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Long-term hydrochlorothiazide use and risk of cutaneous neoplasms

Background: Hydrochlorothiazide is a diuretic commonly used in the treatment of hypertension. Recently, there have been published reports of hydrochlorothiazide-induced cutaneous neoplasms among Caucasians. We therefore investigated the risk for cutaneous neoplasms with hydrochlorothiazide use among the Indian population. Methods: We conducted a case–control study comparing hydrochlorothiazide use among patients diagnosed with cutaneous neoplasms between 2008 and 2017. Patients who underwent skin biopsy and had a pathological diagnosis of either nonmelanoma skin cancers or mycosis fungoides were matched with control patients without a skin cancer diagnosis in a 1:1 ratio. Hydrochlorothiazide use, its dose, and duration of use were compared between the groups. Odds ratio (OR) and 95% confidence intervals (CIs) for cutaneous neoplasms were calculated. Results: Among 90 patients in each group, 7 cases (7.78%) and 7 controls (7.78%) had hydrochlorothiazide exposure for at least 30 days, up to 1 year before cancer diagnosis (OR 1.0, 95% CI 0.34–2.98). Cumulative dose (P = 0.242) and duration of hydrochlorothiazide use (P = 0.08) did not differ between cases (n = 6) and controls (n = 5). There was a trend toward increasing risk of cutaneous neoplasms with high cumulative dose (≥25,000 mg) of hydrochlorothiazide (57.14% vs. 14.29%). The groups were similar with respect to comorbidities and concomitant drug intake; however, cases included more homemakers than controls (P = 0.008). Among hydrochlorothiazide-exposed cases, the body site of basal cell carcinoma involvement was predominantly the head/neck (n = 2; 66.67%), followed by the trunk (n = 1; 33.33%). Conclusion: The current findings did not find an association between long-term hydrochlorothiazide use and occurrence of cutaneous neoplasms.