Psoriasis and Cancer: Is There a Connection?

Can Psoriasis Cause Cancer?

Psoriasis is a chronic inflammatory skin disease that affects people of all ages. It is an autoimmune-mediated disease, and the exact cause is unknown, though it is thought to be genetic.

In psoriasis, the immune system responds to a non-existent danger, leading to rapid skin cell proliferation. This new cell growth moves to the skin's surface, resulting in thickened patches of dead skin on the original surface. In recent times, concerns have arisen that psoriasis, its risk factors, and treatment might lead to cancer.

Psoriasis is considered one of the risk factors for cancer-causing, but it does not directly cause cancer. There is a well-established link between smoking and cancer. However, there is no such well-established link between psoriasis and cancer.

How Did the Question of Cancer Arise?

It is because of inflammation. Long-term skin inflammation increases the risk of cancer. Because skin inflammation is one of the significant symptoms of psoriasis, this is one of the main reasons it has been linked to cancer. Inflammation is also seen in other organs, joints, and blood vessels.

Psoriasis patients have an increased risk of organ-specific cancers in the respiratory tract, digestive system, liver, pancreas, and urinary tract. People with psoriasis are at high risk of developing leukemia, non-Hodgkin lymphoma, Hodgkin's lymphoma, and skin cancers, especially non-melanoma skin cancers.

How Is Psoriasis Treatment Related to Cancer?

Since psoriasis is an autoimmune disorder directly related to the patient's immune system, most medications target the immune system. During treatment, some drugs slow skin cell production, while others suppress the immune system to reduce the patient's symptoms. This weakened immune system is more prone to infections. Hence, the patient with psoriasis is at risk of cancer. Chronic inflammatory diseases such as Crohn’s disease also increase the chances of other cancers.

Certain psoriasis treatments, such as ultraviolet light therapy, which heal psoriatic patches, may increase the risk of developing squamous cell carcinoma. This is directly related to the number of ultraviolet light therapies. Patients who receive 250 ultraviolet light therapies are at risk of developing cancer. Suppose the patients with psoriasis have other habits like tobacco use and alcohol intake; these are associated with cancer risk. Psoriasis patients who receive systemic medications and phototherapy are more likely to develop malignant (cancerous) conditions.

What Is the Difference Between Psoriasis and Skin Cancer?

Psoriasis and skin cancer are the two illnesses that directly relate to the skin. However, they originate, develop, and are treated differently. Here is a comparison to help you understand the key differences:

1. Cause:

• Psoriasis:

It is a chronic inflammatory skin disorder characterized by the overproduction of skin cells due to the immune system attacking healthy skin cells. The rapid proliferation of skin cells creates thick, surface scales where new skin has not yet had time to fully form. Psoriasis results from a combination of genetic and environmental factors, including stress, infections, and injuries.

• Skin Cancer:

Skin cancer is a type of cancer that affects the skin and is mainly attributed to the proliferation of unhealthy skin cells damaged by UV light (sun or tanning booths). Causes include sun exposure, light-colored skin, a history of sunburns, and a family history of skin cancer.

2. Appearance:

• Psoriasis:

Silvery, scaly skin or rashes usually affect the elbows, knees, scalp, and lower back. Sometimes, they have a silvery, scaly appearance. It may be red, swollen, itchy, cracked, and bleeding. Usually unrelenting and relapsing with intermittent phases of exacerbation and quiescence.

• Skin Cancer:

Can take various forms, depending on the type:

• Basal Cell Carcinoma:

Flesh-colored or translucent raised lesions with smooth surfaces, sometimes shiny, with pinpoint hemorrhages.

• Squamous Cell Carcinoma:

Keratotic or macular, papular, or vesicular lesions that may become angular, eroded, or ulcerated with a moist, bleeding crust.

• Melanoma:

Any lesion that has an irregular border, is uneven, or changes color, size, or shape. Usually, they are localized, but if left untreated, they can spread to other parts of the body (metastasize).

3. Symptoms:

• Psoriasis:

  • Long-standing skin lesions or cutaneous involvement.
  • It may also cause joint pain (psoriatic arthritis).
  • It is benign and does not metastasize to other parts of the body.

• Skin Cancer:

  • It may manifest as an ulcerating sore or a new skin tumor.
  • Skin cancers can be painful, itchy, or bleed in some form, depending on the type of cancer.

4. Diagnosis:

• Psoriasis:

  • A dermatologist uses a skin biopsy and a physical examination to diagnose psoriasis.
  • When doctors need to exclude other diseases, they may perform a skin test.

