You know your skin. You live in it, manage it, sometimes even fight it. If you’ve been dealing with psoriasis for a while, you’ve probably memorized every stubborn patch and every new flare. But what happens when something unfamiliar hides behind the familiar?
This question is becoming more relevant:
Can skin cancer, especially melanoma, develop under or near psoriatic plaques? And if it does, would you even notice?
The honest answer is that sometimes, you wouldn’t. Not right away.
Blurred Lines
Psoriasis is obvious. It flares, it flakes, it demands attention. Skin cancer is often quieter. A basal cell carcinoma might look like a small bump. A melanoma could appear as a tiny speck and slowly grow. When your skin is already inflamed or scaling, it’s easy to dismiss something unusual as just another part of your condition.
There have been real cases where melanoma went unnoticed in psoriasis patients because everyone assumed it was just another patch. That’s understandable. But it can also be dangerous.
Skin cancer doesn’t care that your skin has a chronic condition. It doesn’t wait until you’re flare-free.
Are People with Psoriasis More at Risk?
There’s no simple answer, but there are reasons to stay alert.
Phototherapy, especially PUVA, has been linked to a higher risk of squamous cell carcinoma when used over a long period
Immunosuppressive treatments may reduce your body’s ability to recognize and fight off abnormal cells
Chronic inflammation itself is being studied as a possible cancer risk factor, especially when it’s long-lasting and systemic
This doesn’t mean you’re destined to develop skin cancer. It just means your radar needs to be tuned a little higher.
External Risks That Deserve More Attention
Beyond medications and the condition itself, there are other risk factors to keep in mind. If you’ve had years of sun exposure, especially without consistent sunscreen use, your skin may carry more cumulative UV damage than you think. This is particularly important for people who live in sunny climates or work outdoors.
Scalp melanomas, for example, are notoriously easy to miss. The hair often hides them, and the skin in that area is frequently exposed to UV rays. If your psoriasis affects your scalp, regular checkups become even more critical.
Air pollution and environmental stressors are also being investigated for their role in skin damage and inflammation. While the science is still evolving, it’s another reason why protecting your skin from harsh weather, sun, and irritants is never wasted effort.
What You Shouldn’t Ignore
If something changes, hurts, bleeds, or just looks unfamiliar, don’t write it off. Even if it’s next to a plaque. Even if it looks like every other flare you’ve had before.
Watch for:
A mole that looks different from the others
A sore that won’t heal after weeks
A shiny bump that seems new
Something that bleeds or crusts and doesn’t go away
Skin cancer doesn’t always show up where you expect it. Sometimes it appears in places without any psoriasis at all.
The Hardest Part: Knowing When to Speak Up
When you live with a chronic skin condition, you’re trained to be patient, to wait things out, to not panic. You know your skin better than anyone else.
But that’s also why it’s up to you to speak up if something feels off. No one will notice subtle changes the way you will. If you’ve had PUVA treatments, immunosuppressants, frequent sunburns, or a family history of melanoma, make skin checks a habit.
Photo: susceptible mole that requires to be checked.
What You Can Actually Do
Get checked once a year, even if you feel fine
Use SPF every single day, not just during flares
Photograph suspicious areas so you can compare over time
Ask for dermoscopy or mole mapping if your doctor doesn’t offer it
Trust yourself if something doesn’t look or feel right
There’s something deeply frustrating about being so in tune with your skin, yet knowing something serious could still hide in plain sight. That’s not your fault. But it is something you can be prepared for.
Skin cancer doesn’t always scream. Sometimes it barely whispers. Be the one who hears it.
