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Artosi F, Costanza G, Di Prete M, Garofalo V, Lozzi F, Dika E, Cosio T, Diluvio L, Shumak RG, Lambiase S, Di Raimondo C, Campa S, Piscitelli P, Miani A, Bianchi L, Campione E. Epidemiological and clinical analysis of exposure-related factors in non-melanoma skin cancer: A retrospective cohort study. Environ Res 2024; 247:118117. [PMID: 38218521 DOI: 10.1016/j.envres.2024.118117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/15/2024]
Abstract
BACKGROUND The incidence of non-melanoma skin cancers (NMSCs) increased over last decades, probably due to environmental concerns or to the increase of frail patients with age related comorbidities. Currently, the relationship of increasing global skin cancer rates with increased ultraviolet radiations (UVRs) resulting from stratospheric ozone depletion, global warming, and air pollution from fossil-fuel combustion. AIMS We conducted a retrospective epidemiological study including 546 NMSC patients managed at the Dermatology Unit of the Tor Vergata Hospital to highlight different trends of sun exposure or different comorbidities. METHODS Descriptive and inferential statistical analyses were performed to evidence differences between continous variable and Spearman rank test for dicotomical variables. Charlson Comorbidity Index was calculated to obtain the 10-years survival rate in order to identify the mean comorbidity burden of our patients. RESULTS Considering patients with comorbidities (73.81%), actinic keratoses (AKs) was the most frequent lesion. In patients with a history of previous melanoma, basal cell carcinoma (BCC) was predominant (ANOVA test, p < 0.05) with a statistically significant correlation (rho = 0.453; p < 0.01). Squamous cell carcinoma (SCC) showed a higher rate in arterial hypertension patients, followed by the chronic heart failure and hematologic neoplasms (60%, 29.7% and 32.1%, respectively) groups. Men were more affected than women, representing 61.54% of patients. Chronic sun exposure is directly correlated with SCC rho = 0.561; p < 0.01), whereas BCC correlated with a history of sunburns (rho = 0.312; p < 0.05). CONCLUSIONS History of photo-exposition had an important role on NMSC development especially for work or recreational reasons. Sex, age, and presence of comorbidities influenced different NMSC types. BCC was more frequent in younger patients, associated with melanoma and sunburns. The presence of SCC is associated with older patients and the hypertension group. AKs were diagnosed predominantly in oldest men, with a chronic sun-exposure history, and hematologic neoplasms group.
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Affiliation(s)
- Fabio Artosi
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Gaetana Costanza
- Unit of Virology, Department of Experimental Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy.
| | - Monia Di Prete
- Dermatopathology Laboratory, Istituti Fisioterapici Ospitalieri, Istituto San Gallicano, via Fermo Ognibene 23, 00144, Rome, Italy.
| | - Virginia Garofalo
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy
| | - Flavia Lozzi
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Emi Dika
- Dermatology, IRCCS Policlinico Sant'Orsola, via Massarenti 9, 40138, Bologna, Italy.
| | - Terenzio Cosio
- PhD Course Microbiology, Immunology, Infectious Diseases, and Transplants (MIMIT), Microbiology Section, Department of Experimental Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy.
| | - Laura Diluvio
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Ruslana Gaeta Shumak
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Sara Lambiase
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Cosimo Di Raimondo
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Serena Campa
- Italian Society of Environmental Medicine, SIMA, Italy.
| | - Prisco Piscitelli
- Italian Society of Environmental Medicine, SIMA, Italy; University of Salento, Lecce, Italy.
| | - Alessandro Miani
- Italian Society of Environmental Medicine, SIMA, Italy; Department of Environmental Sciences and Policies, University of Milan, Milan, Italy.
| | - Luca Bianchi
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Elena Campione
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
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Fleming S, Dolan M, Greenwood M, Blake C, Tobin AM, Connolly M. Sunburn, sunbeds and melanoma skin cancer: a story behind the statistics. Clin Exp Dermatol 2024; 49:412-413. [PMID: 38069909 DOI: 10.1093/ced/llad408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 11/14/2023] [Indexed: 03/23/2024]
Abstract
Our patient’s story highlights the ongoing psychological impact the diagnosis of skin cancer has on patients.
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Affiliation(s)
- Sarah Fleming
- Department of Dermatology, Tallaght University Hospital, Dublin, Ireland
| | | | | | | | - Anne-Marie Tobin
- Department of Dermatology, Tallaght University Hospital, Dublin, Ireland
| | - Maureen Connolly
- Department of Dermatology, Tallaght University Hospital, Dublin, Ireland
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Liu M, Lan Y, Zhang H, Wu M, Zhang X, Leng L, Zheng H, Li J. Analysing the causal relationship between potentially protective and risk factors and cutaneous melanoma: A Mendelian randomization study. J Eur Acad Dermatol Venereol 2024; 38:102-111. [PMID: 37712456 DOI: 10.1111/jdv.19484] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/18/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Previous observational studies reported altered melanoma risks in relation to many potential factors, such as coffee intake, smoking habits and photodamage-related conditions. Considering the susceptibility of epidemiological studies to residual confounders, there remains uncertainty about the actual causal roles of these reported factors in melanoma aetiology. OBJECTIVES This study aims to investigate the causal association between cutaneous melanoma (CM) and previously reported factors: coffee intake, alcohol consumption, lifetime smoking, socioeconomic status (SES), ease of skin tanning, childhood sunburn and facial ageing, providing insight into its underlying aetiology and preventative strategies. METHODS We utilized a two-sample MR analysis on data from the largest meta-analysis summary statistics of confirmed cutaneous melanoma including 30,134 patients. Genetic instrumental variables were constructed by identifying single nucleotide polymorphisms (SNPs) that associate with corresponding factors. Inverse variance weighted (IVW) was the primary MR method. For sensitivity and heterogeneity, MR Egger, weighted median, simple mode, weighted mode and MR Egger intercept tests were examined. RESULTS Cutaneous melanoma risks were found to be elevated in association with a predisposition towards ease of skin tanning (IVW: OR = 2.842, 95% CI 2.468-3.274, p < 0.001) and with childhood sunburn history (IVW: OR = 6.317, 95% CI 4.479-8.909, p < 0.001). Repeated MR after removing potential confounders and outliers demonstrated resolved horizontal pleiotropy and statistically significant results that closely mirrored the initial findings. Other potential factors, such as coffee intake, alcohol consumption, smoking and socioeconomic status (SES), indicated insignificant effects on melanoma risk in the analysis, and therefore, our Mendelian randomization study does not support their roles in modifying melanoma risks. CONCLUSIONS Our extensive MR analysis provides strong evidence of the causative role of ease of skin tanning and childhood sunburn history in elevating melanoma risk. Curtailing ultraviolet radiation (UVR) exposure may be the single best preventative strategy to reduce melanoma risk.
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Affiliation(s)
- Mingjuan Liu
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Translational Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- 4+4 M.D. Program, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yining Lan
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Translational Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hanlin Zhang
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Translational Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Mengyin Wu
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Translational Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xinyi Zhang
- Departments of Internal Medicine and Cellular & Molecular Physiology, Yale School of Medicine, Connecticut, New Haven, USA
| | - Ling Leng
- State Key Laboratory of Complex Severe and Rare Diseases, Translational Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Heyi Zheng
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Translational Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jun Li
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Translational Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Li Y, Wu J, Cao Z. Childhood sunburn and risk of melanoma and non-melanoma skin cancer: a Mendelian randomization study. Environ Sci Pollut Res Int 2023; 30:122011-122023. [PMID: 37962759 PMCID: PMC10724097 DOI: 10.1007/s11356-023-30535-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/13/2023] [Indexed: 11/15/2023]
Abstract
Previous evidence has suggested that childhood sunburn could be a risk factor for cutaneous malignant melanoma (MM) and non-melanoma skin cancer (NMSC). However, existing observational studies could not reveal the causal associations genetically. This study aimed to investigate whether there was a genetic causal relationship between childhood sunburn and skin cancers. Univariable Mendelian randomization (MR) and Causal Analysis Using Summary Effect analysis was carried out for causal estimates and evaluation for the horizontal pleiotropy. Multivariable MR and the mediation effects analysis were used to test whether the causal associations were mediated by potential confounders. A suggestively significant causal association between childhood sunburn and MM was indicated (OR = 4.74; 95% CI: 1.31-17.19; p = 1.79E-02). Genetically predicted childhood sunburn was significantly associated with increased risk of overall melanoma in situ (MIS) (OR = 4.02; 95% CI: 2.00-8.08; p = 9.40E-05), MIS of face (OR = 18.28; 95% CI: 5.28-63.35; p = 4.59E-06), and MIS of trunk (OR = 7.05; 95% CI: 2.06-24.13; p = 1.88E-03). Similar trends were found for childhood sunburn and NMSC (OR = 8.16; 95% CI: 6.07-10.99; p = 1.53E-20), including both basal cell carcinoma (BCC) (OR = 3.76; 95% CI:2.96-4.77; p = 2.19E-08) and squamous cell carcinoma (SCC) (OR = 7.44; 95% CI: 5.09-10.87; p = 2.19E-08). After adjustment for hair and skin color, facial ageing, vitamin D levels, body mass index, alcohol consumption, and smoking status, childhood sunburn showed an independent association with MIS, MIS of face, MIS of trunk, as well as NMSC, including both BCC and SCC. Mediation analysis showed no significant mediation effect. This study demonstrated a causal relationship between childhood sunburn and the risk of both MM and NMSC, which suggested that enhanced screening and prevention for childhood sunburn could contribute to the early detection and decreased risk of MM and NMSC.
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Affiliation(s)
- Yajia Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jianhuang Wu
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Ziqin Cao
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.
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Zhong S, Lan L, Wen Y. Evaluating the effect of childhood sunburn on the risk of cutaneous melanoma through Mendelian randomization. Cancer Sci 2023; 114:4706-4716. [PMID: 37752763 PMCID: PMC10728005 DOI: 10.1111/cas.15974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/01/2023] [Accepted: 09/09/2023] [Indexed: 09/28/2023] Open
Abstract
Despite numerous observational studies indicating an increased risk of cutaneous melanoma (CM) due to childhood sunburn, no studies have established a definitive cause-and-effect relationship. Therefore, our objective was to employ a Mendelian randomization (MR) design to explore a possible causal association between childhood sunburn and the risk of CM. To investigate the causal relationship between childhood sunburn and CM, we used large-scale genetic summary-level data from genome-wide association studies (GWAS), including childhood sunburn (n = 346,955) and CM (n = 262,288), building upon previous observational studies. In the analysis, we mainly used the inverse-variance weighted (IVW) method of the random effects model, supplemented by the weighted median method and MR-Egger method. The results of the IVW method demonstrated that genetically predicted childhood sunburn was significantly associated with higher odds of CM, with an odds ratio (OR) of 2.418 (95%CI, 1.426-4.099; p = .001). The weighted median method and MR-Egger regression also demonstrated directionally similar results (both p < .05). Furthermore, both the funnel plot and the MR-Egger intercepts showed the absence of directional pleiotropy between childhood sunburn and CM. Our study offers potential evidence linking genetically predicted childhood sunburn with CM, underscoring the need for individuals with a history of childhood sunburn to be extra vigilant regarding the occurrence of CM.
