There is increased incidence of cutaneous squamous cell carcinoma among patients with systemically treated psoriasis who were ever exposed to biologics, the majority of which were TNF-alfa inhibitors, a recent study found. Increased skin cancer surveillance in this population may be warranted. Researchers identified a cohort of adult Kaiser Permanente Northern California health plan members with psoriasis diagnosed from 1998 to 2011 and treated with at least 1 systemic anti-psoriatic agent and categorized them into ever-biologic or non-biologic users. They found:

• Most biologic-exposed members were treated with TNF-alfa inhibitors (n=2,214, 97%).
• Overall incident cancer rates were comparable between ever-biologic as compared to non-biologic users (aHR 0.86).
• Non-melanoma skin cancer rates were 42% higher among individuals ever exposed to a biologic (aHR 1.42), largely driven by increased cutaneous squamous cell carcinoma risk (aHR 1.81).