Psoriasis and Skin Cancer

Because psoriasis is such a common disease affecting about 2% of all Americans, and skin cancer is epidemic, especially in our southwest Florida subtropical climate zone, we have patients who present with both psoriasis and skin cancer.  While there are many other effective external and internal treatments for psoriasis which we will discuss in future blogs,  I would still consider narrowband ultraviolet B light to be a reasonable choice for such patients.  First, a complete body skin exam is done to find any preexisting pre-cancers (called actinic keratoses) and skin cancers while simultaneously evaluating the extent and severity of the psoriasis lesions.  Freezing or liquid nitrogen cryosurgery is done for the precancers, and skin biopsies may be performed for any suspected skin cancers.  If basal cell carcinoma, squamous cell carcinoma, or melanoma is confirmed, then definitive treatment, usually surgical, would be completed before initiation of the phototherapy for psoriasis.  A followup skin cancer surveillance  check is done every three months while monitoring the responsiveness of the psoriasis lesions to the ultraviolet light.  Sometimes we find that precancerous lesions or superficial skin cancers were hidden within a psoriasis plaque, particularly in sun-exposed areas, and these are revealed when the psoriasis heals.

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