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Cohen OG, Taylor M, Mohr C, Nead KT, Hinkston CL, Giordano SH, Langan SM, Margolis DJ, Wehner MR. Antihypertensive Medications and Risk of Melanoma and Keratinocyte Carcinomas: A Systematic Review and Meta-Analysis. JID INNOVATIONS 2024; 4:100272. [PMID: 38736521 PMCID: PMC11087973 DOI: 10.1016/j.xjidi.2024.100272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 05/14/2024] Open
Abstract
Some antihypertensive medications are photosensitizing. The implications for skin cancer risk remain unclear because results from prior studies are inconsistent and as new evidence is published. We performed a systematic review and meta-analysis to evaluate the association between antihypertensives and common skin cancers (cutaneous squamous cell carcinoma, basal cell carcinoma, and melanoma) and to evaluate dose-response relationships. Forty-four articles met inclusion criteria, and 42 could be meta analyzed. Increased risks were seen for basal cell carcinoma with calcium channel blockers (relative risk [RR] = 1.17, 95% confidence interval [CI] = 1.11-1.22), diuretics (RR = 1.06, 95% CI = 1.03-1.10), and thiazides (RR = 1.10, 95% CI = 1.04-1.16); for squamous cell carcinoma with calcium channel blockers (RR = 1.08, 95% CI = 1.01-1.14), diuretics (RR = 1.29, 95% CI = 1.17-1.43), and thiazides (RR = 1.36, 95% CI = 1.15-1.61); and for melanoma in angiotensin-converting enzyme inhibitors (RR = 1.09, 95% CI = 1.03-1.14), calcium channel blockers (RR = 1.08, 95% CI = 1.03-1.12), and thiazides (RR = 1.09, 95% CI = 1.02-1.17). The quality of evidence was low or very low. We observed evidence for dose-response for thiazides with basal cell carcinoma; angiotensin-converting enzyme inhibitors, diuretics, and thiazides with squamous cell carcinoma; and angiotensin-converting enzyme inhibitors, diuretics, and thiazides with melanoma. Our meta-analysis supports a potential causal association between some antihypertensives, particularly diuretics, and skin cancer risk.
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Affiliation(s)
- Olivia G. Cohen
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Matthew Taylor
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Cassandra Mohr
- Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kevin T. Nead
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Candice L. Hinkston
- Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sharon H. Giordano
- Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sinead M. Langan
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - David J. Margolis
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mackenzie R. Wehner
- Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Dermatology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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2
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Heisel AGU, Vuurboom MD, Daams JG, de Rie MA, Vogt L, van den Born BJH, Olde Engberink RHG. The use of specific antihypertensive medication and skin cancer risk: A systematic review of the literature and meta-analysis. Vascul Pharmacol 2023; 150:107173. [PMID: 37084802 DOI: 10.1016/j.vph.2023.107173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/15/2023] [Accepted: 04/17/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND The use of hydrochlorothiazide has recently been linked to skin cancer in observational studies. This may be explained by its photosensitizing properties, but photosensitivity has also been reported for other antihypertensive drugs. We conducted a systematic review and meta-analysis to compare skin cancer risk among antihypertensive drug classes and individual blood pressure lowering drugs. METHODS We searched Medline, Embase, Cochrane and the Web of Science and included studies that investigated the association between antihypertensive medication exposure and non-melanoma skin cancer (NMSC) or cutaneous malignant melanoma (CMM). We combined the extracted odds ratios (OR) using a random effects model. RESULTS We included 42 studies with a total of 16,670,045 subjects. Diuretics, in particular hydrochlorothiazide, were examined most frequently. Only 2 studies provided information about antihypertensive co-medication. Exposure to diuretics (OR 1.27 [1.09-1.47]) and CCB (OR 1.06 [1.04-1.09]) was associated with an increased risk for NMSC. The increased risk for NMSC was only observed in case control studies and studies that did not correct for sun exposure, skin phototype or smoking. Studies that did correct for covariates as well as cohort studies did not show a significantly increased risk for NMSC. Egger's test revealed a significant publication bias for the subgroup of diuretics and hydrochlorothiazide concerning NMSC (p < 0.001). CONCLUSION The available studies investigating the potential skin cancer risk that is associated with antihypertensive medication have significant shortcomings. Also, a significant publication bias is present. We found no increased skin cancer risk when analyzing cohort studies or studies that corrected for important covariates. (PROSPERO (CRD42020138908)).
