Does Psoriasis Lead to Skin Cancer? Know the Truth

Introduction

Psoriasis is a chronic inflammatory disease of the skin and joints that is associated with comorbidities such as obesity and cardiovascular disease. Because systemic inflammation can sometimes play a role in the development of cancer, there have been several studies investigating the risk of cancer development in patients with psoriatic disease. Many of these studies have demonstrated a slightly increased risk of cancer among patients with psoriasis. But the risk appears to be limited to certain cancers, such as squamous cell carcinomas (SCC), basal cell carcinoma (BCC) and lymphomas.

Psoriasis and Skin Cancer

An important consideration in the management of psoriasis is the potential risk of developing skin cancers. This risk is indeed a growing concern, as skin neoplasms are among the most frequent cancers worldwide. The epidemiology of skin cancers is complex and dependent on geographic, demographic and environmental factors.

The World Health Organization (WHO) estimates that there are more than 2 million new cases of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) classified as non-melanoma skin cancers (NMSCs) each year. Although they are rarely fatal, these tumors can have important implications for patients’ quality of life and psychological well-being.

Skin cancers are caused mainly by over-exposure to the sun’s ultraviolet (UV) radiation. These cancers are much more frequent in areas with high sun exposure and fair-skinned people, or those with Fitzpatrick phototype-I are more susceptible. UV damages the DNA of skin cells increasing the risk of genetic mutations that can lead to cancer formation. But the danger isn’t just from sun exposure.

Other risk factors include the use of tanning lamps, many freckles or moles, immunosuppression, family history of skin cancer, and age.

Genetic predisposition is an important factor in skin cancer susceptibility. It is true that persons with a family history of malignant melanoma (MM) or other skin cancers may be at increased risk.

Certain inherited conditions, such as xeroderma pigmentosum syndrome, that impair cells’ ability to repair DNA damage caused by UV exposure greatly increase the risk of developing skin cancers.

Types of Skin Cancer

Most common type of skin cancer are:

1. Basal cell carcinoma (BCC)

It is the most common type of skin cancer.

People with lighter skin are more likely to develop BCC. This skin cancer also occurs in people with skin of color.

BCCs often appear as a round, flesh-colored bump, a pearl-like growth, or a pinkish bit of skin.

BCCs usually develop over many years of frequent sun exposure or indoor tanning.

BCCs are often found on the head, neck and arms, but can occur on any part of the body, including the chest, abdomen and legs.

Early diagnosis and treatment of BCC is crucial. BCC can go deep. If allowed to grow it can invade nerves and bones, damaging and disfiguring.

2. Squamous cell carcinoma (SCC)

SCC is the second most common form of skin cancer.

SCC tends to occur more often in people with light skin. Also, this skin cancer can affect people with darker skin.

SCC often appears as a red, firm bump, a scaly patch or a sore that heals and then reopens.

SCC usually appears on parts of the skin that have been exposed to the sun often, like the rim of the ear, face, neck, arms, chest and back.

SCC can burrow deep into the skin and cause damage and disfigurement.

If SCC is diagnosed and treated early, it usually does not grow deep or spread to other parts of the body.

3. Melanoma

Because it tends to spread melanoma is often called “the most serious skin cancer”.

Melanoma can start in an existing mole on your skin or it can appear out of nowhere as a dark spot on your skin that looks different from the rest.

Early diagnosis and treatment is key.

Knowing the ABCDE warning signs of melanoma may help you find a melanoma early.

Psoriasis and Skin Cancer: How to Differentiate Them

Psoriasis and skin cancer can sometimes appear similar, making professional evaluation important.

Feature	Psoriasis	Skin Cancer
Appearance	Red, raised patches covered with silvery-white scales	New or changing growth, sore, nodule, or mole that may not heal
Itching	Common, often accompanied by burning or irritation	May or may not be itchy; some lesions are painless
Symmetry	Generally symmetrical, often affecting both sides of the body	Often asymmetrical or irregular in shape
Duration	Chronic condition with recurring flare-ups and periods of remission	Progressive growth that persists or gradually worsens over time
Response to Treatment	Usually improves with appropriate psoriasis treatment	Persists despite routine skin care and requires specific treatment for skin cancer

If you notice a new lesion, a sore that does not heal, or changes within an existing psoriasis plaque, seek medical evaluation promptly.

