Assessing Skin Cancer Risk in Patients with RA and Psoriatic

Rheumatoid arthritis and psoriasis patients are at increased risk for non-melanoma skin cancers (NMSC), and TNF antagonists may increase the risk further. This association has resulted in recent changes to product labeling, indicating an increased risk of skin cancer and the need for detailed skin examinations in patients receiving TNF inhibitors. Specifically, these regulatory guidelines suggest that patients receiving chronic immunosuppressive therapies or psoriasis patients with a history of PUVA should be examined for presence of NMSC before and during treatment with TNF inhibitor. This review will address the issue of skin cancer screening and risk in patients receiving TNF inhibitor. Cancer is highly prevalent in society, with an estimated one-third of the population having a lifetime risk of neoplasia. Skin cancer is most prevalent with an estimated lifetime risk of 20%. Nonmelanoma skin cancers includes basal cell carcinoma