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Risk of Non-melanoma Skin Cancer in Autoimmune Hepatitis

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Abstract

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.

Objectives

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).

Conclusion

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.

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Acknowledgments

The authors are indebted to Ms Stephanie Li for data assembly, the Design and Data Resource Center and Clinical and Translational Science Institute at Tufts Medical Center.

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Authors and Affiliations

  1. Division of Gastroenterology, Tufts Medical Center, 800 Washington Street, Boston, MA, USA

    John Leung, Peter A. Bonis, Marshall M. Kaplan & Kathleen Viveiros

  2. Department of Internal Medicine, Tufts Medical Center, 800 Washington Street, Boston, MA, USA

    Lauren Dowling & James Davis

  3. Institute for Clinical Research and Health Policy Studies, Design and Data Resource Center, Tufts Medical Center, 800 Washington Street, Boston, MA, USA

    Isi Obadan

  4. Division of Pathology, Tufts Medical Center, 800 Washington Street, Boston, MA, USA

    Darlene Casey

Authors
  1. John Leung
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  2. Lauren Dowling
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  3. Isi Obadan
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  4. James Davis
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  5. Peter A. Bonis
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  6. Marshall M. Kaplan
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  7. Darlene Casey
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  8. Kathleen Viveiros
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Correspondence to John Leung.

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Leung, J., Dowling, L., Obadan, I. et al. Risk of Non-melanoma Skin Cancer in Autoimmune Hepatitis. Dig Dis Sci 55, 3218–3223 (2010). https://doi.org/10.1007/s10620-010-1145-1

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  • DOI: https://doi.org/10.1007/s10620-010-1145-1

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