BACKGROUND Several antiepileptic drugs are photosensitizing; however, it is not known whether this confers an increased risk of skin cancer. OBJECTIVE To examine the association between common antiepileptic drugs and basal cell carcinoma, squamous cell carcinoma (SCC), and malignant melanoma. METHODS We conducted a nested case-control study identifying skin cancer patients in Denmark from 2004 through 2015 matched 1:10 with disease-free controls. We estimated odds ratios (ORs) for skin cancer associated with high cumulative use of antiepileptic drugs (≥500 defined daily doses) compared with nonuse. RESULTS Most antiepileptic drugs were not associated with skin cancer. SCC was associated with use of carbamazepine (OR, 1.88; 95% confidence interval, 1.42-2.49) and lamotrigine (OR, 1.57; 95% confidence interval, 1.12-2.22) with evidence of a dose-response relationship for carbamazepine. The estimated absolute risks were low; for example, 6335 person-years of high cumulative exposure to carbamazepine were required for 1 additional SCC to occur. LIMITATIONS Data on important risk factors for skin cancer, such as sun exposure, were not available. CONCLUSIONS Most antiepileptic drugs were not associated with skin cancer; however, carbamazepine and lamotrigine were associated with SCC. These findings need to be replicated and characterized further in other settings and have no direct clinical implications.

中文翻译：

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抗癫痫药的使用和皮肤癌的风险：一项全国病例对照研究。

背景技术几种抗癫痫药是光敏性的。但是，尚不清楚这是否会增加皮肤癌的风险。目的探讨常见的抗癫痫药与基底细胞癌，鳞状细胞癌（SCC）和恶性黑色素瘤之间的关系。方法我们进行了一项嵌套的病例对照研究，确定了2004年至2015年在丹麦的皮肤癌患者与无病对照的1:10匹配。我们估计与不使用抗癫痫药物（累计定义的每日剂量≥500）的高累积使用量相关的皮肤癌比值比（OR）。结果大多数抗癫痫药与皮肤癌无关。SCC与使用卡马西平（OR，1.88; 95％置信区间，1.42-2.49）和拉莫三嗪（OR，1.57; 95％置信区间，1.12-2）相关。22）具有卡马西平的剂量反应关系的证据。估计的绝对风险很低；例如，要多发生1例SCC，需要6335人年的高卡马西平累积暴露量。局限性尚无关于皮肤癌重要危险因素（例如日晒）的数据。结论多数抗癫痫药与皮肤癌无关。然而，卡马西平和拉莫三嗪与SCC有关。这些发现需要在其他情况下进行复制和进一步表征，没有直接的临床意义。如日光照射，则不可用。结论多数抗癫痫药与皮肤癌无关。然而，卡马西平和拉莫三嗪与SCC有关。这些发现需要在其他情况下进行复制和进一步表征，没有直接的临床意义。如日光照射，则不可用。结论多数抗癫痫药与皮肤癌无关。然而，卡马西平和拉莫三嗪与SCC有关。这些发现需要在其他情况下进行复制和进一步表征，没有直接的临床意义。