Phototherapy is a standard treatment for moderate-to-severe
psoriasis. However, concern remains regarding the associated cutaneous carcinogenic risk. Our objective is to conduct a systematic review of
skin cancer risk for
psoriasis patients treated with
phototherapy. To achieve our goal, we searched Cochrane, PubMed, and Embase databases. We aimed to evaluate existing literature (from July 1, 2010, to December 31, 2020) on
phototherapy for all Fitzpatrick skin phototypes (FSP) which includes 71 articles, and eight articles being categorized in this review. Five studies did not report an increased
skin cancer risk with narrowband-ultraviolet blue (UVB) and unspecified UVB for FSP II through VI, with one study not reporting FSP. Three studies did report an increased risk of
skin cancer with narrowband-UVB and broadband-UVB for FSP I-VI, with one study also not specifying skin phototypes or UVB
phototherapy type. Additionally, a study with
psoralen and ultraviolet A with and without narrowband-UVB demonstrated an increased risk of
skin cancer in phototypes III and IV. The most commonly reported secondary outcomes with
phototherapy were
actinic keratosis (123) and solar
lentigines (10). Numerous patients were also on additional
therapies including
methotrexate,
acitretin, and biologics. Study limitations include publication bias due to limited number of studies published on this topic in the last ten years along with heterogeneity in reporting. The relationship between
phototherapy,
psoriasis, and cutaneous oncogenic risk remains contradictory. While
phototherapy for
psoriasis is an efficacious
therapy, further studies are needed to understand the cutaneous oncogenic risk based on FSP to help clinicals tailor treatment recommendations based on skin phototypes.