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Affiliation(s)
- Annalena G U Heisel
- Department of Internal Medicine, section Nephrology, Amsterdam University Medical Centres, Amsterdam, Amsterdam Cardiovascular Sciences, University of Amsterdam, the Netherlands
| | - Mart D Vuurboom
- Department of Internal Medicine, section Nephrology, Amsterdam University Medical Centres, Amsterdam, Amsterdam Cardiovascular Sciences, University of Amsterdam, the Netherlands
| | - Joost G Daams
- Medical Library, Amsterdam University Centres, Amsterdam, the Netherlands
| | - Menno A de Rie
- Department of Dermatology, Amsterdam University Medical Centres, Amsterdam, the Netherlands
| | - Liffert Vogt
- Department of Internal Medicine, section Nephrology, Amsterdam University Medical Centres, Amsterdam, Amsterdam Cardiovascular Sciences, University of Amsterdam, the Netherlands
| | - Bert-Jan H van den Born
- Department of Internal Medicine, section Vascular Medicine, Amsterdam University Medical Centres, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Rik H G Olde Engberink
- Department of Internal Medicine, section Nephrology, Amsterdam University Medical Centres, Amsterdam, Amsterdam Cardiovascular Sciences, University of Amsterdam, the Netherlands.
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3
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Assessing individual patients’ knowledge of benign versus malignant skin lesions in the dermatology clinic population. Int J Womens Dermatol 2022; 8:e032. [PMID: 35923587 PMCID: PMC9324629 DOI: 10.1097/jw9.0000000000000032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 06/01/2022] [Indexed: 11/26/2022] Open
Abstract
Skin cancer education targeted to patients’ needs is a goal of practicing dermatologists. Data regarding dermatology patients’ baseline knowledge regarding skin cancer could aid clinicians in tailoring education efforts.
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4
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Zhu Y, Wang H, He J, Yang L, Zhou X, Li Z, Zhou H, Zhao H, Li Y. Atopic Dermatitis and Skin Cancer Risk: A Systematic Review. Dermatol Ther (Heidelb) 2022; 12:1167-1179. [PMID: 35430723 PMCID: PMC9110609 DOI: 10.1007/s13555-022-00720-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 03/30/2022] [Indexed: 01/10/2023] Open
Affiliation(s)
- Yun Zhu
- Department of Dermatology, The Sixth Affiliated Hospital of Kunming Medical University, No. 21 Nieer Road, Yuxi, 653100, Yunnan, China
- Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming, 650032, Yunnan, China
| | - Hongmei Wang
- Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming, 650032, Yunnan, China
| | - Juan He
- Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming, 650032, Yunnan, China
| | - Luhui Yang
- Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming, 650032, Yunnan, China
| | - Xiaoyan Zhou
- Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming, 650032, Yunnan, China
| | - Zhe Li
- Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming, 650032, Yunnan, China
| | - Huiling Zhou
- Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming, 650032, Yunnan, China
| | - Huadi Zhao
- Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming, 650032, Yunnan, China
| | - Yuye Li
- Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming, 650032, Yunnan, China.
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5
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Beatson M, Misitzis A, Landow S, Yoon J, Higgins HW, Phibbs C, Weinstock MA. Predictors of Basal Cell Carcinoma and Implications for Follow-Up in High-Risk Patients in the Veterans Affairs Keratinocyte Carcinoma Chemoprevention (VAKCC) Trial. J Cutan Med Surg 2020; 25:102-103. [PMID: 32880186 DOI: 10.1177/1203475420945230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Meghan Beatson
- Center for Dermatoepidemiology-111D, Veterans Affairs Medical Center, Providence, RI, USA.,Department of Dermatology, Alpert Medical School of Brown University, Providence, RI, USA.,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Angelica Misitzis
- Center for Dermatoepidemiology-111D, Veterans Affairs Medical Center, Providence, RI, USA.,Department of Dermatology, Alpert Medical School of Brown University, Providence, RI, USA
| | - Shoshana Landow
- Center for Dermatoepidemiology-111D, Veterans Affairs Medical Center, Providence, RI, USA.,Department of Dermatology, Alpert Medical School of Brown University, Providence, RI, USA
| | - Jean Yoon
- Health Economics Resource Center and Center for Innovation to Implementation, Veterans Affairs Palo Alto, USA
| | - H William Higgins
- Department of Dermatology, Alpert Medical School of Brown University, Providence, RI, USA
| | - Ciaran Phibbs
- Health Economics Resource Center and Center for Innovation to Implementation, Veterans Affairs Palo Alto, USA.,Stanford University School of Medicine, Palo Alto, CA, USA
| | - Martin A Weinstock
- Center for Dermatoepidemiology-111D, Veterans Affairs Medical Center, Providence, RI, USA.,Department of Dermatology, Alpert Medical School of Brown University, Providence, RI, USA
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6
