Should Cervical Cancer Screening with Papanicolaou Smear be Recommended for Female Patients with Psoriasis before Biological Agent Treatment?

Abstract

": Chronic inflammation and immunosuppressive treatment may play a role in the etiopathogenesis of cancer in psoriasis patients. We wanted to evaluate the Papanicolaou smear (Pap smear) results of female patients with psoriasis which were performed for cervical cancer screening before the initiation of biological agent treatment. Between April 2019 and November 2021, Pap smear results of female patients with psoriasis were reviewed retrospectively. This study included 70 female psoriasis patients with a mean age of 48.41±11.62 years. 49 (70%) patients were biologically naive, whereas 21 (30%) patients previously received biological agents. Obscuring inflammation was reported in 33 (47.1%) patients. Atrophy, intermediate cell predominance, reactive cellular changes due to inflammation, and both atrophy and reactive cellular changes were detected in 15 (21.4%), 7 (10%), 3 (4.3%) patients, and 1 (1.4%) patient, respectively. No malignancy or intraepithelial lesion was observed in 69 (98.6%) patients, whereas atypical squamous cells of undetermined significance were reported in 1 (1.4%) patient. Infections such as bacterial vaginosis, candidiasis, and actinomycosis were detected in 13 (18.6%) patients. Pap smear tests should be performed in female psoriasis patients to detect premalignant lesions of the cervix before the initiation of biological agent treatment. Moreover, psoriasis treatment guidelines should be updated accordingly"