PUVA Phototoxicity — SCE Dermatology MCQ

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HardPhotobiologyPUVA PhototoxicitySCE Dermatology

A patient has received many courses of PUVA. Which cumulative long-term malignancy risk has the clearest dose-dependent association?

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Correct answer: B — Dose-dependent cutaneous squamous-cell carcinoma

The best answer is “Dose-dependent cutaneous squamous-cell carcinoma”. High cumulative PUVA exposure has its strongest established dose-related association with cutaneous SCC. Other skin cancers remain relevant to surveillance, but the keyed risk should not blur this best-established signal. The alternatives “Dose-dependent dermatofibrosarcoma protuberans”, “Dose-dependent Merkel-cell carcinoma”, “Dose-dependent cutaneous T-cell lymphoma”, “Dose-dependent sebaceous carcinoma” are clinically adjacent possibilities, but they do not fit the defining morphology, distribution, histopathology, risk signal or management sequence in this stem.

Reference: BAD and British Photodermatology Group PUVA guideline: https://academic.oup.com/bjd/article/174/1/24/6616636