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Affiliation(s)
- Shengdong Zhong
- Department of Plastic surgeryLongyan First Affiliated Hospital of Fujian Medical UniversityLongyanChina
| | - Liting Lan
- Clinical Research CenterThe First Affiliated Hospital of Shantou University Medical CollegeShantouChina
- Clinical Research CenterLonggang Maternity and Child Clinical Institute of Shantou University Medical CollegeShenzhenChina
| | - Yuqing Wen
- Department of Plastic surgeryLongyan First Affiliated Hospital of Fujian Medical UniversityLongyanChina
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Monié A, Cournot M, Dumez J, Miquel J, Bertolotti A, Sultan-Bichat N. Evaluation of a school-based sun safety education program in Reunion Island, 2016-2017. Ann Dermatol Venereol 2023; 150:195-198. [PMID: 37385911 DOI: 10.1016/j.annder.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 01/16/2023] [Accepted: 03/24/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Sun exposure, especially during childhood, is the main environmental risk factor for skin cancers. This study evaluated the impact of the school-based sun safety education program "Living with the Sun" on the knowledge and behavior of primary school children regarding sun safety in Reunion Island. METHODS This multicenter, comparative intervention study was conducted in selected primary schools of Reunion during the 2016-2017 school year. The intervention consisted of an in-class slide-show presentation on sun safety, a teaching guide, and school trips during which children were offered sunscreen and were requested to wear sunglasses, a T-shirt, and a cap. The children completed a questionnaire before and after the intervention. The percentage of children wearing a cap in school playgrounds at the end of the school year was compared between paired intervention and control schools. RESULTS Seven hundred children from 7 Reunionese schools completed the questionnaire before and after the intervention. There was a statistically significant improvement in children's knowledge of sun safety, with differences between schools, teachers, school levels, and questionnaire responses. The percentage of children wearing a cap at the end of the school year was significantly higher in intervention schools compared to control schools. CONCLUSIONS Children's knowledge and behavior regarding sun safety improved significantly as a result of the intervention.
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Affiliation(s)
- A Monié
- Mission Soleil Réunion, Saint Paul, La Réunion, France
| | - M Cournot
- CHOR, Service de Cardiologie, Saint Paul, La Réunion, France
| | - J Dumez
- UFR La Réunion, Département de Médecine Générale, La Réunion, France; CIC-INSERM 1410, CHU Réunion, Service des Maladies Infectieuses - Dermatologie, Saint Pierre, La Réunion, France.
| | - J Miquel
- Mission Soleil Réunion, Saint Paul, La Réunion, France; CHU Réunion, Unité de Dermatologie - pédiatrique, Saint Pierre, La Réunion, France
| | - A Bertolotti
- Mission Soleil Réunion, Saint Paul, La Réunion, France; CIC-INSERM 1410, CHU Réunion, Service des Maladies Infectieuses - Dermatologie, Saint Pierre, La Réunion, France; CHU Réunion, Service des Maladies Infectieuses - Dermatologie, Saint Pierre, La Réunion, France
| | - N Sultan-Bichat
- Mission Soleil Réunion, Saint Paul, La Réunion, France; CHOR, Service de Dermatologie, Saint Paul, La Réunion, France
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Lewandowska A, Lewandowski T, Rudzki G, Próchnicki M, Laskowska B, Pavlov S, Vlasenko O, Rudzki S, Wójcik W. The Risk of Melanoma due to Exposure to Sun and Solarium Use in Poland: A Large-Scale, Hospital Based Case - Control Study. Asian Pac J Cancer Prev 2023; 24:2259-2269. [PMID: 37505755 PMCID: PMC10676492 DOI: 10.31557/apjcp.2023.24.7.2259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 07/02/2023] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVE The incidence of skin cancer is constantly growing, it is considered a serious problem of public health. Most cases of skin cancer are caused by a combination of non-modifiable genetic, and modifiable environmental risk factors. The study objective was to analyse the correlation between pigmentation traits, excessive sunlight exposure, solarium use and the risk of melanoma development. METHODS The study included 480 patients diagnosed with melanoma and 400 within the control group. Subjects diagnosed with the melanoma confirmed by histopathology were invited to take part in the study. The research was based on a clinical, direct, individual, structured, in-depth and focused interview. RESULTS The mean age of the study subjects was 44.3 ± 7.86, while in the control group 59.5 (7.93) Most frequently, melanoma was located on the upper extremities (64%). A family history of neoplastic diseases was found in 55% of the patients. The assessment of sunburns showed that only 15% of the respondents never experienced sunburn, 49% of the study subjects never used solarium. Among patients with multiple sunburns, the risk of developing skin cancer was 1.27 (AOR = 1,27; 95% CI, 1.07-1.55) compared with non-sunburns subjects. CONCLUSIONS Risky behaviours including excessive exposure to UV radiation, both natural and artificial, are of special significance in women with fair complexion and fair hair. Indoor tanning is a probable factor of increased skin cancer incidence in younger women, as compared to men.
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Affiliation(s)
- Anna Lewandowska
- Institute of Healthcare, State School of Technology and Economics in Jaroslaw, 37-500 Jaroslaw, Poland.
| | - Tomasz Lewandowski
- Institute of Technical Engineering, State School of Technology and Economics in Jaroslaw, 37-500 Jaroslaw, Poland.
| | - Grzegorz Rudzki
- Chair and Department of Endocrinology, Medical University of Lublin, 20-090, Poland.
| | - Michał Próchnicki
- Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 20-439, Poland.
| | - Barbara Laskowska
- Institute of Healthcare, State School of Technology and Economics in Jaroslaw, 37-500 Jaroslaw, Poland.
| | - Sergii Pavlov
- Vinnytsia National Technical University, Biomedical Engineering Department, Scientific Laboratory of Biomedical Optics, Ukraina.
| | - Oleg Vlasenko
- Vinnytsia National Medical University, Normal Physiology Department, Ukraina.
| | - Sławomir Rudzki
- Chair and Department of General and Transplant Surgery and Nutritional, Medical University of Lublin, 20-090, Poland.
| | - Waldemar Wójcik
- Faculty of Electrical Engineering and Computer Science, Lublin University of Technology, 20-618, Lublin, Poland.
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Tsujimoto M, Kakei Y, Yamano N, Fujita T, Ueda T, Ono R, Murakami S, Moriwaki S, Nishigori C. Clinical trial on the efficacy and safety of NPC-15 for patients with xeroderma pigmentosum exaggerated sunburn reaction type: XP-1 study protocol for a multicentre, double-blinded, placebo-controlled, two-group crossover study followed by a long-term open study in Japan. BMJ Open 2023; 13:e068112. [PMID: 36948554 PMCID: PMC10040004 DOI: 10.1136/bmjopen-2022-068112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
INTRODUCTION Xeroderma pigmentosum (XP) is a rare intractable disease without a fundamental treatment, presenting with severe photosensitivity, freckle-like pigmented and depigmented maculae and numerous skin cancers before the age of 10 years without strict sun protection. About 70% of the patients exhibit extremely severe sunburn reactions and most of them develop neurological symptoms, including sensorineural hearing impairment and progressive peripheral and central nervous disorders beginning from childhood ages. In the preclinical study, we found that N-acetyl-5-methoxytryptamine was effective in suppressing skin tumour development in addition to improvement of auditory brainstem response in chronically ultraviolet-irradiated XP-A model mice. METHODS AND ANALYSIS On the bases of the preclinical study, we conduct a clinical trial on the efficacy of NPC-15 for patients with XP with exaggerated sunburn reaction type by a multicentre, double-blinded placebo-controlled, two-group crossover study followed by a 52 weeks open study. ETHICS AND DISSEMINATION Ethics approval is overseen by the Kobe University Institutional Review Board and Osaka Medical and Pharmaceutical University Institutional Review Board, and the study is conducted in accordance with the approved protocol. All participants will be required to provide written informed consent. Findings will be disseminated through scientific and professional conferences and peer-reviewed journal publications. The data sets generated during the study will be available from the corresponding author on reasonable request. TRIAL REGISTRATION NUMBER jRCTs051210181.
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Affiliation(s)
- Mariko Tsujimoto
- Dermatology, Kobe University Graduate School of Medicine School of Medicine, Kobe, Japan
| | - Yasumasa Kakei
- Clinical & Translational Research Center, Kobe University Hospital, Kobe, Japan
- Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine School of Medicine, Kobe, Japan
| | - Nozomi Yamano
- Dermatology, Kobe University Graduate School of Medicine School of Medicine, Kobe, Japan
| | - Takeshi Fujita
- Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine School of Medicine, Kobe, Japan
| | - Takehiro Ueda
- Neurology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Ryusuke Ono
- Dermatology, Kobe University Graduate School of Medicine School of Medicine, Kobe, Japan
| | - Sae Murakami
- Clinical & Translational Research Center, Kobe University Hospital, Kobe, Japan
| | - Shinichi Moriwaki
- Dermatology, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Chikako Nishigori
- Dermatology, Kobe University Graduate School of Medicine School of Medicine, Kobe, Japan
- Hyogo Red Cross Blood Center, Kobe, Japan
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Lergenmuller S, Rueegg CS, Perrier F, Robsahm TE, Green AC, Lund E, Ghiasvand R, Veierød MB. Lifetime Sunburn Trajectories and Associated Risks of Cutaneous Melanoma and Squamous Cell Carcinoma Among a Cohort of Norwegian Women. JAMA Dermatol 2022; 158:1367-1377. [PMID: 36197657 PMCID: PMC9535508 DOI: 10.1001/jamadermatol.2022.4053] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/31/2022] [Indexed: 01/13/2023]
Abstract
Importance To our knowledge, no study has prospectively investigated sunburn patterns over age periods from childhood to adulthood and their associations with skin cancer risk. Objective To identify lifetime trajectories of sunburns and compare the association between these trajectories and subsequent risk of cutaneous melanoma and squamous cell carcinoma (cSCC). Design, Setting, and Participants This population-based cohort study included participants from the Norwegian Women and Cancer Study, established in 1991, with follow-up through 2018. Baseline questionnaires were issued from 1991 to 2007, with follow-up questionnaires every 5 to 7 years. Data analysis was performed from March 16, 2021, to December 4, 2021. Exposures Participants reported pigmentation factors, sunbathing vacations, and indoor tanning. Annual frequencies of sunburns were reported for childhood, adolescence, and adulthood. Main Outcomes and Measures Information on cancer diagnoses, emigration, and death were obtained through linkage to the Cancer Registry of Norway using the unique personal identification number of Norwegian citizens. Results Of the 172 472 women (age range, 31-70 years) who returned questionnaires, 169 768 received questions about sunburns at study inclusion. Five classes (stable low, low-moderate-low, low to high, high to low, and stable high) of individual lifetime sunburn trajectories with similar shapes were estimated in 3 samples up to 39 years (n = 159 773), up to 49 years (n = 153 297), and up to 59 years (n = 119 170). Mean follow-up ranged from 14.3 to 19.5 years in the 3 samples, during which 1252 to 1774 women were diagnosed with incident primary melanoma and 739 to 871 women with incident primary cSCC. With hazard ratios (HRs) and 95% CIs estimated using a Cox proportional hazards model, the stable high and high to low trajectories showed statistically significant increased melanoma and cSCC risks compared with the stable low trajectory across all samples (≤39 years for stable high and high to low trajectories: melanoma: HR, 1.50 [95% CI, 1.28-1.75] and HR, 1.44 [95% CI, 1.20-1.73]; cSCC: HR, 1.51 [95% CI, 1.22-1.87] and HR, 1.47 [95% CI, 1.14-1.91]). Other trajectories showed increased risk, though generally weaker and mainly estimates that were not statistically significant. There was no statistically significant heterogeneity between melanoma and cSCC estimates. Conclusion and Relevance This cohort study showed that high sunburn frequency throughout life was associated with increased melanoma and cSCC risk. Furthermore, sunburns in childhood are especially important for subsequent risk of these skin cancers. Avoiding sunburns throughout life, in particular in childhood, is therefore crucial.
