Risk of non-melanoma skin cancer in autoimmune hepatitis.
BACKGROUND
Most patients with autoimmune hepatitis (AIH) require long-term immunosuppressive therapy (IS). While it is well established that solid organ transplant recipients have a high risk of developing non-melanoma skin cancer (NMSC) as a result of immunosuppression, little is known about the risk of NMSC associated with IS in patients with AIH.


OBJECTIVE
The aim of this study is to determine the incidence and risk factors for NMSC in patients on IS for AIH.


METHODS
We reviewed the medical records of all patients with AIH seen at a tertiary care medical center between 1998 and 2008. We compared the incidence of NMSC to an age- and sex-matched control population and analyzed risk factors for NMSC.


RESULTS
A total of forty-five patients with AIH were identified. Twenty NMSC lesions were found in eight patients. Compared to the age and sex-matched general population, the risk of SCC and BCC were increased as quantified by elevated standardized incidence ratios (28.5 and 5.0, respectively). Patients who developed NMSC were on average 24 years older (78.4 vs. 54.2 years old, p < 0.0001) and had AIH diagnosed at a more advanced age (66.0 vs. 45.4 years old, p = 0.0003).


CONCLUSIONS
The risk of NMSC is significantly increased in patients with AIH on immunosuppression. Independent risk factors include current age and age at diagnosis of AIH.
Leung
John
J
Division of Gastroenterology, Tufts Medical Center, 800 Washington Street, Boston, MA, USA. jleung3@tuftsmedicalcenter.org
Dowling
Lauren
L
Obadan
Isi
I
Davis
James
J
Bonis
Peter A
PA
Kaplan
Marshall M
MM
Casey
Darlene
D
Viveiros
Kathleen
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D019693:Hepatitis, Autoimmune / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D016867:Immunocompromised Host; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008545:Melanoma / Q000453:epidemiology*; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology*; D055815:Young Adult