炎症性肠病（IBD）患者接受硫唑嘌呤治疗会增加角质细胞皮肤癌（KSC）的风险。大多数国际指南建议对接受硫唑嘌呤治疗的患者进行年度皮肤病学筛查。目前尚不清楚KSC发展与硫唑嘌呤用量之间是否存在剂量依赖性的关联。本研究旨在调查IBD患者累积硫唑嘌呤用量与KSC发展之间的关联，为IBD患者进一步皮肤癌风险分层和筛查建议个性化提供帮助。我们进行了一项单中心病例对照研究，包括具有和不具有KSC病史的IBD患者（分别为病例和对照）。主要观察指标是累积的硫唑嘌呤和硫代嘌呤剂量与KSC发展的关联。进行了单变量和多变量 logistic 回归分析，后者校正了年龄和吸烟，这是已知的KSC风险因素。我们包括了50名病例和150名对照，以白人为主。年龄和当前的硫唑嘌呤使用在单变量分析中与KSC发展显著相关。在多变量 logistic 回归分析中，入组时的年龄仍然与KSC发展显著相关。硫唑嘌呤（单独或联合）的累积剂量或使用时间对KSC风险没有影响，即使在校正年龄和吸烟后也是如此。累积的硫唑嘌呤剂量和使用时长与KSC发展没有关联。将来基于所有可用KSC风险因素的风险分层可能有助于选择最有益于皮肤病学筛查计划的个体。© 2023 Wolters Kluwer Health，Inc. 保留所有权利。

Patients with inflammatory bowel disease (IBD) treated with thiopurines are at increased risk of keratinocyte skin cancer (KSC). Most international guidelines recommend yearly dermatological screening of thiopurine-treated patients. Whether the association between the development of KSC and the use of thiopurines is dose-dependent remains unclear. The aim of this study was to investigate the association between the cumulative thiopurine dose and KSC development in patients with IBD which can be helpful to assist in further skin cancer risk stratification and personalization of screening recommendations in patients with IBD.We performed a single-center case-control study, including patients with IBD with and without a history of KSC (cases and controls, respectively). The primary outcome was the association of cumulative azathioprine, mercaptopurine and thioguanine dose with KSC development. Univariable and multivariable logistic regression analyses were performed, the latter corrected for age and smoking, known risk factors of KSC.We included 50 cases and 150 controls, predominantly white population. Age and current azathioprine use were univariably significantly associated with KSC development. In multivariable logistic regression analyses, age at inclusion remained significantly associated. Cumulative doses of thiopurines (separate or combined) or duration of thiopurine use did not impact KSC risk, also after correcting for age and smoking.Cumulative thiopurine dose and duration did not show an association with KSC development. Future KSC risk stratification, based on all available KSC risk factors, may aid in selecting individuals who can benefit most from dermatologic screening programs.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.