Ultraviolet B sensitivity of peripheral lymphocytes as an independent risk factor for cutaneous melanoma

Five-point checklist for skin cancer detection in primary care

BACKGROUND

Skin cancer screening interventions often relay on the involvement of general practitioners (GPs). Many interventions up to now have been directed to training approaches focusing on the clinical features of skin malignancies to increase GPs skill in skin cancer recognition.

METHODS

Based on the available current knowledge about skin cancer epidemiology and risk factors, we built up a 5-point checklist to help GPs in triaging patients to be referred to a dermatologist.

RESULTS

Five-point check-list: 1) visible sun damaged skin on exposed areas (red and brown to black macules and crusts on visible skin); 2) more than 20 nevi on the arms; 3) one or more ABCD positive lesions (flat, large and asymmetric macules); 4) one or more EFG positive lesions (elevated, firm and growing skin lesions); 5) a pigmented lesion larger than 1.5 cm in diameter.

CONCLUSIONS

Our aim was to provide a short list of practical rules, easy to adopt into a routine practice, in order to achieve a more effective triage of patients requiring a dermatology consultation for skin cancer examination. The novelty of the proposed method relies on the approach. The proposed method does not require the GP to diagnose skin cancer. The aim is to involve GPs in the selection of patients to be referred to the specialist, in order to reduce the waiting time while avoiding the risk to leave cancers untreated.

Gadd45a Activation Protects Melanoma Cells from Ultraviolet B-Induced Apoptosis

Epidemiological and biological studies indicate that solar UVB radiation is involved in cutaneous malignant melanoma etiology. Indeed, melanocytes are very frequently exposed to solar UV radiation, which induces cell damage and may promote cell transformation. We previously showed that melanocytes and melanoma cells exposed to UVB radiation activates a p53-independent pathway involving Gadd45a and, more recently, that Gadd45a plays a critical role in UVB-induced G2 cell cycle arrest of melanoma cells. In this study, we demonstrate that the inhibition of UV-induced Gadd45a overexpression by RNA interference results in a dramatic increase of cell death. We identify this cell death as apoptosis, with activation of Caspase-3 and a decrease in Bcl-x(L) expression. Furthermore, we show that inhibition of UV-induced Gadd45a overexpression also leads to increased sensitivity of melanoma cells to therapeutic agents such as DTIC and Cisplatin. We conclude that UVB-induced Gadd45a overexpression protects melanoma cells from apoptosis, both by causing a G2 cell cycle arrest and by inhibiting the mitochondrial apoptotic pathway. These observations suggest that Gadd45a inactivation could be a useful way to sensitize melanoma cells to chemotherapy. JID journal club article: For questions, answers, and open discussion about this article please go to http://network.nature.com/group/jidclub