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Muir AB, Whelan KA, Dougherty MK, Aaron B, Navarre B, Aceves SS, Dellon ES, Jensen ET. The potential for malignancy from atopic disorders and allergic inflammation: A systematic review and meta-analysis. Clin Exp Allergy 2020; 50:147-159. [PMID: 31743536 PMCID: PMC6994341 DOI: 10.1111/cea.13537] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 10/23/2019] [Accepted: 11/07/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVE While chronic inflammation is a well-established risk factor for malignancy, studies evaluating the relationship between allergic inflammation and cancer have revealed conflicting results. Here, we aimed to assess the association between allergic inflammation in the lung (asthma), skin (eczema) or oesophagus (eosinophilic oesophagitis; EoE) and cancer at the organ site. DESIGN We conducted a systematic review of the literature to identify observational studies (case-control, cohort and cross-sectional) evaluating the association between asthma and lung cancer, eczema and skin cancer, or EoE and oesophageal cancer. Random-effects meta-analysis was performed to define pooled estimates of effects. DATA SOURCES PubMed, EMBASE and Web of Science. ELIGIBILITY CRITERIA FOR SELECTION Included studies evaluated the incidence of cancer. RESULTS Thirty-two studies met the inclusion criteria, 27 in the lung, four in the skin and one in the oesophagus. Meta-analysis of the three studies with prospective data collection of asthma diagnosis revealed a positive association with incident lung cancer (OR 1.27, 95% CI 1.09-1.44); however, this result was not consistently supported by the larger dataset of retrospective studies (OR 1.37, 95% CI 0.90-1.83). Overall, studies in the lung displayed significant heterogeneity (I2 98%, P < .0001), but no significant effect modification on the association between asthma and lung cancer was identified for the variables of sex, smoking or study design. Meta-analysis could not be applied to the four papers reviewed in the skin, but three suggested an association between eczema and non-melanoma skin cancer, while the remaining study failed to identify an association between melanoma and eczema. A single study meeting inclusion criteria showed no association between EoE and oesophageal malignancy. CONCLUSIONS The current data cannot exclude the possibility of an association between atopy and malignancy the lung, skin and oesophagus. The relationship between allergy and cancer should be explored further in prospective studies that any association identified between these conditions has the potential for significant public health implications.
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Affiliation(s)
- Amanda B Muir
- Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perlman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Kelly A Whelan
- Fels Institute for Cancer Research & Molecular Biology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Michael K Dougherty
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Bailey Aaron
- Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Brianna Navarre
- Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Seema S Aceves
- Division of Allergy, Immunology, Department of Pediatrics, University of California San Diego and Rady Children's Hospital, San Diego, CA, USA
| | - Evan S Dellon
- Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Elizabeth T Jensen
- Wake Forest University School of Medicine, Department of Epidemiology and, Prevention, Winston-Salem, NC
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7
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Gandini S, Palli D, Spadola G, Bendinelli B, Cocorocchio E, Stanganelli I, Miligi L, Masala G, Caini S. Anti-hypertensive drugs and skin cancer risk: a review of the literature and meta-analysis. Crit Rev Oncol Hematol 2018; 122:1-9. [PMID: 29458778 DOI: 10.1016/j.critrevonc.2017.12.003] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 10/04/2017] [Accepted: 12/06/2017] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Several anti-hypertensive drugs have photosensitizing properties, however it remains unclear whether long-term users of these drugs are also at increased risk of skin malignancies. We conducted a literature review and meta-analysis on the association between use of anti-hypertensive drugs and the risk of cutaneous melanoma and non-melanoma skin cancer (NMSC). METHODS We searched PubMed, EMBASE, Google Scholar and the Cochrane Library, and included observational and experimental epidemiological studies published until February 28th, 2017. We calculated summary relative risk (SRR) and 95% confidence intervals (95% CI) through random effect models to estimate the risk of skin malignancies among users of the following classes of anti-hypertensive drugs: thiazide diuretics, angiotensin converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARB), calcium channel blockers (CCB) and β-blockers. We conducted sub-group and sensitivity analysis to explore causes of between-studies heterogeneity, and assessed publication bias using a funnel-plot based approach. RESULTS Nineteen independent studies were included in the meta-analysis. CCB users were at increased skin cancer risk (SRR 1.14, 95% CI 1.07-1.21), and β-blockers users were at increased risk of developing cutaneous melanoma (SRR 1.21, 95% CI 1.05-1.40), with acceptable between-studies heterogeneity (I2 < 50%). There was no association between thiazide diuretics, ACEi or ARB use and skin cancer risk. We found no evidence of publication bias affecting the results. CONCLUSION Family doctors and clinicians should inform their patients about the increased risk of skin cancer associated with the use of CCB and β-blockers and instruct them to perform periodic skin self-examination. Further studies are warranted to elucidate the observed associations.