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Affiliation(s)
- Simon Lergenmuller
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Now with Department of Clinical and Registry-Based Research, Institute of Population-Based Cancer Research, Cancer Registry of Norway, Oslo, Norway
| | - Corina S. Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Flavie Perrier
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Trude E. Robsahm
- Department of Research, Institute of Population-Based Cancer Research, Cancer Registry of Norway, Oslo, Norway
| | - Adele C. Green
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- Cancer Research UK Manchester and Faculty of Biology, Medicine and Health, University of Manchester, Manchester, England, United Kingdom
| | - Eiliv Lund
- Department of Research, Institute of Population-Based Cancer Research, Cancer Registry of Norway, Oslo, Norway
- Department of Public Health, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
| | - Reza Ghiasvand
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
- Department of Research, Institute of Population-Based Cancer Research, Cancer Registry of Norway, Oslo, Norway
| | - Marit B. Veierød
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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10
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Kolitz E, Lopes FCPS, Arffa M, Pineider J, Bogucka R, Adamson AS. UV Exposure and the Risk of Keratinocyte Carcinoma in Skin of Color: A Systematic Review. JAMA Dermatol 2022; 158:542-546. [PMID: 35319719 PMCID: PMC8943625 DOI: 10.1001/jamadermatol.2022.0263] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Ultraviolet radiation exposure is an important modifiable risk factor for keratinocyte carcinoma (KC) in fair-skinned non-Hispanic White populations; however, the evidence for this relationship in darker-skinned populations is less certain. Objective To assess and synthesize the published data concerning the association between UV exposure and the risk of KC in individuals with skin of color. Evidence Review PubMed, Cochrane, and Web of Science databases were searched from database origin through January 2022. Studies deemed eligible included UV exposure as a risk factor for KC in individuals with skin of color, defined as any race other than non-Hispanic White, Fitzpatrick skin types IV to VI, or tanning ability of rarely or never burns. The UV index, irradiance, latitude, history of phototherapy, history of sunburn, or occupational exposure were used as measures of exposure. The Oxford Centre for Evidence-Based Medicine guidelines were used to assess evidence quality. Findings A total of 72 716 articles appeared in the search. After duplicate removal, 29 393 database records were screened, 454 full-text articles were assessed, a forward and reverse citation search was performed, and 12 articles, with clinical data spanning the years 1990 to 2019, met inclusion criteria. More than 32 970 KCs in individuals with skin of color were included. Eight studies found no association between UV exposure and KC, while 4 studies showed a positive association. Study types included 1 ecological study, 9 cohort studies, and 2 case-control studies. The quality of the studies was rated from moderate to low (2b to 4). Conclusions and Relevance Results of this systematic review show that the evidence assessing the association of UV exposure with KC is of moderate to low quality. The studies that found no association were among patients receiving phototherapy. Studies assessing nonphototherapy-related UV exposure, such as geographic location or occupation, found small positive associations in primarily East Asian individuals. There were no studies performed in the US, no studies among Black individuals, and only 1 study among a Hispanic population. Further research is required to better assess whether these associations exist across populations of patients with darker skin types.
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Affiliation(s)
- Elysha Kolitz
- The University of Texas Southwestern Medical School, The University of Texas Southwestern Medical Center, Dallas
| | - Fabiana C. P. S. Lopes
- Division of Dermatology, Department of Internal Medicine, Dell Medical School, The University of Texas at Austin
| | - Matthew Arffa
- Division of Dermatology, Department of Internal Medicine, Dell Medical School, The University of Texas at Austin
| | - Juliana Pineider
- The University of Texas Southwestern Medical School, The University of Texas Southwestern Medical Center, Dallas
| | - Roxanne Bogucka
- Life Science Library, University of Texas Libraries, The University of Texas at Austin
| | - Adewole S. Adamson
- Division of Dermatology, Department of Internal Medicine, Dell Medical School, The University of Texas at Austin
- Associate Editor and Web Editor, JAMA Dermatology
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11
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Camponogara C, Oliveira SM. Are TRPA1 and TRPV1 channel-mediated signalling cascades involved in UVB radiation-induced sunburn? Environ Toxicol Pharmacol 2022; 92:103836. [PMID: 35248760 DOI: 10.1016/j.etap.2022.103836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/09/2022] [Accepted: 02/28/2022] [Indexed: 06/14/2023]
Abstract
Burn injuries are underappreciated injuries associated with substantial morbidity and mortality. Overexposure to ultraviolet (UV) radiation has dramatic clinical effects in humans and is a significant public health concern. Although the mechanisms underlying UVB exposure are not fully understood, many studies have made substantial progress in the pathophysiology of sunburn in terms of its molecular aspects in the last few years. It is well established that the transient receptor potential ankyrin 1 (TRPA1), and vanilloid 1 (TRPV1) channels modulate the inflammatory, oxidative, and proliferative processes underlying UVB radiation exposure. However, it is still unknown which mechanisms underlying TRPV1/A1 channel activation are elicited in sunburn induced by UVB radiation. Therefore, in this review, we give an overview of the TRPV1/A1 channel-mediated signalling cascades that may be involved in the pathophysiology of sunburn induced by UVB radiation. These data will undoubtedly help to explain the various features of sunburn and contribute to the development of novel therapeutic approaches to better treat it.
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Affiliation(s)
- Camila Camponogara
- Graduated Program in Biological Sciences: Toxicological Biochemistry, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Sara Marchesan Oliveira
- Graduated Program in Biological Sciences: Toxicological Biochemistry, Federal University of Santa Maria, Santa Maria, RS, Brazil; Department of Biochemistry and Molecular Biology, Centre of Natural and Exact Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil.
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12
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Strome A, Chang T, Waselewski M, Lamberg O, Herbert K. Skin cancer prevention: knowledge and perceptions of a nationwide sample of youth. Ann Fam Med 2022; 20:3115. [PMID: 36696668 PMCID: PMC10548984 DOI: 10.1370/afm.20.s1.3115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Context: Skin cancer is the most common type of cancer in the United States and incidence continues to rise. The leading risk factor for skin cancer is sun exposure in adolescence. Given this, sun protection in young adults is an effective way to reduce the occurrence of skin cancer. The goal of this study is to identify knowledge, behaviors, and barriers among young adults toward the use of sunscreen. Primary care physicians interact with a large number of young adults and have the ideal opportunity to counsel this population. Objective: To identify youths' knowledge and experiences with sun protection and elicit recommendations to increase protection usage. Study Design: Data was obtained using MyVoice, a national poll of youth (www.hearmyvoicenow.org). Five open-ended questions were sent via text message to 1,151 youth on April 9, 2021. Responses were analyzed by two independent investigators after using a modified grounded theory approach to iteratively develop codes based on salient themes. Setting: Participants are youth from the United States aged 14-24 years old who were recruited from social media to meet national benchmarks based on weighted samples of the American Community Survey. Results: Of 1,151 youth, 977 responded to at least one question (response rate= 84.9%). Respondents' mean age was 19.3 years (SD=2.4), 48.1% identified as male, and 62.2% as non-Hispanic white. Nearly all respondents stated "It is very important" or "It's important!" (62.1%, 25.5% respectively) to protect your skin from the sun. The most frequently reported reason for using sun protection was to "reduce the risk of getting skin cancer" (51.7%). Nearly all (90.1%) youth reported use of sunscreen, but 81.1% of respondents have had at least one sunburn and 28.4% have had 5 or more "Many [sunburns], and yes some have blistered". Participants commonly recommended emphasizing the consequences of sun exposure to encourage sun protection use, "Inform people about the dangers of not wearing sun protection" (41.1%). Conclusions: Youth in our nationwide sample understand both the short and long term risks of sun exposure and believe that sun protection is important. Though nearly all reported sunscreen use, youth struggle with implementation of consistent sun protective behaviors with a large number reporting numerous sunburns. These youth reported insights can inform more effective strategies to improve the use of sun protection by youth.
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Abstract
This survey study examines sun protection knowledge and behaviors among US youth aged 14 to 24 years.
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Affiliation(s)
| | | | - Kevin Walsh
- University of Michigan Medical School, Ann Arbor
| | | | | | - Tammy Chang
- Department of Family Medicine, University of Michigan, Ann Arbor
- Institute of Healthcare Policy and Innovation, University of Michigan, Ann Arbor
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14
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Roberts CA, Goldstein EK, Goldstein BG, Jarman KL, Paci K, Goldstein AO. Men's Attitudes and Behaviors About Skincare and Sunscreen Use Behaviors. J Drugs Dermatol 2021; 20:88-93. [PMID: 33400407 DOI: 10.36849/jdd.5470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
IMPORTANCE Skin cancer is the most common cancer in the United States, and men experience higher rates of skin cancer than women. Despite publicized preventative measures, men are less likely than women to use sunscreen. OBJECTIVE To assess men's motivations, behaviors, and preferred product characteristics towards daily sunscreen use. DESIGN AND SETTING Cross-sectional online survey of 705 men, administered July– August 2019, using Survey Monkey and distributed through Amazon Mechanical Turk. PARTICIPANTS Men ages 20–70, having completed at least High School/GED, and living in the United States were eligible. Sampling strategy ensured diversity in terms of race, ethnicity, and sexual orientation. Main Outcome(s) and Measures: Men’s sunscreen use, behaviors, and preferred skincare product characteristics. RESULTS Final participants included 705 men. The most frequent skincare products used regularly were liquid soap/body wash (65%), bar soap (47%), and moisturizers (32%). Most men (n=612; 83%) reported not using sunscreen daily, and 38% reported using sunscreen weekly. Income was related to daily and weekly sunscreen use, as males who earned between $40-$50,000 annually used sunscreen less often compared to people who earned $100,000 annually (OR 0.54%, 95% CI −0.34% to .88%; P = .01). Age, sexual orientation, race, ethnicity, and region were not related to daily or weekly sunscreen use. Main motivators for daily sunscreen use included reducing skin cancer risk (n=575; 82%) and looking younger (n=299; 42%). CONCLUSIONS AND RELEVANCE This survey shows lapses in evidenced-based sunscreen behaviors to reduce skin cancer among men. Campaigns to reduce skin cancer should focus on increasing men's interest in daily sunscreen use and adherence to wearing sun-protective products. J Drugs Dermatol. 2021;20(1):88-93. doi:10.36849/JDD.5470.
