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Mucous Membrane Pemphigoid Linked to Higher Skin Cancer Risk

Investigators found that patients with mucous membrane pemphigoid, especially those with severe disease, face increased risks of squamous and basal cell carcinomas.

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Patients with severe mucous membrane pemphigoid may have more than double the risk of developing nonmelanoma skin cancers compared with matched controls, according to a recent study.

In a retrospective cohort study, investigators assessed the risk of skin cancers in patients with mucous membrane pemphigoid (MMP) using a large-scale U.S. electronic health record database from the TriNetX Analytics Network. The analysis included over 117 million patients, from which a matched cohort of 3,723 patients with MMP and an equal number of controls was constructed using 1:1 propensity-score matching to balance demographic and clinical variables.

Lead study author Amar Nouri, of the Dermato-Venereology Clinic at the Karolinska University Hospital in Stockholm, and colleagues examined the incidence of squamous cell carcinoma (SCC), basal cell carcinoma (BCC), malignant melanoma (MM), and nonmelanoma skin cancer (NMSC) during a 5-year follow-up period. Patients with MMP exhibited an increased risk of skin cancers, with a hazard ratio of 1.892 for SCC, 1.501 for BCC, and 1.807 for NMSC in the matched analysis. While MM appeared to be more common in the crude analysis, the association wasn't maintained after matching.

Disease severity significantly influenced outcomes. Among patients with severe MMP—defined using systemic immunosuppressive therapy—the risk of SCC was doubled, the risk of BCC increased by more than twofold, and the risk of NMSC was more than doubled compared with matched controls. These associations weren't observed in patients with mild MMP when matched baseline characteristics.

Temporal analyses demonstrated that SCC risk was more than doubled within the first year after diagnosis, and the risk of NMSC remained consistently elevated across both short-term and longer-term follow-up periods.

The investigators highlighted a substantial link between MMP and the development of keratinocyte-derived skin cancers. The findings suggested that routine skin cancer surveillance should be incorporated into the care of patients with MMP, particularly those with more severe disease, to support early diagnosis and timely intervention.

Full disclosures can be found in the published study.

Source: Frontiers in Medicine