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Affiliation(s)
- Sara Gandini
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
| | - Domenico Palli
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - Giuseppe Spadola
- Division of Melanoma and Muscolo-Cutaneous Sarcoma, European Institute of Oncology, Milan, Italy
| | - Benedetta Bendinelli
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - Emilia Cocorocchio
- Division of Melanoma and Muscolo-Cutaneous Sarcoma, European Institute of Oncology, Milan, Italy
| | - Ignazio Stanganelli
- Skin Cancer Unit, IRCCS-IRST Scientific Institute of Romagna for the Study and Treatment of Cancer, Meldola, Italy
| | - Lucia Miligi
- Environmental and Occupational Epidemiology Branch, Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - Giovanna Masala
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - Saverio Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy.
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8
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Smedinga H, Verkouteren JAC, Steyerberg EW, Hofman A, Nijsten T, Vergouwe Y. Occurrence of metachronous basal cell carcinomas: a prognostic model. Br J Dermatol 2017; 177:1113-1121. [PMID: 28664573 DOI: 10.1111/bjd.15771] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND A third of patients with a first basal cell carcinoma (BCC) will develop subsequent (metachronous) BCCs. OBJECTIVES To study the prognostic effect of the number of previous BCC diagnosis dates a patient has experienced to derive a prediction model to assess the risk of metachronous BCCs that may inform individualized decision making on surveillance. METHODS We considered participants of north-western European ancestry from a prospective population-based cohort study (Rotterdam Study). After linkage with the Dutch Pathology Registry, 1077 patients with a first BCC were included. Candidate predictors for metachronous BCCs included patient, lifestyle and tumour characteristics. The prognostic model was developed with Fine and Gray regression analysis to account for competing risk of death. We used bootstrapping to correct for within-patient correlation and statistical optimism in predictive performance. RESULTS Second to fifth BCCs occurred in 293, 122, 58 and 36 patients, with median follow-up times of 3·0, 2·1, 1·7 and 1·8 years after the previous BCC, respectively. The risk of a new BCC was higher for patients with more metachronous BCCs. Having more than one BCC at diagnosis was another strong predictor of metachronous BCCs. Discriminative ability of the model was reasonable with an optimism-corrected c-index of 0·70 at 3 years. CONCLUSIONS The number of previous BCC diagnosis dates was a strong prognostic factor and should be considered when predicting the risk of metachronous BCCs. When the number of previous BCC diagnosis dates is combined with other readily available characteristics into a prognostic model, patients at high risk of a new BCC can be identified.
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Affiliation(s)
- H Smedinga
- Department of Public Health, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - J A C Verkouteren
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - E W Steyerberg
- Department of Public Health, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - A Hofman
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - T Nijsten
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Y Vergouwe
- Department of Public Health, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
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9
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Savas S, Turgut Erdemir AV, Koku Aksu AE, Gurel MS, Ozkur E. Clinical and prognostic factors in the development of basal cell carcinoma. Clin Dermatol 2017; 35:616-623. [PMID: 29191355 DOI: 10.1016/j.clindermatol.2017.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We investigated the environmental and personal risk factors associated with the development of basal cell carcinoma (BCC). This retrospective cohort study included a total of 997 patients whose diagnosis was confirmed by histopathologic examination between 2007 and 2014. A control examination was performed in 363 of these patients, who were accessed via telephone. A total of 1151 tumors were detected in 997 patients. During their follow-up, 13% of them developed subsequent tumors. The risk of developing subsequent tumor was 2.7-fold higher in patients with multiple BCCs at the time of diagnosis than those with single BCC. Multiple BCCs tended to develop in older patients and men. The risk of developing multiple BCCs was increased in patients with a history of BCC, skin type 1 or 2, and chronic sun exposure (sun exposure of >500 weeks, a high photoaging score [≥30], and the presence of actinic keratosis). We concluded that chronic sun exposure may increase the risk of developing multiple BCCs. These data also indicate that cumulative sun exposure is as important for developing BCC as for squamous cell carcinoma.
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Affiliation(s)
- Sevil Savas
- Istanbul Training and Research Hospital, Department of Dermatology, Artvin State Hospital, Artvin, Turkey Istanbul, Turkey.