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15
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Liu FC, Grimsrud TK, Veierød MB, Robsahm TE, Ghiasvand R, Babigumira R, Shala NK, Stenehjem JS. Ultraviolet radiation and risk of cutaneous melanoma and squamous cell carcinoma in males and females in the Norwegian Offshore Petroleum Workers cohort. Am J Ind Med 2021; 64:496-510. [PMID: 33682179 DOI: 10.1002/ajim.23240] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 02/01/2021] [Accepted: 02/13/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Increased risk of cutaneous melanoma and squamous cell carcinoma (SCC) has been reported among petroleum workers, but few studies include females, exposure data on ultraviolet radiation (UVR), and potential confounding factors. We aimed to examine UVR exposure in relation to risk of melanoma and SCC among male and female offshore petroleum workers. We also examined the association between UVR exposure and melanoma (Breslow) thickness. METHODS The Norwegian Offshore Petroleum Workers (NOPW) cohort (n = 27,917) holds information on sunbathing, indoor tanning, sunburns, sunscreen use, and other lifestyle factors recorded in 1998. Linkage to the Cancer Registry of Norway gave information on cancer diagnosis through 2017. We used Cox and logistic regression to estimate hazard ratios (HRs) of skin cancer and odds ratios (OR) of thick (≥1 mm) melanomas, respectively, with 95% confidence intervals (CIs). RESULTS Melanoma risk increased with increasing frequency of sunbathing after age 20 (ptrend = 0.031), sunburn average intensity (ptrend = 0.028), and sunscreen use (HR = 2.16; 95% CI: 1.42 -3.27 for almost always vs. never/rarely). The risk of thick melanoma was inversely associated with sunbathing frequency after age 20 (OR = 0.38; 95% CI: 0.16 - 0.90 for ≥4 weeks/year vs. 1 week/year). SCC risk increased with increasing frequency of indoor tanning after age 20 (HR = 2.72; 95% CI: 1.22 - 6.05 for ≥3 times/months vs. never), sunburn average intensity (ptrend < 0.001), and sunscreen use (ptrend < 0.001). CONCLUSIONS Our results support associations between UVR exposure and skin cancer risk in male and female offshore petroleum workers. This occupational group may be especially relevant for targeted sun protection advice.
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Affiliation(s)
- Fei-Chih Liu
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Biostatistics, Oslo Centre for Biostatistics and Epidemiology, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Tom K Grimsrud
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Marit B Veierød
- Department of Biostatistics, Oslo Centre for Biostatistics and Epidemiology, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Trude E Robsahm
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Reza Ghiasvand
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Ronnie Babigumira
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Nita K Shala
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Biostatistics, Oslo Centre for Biostatistics and Epidemiology, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Jo S Stenehjem
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Biostatistics, Oslo Centre for Biostatistics and Epidemiology, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
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16
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Affiliation(s)
- H Gilbert Welch
- From the Center for Surgery and Public Health, Brigham and Women's Hospital, Boston (H.G.W.); the Department of Pathology, Yale University School of Medicine, New Haven, CT (B.L.M.); and the Division of Dermatology, Dell Medical School, University of Texas, Austin (A.S.A.)
| | - Benjamin L Mazer
- From the Center for Surgery and Public Health, Brigham and Women's Hospital, Boston (H.G.W.); the Department of Pathology, Yale University School of Medicine, New Haven, CT (B.L.M.); and the Division of Dermatology, Dell Medical School, University of Texas, Austin (A.S.A.)
| | - Adewole S Adamson
- From the Center for Surgery and Public Health, Brigham and Women's Hospital, Boston (H.G.W.); the Department of Pathology, Yale University School of Medicine, New Haven, CT (B.L.M.); and the Division of Dermatology, Dell Medical School, University of Texas, Austin (A.S.A.)
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17
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Kawai K, VoPham T, Drucker A, Curhan SG, Curhan GC. Ultraviolet Radiation Exposure and the Risk of Herpes Zoster in Three Prospective Cohort Studies. Mayo Clin Proc 2020; 95:283-292. [PMID: 31883695 PMCID: PMC7007833 DOI: 10.1016/j.mayocp.2019.08.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 06/25/2019] [Accepted: 08/09/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To examine the association between ultraviolet radiation (UVR) exposure and the risk of herpes zoster (HZ) in 3 prospective cohorts. PATIENTS AND METHODS We included 205,756 participants from the Health Professionals Follow-up Study (HPFS; 1986-2008), Nurses' Health Study (NHS; 1996-2012), and Nurses' Health Study II (NHS II; 1991-2013). Ambient UVR exposure was based on updated geocoded address histories linked with a high-resolution spatiotemporal ultraviolet model. Incident HZ cases were identified by self-reported clinician diagnosis. Sunburn history and medical, lifestyle, and dietary factors were assessed using biennial questionnaires. Multivariable Cox proportional hazards models were used. RESULTS A total of 24,201 cases of HZ occurred during 3,626,131 person-years. Ambient UVR exposure was associated with a higher risk of HZ in men (HPFS: multivariable-adjusted hazard ratio [MVHR] comparing highest vs lowest quintiles, 1.14; 95% CI, 1.02-1.29; P=.03 for trend) but not in women (NHS: MVHR, 0.99; 95% CI, 0.93-1.05; NHS II: MVHR, 0.96; 95% CI, 0.90-1.03). A higher lifetime number of severe sunburns was associated with a higher risk of HZ in all cohorts (HPFS: MVHR for ≥10 sunburns vs none, 1.08; 95% CI, 0.96-1.20; P=.02 for trend; NHS: MVHR, 1.14; 95% CI, 1.05-1.22; P=.01 for trend; NHS II: MVHR, 1.13; 95% CI, 1.00-1.28; P<.001 for trend). CONCLUSION Ambient UVR exposure was associated with a higher risk of HZ in men but not in women. A history of severe sunburn was associated with a modest increased risk of HZ in men and women, possibly because of immunosuppression from overexposure to the sun.
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Affiliation(s)
- Kosuke Kawai
- Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
| | - Trang VoPham
- Epidemiology Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Aaron Drucker
- Department of Medicine, University of Toronto, Ontario, Canada; Women's College Research Institute, Toronto, Ontario, Canada; Department of Medicine, Division of Dermatology, Women's College Hospital, Toronto, Ontario, Canada
| | - Sharon G Curhan
- Harvard Medical School, Boston, MA; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA
| | - Gary C Curhan
- Harvard Medical School, Boston, MA; Department of Medicine, Renal Division, Brigham and Women's Hospital, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
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18
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Manganoni AM, Cainelli T, Zumiani G, Bufalino R, Calzavara-Pinton P, Camerini T, Tucci G, Baldi M, Venturini M, Marini G, Cascinelli N. Study of Sunbathing in Children: The Preliminary Evaluation of a Prevention Program. Tumori 2019; 91:116-20. [PMID: 15948536 DOI: 10.1177/030089160509100202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and background Sunburn during childhood is associated with an increased risk for developing melanoma in an adult age. The aim of the present study was to define the validity of our educational program in order to teach the positive effects and risks of sun exposure during childhood. Patients and methods We conducted a population-based, case-control study in primary schools of three towns in Northern Italy (Brescia, Bergamo and Trento) between 2001 and 2002. The study was carried out on 1945 pupils (aged 8-9 years) and included 1309 case children who received an educational program before the summer to increase awareness towards sun exposure and 636 control children who did not. Parents of case and control children were interviewed using a questionnaire about their children's skin characteristics, sun protective behavior and sunburns. The questionnaire was completed twice, before and after the summer, to verify the changes of sun exposure habits. Results A significant decrease in sunburns was demonstrated in the group of subjects who received the educational program, indicating the validity of our operative procedure (from 14.6% to 10%, P = 4 × 10−4). Conclusions Our educational melanoma program may be important to disseminate in a wider range of children a correct education on sun exposure during childhood.
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Lindstrom AR, von Schuckmann LA, Hughes MCB, Williams GM, Green AC, van der Pols JC. Regular Sunscreen Use and Risk of Mortality: Long-Term Follow-up of a Skin Cancer Prevention Trial. Am J Prev Med 2019; 56:742-746. [PMID: 30885518 DOI: 10.1016/j.amepre.2018.11.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 11/28/2018] [Accepted: 11/29/2018] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Sunscreen is widely used to protect the skin from harmful effects of sun exposure. However, there are concerns that sunscreens may negatively affect overall health. Evidence of the general safety of long-term regular sunscreen use is therefore needed. METHODS The effect of long-term sunscreen use on mortality was assessed over a 21-year period (1993-2014) among 1,621 Australian adults who had participated in a randomized skin cancer prevention trial of regular versus discretionary sunscreen use (1992-1996). In 2018, an intention-to-treat analysis was conducted using Cox proportional hazards regression to compare death rates in people who were randomized to apply sunscreen daily for 4.5years, versus randomized to use sunscreen at their usual, discretionary level. All-cause mortality and deaths resulting from cardiovascular disease, cancer, and other causes were considered. RESULTS In total, 160 deaths occurred in the daily sunscreen group compared with 170 deaths in the discretionary sunscreen group (hazard ratio=0.94, 95% CI=0.76, 1.17); 59vs 76 cardiovascular disease deaths (hazard ratio=0.77, 95% CI=0.55, 1.08), 63vs 58 cancer deaths (hazard ratio=1.09, 95% CI=0.76, 1.57), and 45vs 44 deaths resulting from other causes (hazard ratio=1.02, 95% CI=0.67, 1.54) occurred respectively. CONCLUSIONS Regular use of a sun protection factor 16 sunscreen on head, neck, arms, and hands for 4.5years did not increase mortality.
