McGregor et al have noted correctly that our methodology evaluating
the risk of overall and cancer mortality would not capture non-fatal cases
of skin malignancy (or other non-fatal morbidities). In another
publication, we also have made the point that skin cancer risk may be
elevated in patients receiving immunosuppressive therapy.1 We concur
with the recommendation that patients receiving immunosuppression should
be particularly careful to limit ultraviolet exposure, and should seek
care promptly for suspicious skin lesions. We thank these colleagues for
their interest in our paper and in this important topic.
References
1. Kempen JH, Gangaputra S, Daniel E, Levy-Clarke GA, Nussenblatt
RB, Rosenbaum JT, Suhler EB, Thorne JE, Foster CS, Jabs DA, Helzlsouer KJ.
Long-term risk of malignancy among patients treated with immunosuppressive
agents for ocular inflammation: A critical assessment of the evidence. Am
J Ophthalmol 2008;146:802-812.
Competing interests:
Our statement of interests has not changed from that in our original manuscript.
Competing interests:
No competing interests
14 August 2009
John H Kempen
Associate Professor of Ophthalmology and Epidemiology
Ebenezer Daniel, James P Dunn, C Stephen Foster, Sapna Gangaputra, Asaf Hanish, Kathy Helzlsouer, Douglas Jabs, R Oktay Kaçmaz, Grace Levy-Clarke, Teresa Liesegang, Craig Newcomb, Robert Nussenblatt, S S Pujari, James Rosenbaum, Eric Suhler, J E Thorne
University of Pennsylvania School of Medicine, Philadelphia, PA 19104
Rapid Response:
Re: What about therapy-related cancer morbidity?
McGregor et al have noted correctly that our methodology evaluating
the risk of overall and cancer mortality would not capture non-fatal cases
of skin malignancy (or other non-fatal morbidities). In another
publication, we also have made the point that skin cancer risk may be
elevated in patients receiving immunosuppressive therapy.1 We concur
with the recommendation that patients receiving immunosuppression should
be particularly careful to limit ultraviolet exposure, and should seek
care promptly for suspicious skin lesions. We thank these colleagues for
their interest in our paper and in this important topic.
References
1. Kempen JH, Gangaputra S, Daniel E, Levy-Clarke GA, Nussenblatt
RB, Rosenbaum JT, Suhler EB, Thorne JE, Foster CS, Jabs DA, Helzlsouer KJ.
Long-term risk of malignancy among patients treated with immunosuppressive
agents for ocular inflammation: A critical assessment of the evidence. Am
J Ophthalmol 2008;146:802-812.
Competing interests:
Our statement of interests has not changed from that in our original manuscript.
Competing interests: No competing interests