| | - Aslı V Turgut Erdemir
- Istanbul Training and Research Hospital, Department of Dermatology, Artvin State Hospital, Artvin, Turkey Istanbul, Turkey
| | - Ayse E Koku Aksu
- Istanbul Training and Research Hospital, Department of Dermatology, Artvin State Hospital, Artvin, Turkey Istanbul, Turkey
| | - Mehmet S Gurel
- Istanbul Training and Research Hospital, Department of Dermatology, Artvin State Hospital, Artvin, Turkey Istanbul, Turkey
| | - Ezgi Ozkur
- Istanbul Training and Research Hospital, Department of Dermatology, Artvin State Hospital, Artvin, Turkey Istanbul, Turkey
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10
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Gandini S, Stanganelli I, Palli D, De Giorgi V, Masala G, Caini S. Atopic dermatitis, naevi count and skin cancer risk: A meta-analysis. J Dermatol Sci 2016; 84:137-143. [DOI: 10.1016/j.jdermsci.2016.07.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 07/12/2016] [Accepted: 07/15/2016] [Indexed: 12/23/2022]
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11
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Pomerantz H, Korgavkar K, Lee KC, Lew R, Weinstock MA. Validation of Photograph-Based Toxicity Score for Topical 5-Fluorouracil Cream Application. J Cutan Med Surg 2016; 20:458-66. [PMID: 27207349 DOI: 10.1177/1203475416643952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND An objective tool quantifying the toxicity of 5-fluorouracil (5-FU) from photographs was recently reported, and its reliability was confirmed. OBJECTIVE The aim of this study was to validate the photograph-based toxicity score. METHODS Photograph-based toxicity scores of participants assigned to the 5-FU arm of a randomized placebo-controlled trial were tested for correlations with their patient-reported symptom scores and baseline characteristics. RESULTS Each pair of individual and overall scores of patient-reported symptoms and photograph-based toxicity was correlated at 2 and 4 weeks (correlation coefficient range, 0.34-0.95; P < .001 for all). Older age, more actinic keratoses, previous topical 5-FU use, and more keratinocyte carcinomas on the face and ears in the previous 5 years were correlated with increased 5-FU toxicity at 2 weeks (P < .05). An increase in the total number of 5-FU applications during the trial was correlated with less severe toxicity at 2 weeks (P < .001), but with increased toxicity at 4 weeks (P < .001). CONCLUSION This study provides evidence for construct validity of the photograph-based 5-FU toxicity score. The tool can be used to objectively measure 5-FU toxicity in clinical or research setting, and it can be a prototype for toxicity measurements of other topical medications.
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Affiliation(s)
- Hyemin Pomerantz
- Center for Dermatoepidemiology, VA Medical Center, Providence, RI, USA Department of Dermatology, Brown University, Providence, RI, USA
| | - Kaveri Korgavkar
- Center for Dermatoepidemiology, VA Medical Center, Providence, RI, USA Department of Dermatology, Brown University, Providence, RI, USA
| | - Kachiu C Lee
- Center for Dermatoepidemiology, VA Medical Center, Providence, RI, USA Department of Dermatology, Brown University, Providence, RI, USA
| | - Robert Lew
- The Massachusetts Veterans Epidemiology Research and Information Center, Boston, MA, USA
| | - Martin A Weinstock
- Center for Dermatoepidemiology, VA Medical Center, Providence, RI, USA The Massachusetts Veterans Epidemiology Research and Information Center, Boston, MA, USA Department of Epidemiology, Brown University, Providence, RI, USA
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12
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Hajdarbegovic E, Blom H, Verkouteren J, Hofman A, Hollestein L, Nijsten T. Atopic dermatitis is not associated with actinic keratosis: cross‐sectional results from the Rotterdam study. Br J Dermatol 2016; 175:89-94. [DOI: 10.1111/bjd.14423] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2016] [Indexed: 11/30/2022]
Affiliation(s)
- E. Hajdarbegovic
- Department of Dermatology and Venerology Erasmus Medical Centre Burgemeester s'Jacobplein 51 3015 CA Rotterdam the Netherlands
| | - H. Blom
- Department of Dermatology and Venerology Erasmus Medical Centre Burgemeester s'Jacobplein 51 3015 CA Rotterdam the Netherlands
| | - J.A.C. Verkouteren
- Department of Dermatology and Venerology Erasmus Medical Centre Burgemeester s'Jacobplein 51 3015 CA Rotterdam the Netherlands
| | - A. Hofman
- Department of Epidemiology Erasmus Medical Centre Burgemeester s'Jacobplein 51 3015 CA Rotterdam the Netherlands
| | - L.M. Hollestein
- Department of Dermatology and Venerology Erasmus Medical Centre Burgemeester s'Jacobplein 51 3015 CA Rotterdam the Netherlands
| | - T. Nijsten
- Department of Dermatology and Venerology Erasmus Medical Centre Burgemeester s'Jacobplein 51 3015 CA Rotterdam the Netherlands
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13
