Introduction
Psoriasis is a chronic inflammatory skin disease that affects people of all ages. It is an autoimmune-mediated disease, and the exact cause is not known but related to genetics.
In psoriasis, the immune system responds to nonexistent danger, and in response to this danger, skin cells proliferate rapidly. This new growth of cells moves to the surface of the skin and results in thickened patches of dead skin on the original surface of the skin. And in recent times, concerns have arisen that psoriasis, its risk factors, and treatment might lead to cancer.
What Is Psoriasis?
Psoriasis is a long-term autoimmune skin disorder with symptoms of dry, itchy, scaly patches on the skin seen mainly on knees, elbows, trunk, and scalp, and it has no cure. This condition shows periods of flare-ups and remissions. The cause of psoriasis is related to immune system problems, where the infection-fighting cells of the body attack and damage skin cells that are healthy by mistake. Psoriasis is not contagious, and environmental genetic factors play an important role in this condition. Genetic predisposition when combined with triggering factors such as infections, stress, and trauma could lead to psoriasis.
What Are the Triggering Factors for Psoriasis?
Many people with psoriasis remain non-symptomatic until some factors, like environmental factors, trigger psoriasis. Some of them include the following:
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Weather conditions like extreme cold and dry climates.
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Certain medications.
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Alcohol consumption and smoking.
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Hormonal factors, especially in women after puberty.
What Are the Treatment Options for Psoriasis?
Treatment options include:
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Topical Therapy: With corticosteroids, salicylic acid, retinoids, and vitamin D analogs.
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Light Therapy: They include sunlight, PUVA (psoralen plus ultraviolet A), UVB broadband, and narrow brand.
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Oral Or Injected Drugs: Steroids, retinoids, biologics, methotrexate, cyclosporine.
Can Psoriasis Cause 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, such a well-established link cannot be seen between psoriasis and cancer.
How Did the Question of Cancer Arise?
It is because of inflammation. Long-term inflammations of the skin have an increased risk of cancer. Because skin inflammation is one of the major 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's lymphoma, and Hodgkin's lymphoma. People with psoriasis have an increased risk of 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. In the treatment process, some drugs slow down skin cell production, while some suppress the body’s immune system to reduce the patient's symptoms. And this weakened immune system is more prone to infections. Hence the patient with psoriasis is at threat of cancer. Chronic inflammatory diseases such as Crohn’s disease also increase the chances of other cancers.
Certain treatments in psoriasis like ultraviolet light therapy, which heals 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. Patients with psoriasis have other habits like tobacco use and alcohol intake. And these conditions 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 cancers are two different conditions. But signs and symptoms of certain types of skin cancer may look very similar to psoriasis.
The Appearance Of Psoriasis - The appearance differs depending on skin tone and color.
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Fair skin: Psoriasis looks pink or red, with silvery-white scales.
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Medium skin: It appears pinkish-orange, with silvery white flakes.
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Darker skin: It appears dark brown or sometimes difficult to see, and the scales look gray.
Symptoms of Psoriasis -
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Skin appears to be dry. Cracking and bleeding can also be seen.
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Feels like burning and itching of the skin, followed by pain.
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Nails become very thick. Most patients with psoriasis have flare-up periods and remission. However, in flare-up periods, the symptoms get aggressive and worsen.
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Psoriasis covers larger areas of the body, but skin cancers cover only small areas and mostly occur on the skin regularly exposed to the sun.
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Psoriasis has intervals of remission and flare-ups. But skin cancer symptoms will worsen without treatment.
Symptoms of Skin Cancer -
Like any other cancer, skin cancer is also an uncontrolled growth of faulty skin cells. And this uncontrolled growth of cells piles up and moves onto the surface of the surface, causing lumps known as tumors.
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Skin appears symmetrical in shape due to rapid growth.
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Psoriasis has intervals of remission and flare-ups, but skin changes and grows over time without remission in skin cancers.
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Scaly skin, bleeding, crusting.
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Skin appears waxy, shiny, raised, oddly colored, with a firm texture.
How to Reduce Cancer Risk if Diagnosed With Psoriasis?
Lifestyle modifications like avoiding smoking and alcohol, and eating a healthy and 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. But patients with psoriasis present an overall high risk of developing cancer. Psoriasis is a lifelong disorder, but if efforts were made to lead a healthy lifestyle, one could reduce or minimize the risk of cancer and other health conditions. Increased inflammation due to psoriasis and treatment side effects of psoriasis may likely increase cancer-causing conditions in the patient. A person with psoriasis must be in regular checks and follow-ups. Cancer screening must also be discussed with the doctor. However, cancer-causing chances are more in psoriasis patients who have received medications and phototherapy. Therefore, dermatologists who treat psoriasis must advise cancer screening to their patients.
