Lack of association between exposure to topical calcineurin inhibitors and skin cancer in adults.
BACKGROUND
Two topical calcineurin inhibitors (TCI) are available for the treatment of atopic dermatitis and there has been concern that their use could be associated with an increased risk of nonmelanoma skin cancer (NMSC).


OBJECTIVE
To determine if TCI exposure is associated with an increased risk of NMSC in adults.


METHODS
A case-control study using a questionnaire mailed to 5,000 adults with dermatitis.


RESULTS
We received responses from 70.7% of those surveyed by mail. Overall, 25.7% reported exposure to TCI. TCI exposure was 14.4% for the cases and 30.7% for the controls. Our primary analysis was a comparison between those with NMSC and those without. The unadjusted odds ratio was 0.38 (0.31-0.47) and the adjusted (age, gender, previous NMSC, history of atopic dermatitis) was 0.54 (0.41-0.69). The odds ratio of association for NMSC decreased as the number of tubes used and the potency of the agent increased.


CONCLUSIONS
This early study shows that TCI use is not associated with an increased risk of NMSC in adults.
Margolis
David J
DJ
Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA 19104, USA. dmargoli@cceb.med.upenn.edu
Hoffstad
Ole
O
Bilker
Warren
W
D000287:Administration, Topical; D000368:Aged; D065095:Calcineurin Inhibitors; D016022:Case-Control Studies; D003876:Dermatitis, Atopic / Q000188:drug therapy; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012878:Skin Neoplasms / Q000139:chemically induced*; D016559:Tacrolimus / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives
D065095:Calcineurin Inhibitors; D004791:Enzyme Inhibitors; C117268:pimecrolimus; D016559:Tacrolimus