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Degree of Actinic Elastosis Is a Surrogate of Exposure to Chronic Ultraviolet Radiation and Correlates More Strongly with Cutaneous Squamous Cell Carcinoma than Basal Cell Carcinoma. Life (Basel) 2023; 13:life13030811. [PMID: 36983966 PMCID: PMC10055681 DOI: 10.3390/life13030811] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/13/2023] [Accepted: 03/16/2023] [Indexed: 03/19/2023] Open
Abstract
(1) Background: Keratinocyte cancer (KC) is associated with exposure to ultraviolet (UV) radiation. However, data are controversial as to whether chronic UV exposure or high intermittent UV exposure are key drivers of carcinogenesis in cutaneous squamous cell carcinoma (cSCC) and basal cell carcinoma (BCC). Prolonged sun exposure of the skin causes photo-aging, which is associated with actinic elastosis, a condition characterized by the degeneration of elastin in the upper dermis, which is assessable via conventional histology. In this study, we aimed to compare the degree of actinic elastosis in different types of KC with regard to various patient characteristics. (2) Methods: We defined a semiquantitative score for the degree of actinic elastosis ranging from 0 = none to 3 = total loss of elastic fibers (basophilic degeneration). The extent was measured histometrically by two independent dermatohistopathologists in the immediate vicinity of 353 KC. The scores were merged and matched with tumor types (cSCC and BCC with subtypes), and clinical variables such as body site, sex and age. (3) Results: As expected, the degree of actinic elastosis correlated with age. However, it was significantly higher in cSCC compared to BCC irrespective of age, sex, body site and tumor subtypes. (4): Conclusions: Lifetime sun exposure may be estimated via routine histology using this scoring technique for actinic elastosis as a surrogate marker. cSCCs are more strongly associated with chronic UV exposure than BCCs, even in sun-exposed localizations such as the face.
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Li X, Qin S, Shi S, Feng Y, Li H, Feng Y, Li M, Wen J. Prospective study of efficacy and safety of non-ablative 1927 nm fractional thulium fiber laser in Asian skin photoaging. Front Surg 2023; 10:1076848. [PMID: 36950052 PMCID: PMC10025463 DOI: 10.3389/fsurg.2023.1076848] [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: 10/22/2022] [Accepted: 02/10/2023] [Indexed: 03/08/2023] Open
Abstract
Background and Objective Photoaging manifests as deeper wrinkles and larger pores. It has been tried to rejuvenate photoaging skin using a variety of lasers, including fractionated lasers, which are a popular photorejuvenation treatment. A new breakthrough for skin rejuvenation is the 1927 nm fractional thulium fiber laser (FTL), a laser and light-based treatment option. Clinical data regarding the FTL for treating photoaging are limited despite its effectiveness and safety. This study is aim to evaluate FTL' clinical effectiveness and safety. Methods Fitzpatrick skin types II-IV subjects with mild to moderate photoaging signs were enrolled in this prospective study. At intervals of one month, patients received three full face treatments. Wrinkles, spots, texture, pores, melanin index, erythema index (MI and EI), skin elasticity and hydration were measured with non-invasive tool. The epidermal thickness and dermal density on ultrasonography were compared between baseline and one month after all treatment sessions. The Global Score for Photoaging scale (GSP) was rated by two independent evaluators at the baseline and final follow-up visit. Secondary outcomes included patient-rated pain on a 10-point visual analog scale (VAS), as well as overall satisfaction. Following each treatment, adverse events were noted. Results Totally 27 subjects (24 females and 3 males) with Fitzpatrick skin types II to IV and a mean age of 44.41 (range33-64) were enrolled. Results suggests that the epidermal thickness has significantly improved after treatment. Statistically significant improvements in melanin index, skin elasticity and wrinkles were noted. An analysis of 12 subjects' reports (44%) suggested their skin felt brighter. No post-inflammatory hyperpigmentation changes or adverse events were observed. 70% patients reporting "satisfied" or "extremely satisfied". Conclusions In this study, FTL was found to be a safe and effective treatment option for treating photoaging.
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Affiliation(s)
- Xianwen Li
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Dermatology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Si Qin
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Dermatology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Siman Shi
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Dermatology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yingjun Feng
- Department of Dermatology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Huarun Li
- Department of Dermatology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yuqin Feng
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Dermatology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Mujin Li
- Department of Dermatology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Ju Wen
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Dermatology, Guangdong Second Provincial General Hospital, Guangzhou, China
- Correspondence: Ju Wen
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Wang J, Ma W, Si C, Zhang M, Qian W, Park G, Zhou B, Luo D. Exosome-mediated miR-4655–3p contributes to UV radiation-induced bystander effects. Exp Cell Res 2022; 418:113247. [DOI: 10.1016/j.yexcr.2022.113247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/04/2022] [Accepted: 06/05/2022] [Indexed: 11/04/2022]
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Perez M, Abisaad JA, Rojas KD, Marchetti MA, Jaimes N. Skin Cancer: Primary, Secondary, and Tertiary Prevention. Part I. J Am Acad Dermatol 2022; 87:255-268. [DOI: 10.1016/j.jaad.2021.12.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/03/2021] [Accepted: 12/15/2021] [Indexed: 10/19/2022]
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Dary Gutiérrez-Castañeda L, Nova J, Irene Cerezo-Cortés M. Somatic Mutations in TP53 Gene in Colombian Patients With Non-melanoma Skin Cancer. CANCER DIAGNOSIS & PROGNOSIS 2022; 2:107-114. [PMID: 35400008 PMCID: PMC8962838 DOI: 10.21873/cdp.10084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 11/03/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND/AIM Non-melanoma skin cancer is the most common cancer in the world. Somatic mutations in the TP53 gene are associated with the development of this cancer. To describe mutations in exons 5-8 of the TP53 gene in a sample of Colombian patients with non-melanoma skin cancer. MATERIALS AND METHODS One hundred and fifteen patients with non-melanoma skin cancer were included. Exons 5-8 were amplified and analyzed by PCR-High Resolution Melting and Sanger sequencing. RESULTS Fifty-seven patients with basal cell carcinomas and 58 with squamous cell carcinomas were studied. 16% of patients with basal cell carcinoma and 26% of patients with squamous cell carcinoma had mutations in the TP53 gene. The most frequent mutations were substitutions, while three patients had deletions. The most frequent mutation was p.R158G. CONCLUSION The analysis showed that Colombian individuals with non-melanoma skin cancer have genetic TP53 variants different from those reported as recurrent for this disease.
