Background Research demonstrating an increased incidence of skin cancer with psoralen plus ultraviolet A (PUVA) therapy has reflected the Caucasian experience. Our objective was to review the literature on skin cancer risk associated with long-term PUVA therapy in non-Caucasians.
Methods Our analysis included 4294 long-term PUVA patients in Japan, Korea, Thailand, Egypt, and Tunisia with a follow-up period of at least 5 years.
Results The relative risk of PUVA patients developing nonmelanoma skin cancer relative to general dermatology outpatients was 0.86 [CI 0.36–1.35].
Conclusions There does not appear to be an increased risk of nonmelanoma skin cancer with long-term PUVA therapy in Asian and Arabian-African populations. Therefore, in phototherapy risk assessment, it is important to consider the patient's skin phototype and the potential protection that more pigmented skin may confer.