How to Prevent Skin Cancer?

UV Protection:

Seek shade if needed, but be aware that the sun’s rays are strongest from 10 a.m. to 2 p.m. If your shadow is smaller than you are, go into the shade.

If you can, wear sun-protective clothing such as a lightweight, long-sleeved shirt and pants, a wide-brimmed hat and sunglasses with UV protection. To protect your skin better from the sun, select clothing with an ultraviolet protection factor (UPF) label.

Apply a broad-spectrum, water-resistant sunscreen with an SPF of at least 30. A broad-spectrum sunscreen protects you from UVA and UVB rays.

Wear sunscreen whenever you will be outside, even if it is cloudy.

Reapply sunscreen every two hours, or after swimming or sweating, when outdoors.

Water, snow and sand are all more reflective of the sun's harmful rays, so be extra careful around them as this reflection can increase your chance of sunburn.

Don’t use tanning beds. Tanning beds emit ultraviolet light that can lead to skin cancer and premature aging of the skin.

If you want to look tan, consider using a self-tanning product, but continue to use sunscreen with it.

Phototherapy:

Ultraviolet (UV) light therapy has been an effective treatment for many people with moderate to severe psoriasis.

Contemporary narrowband UVB phototherapy, now frequently employed, has a good safety profile when used appropriately. However, long-term cumulative exposure or older treatment methods like PUVA (psoralen plus UVA) have been linked to an increased risk of squamous cell carcinoma, especially after numerous treatment sessions.

Immunosuppressants:

Some systemic medications for severe psoriasis work by suppressing immune system activity to help control inflammation. Some immunosuppressive drugs may slightly increase the risk of some cancers (including non-melanoma skin cancers) in susceptible individuals with long-term use.

Your dermatologist has prescribed these medications after weighing up the benefits and risks and you will be monitored regularly.

Lifestyle Factors:

People with psoriasis may have other risk factors that increase their risk for skin cancer including:

Cigarette Smoking

Heavy alcohol use

Obesity

Sunburns frequently

High total UV exposure

Regularly check your skin to catch skin cancer early, when it’s most treatable. If you see anything new or suspicious on your skin, or anything changing, itching or bleeding, see a board-certified dermatologist.

Conclusion

Psoriasis is a chronic immune-mediated disease. It does not directly cause skin cancer. Psoriasis plaques do not turn into cancer. Some factors associated with psoriasis, such as chronic inflammation, long-term exposure to ultraviolet light from some treatments, and some systemic medications, may slightly increase the risk of developing some skin cancers in some people. Patients with psoriasis have a slightly increased risk of some cancers. It is yet to be determined whether this increased cancer risk is related to chronic inflammation, lifestyle, comorbidities, or prior treatments for psoriasis. Prior to the advent of biologic therapy and narrow-band ultraviolet B (nbUVB) phototherapy, psoriasis therapies such as psoralen and UVA (PUVA) and cyclosporine were linked to an increased risk of malignancies, particularly SCCs.

The good news is that these risks can often be minimized with appropriate treatment monitoring, regular dermatological evaluations, sun protection and healthy lifestyle habits. Understanding your skin and consulting a doctor about any persistent or unusual lesions can help promote early detection and prompt treatment. Most people living with psoriasis can successfully manage their condition and have healthy skin for the long term with regular follow-up with appropriate care.

Frequently Asked Questions (FAQs)

1. Is psoriasis a cause of skin cancer?

No. Psoriasis does not become skin cancer.

2. Does psoriasis make me more at risk for skin cancer?

For people with severe psoriasis or chronic exposure to some treatments, the risk may be slightly higher, but in general the risk depends on individual factors.

3. Is phototherapy safe?

Modern narrowband UVB phototherapy is generally considered safe when done under the care of a dermatologist. The aim of your treatment plan is to find a balance between effectiveness and safety.

4. Should I discontinue my psoriasis medication due to skin cancer risk?

No. Do not stop taking any prescribed medication without talking to your healthcare provider. Your dermatologist will talk to you about the benefits and potential risks of treatment.

5. How should I take care of my skin?

Use sun protection, avoid too much UV exposure, have regular skin checks, and see your doctor quickly if you notice any unusual changes to your skin.

Can Psoriasis Cause Skin Cancer?