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Tod B, Whitaker D, Visser W, Isaacs T, Jacobs T, Wiid K, Dlova NC, Wright CY. Integrated sun protection advice for the South African population. Int J Dermatol 2024; 63:277-287. [PMID: 38124402 DOI: 10.1111/ijd.16980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/30/2023] [Accepted: 12/02/2023] [Indexed: 12/23/2023]
Abstract
Exposure to solar ultraviolet radiation (UVR) is associated with several cutaneous adverse effects. However, to the best of our knowledge, in South Africa there are no formal guidelines on sun protection. A group of South African dermatologists and researchers convened over the course of 1 year to deliberate on integrated advice for sun protection among the multi-ethnic South African population. For people with light skin and those with genetic skin disorders (e.g., oculocutaneous albinism), sun protection was identified as critical to prevent sunburn, skin cancer, and photoaging. The evidence is less clear for people with medium and darker skin types, especially the latter, in whom melanin may confer a degree of protection against some parts of the solar spectrum. Recent studies have demonstrated that visible light can cause pigmentary changes in individuals with darker skin types in particular. Sun protection for people of all skin colors is beneficial to protect against photoaging and ocular damage. Herein sun protection advice is suggested for South Africans of all skin colors to reduce morbidity and mortality from sun exposure, particularly relating to skin cancer. Several knowledge gaps are identified as future research priorities.
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Affiliation(s)
- Bianca Tod
- Division of Dermatology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | | | - Willie Visser
- Division of Dermatology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Thuraya Isaacs
- Division of Dermatology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | | | - Kim Wiid
- L'Oréal Dermatological Beauty, Johannesburg, South Africa
| | - Ncoza C Dlova
- Dermatology Department, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Caradee Y Wright
- Climate Change and Health Research Programme, Environment and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa
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2
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The paradoxical promotion of ultraviolet tanning by US tanning salons offering a sunless option: A cross-sectional secret shopper study. J Am Acad Dermatol 2022; 87:1458-1459. [PMID: 35868570 DOI: 10.1016/j.jaad.2022.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/13/2022] [Accepted: 07/15/2022] [Indexed: 11/22/2022]
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3
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Abstract
Vitamin D is a steroid hormone of importance to the field of dermatology. Skin is unique in that it is the site of vitamin D synthesis upon sun exposure and a target organ for its activity. We explore the physiology and metabolic mechanism of action of vitamin D, as well as its effects on the skin. We also discuss the current evidence of the efficacy and safety of oral and topical vitamin D analogues on skin conditions such as psoriasis, atopic dermatitis, vitiligo, sunburn, actinic keratosis, and fibrosing skin disorders. Based on currently available scientific evidence, the National Academy of Medicine's recommended dietary allowance for vitamin D ranges from 400 IU to 800 IU daily based on age categories.
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Affiliation(s)
- Erisa Alia
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Philip E Kerr
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
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4
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Lyons S, Lorigan P, Green AC, Ferguson A, Epton T. Reasons for indoor tanning use and the acceptability of alternatives: A qualitative study. Soc Sci Med 2021; 286:114331. [PMID: 34438184 DOI: 10.1016/j.socscimed.2021.114331] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 07/26/2021] [Accepted: 08/19/2021] [Indexed: 01/08/2023]
Abstract
RATIONALE Using indoor tanning devices is associated with substantial health consequences, such as an increased risk of melanoma and other skin cancers. Many people including minors and some at high risk of skin cancer continue to use these devices. In the absence of effective restrictions on use, it is important that behaviour change interventions are designed to reduce indoor tanning. OBJECTIVE To explore reasons for use of indoor tanning devices and the acceptability of alternatives in adult users residing in North-West England. METHODS Participants were required to be current indoor tanners aged 18 years and above and were recruited online. Twenty-one participants took part in either a focus group or semi-structured interview. An inductive thematic analysis was conducted. RESULTS Six themes were identified: psychological benefits; improving physical health; denial of health risks; alternatives do not meet psychological needs; alternatives do not meet physical needs; and perceived side-effects. Participants used indoor tanning devices to improve their self-esteem and to prevent sun damage to their skin (by gaining a 'base tan'). Participants appeared to justify their usage by responding defensively to avoid accepting they were at risk, exaggerating the benefits of indoor tanning, and discounting alternatives to indoor tanning. Alternatives to indoor tanning were perceived as risky for health, inadequate to provide the desired aesthetic, and incapable of meeting their self-esteem needs. CONCLUSIONS Interventions to reduce indoor tanning behaviour should increase sources of self-esteem other than appearance, increase media literacy and address defensive responses to information around indoor tanning and alternatives. Further research is needed to develop these interventions and assess their feasibility.
