Thiopurines and non-melanoma skin cancer: partners in crime in inflammatory bowel diseases

Abstract

AbstractIntroductionSeveral studies have shown that inflammatory bowel diseases (IBD) patients treated with thiopurines have an increased risk of developing skin cancer.Sources of dataThis review is based on recent published literature regarding the use of thiopurines in IBD and skin malignancies.Areas of agreementExposure to thiopurines is significantly associated with nonmelanoma skin cancer, but not with melanoma. Primary and secondary prevention including sun-protective measures and regular dermatologic screening are recommended in IBD patients, particularly in those exposed to thiopurines.Areas of controversyBoth when and how immunosuppressive therapy should be resumed in patients with a prior history of skin cancer still remain debatable topics.Growing pointsThe benefit–risk balance between thiopurine therapy and risk of skin cancer should be evaluated in the drug decision process.Areas timely for developing researchThe approval of new effective strategies requires the re-evaluation of the positioning of thiopurines within the therapeutic algorithm based on an increasingly individualized approach.