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Affiliation(s)
- Luz Dary Gutiérrez-Castañeda
- General Dermatology Group, Hospital Universitario Centro Dermatológico Federico Lleras Acosta E.S.E, Bogotá, Colombia
| | - John Nova
- General Dermatology Group, Hospital Universitario Centro Dermatológico Federico Lleras Acosta E.S.E, Bogotá, Colombia
| | - María Irene Cerezo-Cortés
- General Dermatology Group, Hospital Universitario Centro Dermatológico Federico Lleras Acosta E.S.E, Bogotá, Colombia
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Hezaveh E, Jafari S, Jalilpiran Y, Zargarzadeh N, Mahdavi R, Gargari BP. Dietary components and the risk of non-melanoma skin cancer: A systematic review of epidemiological studies. Crit Rev Food Sci Nutr 2021:1-16. [PMID: 34933633 DOI: 10.1080/10408398.2021.2016600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Non-melanoma skin cancer (NMSC) is the most common cancer among white-skinned people. The main environmental risk factor for all types of skin cancer is ultraviolet (UV) exposure to the sun. However, significant modifiable risk factors, such as diet, have been studied about NMSC risk. Several original studies have been conducted on the link between various dietary components and the risk of NMSC in the past decade, but have not been systematically reviewed. This review focuses on the potential impact of dietary components in the prevention of NMSC and evaluates the findings of epidemiologic evidence for dietary factors. We conducted a systematic search of three databases, including Scopus, ISI Web of Science, and PubMed, to identify relevant epidemiological studies published between 2000 and July 6, 2021. Finally, forty-three articles were included. Because of the inherent limitations of epidemiological studies, no definitive conclusions can be drawn; however, the links between folate, citrus, caffeine, and alcohol with BCC are notable; thus, high dietary folate intake, as well as citrus and alcohol consumption, are associated with an increased risk of basal cell carcinoma (BCC), whereas caffeine is associated with a lower risk. More research is required to reach a definitive conclusion.
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Affiliation(s)
- Erfan Hezaveh
- Department of Biochemistry and Dietetics, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sahar Jafari
- Department of Community Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yahya Jalilpiran
- Department of Clinical Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Nikan Zargarzadeh
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Mahdavi
- Nutrition Research Center, Department of Biochemistry and Dietetics, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bahram Pourghassem Gargari
- Nutrition Research Center, Department of Biochemistry and Dietetics, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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de Villiers EM, zur Hausen H. Bovine Meat and Milk Factors (BMMFs): Their Proposed Role in Common Human Cancers and Type 2 Diabetes Mellitus. Cancers (Basel) 2021; 13:cancers13215407. [PMID: 34771570 PMCID: PMC8582480 DOI: 10.3390/cancers13215407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/24/2021] [Accepted: 10/25/2021] [Indexed: 12/16/2022] Open
Abstract
Simple Summary This manuscript emphasizes the mechanistic differences of infectious agents contributing to human cancers either by “direct” or “indirect” interactions. The epidemiology of cancers linked to direct carcinogens differs (e.g., response to immunosuppression) from those cancers linked with indirect infectious interactions. We discuss their role in colon, breast, and prostate cancers and type II diabetes mellitus. A brief discussion covers the potential role of BMMF (bovine meat and milk factor) infections in acute myeloid leukemia. Abstract Exemplified by infections with bovine meat and milk factors (BMMFs), this manuscript emphasizes the different mechanistic aspects of infectious agents contributing to human cancers by “direct” or “indirect” interactions. The epidemiology of cancers linked to direct carcinogens (e.g., response to immunosuppression) differs from those cancers linked with indirect infectious interactions. Cancers induced by direct infectious carcinogens commonly increase under immunosuppression, whereas the cancer risk by indirect carcinogens is reduced. This influences their responses to preventive and therapeutic interferences. In addition, we discuss their role in colon, breast and prostate cancers and type II diabetes mellitus. A brief discussion covers the potential role of BMMF infections in acute myeloid leukemia.
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Affiliation(s)
- Ethel-Michele de Villiers
- Correspondence: (E.-M.d.V.); (H.z.H.); Tel.: +49-151-4312-3085 (E.-M.d.V.); +49-6221-423850 (H.z.H.)
| | - Harald zur Hausen
- Correspondence: (E.-M.d.V.); (H.z.H.); Tel.: +49-151-4312-3085 (E.-M.d.V.); +49-6221-423850 (H.z.H.)
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Caini S, De Angelis SP, Corso F, Fantini C, Raimondi S, Pala L, Stanganelli I, de Giorgi V, Gandini S. Exogenous sex hormones, menstrual and reproductive history, and risk of non-melanoma skin cancer among women: a systematic literature review and meta-analysis. Sci Rep 2021; 11:8524. [PMID: 33875740 PMCID: PMC8056000 DOI: 10.1038/s41598-021-88077-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 03/30/2021] [Indexed: 11/09/2022] Open
Abstract
Non-melanoma skin cancers (NMSC) are more frequent among men, but women (especially those aged < 40 years) have experienced steeper growth in their incidence rates in recent years. Hormonal factors were hypothesized to be playing a role in modulating NMSC risk, but the studies published to date provided conflicting results. We systematically reviewed and meta-analysed the studies focusing on the association between hormone-related characteristics (use of exogenous sex hormones, and aspects of menstrual and reproductive history) and the risk of NMSC among women. We included observational and experimental studies published in PubMed and EMBASE until February 2020. We calculated summary relative risk (SRR) and 95% confidence intervals (CI) by applying random effects models with maximum likelihood estimation, and used the I2 statistics to quantify the degree of heterogeneity of risk estimates across studies. Eleven independent studies encompassing a total of over 30,000 NMSC cases were included in quantitative analyses. No evidence of an increased NMSC risk emerged among ever vs. never users of oral contraceptives (SRR 1.13, 95% CI 0.88-1.45) or hormones for menopause (SRR 1.09, 95% CI 0.87-1.37). Likewise, age at menarche or at menopause and parity were not associated with NMSC risk. Heterogeneity across studies was low, and pooled results were comparable between NMSC subtypes. We found no evidence that hormonal factors play a role in the pathogenesis of NMSC among women.