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Forbes D, Johnston L, Gardner J, MacCallum SF, Campbell LE, Dinkova-Kostova AT, McLean WHI, Ibbotson SH, Dawe RS, Brown SJ. Filaggrin genotype does not determine the skin's threshold to UV-induced erythema. J Allergy Clin Immunol 2016; 137:1280-1282.e3. [PMID: 26830116 PMCID: PMC4819769 DOI: 10.1016/j.jaci.2015.11.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 09/28/2015] [Accepted: 11/14/2015] [Indexed: 01/01/2023]
Affiliation(s)
- Deborah Forbes
- Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Leona Johnston
- Photobiology Unit, Dermatology Department, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - June Gardner
- Photobiology Unit, Dermatology Department, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Stephanie F MacCallum
- Dermatology and Genetic Medicine, Division of Molecular Medicine, College of Life Sciences and College of Medicine, Dentistry and Nursing, University of Dundee, Dundee, United Kingdom
| | - Linda E Campbell
- Dermatology and Genetic Medicine, Division of Molecular Medicine, College of Life Sciences and College of Medicine, Dentistry and Nursing, University of Dundee, Dundee, United Kingdom
| | - Albena T Dinkova-Kostova
- Division of Cancer Research, Medical Research Institute, Jacqui Wood Cancer Centre, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - W H Irwin McLean
- Dermatology and Genetic Medicine, Division of Molecular Medicine, College of Life Sciences and College of Medicine, Dentistry and Nursing, University of Dundee, Dundee, United Kingdom
| | - Sally H Ibbotson
- Photobiology Unit, Dermatology Department, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Robert S Dawe
- Photobiology Unit, Dermatology Department, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Sara J Brown
- Dermatology and Genetic Medicine, Medical Research Institute, College of Medicine, Dentistry and Nursing, Ninewells Hospital and Medical School, Dundee, United Kingdom.
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14
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Correia de Sá TR, Silva R, Lopes JM. Basal cell carcinoma of the skin (part 1): epidemiology, pathology and genetic syndromes. Future Oncol 2015; 11:3011-21. [PMID: 26449153 DOI: 10.2217/fon.15.246] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Basal cell carcinoma (BCC) is the most common skin cancer worldwide with increasing incidence, but difficult to assess due to the current under registration practice. Despite the low mortality rate, BCC is a cause of great morbidity and an economic burden to health services. There are several risk factors that increase the risk of BCC and partly explain its incidence. Low-penetrance susceptibility alleles, as well as genetic alterations in signaling pathways, namely SHH pathway, also contribute to the carcinogenesis. BCC associate with several genetic syndromes, of which basal cell nevus syndrome is the most common.
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Affiliation(s)
| | - Roberto Silva
- Faculty of Medicine, Porto University, 4099-002 Porto, Portugal
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15
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Ortiz ML, Kumar V, Martner A, Mony S, Donthireddy L, Condamine T, Seykora J, Knight SC, Malietzis G, Lee GH, Moorghen M, Lenox B, Luetteke N, Celis E, Gabrilovich D. Immature myeloid cells directly contribute to skin tumor development by recruiting IL-17-producing CD4+ T cells. ACTA ACUST UNITED AC 2015; 212:351-67. [PMID: 25667306 PMCID: PMC4354367 DOI: 10.1084/jem.20140835] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Ortiz et al. report the accumulation of immature myeloid cells in skin tissue of patients with inflammatory conditions, which predisposes to the development of cancer. Evidence links chronic inflammation with cancer, but cellular mechanisms involved in this process remain unclear. We have demonstrated that in humans, inflammatory conditions that predispose to development of skin and colon tumors are associated with accumulation in tissues of CD33+S100A9+ cells, the phenotype typical for myeloid-derived suppressor cells in cancer or immature myeloid cells (IMCs) in tumor-free hosts. To identify the direct role of these cells in tumor development, we used S100A9 transgenic mice to create the conditions for topical accumulation of these cells in the skin in the absence of infection or tissue damage. These mice demonstrated accumulation of granulocytic IMCs in the skin upon topical application of 12-O-tetradecanoylphorbol-13-acetate (TPA), resulting in a dramatic increase in the formation of papillomas during epidermal carcinogenesis. The effect of IMCs on tumorigenesis was not associated with immune suppression, but with CCL4 (chemokine [C-C motif] ligand 4)-mediated recruitment of IL-17–producing CD4+ T cells. This chemokine was released by activated IMCs. Elimination of CD4+ T cells or blockade of CCL4 or IL-17 abrogated the increase in tumor formation caused by myeloid cells. Thus, this study implicates accumulation of IMCs as an initial step in facilitation of tumor formation, followed by the recruitment of CD4+ T cells.
