Association Between Topical Calcineurin Inhibitor Use and Keratinocyte Carcinoma Risk Among Adults With Atopic Dermatitis

Retrospective cohort study (n=93,746) found no apparent association between topical calcineurin inhibitor exposure and overall keratinocyte carcinoma, basal cell carcinoma or squamous cell carcinoma risk, nor were there links with dose, frequency, and duration of exposure.

SPS commentary:

According to an editorial, given the limitations of observational pharmacoepidemiologic studies of cancer risk, it may never be known with the same level of certainty as acute adverse events whether prolonged, high-volume topical calcineurin inhibitor (TCI) use leads to some increased risk of keratinocyte carcinoma. It suggests that future analyses could add knowledge on cumulative dose or by using methods that attempt to match patients exposed to TCIs with controls who are as similar as possible. It adds that the study does provide reassurance and findings are in line with previous literature, which has consistently reported no or minimal association between TCI use and skin cancer, and a recent study in children that observed no apparent increase in cancer risk overall. It notes that if an association does exist, it is likely very small, meaning that skin cancer attributable to TCI use is rare and clinicians can use this evidence to counsel and reassure patients.


JAMA Dermatology

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