Work

Risk of Nonmelanoma Skin Cancer in Patients with Moderate-to-Severe Atopic Dermatitis: A United States Population-Based Study

Year: 2025

Type: article

Abstract: Nonmelanoma skin cancer (NMSC) risk may be increased in patients with immune-mediated inflammatory disorders. Although atopic dermatitis (AD), an inflammatory immune-mediated chronic skin disease, has been associated with the risk of skin cancer, data on the underlying risk of NMSC in patients with AD in the USA are unclear. The objective of this analysis was to evaluate NMSC incidence and risk in patients with AD generally and those with moderate-to-severe disease specifically compared with a non-AD matched control cohort and patients with rheumatoid arthritis (RA). This retrospective observational study examined US claims data (2017–2023) from Optum’s de-identified Clinformatics® Data Mart Database of adults with AD and RA, as well as non-AD control cohorts matched 1:1 to patients with AD and patients with moderate-to-severe AD. This analysis included data from 391,753 patients with AD and 97,445 patients with RA. The matched AD and non-AD cohorts each included 381,221 patients. Patients with AD had a higher NMSC incidence rate (cases/100 person-years [95% CI]) than non-AD matched controls (2.12 [2.10, 2.15] vs 1.74 [1.72, 1.77]) and greater relative NMSC risk (adjusted hazard ratio 1.32 [1.30, 1.35]). NMSC incidence and relative risk were similar between patients with AD and RA. Patients with AD were at greater risk of NMSC if they had a history of NMSC, other malignancies, or organ transplantation. Trends were similar among patients with moderate-to-severe disease. Patients with AD and those with moderate-to-severe AD had a higher incidence and risk of NMSC than matched individuals without AD. Atopic dermatitis (AD), or eczema, is a long-term inflammatory skin disease that causes patients to have dry, itchy, and inflamed skin. Patients with AD may have an increased risk for developing other health issues, including an increased risk for nonmelanoma skin cancer (NMSC). Understanding the background risk of NMSC in patients with AD will help underscore the importance of periodic skin examinations and recommendations that those at increased risk for NMSC limit exposure to sunlight and UV light by wearing protective clothing and using broad-spectrum sunscreen. In this study, we compared the risk of NMSC in patients with AD, patients with rheumatoid arthritis, and patients who were the same age and sex but did not have AD. We studied data collected over 6 years from a US administrative healthcare claims database. Additionally, we assessed subgroups of patients with more severe disease to see if they had a different NMSC risk compared with patients with less severe disease. We found that patients with AD had a higher risk of NMSC compared with matched patients who did not have AD, and patients with AD had a similar risk of NMSC compared with patients with rheumatoid arthritis and patients with more severe disease. We also found that NMSC risk was higher in patients who had a history of NMSC, other cancers, or organ transplant. These data will help patients with AD and their healthcare providers ensure that patients receive the right preventive care.

Source: Dermatology and Therapy

DOI: 10.1007/s13555-025-01559-z