Related Experiment Video

Updated: Jun 9, 2026

Murine Model of Epicutaneously-Induced Immunomodulation
09:07

Murine Model of Epicutaneously-Induced Immunomodulation

Published on: June 24, 2025

Pharmacologic immunomodulation and cutaneous malignancy in rheumatoid arthritis, psoriasis, and psoriatic arthritis

Michael S Krathen1, Alice B Gottlieb, Philip J Mease

  • 1Department of Dermatology, Tufts Medical Center, 800 Washington Street, Box 114, Boston, MA 02111, USA. mkrathen@tuftsmedicalcenter.org

The Journal of Rheumatology
|September 3, 2010
PubMed
Abstract

Insights

Rheumatoid arthritis (RA) may increase skin cancer risk. Immunomodulatory drugs used for RA, psoriasis, and psoriatic arthritis (PsA) can further elevate this risk, necessitating dermatologic screening for early detection.

Area of Science:

  • Dermatology
  • Rheumatology
  • Oncology

Background:

  • Rheumatoid arthritis (RA), psoriasis (Ps), and psoriatic arthritis (PsA) are autoimmune conditions often treated with immunomodulatory medications.
  • The potential impact of these therapies on skin cancer risk remains an area of clinical uncertainty.

Purpose of the Study:

  • To evaluate and summarize existing data on the association between immunomodulatory drug use and skin cancer risk in patients with RA, Ps, and PsA.

Main Methods:

  • A comprehensive literature search of PubMed was conducted using keywords related to skin cancer, specific cancer types, the inflammatory conditions, and common immunomodulatory drugs.
  • Relevant articles were identified and data were extracted for analysis.

Main Results:

  • RA itself may be a risk factor for cutaneous malignancy.
  • Treatment with tumor necrosis factor inhibitors increases non-melanoma skin cancer (NMSC) rates in RA and psoriasis patients.
  • Combination methotrexate therapy in RA doubles NMSC risk. Methotrexate may also increase malignant melanoma risk in RA patients and NMSC risk in psoriasis patients. Cyclosporine and prior phototherapy are associated with increased NMSC risk.

Conclusions:

  • Patients with RA, psoriasis, and PsA using immunomodulatory therapies may have an increased risk of developing skin cancer.
  • Regular dermatologic screening is recommended for these patient populations to facilitate early detection and management.
  • Improved data collection on skin cancer incidence in clinical trials and cohort studies is crucial for a clearer understanding of these risks.

Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
T Cell Types and Functions01:24

T Cell Types and Functions

When T cells with CD4 markers are activated, they give rise to two types of effector cells: helper T cells and regulatory T cells. Meanwhile, T cells with CD8 markers differentiate into effector cytotoxic T cells. The differentiation of CD4 T cells into helper T cell subsets, such as Th1, Th2, and Th17 cells, is dependent on the antigen type, antigen-presenting cell, and regulatory cytokines.
Th1 cells stimulate dendritic cells to express necessary co-stimulatory molecules on their surfaces for...
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab (Humira),...
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2 (COX-2),...
The JAK-STAT Signaling Pathway01:20

The JAK-STAT Signaling Pathway

Several cytokine receptors have tightly bound Janus kinase or JAK proteins attached at their cytosolic tail. Small signaling molecules such as cytokines, growth hormones, or prolactins bind to the cytokine receptors and initiate their dimerization. The dimerization brings the cytosolic JAKs together that trans-phosphorylate and activates each other. The activated JAKs now phosphorylate cytosolic tails of the cytokine receptors, which serve as binding sites for adaptor proteins such as  SH2...