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Affiliation(s)
- Saverio Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, 50141, Florence, Italy.
| | | | - Federica Corso
- Department of Experimental Oncology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Carolina Fantini
- Dermatology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Sara Raimondi
- Department of Experimental Oncology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Laura Pala
- Department of Experimental Oncology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Ignazio Stanganelli
- Dermatology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
- Skin Cancer Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" (IRST), IRCSS, Meldola, Italy
| | | | - Sara Gandini
- Department of Experimental Oncology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
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Azizova TV, Bannikova MV, Grigoryeva ES, Rybkina VL. Risk of skin cancer by histological type in a cohort of workers chronically exposed to ionizing radiation. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2021; 60:9-22. [PMID: 33389049 DOI: 10.1007/s00411-020-00883-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 11/23/2020] [Indexed: 06/12/2023]
Abstract
The incidence risk of non-melanoma skin cancer (NMSC), in particular basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), was investigated in a cohort of workers of the Russian nuclear facility, the Mayak Production Association (PA), who had been occupationally exposed to low dose-rate ionizing radiation over prolonged periods. The study cohort included all workers who had been hired at the enterprise in 1948-1982 and followed up to 31.12.2018 (22,377 individuals, 25% of females). The mean cumulative skin absorbed dose of external gamma-ray exposure was 0.50 ± 0.73 Gy (the range of 0.00-8.84 Gy); the mean cumulative skin absorbed dose of neutron exposure was 0.002 ± 0.004 Gy (the range of 0.0000002-0.153 Gy). Relative risk and excess relative risk per unit skin absorbed dose of external exposure (RR and ERR/Gy) were estimated using AMFIT module of EPICURE software. Over the entire follow-up period 295 (84.8%) BCC, 48 (13.8%) SCC and 5 (1.4%) skin appendage cell carcinomas (SACC) were registered among NMSC in members of the study cohort. A significant linear association of the BCC incidence with the cumulative skin absorbed dose of external gamma-ray exposure was observed: ERR/Gy = 0.57 (95% CI 0.24, 1.06). Inclusion of an adjustment for neutron dose in the model resulted in a modest reduction of the BCC risk estimate [ERR/Gy = 0.55 (95% CI 0.23, 1.03)]. No significant association was revealed for SCC incidence with cumulative skin absorbed dose of external gamma-ray exposure [ERR/Gy = 0.14 (95% CI - 0.23, 0.91)]; inclusion of the neutron dose adjustment in the model did not modify the estimated SCC risk. No modification of the BCC and SCC incidence risks by sex, age at hire, attained age and facility type was observed.
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Affiliation(s)
- Tamara V Azizova
- Southern Urals Biophysics Institute (SUBI), Ozyorskoe Shosse 19, Ozyorsk Chelyabinsk Region, Ozyorsk, 456780, Russia.
| | - Maria V Bannikova
- Southern Urals Biophysics Institute (SUBI), Ozyorskoe Shosse 19, Ozyorsk Chelyabinsk Region, Ozyorsk, 456780, Russia
| | - Evgeniya S Grigoryeva
- Southern Urals Biophysics Institute (SUBI), Ozyorskoe Shosse 19, Ozyorsk Chelyabinsk Region, Ozyorsk, 456780, Russia
| | - Valentina L Rybkina
- Southern Urals Biophysics Institute (SUBI), Ozyorskoe Shosse 19, Ozyorsk Chelyabinsk Region, Ozyorsk, 456780, Russia
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Development of Multiple-Lesion Basal Cell Carcinoma of the Skin: A Comprehensive Review. MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2020; 53:323-328. [PMID: 32377105 PMCID: PMC7192293 DOI: 10.14744/semb.2019.08058] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 09/02/2019] [Indexed: 11/20/2022]
Abstract
An interesting clinical feature of basal cell carcinoma (BCC) of the skin is a marked variation in tumor number, sites, and accrual. Some individuals develop only a single BCC lesion with no impact on health status, while a significant proportion is affected repeatedly with new primary tumors at various body sites. Approximately 29% of patients with a first BCC will develop at least 1 more lesion during their lifetime. The candidate predictors for multiple BCC development include younger age and a superficial BCC subtype at the time of the first diagnosis, red hair phenotype, initial or frequent tumor location on the trunk or on the upper limbs, and male gender. The pathogenesis of multiple BCC development does not seem to be related to greater UVR exposure. Individual genetic susceptibility may have a greater impact than extrinsic factors. In clinical practice, it is meaningful to estimate the probability of new BCC development in patients who have an initial lesion. A reliable prediction model for individualized risk stratification remains a subject of continued research; however, a focus on the risk factor profile is beneficial for clinical screening and may help clinicians to determine the individuals who should be followed up more closely.
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Tokez S, Alblas M, Nijsten T, Pardo LM, Wakkee M. Predicting keratinocyte carcinoma in patients with actinic keratosis: development and internal validation of a multivariable risk-prediction model. Br J Dermatol 2020; 183:495-502. [PMID: 31856292 PMCID: PMC7496285 DOI: 10.1111/bjd.18810] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Patients with actinic keratosis (AK) are at increased risk for developing keratinocyte carcinoma (KC) but predictive factors and their risk rates are unknown. OBJECTIVES To develop and internally validate a prediction model to calculate the absolute risk of a first KC in patients with AK. METHODS The risk-prediction model was based on the prospective population-based Rotterdam Study cohort. We hereto analysed the data of participants with at least one AK lesion at cohort baseline using a multivariable Cox proportional hazards model and included 13 a priori defined candidate predictor variables considering phenotypic, genetic and lifestyle risk factors. KCs were identified by linkage of the data with the Dutch Pathology Registry. RESULTS Of the 1169 AK participants at baseline, 176 (15·1%) developed a KC after a median follow-up of 1·8 years. The final model with significant predictors was obtained after backward stepwise selection and comprised the presence of four to nine AKs [hazard ratio (HR) 1·68, 95% confidence interval (CI) 1·17-2·42], 10 or more AKs (HR 2·44, 95% CI 1·65-3·61), AK localization on the upper extremities (HR 0·75, 95% CI 0·52-1·08) or elsewhere except the head (HR 1·40, 95% CI 0·98-2·01) and coffee consumption (HR 0·92, 95% CI 0·84-1·01). Evaluation of the discriminative ability of the model showed a bootstrap validated concordance index (c-index) of 0·60. CONCLUSIONS We showed that the risk of KC in patients with AK can be calculated with the use of four easily assessable predictor variables. Given the c-index, extension of the model with additional, currently unknown predictor variables is desirable. Linked Comment: Kim et al. Br J Dermatol 2020; 183:415-416.