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Affiliation(s)
- Akiaja R Lindstrom
- Cancer and Population Studies Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Lena A von Schuckmann
- Cancer and Population Studies Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Maria Celia B Hughes
- Cancer and Population Studies Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Gail M Williams
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Adele C Green
- Cancer and Population Studies Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia; CRUK Manchester Institute and Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Jolieke C van der Pols
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia.
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Serna-Higuita LM, Harrison SL, Buttner P, Glasby M, Raasch BA, Iftner A, Garbe C, Martus P, Iftner T. Modifiable Risk-factors for Keratinocyte Cancers in Australia: A Case-control Study. Acta Derm Venereol 2019; 99:404-411. [PMID: 30547181 DOI: 10.2340/00015555-3107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Keratinocyte cancer is the most common malignancy in Caucasians. The aim of this study was to investigate risk-factors responsible for development of keratinocyte cancer in Australia. A case-control study was conducted, including 112 cases of squamous cell carcinoma (SCC), 95 cases of basal cell carcinoma (BCC) and 122 controls. Freckling during adolescence (SCC: odds ratio (OR) 1.04, p < 0.01; BCC: OR 1.05, p < 0.01), propensity to sunburn (SCC: OR 2.75, p = 0.01, BCC: OR 2.68 p = 0.01) and high cumulative sun-exposure (SCC: OR 2.43, p = 0.04; BCC: OR 2.36 p = 0.04) were independent risk-factors for both SCC and BCC. This study provides further evidence that a sun-sensitive phenotype and excessive sun-exposure during adulthood contribute to the risk of developing keratinocyte cancer. Wearing a hat, long-sleeved shirts, and sunscreen did not significantly reduce the risk of keratinocyte cancer in this study.
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MESH Headings
- Adolescent
- Adult
- Age Factors
- Aged
- Carcinoma, Basal Cell/etiology
- Carcinoma, Basal Cell/pathology
- Carcinoma, Basal Cell/prevention & control
- Carcinoma, Squamous Cell/etiology
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/prevention & control
- Case-Control Studies
- Dose-Response Relationship, Radiation
- Educational Status
- Female
- Humans
- Keratinocytes/pathology
- Keratinocytes/radiation effects
- Male
- Melanosis/etiology
- Middle Aged
- Neoplasms, Radiation-Induced/etiology
- Neoplasms, Radiation-Induced/pathology
- Neoplasms, Radiation-Induced/prevention & control
- Protective Factors
- Queensland
- Risk Assessment
- Risk Factors
- Risk Reduction Behavior
- Skin Neoplasms/etiology
- Skin Neoplasms/pathology
- Skin Neoplasms/prevention & control
- Sunburn/complications
- Sunlight/adverse effects
- Time Factors
- Young Adult
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Affiliation(s)
- Lina Maria Serna-Higuita
- Department of Clinical Epidemiology and Applied Biostatistics, University Hospital Tübingen, DE-72076 Tübingen, Germany
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21
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Cooper E, Schexnayder L, Meaux T. Sunburn Recall Reaction and Mucositis Secondary to Methotrexate Toxicity. Skinmed 2018; 16:340-341. [PMID: 30413231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A 59-year-old Native American female presented with a 4-day history of malaise, abdominal pain, nausea, jaundice, and a "sunburn-like rash" on the upper chest and back despite lack of recent sun exposure (Figure 1). Medical history was significant for a twenty-year history of universal vitiligo and a five-year history of rheumatoid arthritis (RA) treated with methotrexate (MTX), adalimumab, prednisone, and naproxen sodium. Cutaneous examination revealed hemorrhagic crusting of upper and lower lips (Figure 2), scleral icterus, diffuse jaundice of the skin, and well-demarcated erythematous patches on mid-upper back and anterior neck. The patient had a few scattered erythematous papules with whitish center on bilateral extensor surfaces of the upper extremities and scattered petechiae on both the trunk and upper extremities.
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Affiliation(s)
- Elizabeth Cooper
- School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA;
| | - Lyndsey Schexnayder
- School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Tyson Meaux
- School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
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Asdigian NL, Barón AE, Morelli JG, Mokrohisky ST, Aalborg J, Dellavalle RP, Daley MF, Berwick M, Muller KE, Box NF, Crane LA. Trajectories of Nevus Development From Age 3 to 16 Years in the Colorado Kids Sun Care Program Cohort. JAMA Dermatol 2018; 154:1272-1280. [PMID: 30208471 PMCID: PMC6248123 DOI: 10.1001/jamadermatol.2018.3027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 07/13/2018] [Indexed: 11/14/2022]
Abstract
Importance Nevi are a risk factor for melanoma and other forms of skin cancer, and many of the same factors confer risk for both. Understanding childhood nevus development may provide clues to possible causes and prevention of melanoma. Objectives To describe nevus acquisition from the ages of 3 to 16 years among white youths and evaluate variation by sex, Hispanic ethnicity, and body sites that are chronically vs intermittently exposed to the sun. Design, Setting, and Participants This annual longitudinal observational cohort study of nevus development was conducted between June 1, 2001, and October 31, 2014, among 1085 Colorado youths. Data analysis was conducted between February 1, 2015, and August 31, 2017. Main Outcomes and Measures Total nevus counts on all body sites and on sites chronically and intermittently exposed to the sun separately. Results A total of 557 girls and 528 boys (150 [13.8%] Hispanic participants) born in 1998 were included in this study. Median total body nevus counts increased linearly among non-Hispanic white boys and girls between the age of 3 years (boys, 6.31; 95% CI, 5.66-7.03; and girls, 6.61; 95% CI, 5.96-7.33) and the age of 16 years (boys, 81.30; 95% CI, 75.95-87.03; and girls, 77.58; 95% CI, 72.68-82.81). Median total body nevus counts were lower among Hispanic white children (boys aged 16 years, 51.45; 95% CI, 44.01-60.15; and girls aged 16 years, 53.75; 95% CI, 45.40-63.62) compared with non-Hispanic white children, but they followed a largely linear trend that varied by sex. Nevus counts on body sites chronically exposed to the sun increased over time but leveled off by the age of 16 years. Nevus counts on sites intermittently exposed to the sun followed a strong linear pattern through the age of 16 years. Hispanic white boys and girls had similar nevus counts on sites intermittently exposed to the sun through the age of 10 years, but increases thereafter were steeper for girls, with nevus counts surpassing those of boys aged 11 to 16 years. Conclusions and Relevance Youths are at risk for nevus development beginning in early childhood and continuing through midadolescence. Patterns of nevus acquisition differ between boys and girls, Hispanic and non-Hispanic white youths, and body sites that are chronically exposed to the sun and body sites that are intermittently exposed to the sun. Exposure to UV light during this period should be reduced, particularly on body sites intermittently exposed to the sun, where nevi accumulate through midadolescence in all children. Increased attention to sun protection appears to be merited for boys, in general, because they accumulated more nevi overall, and for girls, specifically, during the adolescent years.
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Affiliation(s)
- Nancy L. Asdigian
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
| | - Anna E. Barón
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
| | - Joseph G. Morelli
- Department of Dermatology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
| | | | - Jenny Aalborg
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
| | - Robert P. Dellavalle
- Department of Dermatology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
- Dermatology Service, US Department of Veterans Affairs Rocky Mountain Regional Medical Center, Aurora, Colorado
| | - Matthew F. Daley
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
- Institute for Health Research, Kaiser Permanente Colorado, Aurora
| | - Marianne Berwick
- Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque
- Department of Dermatology, School of Medicine, University of New Mexico, Albuquerque
| | - Keith E. Muller
- Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville
| | - Neil F. Box
- Department of Dermatology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
| | - Lori A. Crane
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
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Mounessa JS, Box NF, Asdigian NL, Braunberger T, Dunnick CA, Crane LA, Dellavalle RR. Portable equipment for taking dramatic sun-damage revealing photos at skin cancer prevention outreach events. Dermatol Online J 2017; 23:13030/qt33j0040b. [PMID: 28537858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 05/22/2017] [Indexed: 06/07/2023] Open
Abstract
In recent years, appearance-based interventions have gained popularity as a means to improve public awareness about skin cancer and sun protective behaviors. Although numerous reports discuss the use of ultraviolet (UV) camera devices for this purpose,studies on the use of portable imaging devices in community outreach events do not presently exist. In this report, we discuss how we successfully utilize portable imaging devices at community outreach events. We also discuss the advantages and disadvantages of our portable devices in comparison to traditional UV cameras. Portable imaging devices are easy to use and have allowed us to increase our involvement in community outreach events targeting a wide range of participants.
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Affiliation(s)
| | | | | | | | | | | | - Robert R Dellavalle
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado Dermatology Service, Eastern Colorado Health Care System, US Department of Veteran Affairs, Denver, Colorado.
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Abstract
The paper presents an atypical case of solar retinopathy after short-term exposure to reflected focused sunbeams. An ophthalmoscopic peculiarity was the presence of intraretinal hemorrhage. The basis for establishing the diagnosis were spectral optical coherence tomography and fluorescein angiography findings.
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Affiliation(s)
- N V Pomytkina
- Khabarovsk branch of the Academician S.N. Fyodorov IRTC 'Eye Microsurgery', 211 Tikhookeanskaya St., Khabarovsk, Russian Federation, 680033
| | - A L Zhirov
- Khabarovsk branch of the Academician S.N. Fyodorov IRTC 'Eye Microsurgery', 211 Tikhookeanskaya St., Khabarovsk, Russian Federation, 680033
| | - T L Sorokin
- Khabarovsk branch of the Academician S.N. Fyodorov IRTC 'Eye Microsurgery', 211 Tikhookeanskaya St., Khabarovsk, Russian Federation, 680033; Far Eastern State Medical University, 35 Muravyeva-Amurskogo St., Khabarovsk, Russian Federation, 680000
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Affiliation(s)
- Gery P Guy
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Dawn M Holman
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Meg Watson
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Salmon N, Tidman MJ. Managing actinic keratosis in primary care. Practitioner 2016; 260:25-29. [PMID: 29016090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Actinic, or solar, keratosis is caused by chronic ultraviolet-induced damage to the epidermis. In the UK, 15-23% of individuals have actinic keratosis lesions. Risk factors include: advanced age; male gender; cumulative sun exposure or phototherapy; Fitzpatrick skin phototypes I-II; long-term immuno-suppression and genetic syndromes e.g. xeroderma pigmentosum and albinism. Actinic keratoses are regarded by some authorities as premalignant lesions that may transform into invasive squamous cell carcinoma (SCC) and by others as in situ SCC that may progress to an invasive stage. The risk of malignant change appears low; up to 0.5% per lesion per year. Up to 20-30% of lesions may spontaneously regress but in the absence of any reliable prognostic clinical indicators regarding malignant potential active treatment is considered appropriate. Actinic keratosis lesions may present as discrete hyperkeratotic papules, cutaneous horns, or more subtle flat lesions on sun-exposed areas of skin. The single most helpful diagnostic sign is an irregularly roughened surface texture: a sandpaper-like feel almost always indicates actinic damage. Dermatoscopy can be helpful in excluding signs of basal cell carcinoma when actinic keratosis is non-keratotic. It is always important to consider the possibility of SCC. The principal indication for referral to secondary care is the possibility of cutaneous malignancy. However, widespread and severe actinic damage in patients who are immunosuppressed is also a reason for referral.
