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PubMed1992

Nonmelanoma skin cancers and infection with the human immunodeficiency virus.

BACKGROUND AND DESIGN: Forty-eight human immunodeficiency virus-infected patients with nonmelanoma skin cancers seen during a four-year period were evaluated in a retrospective, case-control study. Patients were followed up after therapy and recurrence rates were determined. RESULTS: One hundred and sixteen nonmelanoma skin cancers were identified, 101 of which were basal cell carcinomas (87%), mostly superficial multicentric (67%) of the trunk (62%). There were 15 low-grade squamous cell carcinomas, most commonly of the head and neck. Half of the patients had multiple cancers. Compared with age-matched controls, the patients with skin cancer more commonly had blue/hazel eyes (89% vs 66%; odds ratio [OR] 4.1; confidence interval [CI], 1.25 to 13.44; P = .033), blond hair (42% vs 13%; OR = 4.53; CI, 1.40 to 13.74, P = .003), a family history of skin cancer (45% vs 5%; OR = 11.88; CI, 2.85 to 49.57; P = .00), and a history of regular sunbathing (92% vs 48%; OR = 11.24; CI, 3.17 to 39.83; P = .00). The number of cancers or the presence of squamous cell carcinoma did not correlate with the degree of immunosuppression. The recurrence rate for basal cell carcinomas following standard treatment methods (mostly curettage and electrodesiccation and excision) was 5.4% for those tumors followed up for longer than 12 months. Three of the 15 squamous cell carcinomas recurred, all following curettage and electrodesiccation. CONCLUSION: Nonmelanoma skin cancers are a not uncommon cutaneous finding in human immunodeficiency virus-infected patients. The major risk factors for developing skin cancer in association with human immunodeficiency virus disease seem to be the same as in the normal population--fair skin, a positive family history, and sun exposure. Standard treatment methods seem to be associated with acceptable cure rates, except for squamous cell carcinomas, which had a high (20%) recurrence rate following curettage and electrodesiccation.

Adult↗

PubMed2005

[Etiologic factors of malignant melanoma in young adults].

BACKGROUND: Malignant melanoma is the most aggressive type of skin cancers, involving the cutis and the mucosa. Its incidence keeps increasing dramatically in the last decades. It appears rarely in childhood. The main environmental risk factors are: excessive sun exposure and severe sunburns in both childhood and adolescence. Skin phototype, number of nevi, presence of congenital nevi (especially giant congenital nevi) and non-melanoma skin cancer in previous history refer to increased risk. Investigations of genetical factors have come to the front. The role of hormonal influences and traumas are recurring questions. AIM: The presence of melanoma typically concerns the middle-aged population. The purpose of this study was to determine the main risk factors, etiology factors and predisposing pediatric conditions in development of melanoma in young adulthood (under the age of 30). METHOD: A total of 70 new, histologically verified melanoma patient under 30 years were examined between 1993-2003 with a retrospective study. Results of questionnaire based survey and clinical data base about melanoma risk factors were also analysed. RESULTS: 5% of patients had giant congenital nevi, although in half of the patients (19/40) more than 20 moles were found. On the basis of patients' histories 57.5% of melanomas developed on a nevus existing from birth or childhood. 30% of melanomas developed on a pigmented brown alteration which rose on the normal skin. About 1/3 of patients had fair skin type and almost all patients (38/40) suffered from erythematous sunburn at first sunbath. Melanoma developed mostly on the trunk and lower extremities. 51.5% of patients belonged to Stage I (Breslow thickness below 1 mm in 33%). CONCLUSION: There were 70 young (under 30 years) patients were treated for malignant melanoma at the Dermatology Department of the National Institute of Oncology in Budapest from 1993 till 2003. The incidence of melanoma under the age of 30 was 3.3%. In young adulthood the main risk factors were the number of atypical nevi and repeated or severe sunburns in childhood. The skin type was also an important risk factor. 50% of the melanomas in young women developed on the trunk. Authors could not prove any relationship among hormonal factors, pregnancy and the development of the melanoma.

Adult↗

PubMedDate not supplied

[Nonionizing radiation and electromagnetic fields].

Nonionising radiation comprises all kinds of radiation and fields of the electromagnetic spectrum where biological matter is not ionised, as well as mechanical waves such as infrasound and ultrasound. The electromagnetic spectrum is subdivided into individual sections and includes: Static and low-frequency electric and magnetic fields including technical applications of energy with mains frequency, radio frequency fields, microwaves and optic radiation (infrared, visible light, ultraviolet radiation including laser). The following categories of persons can be affected by emissions by non-ionising radiation: Persons in the environment and in the household, workers, patients undergoing medical diagnosis or treatment. If the radiation is sufficiently intense, or if the fields are of appropriate strength, a multitude of effects can occur (depending on the type of radiation), such as heat and stimulating or irritating action, inflammations of the skin or eyes, changes in the blood picture, burns or in some cases cancer as a late sequel. The ability of radiation to penetrate into the human body, as well as the types of interaction with biological tissue, with organs and organisms, differs significantly for the various kinds of nonionising radiation. The following aspects of nonionising radiation are discussed: protection of humans against excessive sunlight rays when sunbathing and when exposed to UV radiation (e.g. in solaria); health risks of radio and microwaves (safety of microwave cookers and mobile radio units); effects on human health by electric and magnetic fields in everyday life.