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Affiliation(s)
- Stephanie Lyons
- Manchester Centre for Health Psychology, The University of Manchester, Oxford Road, M13 9PL, UK
| | - Paul Lorigan
- Division of Cancer Sciences, The University of Manchester, UK; Christie NHS Foundation Trust, Manchester, UK
| | - Adele C Green
- Cancer Research UK Manchester Institute, The University of Manchester, UK; QIMR Berghofer Medical Research Institute, Australia
| | - Ashley Ferguson
- Cancer Research UK Manchester Institute, The University of Manchester, UK
| | - Tracy Epton
- Manchester Centre for Health Psychology, The University of Manchester, Oxford Road, M13 9PL, UK.
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5
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Abstract
Skin color is one of the major attributes that defines both individual distinctiveness and differences between groups. There is a preference for lighter skin world-wide, among both light- and dark-skinned individuals, further leading to skin-color bias based upon skin-color hierarchy within certain ethnoracial groups. The psychiatric and psychosocial ramifications of skin color are important in several situations, including (1) disorders of skin discoloration (eg, vitiligo), which can significantly affect the psychosocial development of the patient especially when it has its first onset during adolescence; (2) widespread use of skin-lightening products, which are used despite knowledge about serious toxicity from inorganic mercury and potent corticosteroids that are some of their main constituents; (3) indoor tanning, which is a recognized carcinogen and practiced by over 50% of university-age adults and 20% of adolescents. Educating about photocarcinogenicity does not change tanning behaviors, which is strongly driven by peer pressure; and (4) when a psychiatric disorder, such as body dysmorphic disorder or major depressive disorder, is the primary basis for skin color dissatisfaction. Despite the role of complex sociocultural and psychiatric factors in clinical manifestations involving skin color, a supportive relation with the dermatologist can significantly aid the patient in managing their disease burden.
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Affiliation(s)
- Madhulika A Gupta
- Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; Psychmed Research, London, Ontario, Canada.
| | - Aditya K Gupta
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Mediprobe Research, London, Ontario, Canada
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6
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Kosche C, Mansh M, Luskus M, Nguyen A, Martinez-Diaz G, Inwards-Breland D, Yeung H, Boos MD. Dermatologic care of sexual and gender minority/LGBTQIA youth, Part 2: Recognition and management of the unique dermatologic needs of SGM adolescents. Pediatr Dermatol 2019; 36:587-593. [PMID: 31259441 PMCID: PMC6750974 DOI: 10.1111/pde.13898] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Sexual and gender minority (SGM) individuals, including lesbian, gay, bisexual, transgender/gender diverse, questioning/queer, intersex, and asexual (LGBTQIA) persons, represent a historically underserved population within the field of medicine, though their unique health needs are increasingly recognized. Part 2 of this two-part review will address unique concerns regarding acne, tanning behavior, sexually transmitted infections, and other health disparities among SGM adolescents. A more comprehensive understanding of the dermatologic needs of SGM youth will better allow pediatric dermatologists to actively and compassionately care for this health disparity population.
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Affiliation(s)
- Cory Kosche
- Rush Medical College, Rush University School of Medicine, Chicago, Illinois
| | - Matthew Mansh
- Department of Dermatology, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Mark Luskus
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Andy Nguyen
- Department of Medicine, Mount Auburn Hospital, Cambridge, Massachusetts
| | | | - David Inwards-Breland
- Division of Adolescent Medicine, Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Washington
| | - Howa Yeung
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Markus D Boos
- Division of Dermatology, Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Washington
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7
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Suppa M, Gandini S, Bulliard JL, Daxhelet M, Zamagni M, Forsea AM, Longo MI, Del Marmol V. Who, why, where: an overview of determinants of sunbed use in Europe. J Eur Acad Dermatol Venereol 2019; 33 Suppl 2:6-12. [PMID: 30811690 DOI: 10.1111/jdv.15318] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 09/20/2018] [Indexed: 12/28/2022]
Abstract
Although exposure to indoor tanning has been established as a clear risk factor for skin cancer, sunbeds are still commonly used in Europe. Understanding the determinants of sunbed use in Europe is key to plan educational interventions, behavioural strategies and legislative measures, which should be tailored to subgroups with different risk profiles. Evidences show that the typical sunbed users in Europe are young-adult women, with intermediate skin type, a current employment and a medium/high socio-economic status. Typical users display sun-seeking behaviours and other risky behaviours such as smoking. Indoor tanning seems more common in northern than southern Europe. However, sunbed use remains common in fair-skinned individuals and among adolescents/pre-adolescents. Commonly reported reasons for sunbed use in Europe include aesthetic motives (i.e. looking attractive), the pursue of a prevacation tan, the influence of peers/parents engaging in the same habit, and the treatment of health conditions. The most commonly reported places to get an artificial tan in Europe are tanning studios and beauty salons. However, sunbeds are also available in sport venues, such as swimming pools and gyms, hotels and private houses. All these factors should be taken into account when planning educational, behavioural and legislative interventions to reduce the popularity of artificial tanning in Europe.