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Guarneri F, Asmundo A, Sapienza D, Borgia F, Papaianni V, Cannavo' SP. Glutathione S-transferase M1/T1 genotype and melanoma in a Southern Italian population: a case-control study. GIORN ITAL DERMAT V 2016; 151:140-144. [PMID: 25588060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND The aim of this study was to assess the frequency of GSTM1 and GSTT1 null genotype in melanoma patients and controls from Sicily and Calabria, two regions of Southern Italy never investigated on this issue before, that present a peculiar gene pool because of their geographical and historical characteristics. METHODS One hundred and twelve Caucasian melanoma patients and 150 age- and sex-matched healthy controls were examined; their GSTM1/GSTT1 genotype was defined by polymerase chain reaction on a sample of oral mucosa cells obtained by buccal swabs. RESULTS Odds ratio for melanoma was increased not significantly in case of fair hair/eye color, presence of many naevi or solar lentigines, or history of actinic keratosis, skin cancer or sunburns; frequencies of GSTM1 null, GSTT1 null and all their possible combinations were not significantly different between patients and controls. CONCLUSIONS Our results, in agreement with worldwide literature, show that melanoma is apparently independent from genetic lack of GSTM1/GSTT1. However, melanoma is notoriously linked to a history of sunburns, and GSTM1/GSTT1 null are a significant risk factor for sunburns. We describe a possible explanation of this apparent contradiction, taking into account the different roles of the multiple components of human skin in photoprotection, and their variable importance in different conditions of exposure to UV radiations. Simultaneous evaluation of a larger number of components of the antioxidant system, to assess their individual contribution to protection against melanoma, is advisable and should be considered in future studies. This could allow to better define risks for each patient and possibly to tailor preventive measures.
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Affiliation(s)
- Fabrizio Guarneri
- Department of Clinical and Experimental Medicine - Dermatology, University of Messina, "G. Martino" Hospital, Messina, Italy -
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Sumner JP, Pucheu-Haston CM, Fowlkes N, Merchant S. Dorsal skin necrosis secondary to a solar-induced thermal burn in a brown-coated dachshund. Can Vet J 2016; 57:305-8. [PMID: 26933270 PMCID: PMC4751775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A 5-year-old neutered male brown dachshund dog was presented for a large dorsal cutaneous burn that occurred following direct sunlight exposure outdoors in high ambient temperatures. Although burns are quite common in dogs, full-thickness solar-induced radiation burns are less common and have not been previously reported in animals without a black hair coat.
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Affiliation(s)
- Julia P. Sumner
- Department of Veterinary Clinical Sciences (Sumner, Pucheu-Haston, Merchant), Department of Pathobiological Sciences (Fowlkes), Louisiana State University School of Veterinary Medicine, 1909 Skip Bertman Drive, Baton Rouge, Louisiana, USA
| | - Cherie M. Pucheu-Haston
- Department of Veterinary Clinical Sciences (Sumner, Pucheu-Haston, Merchant), Department of Pathobiological Sciences (Fowlkes), Louisiana State University School of Veterinary Medicine, 1909 Skip Bertman Drive, Baton Rouge, Louisiana, USA
| | - Natalie Fowlkes
- Department of Veterinary Clinical Sciences (Sumner, Pucheu-Haston, Merchant), Department of Pathobiological Sciences (Fowlkes), Louisiana State University School of Veterinary Medicine, 1909 Skip Bertman Drive, Baton Rouge, Louisiana, USA
| | - Sandra Merchant
- Department of Veterinary Clinical Sciences (Sumner, Pucheu-Haston, Merchant), Department of Pathobiological Sciences (Fowlkes), Louisiana State University School of Veterinary Medicine, 1909 Skip Bertman Drive, Baton Rouge, Louisiana, USA
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Espinosa P, Pfeiffer RM, García-Casado Z, Requena C, Landi MT, Kumar R, Nagore E. Risk factors for keratinocyte skin cancer in patients diagnosed with melanoma, a large retrospective study. Eur J Cancer 2015; 53:115-24. [PMID: 26702765 DOI: 10.1016/j.ejca.2015.10.058] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 10/02/2015] [Accepted: 10/23/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND Melanoma survivors are at an increased risk of developing other malignancies, including keratinocyte skin cancer (KSC). While it is known that many risk factors for melanoma also impact risk of KSC in the general population, no previous study has investigated risk factors for KSC development in melanoma patients. OBJECTIVE We assessed associations of personal and clinical characteristics, including skin phenotype and variations in the melanocortin 1 receptor (MC1R) gene, with KSC risk in melanoma patients. PATIENTS AND METHODS We used prospective follow-up information on 1200 patients treated for melanoma at the Instituto Valenciano de Oncología, Spain, between 2000 and 2011. We computed hazard ratios and 95% confidence intervals (CIs) for the association of clinical, personal and genetic characteristics with risk of KSC, squamous cell carcinoma (SCC), or basal cell carcinoma (BCC) from Cox proportional hazard models. Five-year cumulative incidence based on competing risk models of SCC, BCC or KSC overall was computed using multivariate subdistribution hazard models. To assess predictive performance of the models, we computed areas under the receiver-operating characteristic curves (AUCs, discriminatory power) using cross-validation. RESULTS Median follow-up was 57.2 months; a KSC was detected in 163 patients (13.6%). In multivariable Cox models, age, sex, sunburns, chronic sun exposure, past personal history of non-melanoma skin cancer or other non-cutaneous neoplasia, and the MC1R variants p.D294H and p.R163Q were significantly associated with KSC risk. A cumulative incidence model including age, sex, personal history of KSC, and of other non-cutaneous neoplasia had an AUC of 0.76 (95% CI: 0.71-0.80). When p.D294H and p.R163Q variants were added to the model, the AUC increased to 0.81 (95% CI: 0.77-0.84) (p-value for difference <0.0001). CONCLUSIONS In addition to age, sex, skin characteristics, and sun exposure, p.R163Q and p.D294H MC1R variants significantly increased KSC risk among melanoma patients. Our findings may help identify patients who could benefit most from preventive measures.
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Affiliation(s)
- Pablo Espinosa
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Ruth M Pfeiffer
- Biostatistics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, USA
| | - Zaida García-Casado
- Laboratory of Molecular Biology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Celia Requena
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Maria Teresa Landi
- Genetic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, USA
| | - Rajiv Kumar
- Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain.
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Calzavara-Pinton P, Ortel B, Venturini M. Non-melanoma skin cancer, sun exposure and sun protection. GIORN ITAL DERMAT V 2015; 150:369-378. [PMID: 26186380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The incidence of skin tumors including squamous cell carcinoma (SCC), and its biological precursor, the actinic keratosis, and basal cell carcinoma (BCC) often named together non-melanoma skin cancer (NMSC) is growing all over the world in people of Caucasian ancestry. A plenty of clinical and epidemiological studies have demonstrated the causal relationship with high cumulative solar dosages and number of sunburns, although the hazard may be different for different tumors according to the modalities of ultraviolet (UV) exposure. BCC is much more strongly related to measures of intermittent ultraviolet exposure (particularly those of childhood or adolescence) than to measures of cumulative exposure. In contrast, SCC is more strongly related to constant or cumulative sun exposure. Photobiological studies have clarified that sunlight and UVB radiation are complete carcinogens for AK and SCC although the relationship with UVA exposure is much less known. Also the likelihood of BCC has been related to either sunburns and high lifetime solar, UVA and UVB cumulative doses but the pathogenetic pathways of both UVB and UVA radiation for BCC development need to be clarified so far. The lack of a complete knowledge of the photocarcinogenic pathways of keratinocytes has contributed to the limited results of solar photoprotection strategies, beside the limitations of the available sunscreens and present EU regulations.
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Forbes PD, Davies RE. Quantity, quality and mode of UV administration as denominators of photocarcinogenesis. Curr Probl Dermatol 2015; 15:290-302. [PMID: 3948526 DOI: 10.1159/000412111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Kulichová D, Dáňová J, Kunte C, Ruzicka T, Celko AM. Risk factors for malignant melanoma and preventive methods. Cutis 2014; 94:241-8. [PMID: 25474453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
UV radiation is an important environmental risk factor for cutaneous melanoma; however, information concerning UV exposure in many populations is lacking. The aim of our study was to investigate risk factors for malignant melanoma (MM), particularly those related to UV exposure behavior in the Czech Republic and Germany. This case-control study included 207 patients who were consecutively diagnosed with MM in 2 dermatology clinics in Prague, Czech Republic, and Munich, Germany. Controls were 235 patients with other dermatologic conditions. All 442 participants completed a questionnaire on sociodemographic data and factors related to UV exposure. The association between risk factors and MM was assessed using multivariate logistic regression. Patients with Fitzpatrick skin types I and II had a higher likelihood of developing melanoma than those with Fitzpatrick skin type III. Frequent sunburns during childhood and adolescence were strongly related to developing melanoma. A higher level of education also was associated with a higher melanoma incidence. Variables related to UV exposure were strongly associated with melanoma in our study population. Prevention campaigns should be implemented to improve awareness of melanoma to reduce exposure to UV radiation among high-risk patient populations.
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Affiliation(s)
- Daniela Kulichová
- Department of Dermatology and Allergology, Ludwig Maximilian University, Frauenlobstrasse 9-11, 80337 Munich, Germany.
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Hernandez C, Wang S, Abraham I, Angulo MI, Kim H, Meza JR, Munoz A, Rodriguez L, Uddin S. Evaluation of educational videos to increase skin cancer risk awareness and sun-safe behaviors among adult Hispanics. J Cancer Educ 2014; 29:563-569. [PMID: 24595966 PMCID: PMC4136919 DOI: 10.1007/s13187-014-0624-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Although skin cancer is less common in Hispanics, they are at higher risk for presenting with more advanced stage skin cancer. We performed semi-structured interviews with Hispanic women that found high concern for photoaging from sun exposure. Based on these results, we developed two short Spanish-language films. The first emphasized photoaging benefits of sun protection, while the second focused on its benefits for skin cancer prevention. Our hypothesis was that the reduction of photoaging would be a more persuasive argument than skin cancer prevention for the adoption of sunscreen use by Hispanic women. Study participants were recruited from beauty salons located in predominantly Hispanic neighborhoods. Each of the two Spanish-language films was approximately 3 min long. A pre-intervention questionnaire assessed subjects' general knowledge and sunscreen habits, and a second questionnaire administered after viewing both films assessed for improvements in risk perception and inquired about which film was more persuasive. Eighty Hispanics participated ranging in age from 19 to 75. The pre-education survey found that 54 out of 80 believed that fair-skin Hispanics (FS) were at risk for skin cancer, and 44 out of 80 believed that dark-skin Hispanics (DS) were at risk. These numbers increased to 72 (FS) and 69 (DS) after the intervention (p value: <0.0002 FS, <0.0001 DS). Hispanics overwhelmingly selected the video emphasizing the benefits of sun protection for skin cancer prevention as the more persuasive film (74 out of 80). A Spanish-language video has the potential to make an impact in healthy sun-protective behaviors, and information on how to properly apply sunscreen should be included in educational messages.