Air Pollution, Indoor↗

PubMed1991

Longwave ultraviolet radiation and promotion of skin cancer.

Exposure to solar ultraviolet (UV) radiation is recognized as an important cause of skin cancer. The carcinogenic effects of UV radiation have been attributed almost entirely to wavelengths in the mid-range (UVB, 290-320 nm). However, the development of potent UVB sunscreens has allowed individuals to increase the length of time that they spend sunbathing and, as a consequence, they may be exposed to massive doses of longwave UV radiation (UVA, 320-400 nm). There is now much evidence to suggest that UVA acts to promote tumors that have been initiated by UVB. This review considers possible mechanisms by which UVA promotes tumorigenesis. Evidence is presented which suggests that UVA acts through modulation of protein kinase C.

Animals↗

PubMedDate not supplied

A pilot survey of aquatic activities and related consumption of alcohol, with implications for drowning.

The investigators considered the relationship between participation in aquatic activities and the consumption of alcohol, with their implications for the risk of drowning. In a telephone survey with random-digit dialing, interviewers asked Massachusetts residents ages 20 years and older how often they engaged in various aquatic activities, in what settings, and how often they drank alcohol in connection with participation in aquatic activities. Of 294 respondents, 79 percent of the men and 72 percent of the women reported participating in aquatic activities during August 1988, the month prior to the interview. Respondents were asked to identify their most recent aquatic activity. The mean number of days of participation in the month was 13. The most frequently reported aquatic activities were swimming (76 percent), followed by sunbathing (74 percent), power boating (25 percent), and fishing from shore (15 percent). Among those persons reporting participation in aquatic activities, 55 percent had been at the ocean on the most recent occasion, 26 percent at lakes or ponds, 17 percent at pools, and 2 percent at rivers. Among those persons reporting aquatic activities, 36 percent of the men and 11 percent of the women reported having drunk alcohol on the most recent occasion. Those who reported drinking in aquatic settings were more likely to report driving after drinking than those who did not drive. Implementation of new Federal regulations and State laws concerning drinking and boating should be accompanied by public education on the risks of drowning if aquatic activities and alcohol consumption are combined.

Adult↗

PubMed1990

[Skin pigmentation, nevi and sunshine as etiological factors in cutaneous malignant melanoma].

In this review, an attempt is made to provide a status on the current knowledge concerning the connection between skin pigmentation, naevi, sunshine and development of cutaneous malignant melanoma. Our knowledge is based partly on descriptive epidemiological reports, and partly on information obtained from case control investigations. The descriptive investigations have revealed characteristic geographical and ethnic differences in the distribution of the disease. Cancer registry data have revealed a rapid increase in the incidence among white populations during the past 30-40 years with particularly pronounced increase for the areas of the body normally covered with clothes. Lacking consistency between indicators for cumulative exposure to sunlight and descriptive epidemiological studies have led to the hypothesis that intermittent exposure to sunlight is particularly harmful. Case control investigations have provided further support to this hypothesis and have demonstrated that sunbathing is associated with an increased risk for development of melanoma, particularly during childhood and particularly if it leads to sunburn. In addition, the risk of development of melanoma is increased in persons with a tendency to freckle and/or with many naevi. On this background, certain risk groups may be informed about prophylactic measures with subsequent possibility of reducing the number of new cases of cutaneous melanoma in the future. Finally, it is emphasized that the disease is multifactorial in origin and that the pathogenesis is not fully elucidated.

Female↗

PubMed1990

[Skin pigmentation, nevi and sunlight as etiologic factors of cutaneous malignant melanoma].

In this review, an attempt is made to provide a status on the current knowledge concerning the connection between skin pigmentation, naevi, sunshine and development of cutaneous malignant melanoma. Our knowledge is based partly on descriptive epidemiological reports, and partly on information obtained from case control investigations. The descriptive investigations have revealed characteristic geographical and ethnic differences in the distribution of the disease. Cancerregistry data have revealed a rapid increase in the incidence among white populations during the past 30-40 years with particularly pronounced increase for the areas of the body normally covered with clothes. Lacking consistency between indicators for cumulative exposure to sunlight and descriptive epidemiological studies have led to the hypothesis that intermittent exposure to sunlight is particularly harmful. Case control investigations have provided further support to this hypothesis and have demonstrated that sunbathing is associated with an increased risk for development of melanoma, particularly during childhood and particularly if it leads to sunburning. In addition, the risk of development of melanoma is increased in persons with a tendency to freckle and/or with many naevi. On this background, certain risk groups may be informed about prophylactic measures with subsequent possibility of reducing the number of new cases of cutaneous melanoma in the future. Finally, it is emphasized that the disease is multifactorial in origin and that the pathogenesis is not fully elucidated.

