Epidermoid carcinoma of the gingiva: a possible relationship to PUVA therapy

A case of squamous cell carcinoma arising in the gingiva of a 30-year-old nonsmoking woman receiving PUVA therapy for vitiligo is reported. There were no typical predisposing factors for oral cancer in the history, other than the latter therapy. Although there are several previous reports of cutaneous carcinoma developing in patients under PUVA therapy, most of such involve development of tumors on skin surfaces exposed to direct ultraviolet radiation either through sunlight or via therapeutic mode.s In this case, there was no direct ultraviolet exposure at the site of carcinoma. We suggest the possibility that, in this case, PUVA may exerted a carcinogenic influence via systemic distribution of ultraviolet-activated psoralens or its metabolites to the gingiva. The possibility of microbial interaction with substances within gingival inflammatory exudate to produce carcinogenic substances is postulated.