Indoor tanning and melanoma: are gay and bisexual men more at risk?

Recent-Onset Melanoma and the Implications of the Excessive Use of Tanning Devices-Case Report and Review of the Literature

Introduction: Melanoma, a malignant tumor arising from uncontrolled melanocytic proliferation, commonly found in the skin but capable of affecting extracutaneous sites, ranks fifth among diagnosed oncological entities and is a significant cause of cancer deaths, constituting over 80% of skin cancer mortality. Genetic factors and ultraviolet radiation (UVR) exposure, from both natural and artificial sources, are the primary risk factors. Case Presentation: We reported the case of a 25-year-old female with numerous pigmented nevi and notable changes attributed to extensive indoor tanning sessions. Dermatological examinations and dermoscopic evaluations revealed atypical features in two pigmented nevi, leading to surgical excision. Histopathological and immunohistochemical analyses confirmed a compound nevus in one lesion and superficial spreading melanoma in the other, emphasizing the importance of vigilant follow-up and the correct use of immunohistochemistry. Discussion: Indoor tanning significantly elevates the cutaneous melanoma risk, with initiation before age 35 amplifying the risk by up to 75%, especially in young women. The risk escalates with cumulative sessions, particularly exceeding 480, and individuals undergoing over 30 sessions face a 32% higher risk. UVR induces DNA damage, genetic mutations, and immunosuppression, contributing to oncogenesis. Genetic factors, like the PTCHD2 gene, may influence the tanning dependency. Legislation targeting minors has been enacted globally but only with partial efficacy. Tanning accelerators, though associated with minor side effects, correlate with high-risk behaviors. The case underscores the urgency of addressing indoor tanning risks, emphasizing targeted awareness efforts and legislative improvements. Conclusions: In conclusion, the reported case highlights the increased risk of cutaneous melanoma linked to indoor tanning, particularly among young women and specific sociodemographic groups. Despite legislative measures, challenges persist, suggesting the potential efficacy of online campaigns involving relatable influencers to raise awareness and discourage artificial tanning.

Sun protection use and habits in the LGBTQI+ community in Lebanon: A cross sectional study

BACKGROUND

Sun exposure is an extrinsic risk factor for skin aging, wrinkle formation, and the development of skin cancer, namely melanoma, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC). Sun protection measures have emerged as an important means of preventing these harmful effects. Studies have shown that sexual minority men have a greater prevalence of skin cancer than heterosexual men.

AIMS

There is limited research investigating the reasons behind this risk of skin cancer development. This is especially important because identifying preventable risk factors, like those pertaining to sun exposure behaviors, can be targeted in the fight against skin cancer and help establish screening tools and preventive interventions for the SGM community. This study focused on members of the SGM community and demonstrated their tendency not to use sun-protective measures, as well as their deficits in knowledge of skin cancer prevention.

MATERIALS AND METHODS

This study is a cross-sectional study that investigates sun protection practices and trends among adults in Lebanon's SGM community using a survey. It includes adults aged 18-80 that were recruited from the dermatology clinics at AUBMC as well as LGBTQ+ organizations Helm and SIDC.

RESULTS

A total of 129 participants took part in the study and completed the survey. Reasons for tanning varied among our participants: tanning to get a color (13.1%), tanning to get vitamin D (4.6%), tanning socially (6.9%), and tanning for mood elevation (0.8%). No significant association was found between sexual orientation and SPF use (p = 0.167). No significant association was found between sexual orientation and tanning frequency during summer (p-value: 0.231). Similarly, no significant association was noted between sexual orientation and tanning bed use (0.951). No significant association was noted between the type of job and SPF use (p = 0.601). Despite no significance between SPF use and the highest educational degree attained (p = 0.070), the tendency to use SPF increased with higher levels of education. Moreover, awareness of sun-induced skin cancer did not significantly affect SPF use (p = 0.067). However, a significant association was found between the information source for skin cancer and SPF use (p < 0.001) where participants receiving information from dermatologists displayed notably higher SPF use (72.2%), compared to those obtaining information from media (18.2%) or family and friends (5.3%).

DISCUSSION

Surveying the perception of the Lebanese SGM community towards sun damage and their adaptive practices to prevent it can help implement and gear a nation-wide campaign to spread proper awareness about this subject. Studying their behavioral tendencies for not using sunscreen can help overcome this contributing risk factor for skin cancers.

CONCLUSION

Future investigations have yet to identify confounding variables contributing to higher levels of skin cancers in this population.

Dermatologic care of sexual and gender minority/LGBTQIA youth, Part 2: Recognition and management of the unique dermatologic needs of SGM adolescents

Sexual and gender minority (SGM) individuals, including lesbian, gay, bisexual, transgender/gender diverse, questioning/queer, intersex, and asexual (LGBTQIA) persons, represent a historically underserved population within the field of medicine, though their unique health needs are increasingly recognized. Part 2 of this two-part review will address unique concerns regarding acne, tanning behavior, sexually transmitted infections, and other health disparities among SGM adolescents. A more comprehensive understanding of the dermatologic needs of SGM youth will better allow pediatric dermatologists to actively and compassionately care for this health disparity population.

Dermatologic care for lesbian, gay, bisexual, and transgender persons: Epidemiology, screening, and disease prevention

Lesbian, gay, bisexual, and transgender (LGBT) persons face important health issues relevant to dermatologists. Men who have sex with men (MSM) are at higher risk of certain infectious diseases, including HIV, syphilis and other sexually transmitted diseases (STDs), methicillin-resistant Staphylococcus aureus infections, and invasive meningococcal disease, and might be at higher risk of non-infectious conditions, including skin cancer. Recommendations for preventive health care, including screening for HIV and other STDs, sexual health-related vaccinations, and HIV pre-exposure prophylaxis, differ for MSM compared with non-MSM. Women who have sex with women experience disparities in STDs, including chlamydia and HPV. Transgender patients have unique, and often unmet, dermatologic needs during gender transition (also called gender affirmation), related to hormonal therapy and gender-affirming surgery. Familiarity with LGBT health issues and disease-prevention guidelines can enable dermatologists to provide medically appropriate and culturally competent care to LGBT persons.