Humans↗

PubMed1989

Harmful effects of ultraviolet radiation. Council on Scientific Affairs.

Tanning for cosmetic purposes by sunbathing or by using artificial tanning devices is widespread. The hazards associated with exposure to ultraviolet radiation are of concern to the medical profession. Depending on the amount and form of the radiation, as well as on the skin type of the individual exposed, ultraviolet radiation causes erythema, sunburn, photodamage (photoaging), photocarcinogenesis, damage to the eyes, alteration of the immune system of the skin, and chemical hypersensitivity. Skin cancers most commonly produced by ultraviolet radiation are basal and squamous cell carcinomas. There also is much circumstantial evidence that the increase in the incidence of cutaneous malignant melanoma during the past half century is related to increased sun exposure, but this has not been proved. Effective and cosmetically acceptable sunscreen preparations have been developed that can do much to prevent or reduce most harmful effects to ultraviolet radiation if they are applied properly and consistently. Other safety measures include (1) minimizing exposure to ultraviolet radiation, (2) being aware of reflective surfaces while in the sun, (3) wearing protective clothing, (4) avoiding use of artificial tanning devices, and (5) protecting infants and children.

Basal Cell Carcinoma↗

PubMed1989

Epidemiological studies of the influence of sunlight on the skin.

We examined and interviewed 809 randomly selected individuals (56% women and 44% men, mean age 44 years) from 4 Swedish cities; 1.7% had the sun-reactive skin type I, 26.2% type II, 61.3% type III and 10.7% type IV. Some variations in the distribution of skin types were found between the cities. One hundred subjects (12.4%), mostly women (p less than 0.001), had a history of polymorphous light eruption. People with skin type IV had significantly fewer facial skin problems than the rest of the subjects (p less than 0.05). The majority of subjects with atopic eczema, acne vulgaris or seborrheic dermatitis experienced improvement after exposure to sunlight. Individuals with rosacea also experienced improvement more often than impairment from exposure to sunlight. Facial telangiectases occurred in 57% of the subjects, unilaterally in 8.5% of the cases. The occurrence of telangiectases increased with increasing age (p less than 0.001), increasing sunbathing (p less than 0.01) and poor pigmentation ability (p less than 0.05).

Adult↗

PubMed1986

Current aspects of polymorphous light eruptions in Sweden.

The prevalence of polymorphous light eruptions (PMLE) in a Swedish pharmaceutical company employing 412 individuals was estimated by the use of a detailed questionnaire, and 397 (96.4%) answered the survey. Their ages ranged from 18 to 65 yr (mean 40.2), and 66% were females. Eighty-three individuals (21%), mainly women (89%), had symptoms consistent with the diagnosis PMLE. Duration of their disease ranged from 1 to 53 yr, mean 14 yr. A positive family history of PMLE was surprisingly common (46%). Their threshold for sun tolerance was fairly high. They required rather high doses of sunlight to trigger their eruptions, 42% from 30 min to 2 h, and 45% greater than 2 h of solar irradiation. Only 3% had consulted a physician for their PMLE. A hardening phenomenon occurred in 84%. The PMLE group included habitual sunbathers (70%). A fair complexion was common in the PMLE group, 40% having skin types I and II, but as many as 59% had skin type III. Individuals with no light sensitivity had skin type I and II in 22%, and had skin type III in 69% of cases. In conclusion, PMLE is a common disorder and milder forms seem to be more prevalent than earlier described in northern countries such as Sweden.

Adolescent↗

PubMed1985

UV-induced photoproducts of para-aminobenzoid acid.

Cis- and trans- 4,4'-azodibenzoic acid (AZBA), two photoproducts of para-aminobenzoic acid (PABA), formed by the action of 313 nm light, have been characterized on the basis of UV and mass spectral data. The relative dose of UV light required for azodibenzoic acid formation is comparable to that obtained from a day of sunbathing. The same type of photochemical reaction could lead to the formation of PABA-protein conjugates. These photoproducts may be responsible for the known photosensitizing properties of PABA and perhaps its cytotoxic and mutagenic effects.

4-Aminobenzoic Acid↗

PubMed1980

REM syndrome: an immediate therapeutic response to hydroxychloroquine sulphate.

A 22-year-old woman had been suffering for 11 years with a REM syndrome. Her symptoms were provoked and aggravated by exposure to sunlight. The administration of hydroxychloroquine sulphate had a quick effect. The drug was given for 6 months, and the patient remained symptom-free even in summer, when sunbathing.

