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A Matter of Life and Death Decisions in the Epidermis

Arch Dermatol. 2004;140:873-875.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Creation of thick, scaling erythematous plaques that can persist for decades is a characteristic clinical finding in patients with psoriasis. Probing beneath the skin surface reveals chronic inflammation, altered epidermal keratinocyte (KC) differentiation, KC hyperplasia, prolonged KC survival, elevated telomerase levels, and dermal-based angiogenesis. Moreover, many, if not most, patients are or have been repeatedly exposed to various carcinogens (eg, anthralin, crude coal tar, UV light, and psoralen–UV-A [PUVA]), and/or systemic immunosuppressive agents (eg, corticosteroids and cyclosporine). Given these clinical, pathologic, and treatment considerations, it would be expected that psoriatic plaques would be "hot spots" for sites of various cancer development, including squamous cell carcinoma, basal cell carcinoma, and malignant melanoma. Therefore, it would not be so much a question of whether skin cancer would develop in patients with psoriasis, but rather when the increased skin cancer susceptibility would start to manifest in these patients. Astonishingly, such tumors do not . . . [Full Text of this Article]

Brian J. Nickoloff, MD, PhD

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ABSTRACT | FULL TEXT