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Affiliation(s)
- Claudia Hernandez
- Department of Dermatology (MC 624), University of Illinois at Chicago (UIC), 808 South Wood Street, Room 376 CME, Chicago, IL, 60612, USA,
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Viros A, Sanchez-Laorden B, Pedersen M, Furney SJ, Rae J, Hogan K, Ejiama S, Girotti MR, Cook M, Dhomen N, Marais R. Ultraviolet radiation accelerates BRAF-driven melanomagenesis by targeting TP53. Nature 2014; 511:478-482. [PMID: 24919155 PMCID: PMC4112218 DOI: 10.1038/nature13298] [Citation(s) in RCA: 156] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 03/31/2014] [Indexed: 12/19/2022]
Abstract
Cutaneous melanoma is epidemiologically linked to ultraviolet radiation (UVR), but the molecular mechanisms by which UVR drives melanomagenesis remain unclear. The most common somatic mutation in melanoma is a V600E substitution in BRAF, which is an early event. To investigate how UVR accelerates oncogenic BRAF-driven melanomagenesis, we used a BRAF(V600E) mouse model. In mice expressing BRAF(V600E) in their melanocytes, a single dose of UVR that mimicked mild sunburn in humans induced clonal expansion of the melanocytes, and repeated doses of UVR increased melanoma burden. Here we show that sunscreen (UVA superior, UVB sun protection factor (SPF) 50) delayed the onset of UVR-driven melanoma, but only provided partial protection. The UVR-exposed tumours showed increased numbers of single nucleotide variants and we observed mutations (H39Y, S124F, R245C, R270C, C272G) in the Trp53 tumour suppressor in approximately 40% of cases. TP53 is an accepted UVR target in human non-melanoma skin cancer, but is not thought to have a major role in melanoma. However, we show that, in mice, mutant Trp53 accelerated BRAF(V600E)-driven melanomagenesis, and that TP53 mutations are linked to evidence of UVR-induced DNA damage in human melanoma. Thus, we provide mechanistic insight into epidemiological data linking UVR to acquired naevi in humans. Furthermore, we identify TP53/Trp53 as a UVR-target gene that cooperates with BRAF(V600E) to induce melanoma, providing molecular insight into how UVR accelerates melanomagenesis. Our study validates public health campaigns that promote sunscreen protection for individuals at risk of melanoma.
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Affiliation(s)
- Amaya Viros
- Molecular Oncology Group, Cancer Research UK Manchester Institute, The University of Manchester, Wilmslow Road, Manchester, M20 4BX, UK
| | - Berta Sanchez-Laorden
- Molecular Oncology Group, Cancer Research UK Manchester Institute, The University of Manchester, Wilmslow Road, Manchester, M20 4BX, UK
| | - Malin Pedersen
- Signal Transduction Team, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB, UK
| | - Simon J. Furney
- Molecular Oncology Group, Cancer Research UK Manchester Institute, The University of Manchester, Wilmslow Road, Manchester, M20 4BX, UK
| | - Joel Rae
- Signal Transduction Team, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB, UK
| | - Kate Hogan
- Molecular Oncology Group, Cancer Research UK Manchester Institute, The University of Manchester, Wilmslow Road, Manchester, M20 4BX, UK
| | - Sarah Ejiama
- Molecular Oncology Group, Cancer Research UK Manchester Institute, The University of Manchester, Wilmslow Road, Manchester, M20 4BX, UK
| | - Maria Romina Girotti
- Molecular Oncology Group, Cancer Research UK Manchester Institute, The University of Manchester, Wilmslow Road, Manchester, M20 4BX, UK
| | - Martin Cook
- Molecular Oncology Group, Cancer Research UK Manchester Institute, The University of Manchester, Wilmslow Road, Manchester, M20 4BX, UK
- Histopathology, Royal Surrey County Hospital, Egerton Road, Guildford, GU2 7XX UK
| | - Nathalie Dhomen
- Signal Transduction Team, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB, UK
| | - Richard Marais
- Molecular Oncology Group, Cancer Research UK Manchester Institute, The University of Manchester, Wilmslow Road, Manchester, M20 4BX, UK
- Signal Transduction Team, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB, UK
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Kyle RG, MacMillan I, Forbat L, Neal RD, O'Carroll RE, Haw S, Hubbard G. Scottish adolescents' sun-related behaviours, tanning attitudes and associations with skin cancer awareness: a cross-sectional study. BMJ Open 2014; 4:e005137. [PMID: 24793258 PMCID: PMC4025409 DOI: 10.1136/bmjopen-2014-005137] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To describe Scottish adolescents' sun-related behaviours and tanning attitudes and assess associations with skin cancer awareness. DESIGN Cross-sectional study. SETTING 20 state secondary schools in one Scottish local authority (Glasgow City). PARTICIPANTS 2173 adolescents (females: 50.7%, n=1102) with a mean age of 12.4 (SD=0.55). OUTCOME MEASURES Sun-related behaviour (suntan, sunbathing, sunburn, sunscreen use, sunbed use), tanning attitudes, skin cancer-related symptom and risk factor awareness. RESULTS Adolescents reported poor sun-related practice: 51% of adolescents reported sunburn the previous summer of whom 38% indicated sunburn on more than one occasion. Skin cancer awareness was low: 45% recognised 'change in the appearance of a mole' as a cancer symptom, and 39% agreed that 'getting sunburnt more than once as a child' increased cancer risk. 42% and 26% of adolescents, respectively, reported that friends and family held protanning attitudes. Compared with males, females were statistically significantly more likely to: report sunbathing (p<0.001), use of lotions or oil to aid tanning (p=0.009) and sunburn (p<0.001); know that changes in the appearance of a mole was a skin cancer symptom (p=0.036) and sunburn more than once as a child was a skin cancer risk factor (p=0.005); perceive their friends to hold protanning attitudes (p<0.001) and indicate that a tan made them feel better about themselves (p<0.001), more attractive to others (p=0.011) and healthier (p<0.001). CONCLUSIONS Scottish adolescents had poor sun protection practice and low skin cancer awareness. Girls adopted riskier sun-related behaviour despite greater awareness of skin cancer-related risk. Urgent action is required to promote positive sun-related behaviour and increase skin cancer awareness among Scottish adolescents. However, further research is needed to inform the development of effective sun-safe interventions.
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Affiliation(s)
- Richard G Kyle
- Cancer Care Research Centre, School of Nursing, Midwifery and Health, University of Stirling, Stirling, UK
| | | | - Liz Forbat
- Cancer Care Research Centre, School of Nursing, Midwifery and Health, University of Stirling, Stirling, UK
| | - Richard D Neal
- North Wales Centre for Primary Care Research, Bangor University, Bangor, UK
| | - Ronan E O'Carroll
- Division of Psychology, School of Natural Sciences, University of Stirling, Stirling, UK
| | - Sally Haw
- School of Nursing, Midwifery and Health, University of Stirling, Stirling, UK
| | - Gill Hubbard
- Cancer Care Research Centre, School of Nursing, Midwifery and Health, University of Stirling, Stirling, UK
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Abstract
Basal cell carcinoma (BCC) of the axilla is rare; indeed, 70 axillary BCCs have been described in 69 patients. Using the PubMed database, an extensive literature search was performed on BCC, axilla, and axillary. Relevant papers were reviewed and the characteristics of individuals with BCC of the axilla were summarized. The calculated prevalence of axillary BCC was 0.17%. They occurred predominantly in Caucasians. The majority of patients had no obvious BCC-associated risk factors. They were observed 1.2 times more often in men than in women and twice as often in the right axilla than the left axilla. They frequently presented as an asymptomatic nodule; however, associated features have included elongation of the tumor along the axillary skin lines, ulceration, and pigmentation. The axillary tumor was typically associated with either the superficial or the nodular histologic subtype of BCC. The prognosis for these patients was usually excellent following complete removal or destruction of the tumor. In conclusion, axillary BCC is a rare clinical variant of this type of skin cancer that usually presents as an asymptomatic nodule in an individual who does not have any traditional risk factors for this malignancy. The cancer was typically associated with a non-aggressive histologic subtype. Recurrence or metastasis was uncommon following treatment of the primary tumor.
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Affiliation(s)
- Philip R Cohen
- Division of Dermatology, University of California San Diego, 10991 Twinleaf Court, San Diego, CA, 92131-3643, USA,
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Affiliation(s)
- Hind Benhiba
- Université Mohammed V - Souissi, Service de Dermatologie-Vénéréologie, CHU Ibn Sina, Rabat, Maroc
| | - Badredine Hassam
- Université Mohammed V - Souissi, Service de Dermatologie-Vénéréologie, CHU Ibn Sina, Rabat, Maroc
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40
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Jibbe A, Tefft K, Weir G, Aires D, Liu D. Photo recall reaction following the use of vancomycin. Dermatol Online J 2013; 19:20396. [PMID: 24314773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 11/15/2013] [Indexed: 06/02/2023] Open
Abstract
Drug-induced erythema in the distribution of prior sunburn is called photo recall. Although more commonly induced by chemotherapeutics, it has also been associated with antibiotics such as ampicillin, cephalosporin, and gentamicin. Vancomycin has not been previously reported as a causal agent. This case report describes photo recall in a fifty-three year old woman undergoing treatment with vancomycin for a MRSA infection of the spine. Her eruption followed a photo-distributed pattern on the chest, shoulders, neck and face sparing areas previously protected by her bathing suit. Of note, she reported a similar eruption following vancomycin two years prior.