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Affiliation(s)
- Myrna L Ortiz
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612
| | - Vinit Kumar
- The Wistar Institute, Philadelphia, PA 19104
| | - Anna Martner
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612 Sahlgrenska Cancer Center, University of Gothenburg, S-405 30 Gothenburg, Sweden
| | | | | | | | - John Seykora
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Stella C Knight
- Antigen Presentation Research Group, Imperial College London, London HA1 3UJ, England, UK
| | - George Malietzis
- Antigen Presentation Research Group, Imperial College London, London HA1 3UJ, England, UK St. Mark's Hospital, Harrow HA1 3UJ, England, UK
| | - Gui Han Lee
- Antigen Presentation Research Group, Imperial College London, London HA1 3UJ, England, UK St. Mark's Hospital, Harrow HA1 3UJ, England, UK
| | | | - Brianna Lenox
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612 Sahlgrenska Cancer Center, University of Gothenburg, S-405 30 Gothenburg, Sweden
| | - Noreen Luetteke
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612
| | - Esteban Celis
- Cancer Immunology, Inflammation, and Tolerance Program, Georgia Regents University Cancer Center, Augusta, GA 30912
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16
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Abstract
L’année 2013 a été l’année des études génétiques de type GWAS (Genome wide association studies) au service de maladies fréquentes (psoriasis et dermatite atopique) visant à identifier des gènes candidats et celles des grandes cohortes de population tirées de registres publics ou privés. Ainsi des corrélations épidémiologiques sont déclinées : psoriasis et surrisque vasculaire, psoriasis et pathologies ORL, rosacée et migraines, acné et habitudes alimentaires, eczéma et carcinome basocellulaire, vitiligo et moindre risque de cancers cutanés, lupus cutané Ro/SS-A et cancer, eczéma chronique et inhibiteurs calciques, pemphigoïde et diurétiques de l’anse. Les liens entre isotrétinoïne et MICI ne sont pas confirmés. Ceux liant azathioprine et cancers cutanés le sont. Des toxidermies nouvelles voient le jour (pigmentations à l’interféron, hypodermites et sarcoïdose aux inhibiteurs de BRAF muté, toxidermies au vandétanib, etc.) et des toxidermies anciennes sont « revisitées » (patch-tests dans les toxidermies sévères, pigmentation à l’hydroxychloroquine, dermatoses neutrophiliques à l’azathioprine). Diane35® a fait une fausse sortie en janvier 2013 mais le tétrazépam, lui, a fait une vraie sortie en juillet 2013. Des aspects originaux de différentes infections cutanées sont abordés et des données nouvelles sur les MST (méningococcémies et homosexuels masculins, PVH, herpès, syphilis congénitale). Enfin, quelques articles concernant la dermatoscopie, la microscopie confocale et la dermatologie esthétique seront discutés.
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Affiliation(s)
- M Janier
- Centre clinique et biologique des MST, Hôpital Saint-Louis (AP-HP), 42 rue Bichat, 75010 Paris, France; Service de dermatologie, Fondation-Hôpital Saint-Joseph, 185 rue Raymond-Losserand, 75014 Paris, France.
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17
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Pomerantz H, Weinstock MA. Predictors of local adverse effects caused by topical tretinoin cream 0·1% in the Veterans Affairs Topical Tretinoin Chemoprevention trial. Br J Dermatol 2014; 171:642-5. [PMID: 24666361 DOI: 10.1111/bjd.12987] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Topical tretinoin is commonly prescribed, but its frequent adverse effects are barriers to use. Predictors of resistance or susceptibility to retinoid irritation are not known. OBJECTIVE To identify baseline patient characteristics associated with adverse effects of topical tretinoin. METHODS This cohort study used data collected from 324 participants in the Veterans Affairs Topical Tretinoin Chemoprevention trial who were randomized to apply tretinoin cream on the face and ears. Univariate and multivariate logistic regression models were used to examine the associations between baseline characteristics and local adverse effects. RESULTS One hundred and ninety-seven patients (61% of those randomized to tretinoin) reported local adverse effects within 6 months. Clinical signs of severe photodamage at baseline [odds ratio (OR) 0·15, 95% confidence interval (CI) 0·04-0·54] and history of acne (OR 0·46, 95% CI 0·27-0·77) were associated with a decreased risk of adverse effects to tretinoin. The use of other topical medications at enrolment (OR 1·88, 95% CI 1·15-3·08) predicted an increase in adverse effects. CONCLUSIONS In this study population, the common indications of topical tretinoin treatment were associated with lower risks of adverse effects. The concurrent use of other topical medications may worsen irritation caused by tretinoin.
