MinervaBMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7089.1290 (Published 26 April 1997) Cite this as: BMJ 1997;314:1290
Photochemotherapy with psoralens and ultraviolet radiation (PUVA) was introduced for psoriasis in the mid-1970s and within 10 years was shown to increase the risk of squamous cell carcinomas of the skin. An increased risk has now been shown for melanoma (New England Journal of Medicine 1997;336:1041-5). A study in Boston has found that the risk rises substantially about 15 years after the first treatment and is also higher in patients who have received more than 250 treatments. An editorial in the same issue (336:1090-1) concludes, however, that PUVA should not be abandoned since it is so effective for severe forms of psoriasis.
Hyperlipidaemia is a known complication of renal transplantation, and deaths from ischaemic heart disease are 20 times higher in patients with diabetes who have received transplants than in the general population. A review in Transplantation (1997;63:339-45) argues that all recipients of kidneys, whatever their serum total cholesterol concentrations, should be treated with statin drugs to lower their lipids and so not only reduce the risk of myocardial infarction but also maintain their renal function.