• Skin Cancer:

  • Doctors need to take a sample to identify what type of cancer is present. More tests are needed to determine whether the disease has spread to other parts of the body.

5. Treatment:

• Psoriasis:

  • Doctors treat psoriasis with creams containing steroids and vitamin D compounds, alongside light therapy and immunosuppressive or biologic therapies.

• Skin Cancer:

  • When early detection occurs, doctors use surgery and medical treatment to treat skin cancer based on the disease stage. Preventive care plays a large role in successful infection treatment.

6. Prognosis:

• Psoriasis:

  • Doctors successfully manage the symptoms of conditions that persist forever. Not life-threatening.

• Skin Cancer:

  • The type and spread pattern of skin cancer differ from case to case. Medical research shows that both basal cell carcinoma and squamous cell carcinoma can be easily cured when found early. Detecting melanoma early offers the best chance to treat it before it becomes dangerous.

Can Skin Cancer Look Similar to Psoriasis?

The way certain skin cancers look like psoriasis makes it impossible for anyone to tell them apart without professional help. Here are the key points to consider between psoriasis and cancer connection:

1. Similarities in Appearance:

• Squamous Cell Carcinoma (SCC):

SCC, as a skin cancer type, often shows surface features that make it look like plaque psoriasis. The condition can develop scabs and bleed while becoming painful, just like psoriasis flare-ups do.

• Basal Cell Carcinoma (BCC):

BCC shows up as skin cancer but appears similar to psoriasis. This carcinoma can appear as scaly red patches that doctors may confuse with psoriasis when the growth remains confined to a limited area.

• Bowen's Disease (An Early Form of SCC):

When it appears as red scaly patches, doctors sometimes confuse it with either psoriasis or eczema.

• Melanoma:

A small number of melanoma cases begin as nonuniform macules that can look like psoriasis when they develop an inflamed, scaly appearance.

How Can Psoriasis Increase Cancer Risk?

• Psoriasis may increase cancer risk by causing chronic inflammation, which is a risk factor for cancer.
• Biologic agents and phototherapy can suppress the immune system, thereby reducing the likelihood that the immune system will fight off cancer-forming cells.
• Some of the risk factors for psoriasis, including smoking, obesity, and alcohol use, are also known to cause cancer.
• Also, chronic inflammation and hereditary factors may contribute to the increased susceptibility to developing some cancers, such as non-melanoma skin, lymph, and lung cancer.

Can Scalp Psoriasis Cause Cancer?

Scalp psoriasis by itself is not cancer-causing. However, certain factors associated with scalp psoriasis could potentially increase the risk of cancer because of the ability of inflammation to induce cellular damage. However, this relation is not particularly restrictive to scalp psoriasis and is more universal to chronic inflammatory diseases. Psoriasis medication, such as systemic immunosuppressive agents or biologic agents, may slightly increase the risk of skin cancer or lymphoma due to their immunosuppressive properties. People with psoriasis should consult a doctor regularly and address any concerns about the potential long-term effects of the drugs with the attending physician, especially those on long-term immunosuppressive treatments.

Thus, even though scalp psoriasis does not lead to cancer, it is necessary to monitor the skin or scalp for any changes.

How to Reduce Cancer Risk if Diagnosed With Psoriasis?

Lifestyle modifications like avoiding smoking and alcohol, and eating a balanced diet, keeping the weight under control, help reduce cancer risk factors and other health conditions like heart problems. Psoriatic patients must consult doctors for cancer screening tests like mammograms, lung imaging, and colonoscopies.

Conclusion

Cancer does not cause psoriasis, and psoriasis does not cause cancer. However, patients with psoriasis present an overall high risk of developing cancer. Psoriasis is a lifelong disorder, but if efforts are made to lead a healthy lifestyle, one can reduce or minimize the risk of cancer and other health conditions. Increased inflammation due to psoriasis and the treatment side effects of psoriasis may likely increase cancer-causing conditions in the patient. A person with psoriasis must be in regular check-ups and follow-ups. However, cancer-causing risks are higher in psoriasis patients who have received medications and phototherapy. Therefore, regular check-ups with a skin care specialist are important.

Key Takeaways

• Psoriasis itself is not known to cause cancer, but chronic inflammation and immunomodulatory therapy can predispose to cancer.
• Psoriasis patients are more prone to a variety of cancers, including non-melanoma skin cancers, lymphoma, and cancers of organs, when using long-term phototherapy or systemic immunosuppressants.
• Frequent cancer screening, quitting smoking, and alcohol reduction reduce cancer risk and also help identify serious changes at the initial stages.