Adult↗

PubMed1984

[Photodermatitis bullosa generalisata].

Two observed cases indicate atypical forms of phyto-photodermatitis (photodermatitis bullosa striata). Unusual localisations or generalised outbreaks have to be taken into account in cases of sunbathing without clothes on. Power lawn mowers with rotating blades spread heracleum and other phototoxic juices via freshly cut grass, causing diffuse - as opposed to striped - manifestations on the uncovered skin areas. The most certain prevention of such a reaction is to known which few plants are responsible for phyto-photodermatitis and to avoid them in sunny weather. The plants should by no means be exterminated, even those (such as Heracleum mantegazzianum, "giant hogweed") which have a tendency to spread.

Adolescent↗

PubMed1984

Recall of UVB-induced erythema in breast cancer patient receiving multiple drug chemotherapy.

One day after sunbathing, a breast cancer patient received intravenous methotrexate, cyclophosphamide and 5-fluorouracil and had a recall of her UV erythema over the following week. Phototesting with UVA and UVB prior to and after a subsequent chemotherapy treatment showed a UVB-induced recall of erythema, as well as a phototoxicity-like response. Skin biopsies from test sites were compatible with phototoxic dermatitis. The occurrence of both erythema recall and the phototoxicity-like reaction suggests that more than one mechanism is involved in this side effect.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1984

Comparison of phototherapy (UV-B) and photochemotherapy (PUVA) for clearing and maintenance therapy of psoriasis.

One hundred eighty-three patients with psoriasis were treated with UV-B irradiation or oral methoxsalen plus longwave UV light (PUVA). Patients treated with PUVA, in the initial and maintenance period, achieved in general a higher therapeutic score (95% to 100% clearance) than those receiving UV-B therapy. However, taking 80% to 100% improvement as criterion, no difference was found between initial UV-B and PUVA therapy, if less than 50% of the skin surface was affected by psoriasis. If more than 50% of the skin was involved, PUVA was better than UV-B therapy. The maintenance treatment frequency for the UV-B-treated patients for more than a year seemed to be higher than for PUVA-treated patients. A positive correlation was found between response to sunbathing (questionnaire survey) and the response to UV-B phototherapy. An extra UV-B treatment to the leg lesions appeared useless.

Actuarial Analysis↗

PubMed1980

[Effect of long-wave ultraviolet light (UV-A) and medium-wave ultraviolet rays (UV-B) on human skin. Critical comparison].

When discussing the effects of ultraviolet radiation on human skin, one should carefully distinguish between the long wave ultraviolet light (UV-A) and the short wave radiations (UV-B and UV-C). Ultraviolet A induces immediate pigmentation but, if high energies are applied, a permanent pigmentation is elicited. This type of ultraviolet A-induced pigmentation has been called "spontaneous" pigmentation as no erythematous reaction is necessary to induce or accelerate melanine formation. Ultraviolet B provokes erythema and consecutive pigmentation. Upon chronic exposure, ultraviolet B causes the wellknown actinic damage of the skin and even provokes carcinoma. With exposures to the sunlight (global radiation), one should be most careful. The public must be informed extensively about the dangers of excessive sunbaths. The use of artificial "suns" with spectra between 260 and 400 nm is limited as it may cause the same type of damage as the global radiation. An exact schedule for use of artificial lamps is strongly recommended. After one cycle of exposures, an interruption is necessary until the next cycle of irradiations may start. Upon continual use for tanning of the skin, artificial lamps may provoke irreversible damage of the skin. Radiation sources with emission spectra of wavelengths between 315 and 400 nm exclusively are well suited for the induction of skin pigmentation (cosmetic use). Potent radiation such as UVASUN systems provoke a "pleasant" permanent pigmentation after exposures for less than one hour. The use of ultraviolet A (UV-A) does not carry any risk for the human skin.

Amino Acids↗

PubMed1994

Dermatology.

An increasing number of patients with antibiotic-resistant propionibacteria have been described. Extensive sunbathing, even after sunscreen application, may facilitate development of skin cancers by suppressing natural immunity to these atypical growths.

Dermatology↗

PubMed1993

Factors affecting the development of skin cancer after scalp irradiation.

A nested case control study of persons who developed skin cancer after scalp irradiation in childhood revealed two risk factors for the appearance of radiation-induced skin cancer: (a) an apparently higher radiation dose delivered inadvertently, manifested by a higher prevalence of alopecia and radiation dermatitis (RR = 3.4; CI 1.3-8.8); (b) a more frequent exposure to the sun, manifested by summer sunbathing (RR = 2.6; CI 1.1-6.1). These findings may have certain implications with regard to the understanding of radiation-induced cancer, after low-dose radiation exposure, in general.

Adolescent↗