To evaluate the incidence of skin cancers in patients with alopecia areata (AA) and clarify the association between AA and skin cancer risk, particularly in the context of systemic therapies.
Key Findings:
AA was associated with a statistically significant reduction in melanoma incidence (OR 0.58; 95% CI, 0.36-0.94; p = 0.028).
Overall skin cancer risk was reduced but not statistically significant (OR 0.58, 95% CI, 0.27-1.22).
Pooled estimates for basal cell carcinoma (BCC) suggested an OR of 0.43 (95% CI, 0.11-1.75) and for squamous cell carcinoma (SCC) an OR of 0.66 (95% CI, 0.28-1.57), both indicating reduced associations but not reaching statistical significance.
Interpretation:
AA is not associated with increased skin cancer risk and shows an inverse association with melanoma incidence, although high heterogeneity and sensitivity analyses necessitate cautious interpretation regarding the reliability of these findings.
Limitations:
High between-study heterogeneity (I2 >80% for BCC and SCC).
Limited number of studies included in the meta-analysis may affect the robustness of the conclusions.
Conclusion:
These findings provide important context for patient counseling and long-term safety assessments as systemic therapies for AA, including JAK inhibitors, are increasingly used.