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Affiliation(s)
- M Suppa
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - S Gandini
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | - J L Bulliard
- Cancer Epidemiology Unit, University Institute of Social and Preventive Medicine, Lausanne, Switzerland
| | - M Daxhelet
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - M Zamagni
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - A M Forsea
- Dermatology Department, Elias University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - M I Longo
- Department of Dermatology, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain
| | - V Del Marmol
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
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8
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Tanning dependence and seasonal affective disorder are frequent among sunbathers but are not associated. Psychiatry Res 2019; 272:387-391. [PMID: 30605797 DOI: 10.1016/j.psychres.2018.12.090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 12/17/2018] [Accepted: 12/17/2018] [Indexed: 11/22/2022]
Abstract
Ultraviolet radiation (UVR) is a known risk factor for skin cancers. Those who are tanning dependent seek out UVR exposure. Many tanners have expressed symptoms of seasonal affective disorder (SAD), but conclusive evidence of a connection with tanning dependence is lacking. We evaluated the frequency of tanning dependence or abuse and symptoms of SAD among Finnish sunbathers and analysed whether phenomena are associated which could indicate a common biological mechanism. Sunbathing related tanning dependence/abuse among Finnish sunbathers were assessed using the Structured Interview for Tanning Abuse and Dependence measure (SITAD), and symptoms of SAD were assessed with the Seasonal Pattern Assessment Questionnaire (SPAQ). Of 229 sunbathers, 8% (n = 18) were classified as tanning-dependent, and 26% (n = 59) were classified as tanning abusers. Additionally, 16% (n = 37) met the criteria for SAD, and 26% (n = 60) met the criteria for subsyndromal seasonal affective disorder (S-SAD), but there was no significant association between tanning dependence or abuse and SAD or S-SAD. Sunbathing dependence or abuse and SAD/S-SAD were frequent among sunbathers, and they may promote sun-seeking risk behaviour. However, within this sample, tanning dependence and SAD/S-SAD were not associated.
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cAMP-mediated regulation of melanocyte genomic instability: A melanoma-preventive strategy. ADVANCES IN PROTEIN CHEMISTRY AND STRUCTURAL BIOLOGY 2018; 115:247-295. [PMID: 30798934 DOI: 10.1016/bs.apcsb.2018.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Malignant melanoma of the skin is the leading cause of death from skin cancer and ranks fifth in cancer incidence among all cancers in the United States. While melanoma mortality has remained steady for the past several decades, melanoma incidence has been increasing, particularly among fair-skinned individuals. According to the American Cancer Society, nearly 10,000 people in the United States will die from melanoma this year. Individuals with dark skin complexion are protected damage generated by UV-light due to the high content of UV-blocking melanin pigment in their epidermis as well as better capacity for melanocytes to cope with UV damage. There is now ample evidence that suggests that the melanocortin 1 receptor (MC1R) is a major melanoma risk factor. Inherited loss-of-function mutations in MC1R are common in melanoma-prone persons, correlating with a less melanized skin complexion and poorer recovery from mutagenic photodamage. We and others are interested in the MC1R signaling pathway in melanocytes, its mechanisms of enhancing genomic stability and pharmacologic opportunities to reduce melanoma risk based on those insights. In this chapter, we review melanoma risk factors, the MC1R signaling pathway, and the relationship between MC1R signaling and DNA repair.
