Epidemiological studies indicate that occupational exposure to coal tar may lead to an increased risk of lung, scrotum and skin cancer. Furthermore, studies with laboratory rodents show carcinogenicity of coal tar after dermal application. This effect may be attributable to polycyclic aromatic hydrocarbons (PAH), which are ubiquitous coal tar constituents. Absorbed PAH can be metabolised to reactive derivatives that bind to DNA. These PAH-DNA binding products are thought to be involved in PAH-induced carcinogenesis. However, no clearly increased skin cancer incidences have been reported in psoriasis patients who have been exposed to therapeutically high doses of coal tar. To determine whether patients treated with coal tar actually have an altered risk of cutaneous malignancies, we suggest that further controlled studies and experiments are necessary. Future research should also focus on the possibility of increased risks of developing internal malignancies.