Cyclosporine and PUVA clearly increase the risk of squamous cell carcinomas, and there is evidence that TNF blockers and methotrexate may do so to a lesser degree. UVB phototherapy has not been shown to cause skin cancer. Acitretin offers protection against the development of basal cell and squamous cell carcinomas.
Patients who carry a high-penetrance melanoma predisposition gene can often benefit from screening for other cancers. Patients who receive a positive genetic test result are more likely to embrace prevention and detection measures. A new “Rules of Three” proposes a point-based guideline to help determine who should be referred for genetic counseling and testing.
TNF inhibitors adalimumab and infliximab have evidence-based efficacy for the treatment of hidradentitis suppurativa (HS). Anti-interleukin inhibitors ustekinumab and anakinra also being evaluated in small studies for treatment of HS. Antibiotics, hormones, retinoids, steroids and laser therapies directly targeting the lesions round out an effective treatment plan for HS patients.