BACKGROUND Retrospective studies observe an increased risk of keratinocyte carcinomas (KCs) in patients with inflammatory bowel disease (IBD) on thiopurine (TP) medication. The role of traditional risk factors such as skin type and sun protection behavior has not been studied in this population. This study aimed to examine traditional KC risk factors and thiopurine use on skin cancer development in an IBD cohort. METHODS Consecutive IBD patients were recruited from four specialist centers in Australia and New Zealand, each with varying UV exposure indices. Data pertaining to race, skin color, freckling and sun protection behavior, dose of TP therapy, and skin cancer development were elicited through a self-reported questionnaire. RESULTS A total of 691 IBD patients were included with 62 reporting KC development. Thiopurine usage was similar among patients who developed skin cancer compared with those who did not (92% vs. 89%, p = 0.3). There was no statistically significant association between KC development and TP dose or 6-thioguanine nucleotide levels. In multivariate modeling, four factors were independently and significantly associated with KC: age over 61 years old versus less than 30 years old (OR 6.76; 95% CI 2.38-19.18), residing in Brisbane versus Christchurch (OR 3.3; 95% CI 1.6-6.8), never staying in the shade versus staying in the shade ≥ 50% of the time (OR 3.8; 95% CI 1.4-10.5), and having a skin type that never tanned versus other skin types (OR 6.9; 95% CI 2.9-16.0). CONCLUSION Skin type, age, and sun protection behavior are more important risk factors for KC development than thiopurine medication use in this IBD population.

中文翻译：

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紫外线暴露，皮肤类型和年龄的水平比硫嘌呤对IBD患者角质形成细胞癌的发展更为重要。

背景技术回顾性研究观察到在使用硫嘌呤（TP）药物治疗的炎症性肠病（IBD）患者中，角质形成细胞癌（KCs）的风险增加。在这一人群中，尚未研究传统风险因素如皮肤类型和防晒行为的作用。这项研究旨在检查传统的KC危险因素和硫代嘌呤在IBD队列中对皮肤癌发展的作用。方法从澳大利亚和新西兰的四个专科中心招募连续IBD患者，每个中心的紫外线暴露指数均不同。通过自我报告的问卷调查得出与种族，肤色，雀斑和防晒行为，TP治疗剂量和皮肤癌发展有关的数据。结果总共纳入了691名IBD患者，其中62名报告了KC的发展。与未患皮肤癌的患者相比，硫嘌呤的使用率与未患皮肤癌的患者相似（92％比89％，p = 0.3）。在KC发育与TP剂量或6-硫鸟嘌呤核苷酸水平之间无统计学意义的关联。在多变量建模中，四个因素与KC独立且显着相关：年龄大于61岁而小于30岁（OR 6.76； 95％CI 2.38-19.18），分别居住在布里斯班和基督城（OR 3.3； 95％CI 1.6） -6.8），从不停留在阴影中，而不是在阴影中停留时间≥50％（OR 3.8; 95％CI 1.4-10.5），并且皮肤类型从未晒黑，而其他皮肤类型（OR 6.9; 95％ CI 2.9-16.0）。结论在该IBD人群中，皮肤类型，年龄和防晒行为是比使用硫嘌呤药物更重要的KC发展风险因素。