Atopic dermatitis patients undergo increased risk of nonmelanoma skin cancer: Study

A new study published in the journal of Dermatology and Therapy showed that the patients with atopic dermatitis (AD) and those with moderate-to-severe AD had a greater incidence and risk of nonmelanoma skin cancer (NMSC) when compared to matched persons without AD.

Severe itching and recurring eczematous lesions are hallmarks of AD, a chronic inflammatory skin condition. Its link to a higher risk of NMSC, like squamous cell carcinoma and basal cell carcinoma, has been investigated in recent research. Long-term immunosuppressive therapies, phototherapy, or biologic therapy are frequently administered to patients with moderate-to-severe AD. These treatments may change the skin's immune surveillance and carcinogenic protection.

Furthermore, DNA damage and carcinogenesis are facilitated by persistent inflammation and recurrent breakdown of the epidermal barrier. Optimizing AD management techniques and establishing routine skin cancer surveillance in high-risk patient populations require an understanding of this possible connection. Thus, this study assessed the incidence and risk of NMSC in patients with AD in general and those with moderate-to-severe illness in particular to a control group that was not matched for AD and patients with RA.

The US claims data (2017–2023) from Optum's de-identified Clinformatics® Data Mart Database of people with AD and RA, as well as non-AD control cohorts paired 1:1 to patients with AD and patients with moderate-to-severe AD, were analyzed in this retrospective observational analysis.

There were 381,221 patients in the matched AD and non-AD groups. The NMSC incidence rate (cases/100 person-years [95% CI]) and relative NMSC risk (adjusted hazard ratio 1.32 [1.30, 1.35]) were higher in AD patients than in non-AD matched controls (2.12 [2.10, 2.15] vs. 1.74 [1.72, 1.77]).

The patients with AD and RA had comparable NMSC incidence and relative risk. Individuals with AD who had a history of organ transplantation, other cancers, or NMSC were more likely to develop NMSC. Patients with moderate-to-severe illness showed comparable trends.

Overall, the patients with AD had a greater risk of NMSC than matched non-AD controls, and this risk was larger for those with AD and a history of NMSC. Clinicians may better contextualize the advantages and disadvantages of AD medicines by knowing the background frequencies of NMSC in AD patients.

Reference:

Lebwohl, M., Yue, E., Krueger, W. S., Berman, B., Bunick, C. G., Schlesinger, T., & Grada, A. (2025). Risk of nonmelanoma skin cancer in patients with moderate-to-severe atopic dermatitis: A United States population-based study. Dermatology and Therapy. https://doi.org/10.1007/s13555-025-01559-z