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Affiliation(s)
- S Tokez
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - M Alblas
- Department of Public Health, Erasmus MC University Medical Centre, Rotterdam, the Netherlands
| | - T Nijsten
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - L M Pardo
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - M Wakkee
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
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Reinehr CPH, Bakos RM. Actinic keratoses: review of clinical, dermoscopic, and therapeutic aspects. An Bras Dermatol 2019; 94:637-657. [PMID: 31789244 PMCID: PMC6939186 DOI: 10.1016/j.abd.2019.10.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 10/17/2019] [Indexed: 02/07/2023] Open
Abstract
Actinic keratoses are dysplastic proliferations of keratinocytes with potential for malignant transformation. Clinically, actinic keratoses present as macules, papules, or hyperkeratotic plaques with an erythematous background that occur on photoexposed areas. At initial stages, they may be better identified by palpation rather than by visual inspection. They may also be pigmented and show variable degrees of infiltration; when multiple they then constitute the so-called field cancerization. Their prevalence ranges from 11% to 60% in Caucasian individuals above 40 years. Ultraviolet radiation is the main factor involved in pathogenesis, but individual factors also play a role in the predisposing to lesions appearance. Diagnosis of lesions is based on clinical and dermoscopic examination, but in some situations histopathological analysis may be necessary. The risk of transformation into squamous cell carcinoma is the major concern regarding actinic keratoses. Therapeutic modalities for actinic keratoses include topical medications, and ablative and surgical methods; the best treatment option should always be individualized according to the patient.
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Affiliation(s)
| | - Renato Marchiori Bakos
- Department of Dermatology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
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Argenziano G, Brancaccio G. Genes or environment: what counts most in basal cell carcinoma? J Eur Acad Dermatol Venereol 2019; 33:461. [PMID: 30891847 DOI: 10.1111/jdv.15486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- G Argenziano
- Dermatology Unit, University of Campania, Naples, Italy
| | - G Brancaccio
- Dermatology Unit, University of Campania, Naples, Italy
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Grandahl K, Olsen J, Friis KBE, Mortensen OS, Ibler KS. Photoaging and actinic keratosis in Danish outdoor and indoor workers. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2019; 35:201-207. [PMID: 30687943 PMCID: PMC6850006 DOI: 10.1111/phpp.12451] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 12/23/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The risk of photoaging and actinic keratosis caused by work related solar ultraviolet radiation exposure has not previously been investigated in Nordic countries. The objectives of this study were to describe the occurrence of photoaging, actinic keratosis, and keratinocyte cancer in a population of Danish outdoor and indoor workers, and investigate the association between these clinical findings and semi-objective measures of work related solar ultraviolet radiation exposure in the same population. METHODS A clinical cross-sectional study of the occurrence of facial wrinkles, actinic keratosis, keratinocyte cancer, and melanocytic nevi in a population of Danish outdoor and indoor workers and associations with semi-objective measures of work related solar ultraviolet radiation exposure based on a combination of dosimetry and self-report. RESULTS Work related solar ultraviolet radiation exposure was significantly positively associated with occurrence of facial wrinkles (α = 0.05). Actinic keratosis was associated to status as outdoor worker (OR = 4.272, CI [1.045-17.471]) and age (P < 0.001, CI [1.077-1.262]) and twice as common in outdoor workers (10.3% CI [0.05, 0.15]) compared to indoor workers (5.1% CI [0.00, 0.10]). Only two cases of keratinocyte cancer were diagnosed (<1%). Older age was negatively associated with occurrence of melanocytic nevi. CONCLUSION Outdoor work in Denmark is associated with increased occurrence of facial wrinkles and actinic keratosis from solar ultraviolet radiation exposure, thus justifying sun safety at Danish workplaces from a clinical perspective.
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Affiliation(s)
- Kasper Grandahl
- The Department of Occupational Medicine, Copenhagen University Holbaek, Holbaek, Denmark
| | - Jonas Olsen
- The Department of Dermatology, Zealand University Hospital Roskilde, Roskilde, Denmark
| | | | - Ole Steen Mortensen
- The Department of Occupational Medicine, Copenhagen University Holbaek, Holbaek, Denmark.,Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kristina Sophie Ibler
- The Department of Dermatology, Zealand University Hospital Roskilde, Roskilde, Denmark
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Balcere A, Karls R, Čēma I, Rone Kupfere M, Vīksna L, Krūmiņa A. Treatment of Actinic Keratoses Facilitates Dermatoscopic Diagnosis of Early Basal Cell Carcinoma: A Case Report and Review. Case Rep Dermatol 2019. [DOI: 10.1159/000496329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Chronic exposure to ultraviolet radiation induces gradual changes in cutaneous morphology, which with increasing damage leads to the appearance of cancerous skin lesions. Among them, basal cell carcinomas (BCCs) and actinic keratoses (AKs) are the most common entities. Both lesions often develop as two separate lesions in a single individual at a conspicuous distance, close proximity or as collision lesions, which are characterized by the coexistence of both cancers in the same anatomical site. Collision lesions in which AK precisely overlies BCC is a rarely reported entity. We report a case where the presence of BCC was dermatoscopically detected after an overlying AK was treated with topical chemotherapy, thus indicating that treatment of AK allows better visualization of other underlying malignancies.
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16
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Azizova TV, Bannikova MV, Grigoryeva ES, Rybkina VL. Risk of malignant skin neoplasms in a cohort of workers occupationally exposed to ionizing radiation at low dose rates. PLoS One 2018; 13:e0205060. [PMID: 30289933 PMCID: PMC6173419 DOI: 10.1371/journal.pone.0205060] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 09/19/2018] [Indexed: 12/01/2022] Open
Abstract
Recently an increasing trend in skin cancer rates has been observed in various populations including those exposed to different radiation types. Risk and dose-response following prolonged radiation exposure remain unclear. The present study was aimed to assess skin melanoma (SM) and non-melanoma skin cancer (NMSC) incidence risks in a cohort of workers occupationally exposed to ionizing radiation at low dose rates over prolonged periods. The study cohort included workers of a Russian nuclear production facility, Mayak Production Association (PA), who were first employed in 1948-1982 and followed up till the end of 2013 (the total of 22,377 individuals with 25% of females). Using AMFIT module of EPICURE software, relative risk and excess relative risk per unit dose (RR and ERR/Sv) were calculated. 60 SM and 294 NMSC cases were registered in members of the study cohort. SM and NMSC incidence was dependent on sex, attained age, age at first employment at the enterprise, type of facility, education level and was not dependent on calendar period of first employment, calendar period of diagnosis, duration of employment, smoking and alcohol consumption statuses. The risk of NMSC incidence was found to be significantly increased in workers occupationally exposed to ionizing radiation at cumulative doses above 2.0 Sv (RR = 2.52; 95% CI: 1.60, 3.97) compared to a reference dose category (0-0.05 Sv). NMSC incidence was found to be significantly associated with cumulative external gamma-dose with ERR/Sv of 0.49 (95% CI: 0.22, 0.90) without an adjustment for neutron dose and 0.51 (95% CI: 0.22, 0.93) while adjusted for neutron dose. Results of the analysis did not reveal a significant association of SM incidence with cumulative dose from external gamma-rays with ERR/Sv of 0.22 (95% CI: -0.29, 1.46) not including a neutron dose adjustment and of 0.15 (95% CI: -0.41, 1.31) while adjusted for dose from neutron exposure.
