Skin Cancer Lesion Features and Antihypertensive Use

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The dermatoscopic features of keratinizing skin cancer in patients using antihypertensives were determined and c these features were compared with those of nonusers.

The dermatoscopic features of keratinizing skin cancer lesions in patients with hypertensive drug use were outlined in study data published in Dermatologic Therapy. Overall, dermatoscopic features were similar in antihypertensive drug users and nonusers but differed across diagnostic categories.

Research suggests that the photosensitizing effects of antihypertensive drugs may increase the risk for skin cancer, although the precise effect of their use on skin lesions remains unclear. To explore the potential influence of antihypertensive drug use on the clinical features of keratinizing skin cancer, investigators conducted a prospective cohort study at a tertiary hospital in Ankara, Turkey.

From 2018 to 2019, patients with keratinizing skin cancers were enrolled and underwent examination with a dermatoscope. Demographic features, medical history, and current medication use were obtained through medical record review. The number, duration, localization, and dermatoscopic features of each lesion were noted. Descriptive statistics were used to compare features in diagnostic categories and in patients with and without antihypertensive drug use.

A total of 46 patients with 64 keratinizing skin cancer lesions were enrolled. The distribution of lesion diagnoses was as follows: 47 actinic keratosis (AK), 5 intraepidermal carcinoma (IEC), 10 cutaneous squamous cell carcinoma (cSCC), and 2 keratoacanthoma.

Mean patient age at enrollment was 69.8 (±13.2) years, 52.2% were women. Overall, 22 (47.8%) patients used antihypertensive drugs.

Per dermatoscopic analyses, a red “pseudonetwork” was substantially associated with AK compared with other diagnoses (P =.02), but cSCC was characterized by keratin and “linear-irregular vessels” (P <.001). Skin scaling (P =.04) and glomerular vessels (P <.001) were more common in IEC compared with other lesion types. “Hairpin” vessels, branched vessels, and prominent keratin at the center of the lesion were significant in keratoacanthoma (all P <.001). Keratoacanthoma, IEC, and cSCC also were more commonly associated with ulceration, spots of blood, and “white structureless area[s]” than were AK (P <.001).

The characteristics of AK, IEC, and keratoacanthoma lesions did not appear to differ substantially across antihypertensive drug use categories. Among patients with cSCC, however, white structureless areas were significantly more prevalent in antihypertensive drug users compared with non-users (P =.004).

The primary study limitation is the small patient cohort. Analyses could not be stratified by antihypertensive drug class, which may be a significant confounder.

The investigators suggest that further research is necessary to better understand the potential impact of antihypertensive therapy on skin cancer presentation.


Demirdag HG, Tugrul B. Evaluation of relationship between antihypertensive drug usage and dermatoscopic features in patients with keratinizing skin cancer. Dermatol Ther. Published online April 11, 2021. doi:10.1111/dth.14957