Atypical pigmented lesions following extensive PUVA therapy
T Basarab1, T P Millard, J M McGregor
1St John's Institute of Dermatology, St Thomas' Hospital, London, UK.
Clinical and Experimental Dermatology
|March 25, 2000
Summary
Psoralen photochemotherapy (PUVA) can lead to atypical lentigines, which are dark, large, and stellate skin lesions. While not linked to melanoma, these PUVA lentigines may increase the risk of nonmelanoma skin cancer.
Area of Science:
- Dermatology
- Photomedicine
- Oncology
Background:
- Psoralen photochemotherapy (PUVA) is a common treatment for psoriasis.
- Long-term effects of PUVA on skin pigmentation require further investigation.
Observation:
- A 38-year-old woman with psoriasis developed multiple atypical lentigines after initiating PUVA therapy.
- The lentigines appeared 3 years into treatment and continued to develop over time.
- Clinical presentation included deeply pigmented, large, dark brown or black, stellate macules.
Findings:
- Histological examination confirmed the lesions as PUVA lentigines.
- No atypical melanocytes were identified, ruling out melanoma in situ.
- A potential association between PUVA lentigines and nonmelanoma skin cancer risk is suggested.
Implications:
- PUVA lentigines are a distinct dermatological finding following photochemotherapy.
- Patients undergoing PUVA should be monitored for atypical lentigines.
- Further research is needed to clarify the oncogenic potential of PUVA lentigines, particularly regarding nonmelanoma skin cancer.
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