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Affiliation(s)
- Tamara V. Azizova
- Clinical Department, Southern Urals Biophysics Institute (SUBI), Ozyorsk, Chelyabinsk region, Russia
| | - Maria V. Bannikova
- Clinical Department, Southern Urals Biophysics Institute (SUBI), Ozyorsk, Chelyabinsk region, Russia
| | - Evgeniya S. Grigoryeva
- Clinical Department, Southern Urals Biophysics Institute (SUBI), Ozyorsk, Chelyabinsk region, Russia
| | - Valentina L. Rybkina
- Clinical Department, Southern Urals Biophysics Institute (SUBI), Ozyorsk, Chelyabinsk region, Russia
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17
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Belbasis L, Stefanaki I, Stratigos AJ, Evangelou E. Non-genetic risk factors for cutaneous melanoma and keratinocyte skin cancers: An umbrella review of meta-analyses. J Dermatol Sci 2016; 84:330-339. [PMID: 27663092 DOI: 10.1016/j.jdermsci.2016.09.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 08/25/2016] [Accepted: 09/08/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Skin cancers have a complex disease mechanism, involving both genetic and non-genetic risk factors. Numerous meta-analyses have been published claiming statistically significant associations between non-genetic risk factors and skin cancers without applying a thorough methodological assessment. OBJECTIVE The present study maps the literature on the non-genetic risk factors of skin cancers, assesses the presence of statistical biases and identifies the associations with robust evidence. METHODS We searched PubMed up to January 20, 2016 to identify systematic reviews and meta-analyses of observational studies that examined associations between non-genetic factors and skin cancers. For each meta-analysis, we estimated the summary effect size by random-effects and fixed-effects models, the 95% confidence interval and the 95% prediction interval. We also assessed the between-study heterogeneity (I2 metric), evidence for small-study effects and excess significance bias. RESULTS Forty-four eligible papers were identified and included a total of 85 associations. Twenty-one associations were significant at P<10-6. Fifty-two associations had large or very large heterogeneity. Evidence for small-study effects and excess significance bias was found in fifteen and thirteen associations, respectively. Overall, thirteen associations (actinic keratosis, serum vitamin D, sunburns, and hair color for basal cell carcinoma and density of freckles, eye color, hair color, history of melanoma, skin type, sunburns, premalignant skin lesions, common and atypical nevi for melanoma) presented high level of credibility. CONCLUSION The majority of meta-analyses on non-genetic risk factors for skin cancers suffered from large between-study heterogeneity and small-study effects or excess significance bias. The associations with convincing and highly suggestive evidence were mainly focused on skin photosensitivity and phenotypic characteristics.
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Affiliation(s)
- Lazaros Belbasis
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Irene Stefanaki
- Department of Dermatology, Andreas Sygros Hospital, University of Athens Medical School, Athens, Greece
| | - Alexander J Stratigos
- Department of Dermatology, Andreas Sygros Hospital, University of Athens Medical School, Athens, Greece
| | - Evangelos Evangelou
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
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18
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Caini S, Cattaruzza MS, Bendinelli B, Tosti G, Masala G, Gnagnarella P, Assedi M, Stanganelli I, Palli D, Gandini S. Coffee, tea and caffeine intake and the risk of non-melanoma skin cancer: a review of the literature and meta-analysis. Eur J Nutr 2016; 56:1-12. [PMID: 27388462 DOI: 10.1007/s00394-016-1253-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 06/20/2016] [Indexed: 12/13/2022]
Abstract
PURPOSE Laboratory studies suggested that caffeine and other nutrients contained in coffee and tea may protect against non-melanoma skin cancer (NMSC). However, epidemiological studies conducted so far have produced conflicting results. METHODS We performed a literature review and meta-analysis of observational studies published until February 2016 that investigated the association between coffee and tea intake and NMSC risk. We calculated summary relative risk (SRR) and corresponding 95 % confidence intervals (95 % CI) by using random effects with maximum likelihood estimation. RESULTS Overall, 37,627 NMSC cases from 13 papers were available for analysis. Intake of caffeinated coffee was inversely associated with NMSC risk (SRR for those in the highest vs. lowest category of intake: 0.82, 95 % CI 0.75-0.89, I 2 = 48 %), as well as intake of caffeine (SRR 0.86, 95 % CI 0.80-0.91, I 2 = 48 %). In subgroup analysis, these associations were limited to the basal cell cancer (BCC) histotype. There was no association between intake of decaffeinated coffee (SRR 1.01, 95 % CI 0.85-1.21, I 2 = 0) and tea (0.88, 95 % CI 0.72-1.07, I 2 = 0 %) and NMSC risk. There was no evidence of publication bias affecting the results. The available evidence was not sufficient to draw conclusions on the association between green tea intake and NMSC risk. CONCLUSIONS Coffee intake appears to exert a moderate protective effect against BCC development, probably through the biological effect of caffeine. However, the observational nature of studies included, subject to bias and confounding, suggests taking with caution these results that should be verified in randomized clinical trials.