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10
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Andreassen C, Pallesen S, Torsheim T, Demetrovics Z, Griffiths M. Tanning addiction: conceptualization, assessment and correlates. Br J Dermatol 2018; 179:345-352. [DOI: 10.1111/bjd.16480] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2018] [Indexed: 11/27/2022]
Affiliation(s)
| | - S. Pallesen
- Department of Psychosocial Science; University of Bergen; Bergen Norway
| | - T. Torsheim
- Department of Psychosocial Science; University of Bergen; Bergen Norway
| | - Z. Demetrovics
- Institute of Psychology; Eötvös Loránd University; Budapest Hungary
| | - M.D. Griffiths
- International Gaming Research Unit; Nottingham Trent University; Nottingham U.K
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11
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Kimeswenger S, Schwarz A, Födinger D, Müller S, Pehamberger H, Schwarz T, Jantschitsch C. Infrared A radiation promotes survival of human melanocytes carrying ultraviolet radiation-induced DNA damage. Exp Dermatol 2018; 25:447-52. [PMID: 26844814 DOI: 10.1111/exd.12968] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2016] [Indexed: 01/11/2023]
Abstract
The link between solar radiation and melanoma is still elusive. Although infrared radiation (IR) accounts for over 50% of terrestrial solar energy, its influence on human skin is not well explored. There is increasing evidence that IR influences the expression patterns of several molecules independently of heat. A previous in vivo study revealed that pretreatment with IR might promote the development of UVR-induced non-epithelial skin cancer and possibly of melanoma in mice. To expand on this, the aim of the present study was to evaluate the impact of IR on UVR-induced apoptosis and DNA repair in normal human epidermal melanocytes. The balance between these two effects is a key factor of malignant transformation. Human melanocytes were exposed to physiologic doses of IR and UVR. Compared to cells irradiated with UVR only, simultaneous exposure to IR significantly reduced the apoptotic rate. However, IR did not influence the repair of UVR-induced DNA damage. IR partly reversed the pro-apoptotic effects of UVR via modification of the expression and activity of proteins mainly of the extrinsic apoptotic pathway. In conclusion, IR enhances the survival of melanocytes carrying UVR-induced DNA damage and thereby might contribute to melanomagenesis.
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Affiliation(s)
- Susanne Kimeswenger
- Division of General Dermatology, Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Agatha Schwarz
- Department of Dermatology, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Dagmar Födinger
- Division of General Dermatology, Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Susanne Müller
- Department of Dermatology, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Hubert Pehamberger
- Division of General Dermatology, Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Thomas Schwarz
- Department of Dermatology, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Christian Jantschitsch
- Division of General Dermatology, Department of Dermatology, Medical University of Vienna, Vienna, Austria
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12
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Lewis DJ, Duvic M. Important considerations for legislation banning commercial tanning beds among minors. Clin Dermatol 2017; 36:104-105. [PMID: 29241746 DOI: 10.1016/j.clindermatol.2017.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Daniel J Lewis
- Baylor College of Medicine, Houston, Texas; Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
| | - Madeleine Duvic
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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13
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Habbema L, Halk AB, Neumann M, Bergman W. Risks of unregulated use of alpha-melanocyte-stimulating hormone analogues: a review. Int J Dermatol 2017; 56:975-980. [DOI: 10.1111/ijd.13585] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 12/12/2016] [Accepted: 01/16/2017] [Indexed: 12/21/2022]
Affiliation(s)
| | - Anne Berthe Halk
- University of Leiden; Department of Dermatology; Leiden the Netherlands
| | - Martino Neumann
- Department of Dermatology; Erasmus Medical Center; Rotterdam the Netherlands
| | - Wilma Bergman
- University of Leiden; Department of Dermatology; Leiden the Netherlands
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14
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Torres A. Response to 'Avoidance of sun exposure as a risk factor for major causes of death: a competing risk analysis of the Melanoma in Southern Sweden cohort'. J Intern Med 2017; 281:217-218. [PMID: 27443254 DOI: 10.1111/joim.12538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- A Torres
- American Academy of Dermatology, Schaumburg, IL, USA
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16
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Ricapito NG, Ghobril C, Zhang H, Grinstaff MW, Putnam D. Synthetic Biomaterials from Metabolically Derived Synthons. Chem Rev 2016; 116:2664-704. [PMID: 26821863 PMCID: PMC5810137 DOI: 10.1021/acs.chemrev.5b00465] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The utility of metabolic synthons as the building blocks for new biomaterials is based on the early application and success of hydroxy acid based polyesters as degradable sutures and controlled drug delivery matrices. The sheer number of potential monomers derived from the metabolome (e.g., lactic acid, dihydroxyacetone, glycerol, fumarate) gives rise to almost limitless biomaterial structural possibilities, functionality, and performance characteristics, as well as opportunities for the synthesis of new polymers. This review describes recent advances in new chemistries, as well as the inventive use of traditional chemistries, toward the design and synthesis of new polymers. Specific polymeric biomaterials can be prepared for use in varied medical applications (e.g., drug delivery, tissue engineering, wound repair, etc.) through judicious selection of the monomer and backbone linkage.
