJM 353: 2712-2713 [Full Text]  
• Lambertini, L., Surin, K., Ton, T.-V. T., Clayton, N., Dunnick, J. K., Kim, Y., Hong, H.-H. L., Devereux, T. R., Sills, R. C. (2005). Analysis of p53 Tumor Suppressor Gene, H-ras Protooncogene and Proliferating Cell Nuclear Antigen (PCNA) in Squamous Cell Carcinomas of HRA/Skh Mice Following Exposure to 8-Methoxypsoralen (8-MOP) and UVA Radiation (PUVA Therapy). Toxicol Pathol 33: 292-299 [Abstract] [Full Text]  
• Oh, D. H., King, B. A., Boxer, S. G., Hanawalt, P. C. (2001). Spatially localized generation of nucleotide sequence-specific DNA damage. Proc. Natl. Acad. Sci. USA 98: 11271-11276 [Abstract] [Full Text]  
• Alam, M., Ratner, D. (2001). Cutaneous Squamous-Cell Carcinoma. NEJM 344: 975-983 [Full Text]  
• Kawamura, A. Jr, Sekine, T., Sekiguchi, M., Yanoma, S., Kaneko, A., Haneda, T., Moriya, Y., Hayasaka, K.-i., Kakizoe, T. (2000). Six-year Disease-free Survival of a Patient with Metastatic Eyelid Squamous Cell Carcinoma and Colon Adenocarcinoma after Repeated Postoperative Adoptive Immunotherapy. Jpn J Clin Oncol 30: 267-271 [Abstract] [Full Text]  
• Monti, P., Inga, A., Aprile, A., Campomenosi, P., Menichini, P., Ottaggio, L., Viaggi, S., Ghigliotti, G., Abbondandolo, A., Fronza, G. (2000). p53 mutations experimentally induced by 8-methoxypsoralen plus UVA (PUVA) differ from those found in human skin cancers in PUVA-treated patients. Mutagenesis 15: 127-132 [Abstract] [Full Text]  
• Williams, G. M. (2000). Letter to the Editor. International Journal of Toxicology 19: 65-66  
• Stern, R. S., Lunder, E. J. (1998). Risk of Squamous Cell Carcinoma and Methoxsalen (Psoralen) and UV-A Radiation (PUVA): A Meta-analysis. Arch Dermatol 134: 1582-1585 [Abstract] [Full Text]  
• Morison, W. L., Baughman, R. D., Day, R. M., Forbes, P. D., Hoenigsmann, H., Krueger, G. G., Lebwohl, M., Lew, R., Naldi, L., Parrish, J. A., Piepkorn, M., Stern, R. S., Weinstein, G. D., Whitmore, S. E. (1998). Consensus Workshop on the Toxic Effects of Long-term PUVA Therapy. Arch Dermatol 134: 595-598 [Abstract] [Full Text]  
• Stern, R. S., Nichols, K. T., Vakeva, L. H., The PUVA Follow-up Study, (1997). Malignant Melanoma in Patients Treated for Psoriasis with Methoxsalen (Psoralen) and Ultraviolet A Radiation (PUVA). NEJM 336: 1041-1045 [Abstract] [Full Text]  
• Wolff, K. (1997). Should PUVA Be Abandoned?. NEJM 336: 1090-1091 [Full Text]  
• Wolf, P., Putz, B., Tilz, G. P., Kerl, H. (1997). Rare Presence of Human Herpesvirus 8 in Skin Tumors From Patients With Psoriasis Treated With Oral Psoralen Plus UV-A. Arch Dermatol 133: 538-539 [Abstract]  
• McHenry, P M, Williams, H C, Bingham, E A (1995). Fortnightly Review: Management of atopic eczema. BMJ 310: 843-847 [Abstract] [Full Text]  
• Licata, A. G., Wilson, L. D., Braverman, I. M., Feldman, A. M., Kacinski, B. M. (1995). Malignant Melanoma and Other Second Cutaneous Malignancies in Cutaneous T-Cell Lymphoma: The Influence of Additional Therapy After Total Skin Electron Beam Radiation. Arch Dermatol 131: 432-435 [Abstract]  
• Greaves, M. W., Weinstein, G. D. (1995). Treatment of Psoriasis. NEJM 332: 581-589 [Full Text]  
• Lindelof, B., Sigurgeirsson, B., Tegner, E., Larko, O., Berne, B. (1992). Comparison of the Carcinogenic Potential of Trioxsalen Bath PUVA and Oral Methoxsalen PUVA: A Preliminary Report. Arch Dermatol 128: 1341-1344 [Abstract]  
• Ruzicka, T., Sommerburg, C., Braun-Falco, O. Dr he mult, Koster, W., Lengen, W., Lensing, W., Letzel, H., Meigel, W. N., Paul, E., Przybilla, B., Steinert, M., Winzer, M., Wiskemann, A. (1990). Efficiency of Acitretin in Combination With UV-B in the Treatment of Severe Psoriasis. Arch Dermatol 126: 482-486 [Abstract]  
• Kerker, B. J., Huang, C. P., Morison, W. L. (1990). Photochemotherapy of Generalized Granuloma Annulare. Arch Dermatol 126: 359-361 [Abstract]  
• Forman, A. B., Roenigk, H. H. Jr, Caro, W. A., Magid, M. L. (1989). Long-term Follow-up of Skin Cancer in the PUVA-48 Cooperative Study. Arch Dermatol 125: 515-519 [Abstract]  
• Stern, R. S. (1989). Risk Assessment of PUVA and Cyclosporine: Lessons From the Past; Challenges for the Future. Arch Dermatol 125: 545-547 [Abstract]  
• Peckham, P. E., Weinstein, G. D., McCullough, J. L. (1987). The Treatment of Severe Psoriasis: A National Survey. Arch Dermatol 123: 1303-1307 [Abstract]  
• Abel, E. A., Sendagorta, E., Hoppe, R. T., Hu, C.-H. (1987). PUVA Treatment of Erythrodermic and Plaque-Type Mycosis Fungoides: Ten-Year Follow-up Study. Arch Dermatol 123: 897-901 [Abstract]  
• BERKLEY, S. F., HIGHTOWER, A. W., BEIER, R. C., FLEMING, D. W., BROKOPP, C. D., IVIE, G. W., BROOME, C. V. (1986). Dermatitis in Grocery Workers Associated with High Natural Concentrations of Furanocoumarins in Celery. ANN INTERN MED 105: 351-355 [Abstract]  
• Dunagin, W. G. (1986). Potential Hazards of Dinitrochlorobenzene (DNCB) Disputed. Arch Dermatol 122: 12-12 [Abstract]