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Affiliation(s)
- A Jibbe
- University of Kansas School of Medicine
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41
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Abstract
There is a paucity of data on basal-cell carcinoma (BCC) in the United States, since most national registries do not collect information on BCC. We evaluated BCC incidence trends and associated risk factors for BCC in 140,171 participants from a U.S. female cohort, the Nurses' Health Study (1986-2006), and a U.S. male cohort, the Health Professionals' Follow-up Study (1988-2006). Age-adjusted BCC incidence rates increased from 519 cases per 100,000 person-years to 1,019 cases per 100,000 person years for women and increased from 606 cases per 100,000 person-years to 1,488 cases per 100,000 person-years for men during the follow-up period. Cox proportional hazards analysis identified the following phenotypic risk factors for BCC in both cohorts: family history of melanoma, blond or red hair colors, higher number of extremity moles, higher susceptibility to sunburn as a child/adolescent, and higher lifetime number of severe/blistering sunburns. The multivariate-adjusted risk ratio for the highest quintile of cumulative midrange ultraviolet B flux exposure versus the lowest quintile was 3.18 (95% confidence interval: 2.70, 3.76) in women and 1.90 (95% confidence interval: 1.57, 2.29) in men. BCC incidence was generally higher in men than in women, and BCC risk was strongly associated with several phenotypic and exposure factors, including midrange ultraviolet B radiation, in our study populations.
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42
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Walls AC, Han J, Li T, Qureshi AA. Host risk factors, ultraviolet index of residence, and incident malignant melanoma in situ among US women and men. Am J Epidemiol 2013; 177:997-1005. [PMID: 23579556 PMCID: PMC4023296 DOI: 10.1093/aje/kws335] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2012] [Accepted: 07/23/2012] [Indexed: 11/14/2022] Open
Abstract
The incidences of malignant melanoma in situ (MMIS) and invasive malignant melanoma are rising in the United States, but few studies have examined risk factors for MMIS. We evaluated the risk of MMIS according to the host phenotype and the ultraviolet index of the state of residence. Prospective data were collected via biennial questionnaires from 250,151 women and men aged ≥20 years in the Nurses' Health Study (1980-2008), the Nurses' Health Study 2 (1989-2009), and the Health Professionals Follow-up Study (1986-2008). During 7,144,820 person-years of follow-up, 888 incident MMIS lesions occurred, representing 33% of all incident malignant melanoma. Meta-analysis across the cohorts demonstrated that the presence of multiple nevi on the extremities conferred the highest relative risk for MMIS (relative risk = 3.18, 95% confidence interval: 2.59, 3.90). Family history of melanoma, number of severe sunburns, sunburn susceptibility, hair color, and Fitzpatrick skin types I, II, and III were significantly associated with an increased risk of MMIS. Conversely, the ultraviolet index of the state of residence at birth, at age 15 years, and at age 30 years was not associated with increased risk of MMIS. Continued study of MMIS and associated risk factors will help identify persons who are most at risk and elucidate the role of MMIS within the spectrum of cutaneous melanoma.
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Affiliation(s)
| | | | | | - Abrar A. Qureshi
- Correspondence to Dr. Abrar A. Qureshi, Department of Dermatology, 221L, Brigham and Women's Hospital, Longwood Avenue, Boston, MA 02115 (e-mail: )
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43
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Holman DM, Watson M. Correlates of intentional tanning among adolescents in the United States: a systematic review of the literature. J Adolesc Health 2013; 52:S52-9. [PMID: 23601612 PMCID: PMC4538996 DOI: 10.1016/j.jadohealth.2012.09.021] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 09/13/2012] [Accepted: 09/18/2012] [Indexed: 12/16/2022]
Abstract
PURPOSE Exposure to ultraviolet radiation and a history of sunburn in childhood contribute to risk of skin cancer in adolescence and in adulthood, but many adolescents continue to seek a tan, either from the sun or from tanning beds (i.e., intentional tanning). To understand tanning behavior among adolescents, we conducted a systematic review of the literature to identify correlates of intentional tanning in the United States. METHODS We included articles on original research published in English between January 1, 2001, and October 31, 2011, that used self-reported data on intentional tanning by U.S. adolescents aged 8 to 18 years and examined potential correlates of tanning behaviors. Thirteen articles met our criteria; all used cross-sectional survey data and quantitative methods to assess correlates of intentional tanning. RESULTS Results indicate that multiple factors influence tanning among adolescents. Individual factors that correlated with intentional tanning include demographic factors (female sex, older age), attitudes (preferring tanned skin), and behaviors (participating in other risky or appearance-focused behaviors such as dieting). Social factors correlated with intentional tanning include parental influence (having a parent who tans or permits tanning) and peer influence (having friends who tan). Only four studies examined broad contextual factors such as indoor tanning laws and geographic characteristics; they found that proximity to tanning facilities and geographic characteristics (living in the Midwest or South, living in a low ultraviolet area, and attending a rural high school) are associated with intentional tanning. CONCLUSIONS These findings inform future public health research and intervention efforts to reduce intentional tanning.
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Affiliation(s)
- Dawn M Holman
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
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Abstract
BACKGROUND The objective of this study was to determine the factors associated with sun exposure behaviors among Operating Engineers (heavy equipment operators). METHODS Operating Engineers (N = 498) were asked to complete a cross-sectional survey. Linear and logistic regression analyses were used to determine health behavioral, perceptional, and demographic factors associated with sun exposure behavior (sun burns, blistering, use of sunscreen, and interest in sun protection services). RESULTS Almost half reported two or more sunburns/summer and the median times blistering was 2 with a range of 0-100. About one-third never used sun block, while just over one-third rarely used sun block. Almost one-quarter were interested in sun protection guidance. Multivariate analyses showed that perceptions of skin type, alcohol problems, fruit intake, BMI, sleep quality, age, sex, and race were significantly associated with at least one of the outcome variables (P < 0.05). CONCLUSIONS Operating Engineers are at high risk for skin cancer due to high rates of exposure to ultraviolet light and low rates of sun block use. Subgroups of Operating Engineers are particularly at risk for sun damage. Interventions are needed to decrease sun exposure among Operating Engineers.
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Affiliation(s)
- Sonia A Duffy
- University of Michigan School of Nursing, Ann Arbor, Michigan, USA.
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45
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Shah B, Yavuz ST, Tekşam O. Scalp edema: don't forget sunburn in children. Turk J Pediatr 2012; 54:540-542. [PMID: 23427522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Scalp edema is an uncommon and striking finding in children that may alarm both parents and physicians. The objectives of this case report were to raise awareness among pediatric emergency physicians of the unusual presentation of sunburn as scalp edema. We present the case of an eight-year-old boy with sunburn of the head, presenting with scalp and face edema. Pitting edema and erythema were dominant on the forehead. Shaving of the boy's head the day before the symptoms was the most striking issue, and the sunburn healed gradually without any complications. Healthcare professionals should be aware of this condition, and the diagnosis of sunburn must be kept in mind in otherwise healthy-looking patients with a unique history.
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Affiliation(s)
- Binod Shah
- Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
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46
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Filip A, Clichici S, Daicoviciu D, Catoi C, Bolfa P, Postescu ID, Gal A, Baldea I, Gherman C, Muresan A. Chemopreventive effects of Calluna vulgaris and Vitis vinifera extracts on UVB-induced skin damage in SKH-1 hairless mice. J Physiol Pharmacol 2011; 62:385-392. [PMID: 21893700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Accepted: 06/20/2011] [Indexed: 05/31/2023]
Abstract
Solar ultraviolet radiation (UV) is a major cause of non-melanoma skin cancer in humans. Photochemoprevention with natural products represents a simple but very effective strategy in the management of cutaneous neoplasia. The study investigated the protective activity of Calluna vulgaris (Cv) and red grape seeds (Vitis vinifera L, Burgund Mare variety) (BM) extracts in vivo on UVB-induced deleterious effects in SKH-1 mice skin. Forty SKH-1 mice were randomly divided into 4 groups (n=10): control, UVB irradiated, Cv + UVB irradiated, BM+UVB irradiated. Both extracts were applied topically on the skin in a dose of 4 mg/40 μl/cm(2) before UVB exposure - single dose. The effects were evaluated in skin 24 hours after irradiation through the presence of cyclobutane pyrimidine dimers (CPDs) and sunburn cells, tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6 levels. The antioxidant activity of BM extract was higher than those of Cv extract as determined using stable free radical DPPH assay and ABTS test. One single dose of UVB generated formation of CPDs (p<0.0001) and sunburn cells (p<0.0002) and increased the cytokine levels in skin (p<0.0001). Twenty hours following irradiation BM extract inhibited UVB-induced sunburn cells (p<0.02) and CPDs formation (p<0.0001). Pretreatment with Cv and BM extracts resulted in significantly reduced levels of IL-6 and TNF-α compared with UVB alone (p<0.0001). Our results suggest that BM extracts might be a potential candidate in preventing the damages induced by UV in skin.
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Affiliation(s)
- A Filip
- Department of Physiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
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47
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Sunscreen revisited. Med Lett Drugs Ther 2011; 53:17-8. [PMID: 21383665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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48
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Wasserman DI, Chang A, Lee D, Lee A, Finn D. Underlying amelanotic lentigo maligna melanoma uncovered after a severe blistering sunburn. Cutis 2010; 86:70-72. [PMID: 20919599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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49
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Lin KW, Sharangpani R. Screening for skin cancer. Am Fam Physician 2010; 81:1435-1429. [PMID: 20540480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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50
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Chen YC, Christiani DC, Su HJJ, Hsueh YM, Smith TJ, Ryan LM, Chao SC, Lee JYY, Guo YLL. Early-life or lifetime sun exposure, sun reaction, and the risk of squamous cell carcinoma in an Asian population. Cancer Causes Control 2010; 21:771-6. [PMID: 20084542 DOI: 10.1007/s10552-010-9505-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2009] [Accepted: 01/06/2010] [Indexed: 10/20/2022]
Abstract
BACKGROUND It has been widely accepted that sun exposure is a risk factor of squamous cell carcinoma (SCC) among fair-skinned populations. However, sun exposure and sun reaction have not been explored in Asians and no gender-specific data were available. METHOD In a case-control study, 176 incident skin cancer cases were recruited from National Cheng-Kung University Medical Center from 1996 to 1999. Controls included 216 age-, gender-, and residency-matched subjects from the southwestern Taiwan. A questionnaire was administered to collect information on life style and other risk factors. Logistic regression analysis was performed to evaluate the association between sun exposure or sun reaction and the risk of SCC by gender. RESULTS Early-age (age 15 to 24) and lifetime sun exposure were significantly associated with increased risk of SCC in a dose-response pattern [odds ratio (OR) = 1.49-3.08, trend p = 0.009 and 0.0007, respectively]. After stratified by gender, the third tertile of early-age sun exposure was significantly associated with the SCC risk among men (OR = 3.08). The second and third tertiles of lifetime sun exposure was significantly associated with SCC risk among women (OR = 3.78 and 4.53, respectively). Skin reaction after 2-h sun exposure during childhood and adolescence was not significantly associated with the risk of SCC. CONCLUSIONS Lifetime sun exposure was more related to SCC risk in women, while early-age sun exposure was more relevant to men's SCC risk. This may be attributable to different lifestyle between men and women.
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Affiliation(s)
- Yen-Ching Chen
- Research Center for Genes, Environment, and Human Health, and Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, ROC
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