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Affiliation(s)
- Saverio Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Via delle Oblate 2, 50139, Florence, Italy.
| | - Maria Sofia Cattaruzza
- Department of Public Health and Infectious Diseases, Faculty of Medicine, Policlinico Umberto I, "Sapienza" University, Rome, Italy
| | - Benedetta Bendinelli
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Via delle Oblate 2, 50139, Florence, Italy
| | - Giulio Tosti
- Division of Dermatoncological Surgery, European Institute of Oncology, Milan, Italy
| | - Giovanna Masala
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Via delle Oblate 2, 50139, Florence, Italy
| | - Patrizia Gnagnarella
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
| | - Melania Assedi
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Via delle Oblate 2, 50139, Florence, Italy
| | - Ignazio Stanganelli
- Skin Cancer Unit, Scientific Institute of Romagna for the Study and Treatment of Cancer, IRCSS, IRST, Meldola, Italy
| | - Domenico Palli
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Via delle Oblate 2, 50139, Florence, Italy
| | - Sara Gandini
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
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19
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Snarskaya ES, Tkachenko SB, Kuznetsova EV, Allenova AS. Potential of confocal laser scanning microscopy for non-invasive diagnostics of malignant epithelial skin tumors in the course of dermatoheliosis progression. VESTNIK DERMATOLOGII I VENEROLOGII 2016. [DOI: 10.25208/0042-4609-2016-92-3-75-82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Most cases of malignant epithelial skin neoplasms including actinic keratosis and basal cell carcinoma, which are characterized by the most complicated course and numerous clinical and morphological options, involve dermatoheliosis progression. The risk of actinic keratosis transformation into basal cell carcinoma varies from 0.1% to 20% and up to 80% in cases of multiple AK lesion foci. A non-invasive method known as reflectance confocal laser scanning microscopy is the most promising one for the purposes of early diagnostics of signs pointing at epithelial skin neoplasm development and makes it possible to monitor the tumor in progress in vivo to diagnose the presence of a pool of squamous cells on a timely basis. The confocal laser scanning microscopy method provides high-contrast images of for any horizontal-oriented morphologic structures in the epidermis and upper dermis with a resolution comparable to those characteristic of traditional optical microscopy of skin tissue samples. According to our data obtained as a result of studying dynamic changes and morphologic structures in actinic keratosis foci (50 cases) using the confocal laser scanning microscopy method, we discovered a number of morphologic features, and their further analysis will distinguish the signs of progressing carcinogenesis in case of dermatoheliosis.
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20
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Morales-Sánchez MA, Peralta-Pedrero ML, Jurado-Santa Cruz F, Pomerantz H, Barajas-Nava LA. Interventions for preventing keratinocyte cancer in high-risk groups not receiving immunosuppressive therapy. Hippokratia 2016. [DOI: 10.1002/14651858.cd012266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Martha Alejandra Morales-Sánchez
- Dermatological Center, "Dr. Ladislao de la Pascua"; Education and Research Unit; Dr. José María Vértiz No. 464 Col. Buenos Aires México City Mexico 06780
| | - María Luisa Peralta-Pedrero
- Dermatological Center, "Dr. Ladislao de la Pascua"; Education and Research Unit; Dr. José María Vértiz No. 464 Col. Buenos Aires México City Mexico 06780
| | - Fermín Jurado-Santa Cruz
- Dermatological Center, "Dr. Ladislao de la Pascua"; Education and Research Unit; Dr. José María Vértiz No. 464 Col. Buenos Aires México City Mexico 06780
| | - Hyemin Pomerantz
- Hofstra Northwell School of Medicine; Department of Dermatology; Hempstead New York USA
| | - Leticia A Barajas-Nava
- Hospital Infantil de México Federico Gómez (HIMFG), Health National Institute; Evidence-Based Medicine Research Unit; Dr. Márquez #162 Col. Doctores, Del. Cuauhtémoc México City Mexico 06720
- Iberoamerican Cochrane Network; Institute of Biomedical Research (IIB Sant Pau), C/ Sant Antoni Ma Claret 171 Casa de Convalescència Barcelona Barcelona Spain 08041
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21
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Kuklinski LF, Zens MS, Perry AE, Gossai A, Nelson HH, Karagas MR. Sex hormones and the risk of keratinocyte cancers among women in the United States: A population-based case-control study. Int J Cancer 2016; 139:300-9. [PMID: 26941014 DOI: 10.1002/ijc.30072] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 02/19/2016] [Indexed: 12/20/2022]
Abstract
Men are at a higher risk of developing both squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) than women, but there is emerging evidence that women may be experiencing greater increases in the incidence rates of these malignancies than men. One possible explanation is the expanding use of sex steroids among women, although only a few studies have examined this hypothesis. As part of a population-based, case-control study of women in New Hampshire, USA, we sought to evaluate the risk of SCC, BCC, and early-onset BCC in relation to exogenous and endogenous sex hormones. We found that oral contraceptive (OC) use was associated with an increased risk of SCC (OR = 1.4, 95% CI = 1.1-1.8) and BCC (OR = 1.4, 95% CI = 1.0-1.8), particularly high estrogen dose (>50 mg) OC use. Hormone replacement therapy (HRT) use also related to SCC, with an elevated OR largely for progestin use (OR = 1.4, 95% CI = 1.1-1.8). Additionally, both OC use and combination HRT use were associated with more aggressive BCC subtypes. In contrast, menstrual and reproductive history did not appear to influence keratinocyte cancer risk in our data. Our findings provide evidence that use of sex steroids may enhance risk of keratinocyte cancer.
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Affiliation(s)
| | - Michael S Zens
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH
| | - Ann E Perry
- Department of Pathology, Geisel School of Medicine at Dartmouth, Lebanon, NH
| | - Anala Gossai
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH
| | - Heather H Nelson
- Division of Epidemiology and Community Health, Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH
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22
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Laino L, Elia F, Desiderio F, Scarabello A, Sperduti I, Cota C, DiCarlo A. The efficacy of a photolyase-based device on the cancerization field: a clinical and thermographic study. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2015; 34:84. [PMID: 26282842 PMCID: PMC4539678 DOI: 10.1186/s13046-015-0203-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 08/10/2015] [Indexed: 01/22/2023]
Abstract
Background At skin level, a cancerization field (CF) indicates some chronically photoexposed areas in which, besides a primary tumor, histological or biomolecular modifications without clinical signs are present. Active telethermography (ATT) allows us to observe the imaging of a hyperthermic halo (HH) surrounding the tumor . The Authors hypothesize HH as a possible expression of CF. Objectives The aim of this study were to verify whether HHs have the same histological or immunohistochemical characteristics as the CF and, secondly, to evaluate the efficacy of a device containing the enzyme photolyase in modifying thermographic parameters in these area. Methods The study included 30 patients affected by actinic keratosis, evaluated clinically and by ATT at time 0 and after 3, 6 and 9 months. Results The ATT showed the presence of HHs in all the patients and, after the treatment, a significant modification of both the extension of these areas and the thermal parameters. In 5 patients for whom, while operated, two other biopsies were performed, respectively on the HH and on a perilesional non-hyperthermic area, in the HH, we detected a p53 and Ki 67 over-expression. Conclusions Our results indicate that ATT could represent a useful paraclinic method in identifying CFs in subjects at risk.
