Risk of non-melanoma skin cancer in autoimmune hepatitis

Dig Dis Sci. 2010 Nov;55(11):3218-23. doi: 10.1007/s10620-010-1145-1. Epub 2010 Feb 18.

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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Female
  • Hepatitis, Autoimmune / drug therapy
  • Hepatitis, Autoimmune / epidemiology*
  • Humans
  • Immunocompromised Host*
  • Incidence
  • Logistic Models
  • Male
  • Melanoma / epidemiology*
  • Middle Aged
  • Multivariate Analysis
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Skin Neoplasms / epidemiology*
  • Young Adult