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Affiliation(s)
- H Pomerantz
- Dermatoepidemiology Unit, VA Medical Center, 830 Chalkstone Avenue, Providence, RI, 02908, U.S.A; Department of Dermatology, Brown University, Providence, RI, U.S.A
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18
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Graells J, Ojeda R, García-Cruz A. Effect of Imiquimod as Compared With Surgery on the Cancerization Field in Basal Cell carcinoma. ACTAS DERMO-SIFILIOGRAFICAS 2014. [DOI: 10.1016/j.adengl.2013.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Graells J, Ojeda R, García-Cruz A. Efecto del imiquimod comparado con la cirugía sobre el campo de cancerización en el carcinoma basocelular. ACTAS DERMO-SIFILIOGRAFICAS 2014; 105:53-9. [DOI: 10.1016/j.ad.2013.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 07/22/2013] [Accepted: 09/04/2013] [Indexed: 10/26/2022] Open
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20
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Khodaeiani E, Fakhrjou A, Amirnia M, Babaei-nezhad S, Taghvamanesh F, Razzagh-Karimi E, Alikhah H. Immunohistochemical evaluation of p53 and Ki67 expression in skin epithelial tumors. Indian J Dermatol 2013; 58:181-7. [PMID: 23723466 PMCID: PMC3667278 DOI: 10.4103/0019-5154.110824] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND AIMS The cellular mechanisms responsible for initiating or limiting the tumors including skin types are of great importance. The p53 is a tumor-inhibiting gene which is believed to be defective in many malignant situations. Ki67 is a non-histonic protein which is mainly interfere with the proliferation and has many controlling effects during the cell cycle. Because of their importance in skin tumor cell growth, this study aimed at evaluating the p53 and Ki67 expression in skin epithelial tumors by immunohistochemical method. MATERIALS AND METHODS In a descriptive setting, 50 biopsy samples (30 basal cell carcinomas (BCCs), 10 squamous cell carcinomas (SCCs), 8 keratoacanthomas (KAs), and 2 trichoepitheliomas (TEs)) were immunohistochemically evaluated for p53 and Ki67 expression during a 14-month period. The incidence and expression rate of these two variables were separately reported in each group of samples. RESULTS The expression rate of p53 was 67.77% for the BCCs, 50.20% for the SCCs, and null for the KAs. For both TEs, it was 50%. The expression rate of Ki67 was 57.33% for the BCCs, 47.70% for the SCCs, 37.5% for the KAs, and 0.0% for TEs. The incidence of P53+ cells was 100% and 90% in the BCC and SCC samples, respectively. The both TEs were positive in this regard. The incidence of Ki67+ cells was 100% for the BCC, SCC, and KA samples. The both TEs were negative in this regard. CONCLUSION This study showed that the incidence rate of p53- and Ki67-positive cells is very high in skin malignant epithelial tumors. The expression rate of these two variables is comparable with reports in the literature. Further studies with large sample size are recommended to be carried out for KA and TE samples.
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Affiliation(s)
| | - Ashraf Fakhrjou
- Department of Pathology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehdi Amirnia
- From the Department of Dermatology, Sina Hospital, Tabriz, Iran
| | | | | | | | - Hossein Alikhah
- From the Department of Dermatology, Sina Hospital, Tabriz, Iran
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Predictors of squamous cell carcinoma in high-risk patients in the VATTC trial. J Invest Dermatol 2013; 133:1521-32. [PMID: 23348836 DOI: 10.1038/jid.2013.35] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Invasive squamous cell carcinoma (SCC) of the skin is one of the most common cancers in the United States, with no proven means for prevention other than systemic retinoids, which have significant toxicity, and sunscreen. We sought to determine the risk factors for invasive SCC on the face or ears in a high-risk population comprising 1,131 veterans in the Veterans Affairs Topical Tretinoin Chemoprevention (VATTC) Trial. Participants were required to have been diagnosed with at least two keratinocyte carcinomas (KCs) in the 5 years prior to enrollment. The median duration of follow-up was 3.7 years. Twenty-three percent of the participants developed a new invasive SCC, and the cumulative risk of invasive SCC was 30% at 5 years. The following factors independently predicted for new invasive SCCs: number of invasive SCCs and number of in situ SCCs in the 5 years prior to enrollment, actinic keratoses count at enrollment, a history of ever use of topical 5-fluorouracil, and total occupational time spent outdoors. In contrast, the use of angiotensin-convering enzyme inhibitors or angiotensin receptor blockers during the study and a history of warts anywhere on the body were found to protect against new invasive SCCs. These independent predictors remained the same for all SCCs (invasive and in situ combined). The number of basal cell carcinomas in the 5 years prior to enrollment, sunburns, sun sensitivity, and recreational sun exposure were not associated with new SCCs. These findings identify key risk factors for additional SCCs in patients with multiple prior KCs, and suggest that a history of warts may be associated with reduced SCC risk.
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Elias PM, Williams ML. Comment on 'does a history of eczema predict a future Basal cell carcinoma?'. J Invest Dermatol 2013; 133:1676-7. [PMID: 23340733 DOI: 10.1038/jid.2013.29] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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