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Affiliation(s)
- Luigi Laino
- Thermography, San Gallicano Dermatologic Institute for Research and Care, Via Elio Chianesi 53, 00144, Rome, Italy.
| | - Fulvia Elia
- Radiology, San Gallicano Dermatologic Institute for Research and Care, Via Elio Chianesi 53, 00144, Rome, Italy.
| | - Flora Desiderio
- Radiology, San Gallicano Dermatologic Institute for Research and Care, Via Elio Chianesi 53, 00144, Rome, Italy.
| | - Alessandra Scarabello
- Clinical Dermatology, San Gallicano Dermatologic Institute for Research and Care, Via Elio Chianesi 53, 00144, Rome, Italy.
| | - Isabella Sperduti
- Biostatistical Unit, IFO-Regina Elena National Cancer Institute for Research and Care, Via Elio Chianesi 53, 00144, Rome, Italy.
| | - Carlo Cota
- Dermopathology, San Gallicano Dermatologic Institute for Research and Care, Via Elio Chianesi 53, 00144, Rome, Italy.
| | - Aldo DiCarlo
- Scientific Director, San Gallicano Dermatologic Institute for Research and Care, Via Elio Chianesi 53, 00144, Rome, Italy.
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23
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Apalla Z, Calzavara-Pinton P, Lallas A, Argenziano G, Kyrgidis A, Crotti S, Facchetti F, Monari P, Gualdi G. Histopathological study of perilesional skin in patients diagnosed with nonmelanoma skin cancer. Clin Exp Dermatol 2015; 41:21-5. [PMID: 26189480 DOI: 10.1111/ced.12713] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Epidemiological and clinical data suggest that actinic damage to the skin is an important predictor of skin carcinogenesis. AIM To investigate the association of squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) with sun-damage alterations seen by histopathology. METHOD In the current prospective study, perilesional skin of SCC or BCC lesions was evaluated for presence of alterations associated with chronic photodamage. Presence of scarring, perineural/perivascular invasion, haemorrhage/haemorrhagic crust, ulceration/erosion and margin involvement were also assessed. RESULT Of 6038 included lesions, 4523 (74.9%) were BCCs and 1515 (25.1%) were SCCs. Presence of actinic damage was five times more frequent in SCC than in BCC (OR = 5.29, 95% CI 4.44-6.00, P < 0.001), and diagnosis of SCC was twice as common in photo-exposed than nonphoto-exposed body sites (OR = 2.34, 95% CI 2.03-2.70, P < 0.001). There were twofold higher odds for actinic damage in SCC compared with Bowen disease (OR = 2.015, 95% CI 1.55-2.61, P < 0.001). Assessing the different BCC histological subtypes, we found that nodular BCC had at least twofold higher odds (OR = 2.63, 95% CI 2.09-3.32), infiltrative BCC had 48% higher odds (OR = 1.487, 95% CI 1.18-1.87) and basosquamous BCC had fourfold higher odds (OR = 4.10, 95% CI 3.01-5.57) of having actinic damage compared with superficial BCC. CONCLUSIONS Histological verification of ultraviolet-associated alterations in the perilesional skin in patients with NMSC in our study confirms the aetiopathogenic link between sun exposure and epithelial carcinogenesis on a histopathological basis. This correlation was stronger for SCCs than for BCCs.
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Affiliation(s)
- Z Apalla
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - A Lallas
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - G Argenziano
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - A Kyrgidis
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - S Crotti
- Department of Dermatology, Spedali Civili Brescia, Brescia, Italy
| | - F Facchetti
- Department of Pathology 1-2, Spedali Civili Brescia, Brescia, Italy
| | - P Monari
- Department of Dermatology, Spedali Civili Brescia, Brescia, Italy
| | - G Gualdi
- Department of Dermatology, Spedali Civili Brescia, Brescia, Italy
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24
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Khalesi M, Whiteman DC, Rosendahl C, Johns R, Hackett T, Cameron A, Waterhouse M, Lucas RM, Kimlin MG, Neale RE. Basal cell carcinomas on sun-protected vs. sun-exposed body sites: a comparison of phenotypic and environmental risk factors. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2015; 31:202-11. [PMID: 25787710 DOI: 10.1111/phpp.12170] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/09/2015] [Indexed: 01/17/2023]
Abstract
BACKGROUND Basal cell carcinoma (BCC) is the most commonly diagnosed cancer in White populations. There are indications that risk factors for BCC may differ according to the anatomic site of the tumour but this is not well understood. PURPOSE To compare phenotypic and environmental risk factors for BCCs arising on sun-protected sites with that of those on sun-exposed sites. METHODS We conducted a case-case study in which people who had been diagnosed with incident BCC were recruited between February 2012 and September 2013 in Brisbane, Australia. RESULTS Fair skin (OR: 4.50; 95% CI: 1.22, 16.59), having more than 15 lesions frozen/burnt off compared to less than 5 (OR: 5.68; 95% CI: 1.78, 18.08) and severe acne (OR: 5.25; 95% CI: 1.34, 20.56) were associated with increased risk of BCC on sun-protected sites. The presence of more than 5 nevi on the body was associated with decreased risk (OR: 0.28; 95% CI: 0.11, 0.71). CONCLUSIONS BCCs on sun-protected sites arise as a result of excessive sun exposure, most likely combined with phenotypic susceptibility. The strong negative association with nevi also suggests that there are constitutional factors that underlie the propensity for BCCs to arise on these body sites.