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Affiliation(s)
- Nicole G. Ricapito
- School of Chemical and Biomolecular Engineering, Cornell University, Ithaca, New York 14853, United States
| | - Cynthia Ghobril
- Department of Chemistry, Boston University, Boston, Massachusetts 02215, United States
| | - Heng Zhang
- Department of Chemistry, Boston University, Boston, Massachusetts 02215, United States
| | - Mark W. Grinstaff
- Department of Chemistry, Boston University, Boston, Massachusetts 02215, United States
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, United States
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts 02118, United States
| | - David Putnam
- School of Chemical and Biomolecular Engineering, Cornell University, Ithaca, New York 14853, United States
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York 14853, United States
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17
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Narrow-band ultraviolet B radiation induces the expression of β-endorphin in human skin in vivo. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2016; 155:104-8. [DOI: 10.1016/j.jphotobiol.2016.01.007] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 01/05/2016] [Indexed: 12/30/2022]
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Abstract
Melanoma is among the most aggressive and therapy-resistant human cancers. While great strides in therapy have generated enthusiasm, many challenges remain. Heterogeneity is the most pressing issue for all types of therapy. This chapter summarizes the clinical classification of melanoma, of which the research community now adds additional layers of classifications for better diagnosis and prediction of therapy response. As the search for new biomarkers increases, we expect that biomarker analyses will be essential for all clinical trials to better select patient populations for optimal therapy. While individualized therapy that is based on extensive biomarker analyses is an option, we expect in the future genetic and biologic biomarkers will allow grouping of melanomas in such a way that we can predict therapy outcome. At this time, tumor heterogeneity continues to be the major challenge leading inevitably to relapse. To address heterogeneity therapeutically, we need to develop complex therapies that eliminate the bulk of the tumor and, at the same time, the critical subpopulations.
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Affiliation(s)
- Batool Shannan
- Molecular and Cellular Oncogenesis Program, Melanoma Research Center, The Wistar Institute, 3601 Spruce Street, Philadelphia, PA, 19104, USA
| | - Michela Perego
- Molecular and Cellular Oncogenesis Program, Melanoma Research Center, The Wistar Institute, 3601 Spruce Street, Philadelphia, PA, 19104, USA
| | - Rajasekharan Somasundaram
- Molecular and Cellular Oncogenesis Program, Melanoma Research Center, The Wistar Institute, 3601 Spruce Street, Philadelphia, PA, 19104, USA
| | - Meenhard Herlyn
- Molecular and Cellular Oncogenesis Program, Melanoma Research Center, The Wistar Institute, 3601 Spruce Street, Philadelphia, PA, 19104, USA.
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Friedman B, English JC, Ferris LK. Indoor Tanning, Skin Cancer and the Young Female Patient: A Review of the Literature. J Pediatr Adolesc Gynecol 2015; 28:275-83. [PMID: 26119073 DOI: 10.1016/j.jpag.2014.07.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 07/03/2014] [Accepted: 07/16/2014] [Indexed: 12/18/2022]
Abstract
Young, non-Hispanic white females represent the population most likely to use indoor tanning facilities. This population may be at increased risk of skin cancer as recent meta-analyses support a strong association between cutaneous malignancy and indoor tanning. Public perception of the purported health benefits of indoor tanning may be partially to blame for the popularity of tanning salons as a desire to prepare skin prior to sun exposure is among the most commonly cited motivations for indoor tanning. Improving education and counseling to address misconceptions regarding tanning safety will require the participation of healthcare providers for both physical and psychological screenings as well as for information dissemination. This review presents the association between tanning bed use and skin cancer, biological effects of UV radiation exposure, UV burden associated with tanning devices, public perception of tanning, demographic and psychological profile of indoor tanners, and current legislation regulating tanning bed use.
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Affiliation(s)
- Blake Friedman
- Department of Dermatology, University of Pittsburgh, Pittsburgh, PA
| | - Joseph C English
- Department of Dermatology, University of Pittsburgh, Pittsburgh, PA.
| | - Laura K Ferris
- Department of Dermatology, University of Pittsburgh, Pittsburgh, PA
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20
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Haagensen A, Feldman HA, Gordon CM. Response to Hotta: High prevalence of vitamin D insufficiency and deficiency among patients with anorexia nervosa in Japan. Osteoporos Int 2015; 26:1235-6. [PMID: 25410435 DOI: 10.1007/s00198-014-2956-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 10/27/2014] [Indexed: 11/29/2022]
Affiliation(s)
- A Haagensen
- Division of Endocrinology, Boston Children's Hospital and Harvard Medical School, 333 Longwood Avenue, 6th floor, Boston, MA, 02115, USA,
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