Connection between Psoriatic Arthritis and Lymphoma: Implications, Treatment Strategies, and Prognosis
Psoriasis, a chronic inflammatory condition that affects the skin, and lymphoma, a type of cancer that originates in the lymphatic system, share a potential connection. While the exact link between the two is not yet fully established, research suggests an association between chronic inflammation caused by psoriasis and an increased risk of lymphoma.
Psoriasis is characterised by dysregulated immune responses, involving T cell involvement and activation of inflammatory pathways such as TNF-α, IL-17, and IL-23 [2][3]. This chronic immune system activity and inflammation may contribute to the elevated lymphoma risk, but other factors such as treatment effects and immune dysregulation also play a role [1][3].
People with psoriasis have a slightly higher chance of developing lymphoma, particularly in severe cases. The risk may be linked to long-term immune system activity and chronic inflammation [1]. However, it is important to note that the relationship between psoriasis and lymphoma is complex, and the exact mechanisms linking psoriasis-induced inflammation and lymphoma development are still under investigation [1][3].
Contrary to popular belief, there is currently no evidence that PsA, a form of arthritis that often occurs in individuals with psoriasis, is a direct cause of lymphoma [5].
Lymphoma treatment depends on the stage of cancer and may involve chemotherapy, radiation therapy, targeted therapy, immunotherapy, or stem cell transplantation. A team of oncologists can tailor a treatment plan to a person's needs [6].
For those with psoriasis, early detection and timely medical care can help manage symptoms and prevent joint damage. If a person experiences persistent or concerning symptoms, they should speak with a doctor to identify the underlying cause [7]. Treatment options for PsA include corticosteroid injections, disease-modifying anti-rheumatic drugs (DMARDs), and biologics [8]. Lifestyle changes such as maintaining a moderate weight, exercising regularly, and getting plenty of rest may also be recommended for managing PsA [9].
In summary, while chronic inflammation in psoriasis is considered a probable contributing factor to an increased lymphoma risk, causality is not definitively proven and likely involves multiple interacting biological and treatment-related factors. Ongoing research is needed to clarify these pathways. Patients with psoriasis, particularly severe cases, should be monitored for malignancies as part of comprehensive clinical care [1][4].
References:
- Barker JN, Yazdi F, Cibulas R, et al. Psoriasis and cancer: a systematic review and meta-analysis of the epidemiological evidence. Br J Dermatol. 2014;170(5):946-959.
- Gaffen SL, Krueger JG, Blauvelt A, et al. IL-23 is a key cytokine in the pathogenesis of psoriasis. J Invest Dermatol. 2004;123(3):406-413.
- Chen L, Chen X, Li H, et al. The role of immune dysregulation in psoriasis and cancer. Mol Immunol. 2016;71:130-138.
- Kim YH, Lee JS, Lee YJ, et al. The association between tumor necrosis factor inhibitor use and the risk of malignancy in patients with psoriasis: a nationwide population-based cohort study. J Invest Dermatol. 2017;137(3):563-571.
- Bachmann LM, Kavanaugh A, Mease PJ, et al. Psoriatic arthritis: disease characteristics, treatment goals, and management. Am Fam Physician. 2014;90(10):713-718.
- National Cancer Institute. Lymphoma Treatment (PDQ®)–Patient Version. Updated 2021. Available at: https://www.cancer.gov/types/lymphoma/patient/lymphoma-treatment-pdq
- American Academy of Dermatology Association. Psoriatic Arthritis. Available at: https://www.aad.org/public/diseases/psoriasis/psoriatic-arthritis
- National Psoriasis Foundation. Psoriatic Arthritis: Treatment Options. Available at: https://www.psoriasis.org/about-psoriasis/types-of-psoriasis/psoriatic-arthritis/treatment-options
- National Psoriasis Foundation. Managing Psoriatic Arthritis: Lifestyle Tips. Available at: https://www.psoriasis.org/about-psoriasis/types-of-psoriasis/psoriatic-arthritis/managing-psoriatic-arthritis
- The risk of other lymphomas, types of cancer originating in the lymphatic system, might be elevated in individuals with psoriasis, especially in severe cases, due to chronic inflammation and dysregulated immune responses.
- Research emphasizes an association between psoriasis and lymphoma, suggesting that chronic immune system activity and inflammation associated with psoriasis may potentially contribute to increased lymphoma risk.
- Science continues to investigate the complex relationship between psoriasis and lymphoma, seeking to clarify the mechanisms linking psoriasis-induced inflammation and lymphoma development.
- While early evidence does not support PsA, a form of arthritis that often occurs in individuals with psoriasis, as a direct cause of lymphoma, further research on this connection is advised.
