Abstract
Background/AimsTo investigate a possible association between the use of hydrochlorothiazide (HCT) and/or angiotensin-converting enzyme inhibitors (ACE inhibitors) and the occurrence of periocular non-melanoma skin cancer.MethodsThe files of 929 patients from the University Medical Center Hamburg-Eppendorf who were surgically treated for suspected periocular malignancy were evaluated retrospectively regarding the occurrence of non-melanoma skin cancer and concomitant medication. To be able to put the data in an overall context, we also analyzed age-matched routine data of the DAK-Gesundheit (DAK-G), a nationwide operating German health insurance company.ResultsOf the 929 patient records examined, who underwent surgical excision for suspected non-melanotic malignancy, non-melanocytic skin cancer could actually be determined by histology in 199 patients. In total, 176 patients (103 women, 72 men) had a basal cell carcinoma and 23 patients (16 women, 7 men) suffered from squamous cell carcinoma. The rate of intake of HCT or ACE inhibitors in our patient collective with non-melanotic skin cancer is significantly higher than in the general age-matched population (ORACE: 2.51, p < 0.001; ORHCT: 7.24, p < 0.001, ORBOTH: 4.61, p < 0.001).ConclusionThe rate of intake of HCT or ACE inhibitors is significantly higher in our patient collective with non-melanotic skin cancer compared to the group from the age-matched general population (DAK insured (p < 0.001)) compared to the routine data of the DAK-G. This leads us to the conclusion that taking the medication is associated with an increased risk for non-melanotic skin cancer. We recommend regular skin cancer screening, moderate ordination of photosensitizing medication, but above all comprehensive clarification of possible risks.
Highlights
Non-melanotic skin cancer is more common in our population than melanocytic skin cancer
The results of the retrospective analysis are presented to investigate the declaration of the recently issued Direct Healthcare Professional Communication (“Dear Doctor Letter”). This puts the premedication with hydrochlorothiazide in connection with the increased incidence of basal cell carcinomas and squamous cell carcinomas due to the photosensitizing effect
199 patients of the 929 patients whose files we examined suffered from non-melanocytic skin cancer
Summary
Non-melanotic skin cancer is more common in our population than melanocytic skin cancer. The mortality of non-melanotic skin cancer in the same year is 750 patients per year [1]. In July 2008, skin cancer screening was introduced in Germany. This enables insured persons over the age of 35 to have a comprehensive examination every 2 years. Incidence rates have suddenly risen since introduction—especially at early stages of the disease [1]. This can be demonstrated for both—melanotic and non-melanotic skin cancer. In a report on cancer events published by the Robert Koch Institute 2016, no decline in advanced tumor stages of melanocytic skin cancer was discernible until 2013 [1]
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