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Affiliation(s)
- Mohammad Khalesi
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,NHMRC Centre for Research Excellence in Sun and Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - David C Whiteman
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,NHMRC Centre for Research Excellence in Sun and Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Cliff Rosendahl
- Skin Cancer College Australasia, Brisbane, QLD, Australia.,School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Richard Johns
- Skin Cancer College Australasia, Brisbane, QLD, Australia
| | - Timothy Hackett
- Skin Cancer College Australasia, Brisbane, QLD, Australia.,School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Alan Cameron
- Skin Cancer College Australasia, Brisbane, QLD, Australia.,School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Mary Waterhouse
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, Australia.,Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Michael G Kimlin
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,NHMRC Centre for Research Excellence in Sun and Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Rachel E Neale
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,NHMRC Centre for Research Excellence in Sun and Health, Queensland University of Technology, Brisbane, QLD, Australia
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25
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Abstract
Exposure of the skin to solar ultraviolet (UV) radiation has both risks and benefits for human health. Absorption of UV-B radiation by DNA results in mutations that underlie the development of skin cancers, as is apparent from genetic studies showing high occurrence of UV signature mutations within these tumors. UV-B radiation is also absorbed by 7-dehydrocholesterol to initiate vitamin D synthesis. In experimental studies vitamin D metabolites enhance apoptosis of malignant cells, inhibit angiogenesis and proliferation and increase differentiation, potentially reducing skin cancer development and improving prognosis after diagnosis. There are some supporting human data. We review the links between sun exposure, vitamin D and skin cancers.
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Affiliation(s)
- Candy Wyatt
- National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia.,Telethon Kids Institute, University of Western Australia, Perth, Australia.,National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia.,Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Rachel E Neale
- QIMR Berghofer Institute of Medical Research, Brisbane, Australia.,QIMR Berghofer Institute of Medical Research, Brisbane, Australia
| | - Robyn M Lucas
- National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia.,Telethon Kids Institute, University of Western Australia, Perth, Australia.,National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia.,Telethon Kids Institute, University of Western Australia, Perth, Australia
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26
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Lucas RM, Norval M, Neale RE, Young AR, de Gruijl FR, Takizawa Y, van der Leun JC. The consequences for human health of stratospheric ozone depletion in association with other environmental factors. Photochem Photobiol Sci 2015; 14:53-87. [DOI: 10.1039/c4pp90033b] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Ozone depletion, climate and human health.
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Affiliation(s)
- R. M. Lucas
- National Centre for Epidemiology and Population Health
- The Australian National University
- Canberra 2601
- Australia
- Telethon Kids Institute
| | - M. Norval
- Biomedical Sciences
- University of Edinburgh Medical School
- Edinburgh EH8 9AG
- UK
| | - R. E. Neale
- QIMR Berghofer Medical Research Institute
- Brisbane 4029
- Australia
| | - A. R. Young
- King's College London (KCL)
- St John's Institute of Dermatology
- London SE1 9RT
- UK
| | - F. R. de Gruijl
- Department of Dermatology
- Leiden University Medical Centre
- NL-2300 RC Leiden
- The Netherlands
| | - Y. Takizawa
- Akita University Graduate School of Medicine
- Akita Prefecture
- Japan
- National Institute for Minamata Diseases
- Kumamoto Prefecture
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27
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de la Fouchardière A, Cabaret O, Savin L, Combemale P, Schvartz H, Penet C, Bonadona V, Soufir N, Bressac-de Paillerets B. Germline BAP1 mutations predispose also to multiple basal cell carcinomas. Clin Genet 2014; 88:273-7. [PMID: 25080371 DOI: 10.1111/cge.12472] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 07/24/2014] [Accepted: 07/28/2014] [Indexed: 11/29/2022]
Abstract
The BRCA1-associated protein 1 (BAP1) gene encodes a nuclear deubiquitin enzyme which acts as a tumour suppressor. Loss of function germline mutations of BAP1 have been associated with an enhanced risk of uveal and cutaneous melanomas, mesothelioma, clear cell renal cancer and atypical cutaneous melanocytic proliferations. In two independent BAP1 families, we noticed an unusual frequency of basal cell carcinomas (BCCs). Indeed, 19 BCCs were diagnosed in four patients, either of superficial (13/19) or nodular (6/19) subtype; they were all located in chronic sun-exposed areas (limbs, head or neck). Immunohistochemistry (IHC) identified in the 19 tumours, complete or partial loss of BAP1 protein nuclear expression, restricted to the BCC nests. A control study was conducted in 22 sporadic BCCs in 22 subjects under 65 without known associated BAP1 tumours: no loss of BAP1 expression was found. Overall, our observations suggest that BCCs are part of the BAP1 cancer syndrome, perhaps in relation with chronic sun exposure and melanocortin 1 receptor (MC1R) variants. In conclusion, cutaneous follow-up of BAP1 carriers should not only aim to detect melanocytic neoplasms but also BCCs.
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Affiliation(s)
| | - O Cabaret
- Gustave Roussy, Service de Génétique, Villejuif, France
| | - L Savin
- Service de Dermatologie, Polyclinique de Courlancy, Reims, France
| | - P Combemale
- Service d'Onco-dermatologie, Centre Leon Bérard, Lyon, France
| | - H Schvartz
- Cabinet de Pathologie, Pathologie, Reims, France
| | - C Penet
- Service d'Oncogénétique, Institut du Cancer Courlancy, Reims, France
| | - V Bonadona
- Service de Génétique, Centre Leon Bérard, Lyon, France
| | - N Soufir
- Service de Génétique, Hôpital Bichat Claude Bernard, INSERM U976, Paris, France
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Di Carlo A, Elia F, Desiderio F, Catricalà C, Solivetti FM, Laino L. Can video thermography improve differential diagnosis and therapy between basal cell carcinoma and actinic keratosis? Dermatol Ther 2014; 27:290-7. [PMID: 24909265 DOI: 10.1111/dth.12141] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Various noninvasive techniques (dermoscopy, confocal microscopy, etc.) have been introduced to help the clinical diagnosis in nonmelanoma skin cancer. Among them, the high definition video thermographic technique (VTG) has recently been proposed. The aim of this study is to define the VTG patterns, respectively of actinic keratosis (AK) and basal cell carcinoma (BCC), and to compare these data with them of dermoscopy. The study included 36 patients with a total number of 135 lesions who underwent clinical, VTG, and dermoscopic examination. The VTG showed the presence of a hyperthermic pattern in all the cases of AK, while in the case of the BCC, the pattern was hypothermic. Dermoscopy also showed distinct pattern for AK and for BCC, but in 22% of them the data were not conclusive. Our study permits us to define two specific VTG patterns, BCC and AK respectively.
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Affiliation(s)
- Aldo Di Carlo
- San Gallicano Dermatological Institute for Research and Care, Rome, Italy
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