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P54 Incidence of skin cancer in systemic lupus erythematosus compared with systemic sclerosis and general population
  1. Ilaria Cavazzana1,
  2. Marta Fusano2,3,
  3. Micaela Fredi1,3,
  4. Piergiacomo Calzavara-Pinton2,3 and
  5. Franco Franceschini1,3
  1. 1Rheumatology and Clinical Immunology Unit, ASST Spedali Civili Brescia, Brescia
  2. 2Dermatology Unit, ASST Spedali Civili Brescia, Brescia
  3. 3Dept. of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy


Background/Purpose This is a prospective study analysed the incidence of skin cancer (SC) (melanoma and non-melanoma SC) in 90 adult patients affected by Systemic Lupus Erythematosus (SLE), followed-up in one single Rheumatological Center, compared with 54 patients affected by Systemic Sclerosis (SSc) and 90 sex- and age-matched 90 control subject.

Methods In a period between February and July 2019, every patient underwent a complete dermatological evaluation and filled out a questionnaire regarding their personal or family history of SC, the presence of different risk factors of SC and the occurrence of photosensitivity.

Results 90 SLE patients (96,7% female, mean age: 44 years; range: 18–78) showed photosensitivity in 60%

63% of patients avoided sun exposure at every hour of the day, 80% used photoprotection and 28% referred systemic worsening of SLE features after sun exposure. No new onset skin cancer was diagnosed.

Three SLE patients referred a history of SC (1 basalioma, 1 melanoma, 1 multiple actinic lesions) onset after the SLE diagnosis. Patients with skin cancer (SC+) didn’t show any differences compared with patients without skin cancer (SC-) except for more frequent photodamage features (p: 0.032) and less frequent photosensitivity (0.031).

SLE patients more frequently showed photosensitivity (p<0.0001), photoprotection (p<0.0001), disease worsening and skin worsening after sun exposure (p: 0.033 and 0.002, respectively) compared with SSc cases. No differences in past history of SC was evident between groups.

Comparing SLE with age-, sex- and phototype-matched control cohort, SLE patients showed a lower rate of past history of basalioma skin cancer (p: 0.013), lower rate of photodamage (0.027) and higher rate of photosensitivity (p<0.0001).

Conclusions SLE patients showed a significant lower rate of skin cancer, despite a higher rate of photosensitivity, compared with control cohort. This data could be due to a strict and continued photoprotection.

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