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Navarro-Bielsa A, Gracia-Cazaña T, Almagro M, De-la-Fuente-Meira S, Florez Á, Yélamos O, Montero-Vilchez T, González-Cruz C, Diago A, Abadías-Granado I, Fuentelsaz V, Colmenero M, Bañuls J, Arias-Santiago S, Buendía-Eisman A, Almenara-Blasco M, Gil-Pallares P, Gilaberte Y. Exposome and basal cell carcinoma: a multicenter case-control study. Int J Dermatol 2024. [PMID: 38282244 DOI: 10.1111/ijd.17026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 12/17/2023] [Accepted: 01/02/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND While ultraviolet radiation (UVR) present in sunlight is recognized as the main etiological agent of skin cancer, the most frequent form of which is basal cell carcinoma (BCC), other exposome factors like pollution, diet, and lifestyle may also contribute. This study aimed to investigate the association of BCC and exposome-related factors in the Spanish population. METHODS BCC cases (n = 119) and controls (n = 127) with no history of skin cancer were recruited between April 2020 and August 2022 by 13 dermatologists throughout Spain in this prospective multicenter case-control study. RESULTS The BCC group had a higher proportion of outdoor workers, more years of UVR exposure, and a greater consumption of drugs (statins, ASA, hydrochlorothiazide, ACE inhibitors and omeprazole), P < 0.05. Avoidance of sun exposure was the most used photoprotection measure in both groups. The use of hats or caps was higher in the BCC group (P = 0.01). The solar protection factor (SPF) used 15 years previously was higher in the control group (P = 0.04). The control group had a higher daily screen time (P < 0.001), and practiced more relaxation activities (P = 0.03). Higher linolenic acid intake and lower coffee consumption were the only dietary variables associated with BCC (P < 0.05). Statistical significance for all the aforementioned variables was maintained in the multivariate analysis (P < 0.05). CONCLUSIONS The study found a significant association between BCC and multiple exposome-related factors in addition to chronic sun exposure in the Spanish population. Primary prevention strategies should target specific populations, such as outdoor workers, promoting sun-safe behaviors and stress-reducing activities, and also adequate skin photoprotection in patients on certain medications associated with increased BCC risk.
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Affiliation(s)
- Alba Navarro-Bielsa
- Department of Dermatology, Hospital Universitario Miguel Servet, IIS Aragón, Universidad de Zaragoza, Zaragoza, Spain
| | - Tamara Gracia-Cazaña
- Department of Dermatology, Hospital Universitario Miguel Servet, IIS Aragón, Universidad de Zaragoza, Zaragoza, Spain
| | - Manuel Almagro
- Department of Dermatology, Complejo Hospitalario Universitario A Coruña, Coruña, Spain
| | | | - Ángeles Florez
- Department of Dermatology, University Hospital of Pontevedra, Pontevedra, Spain
| | - Oriol Yélamos
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, IIB SANT PAU, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Trinidad Montero-Vilchez
- Department of Dermatology, Hospital Universitario Virgen de las Nieves, Instituto de investigación IBS, Granada, Spain
| | - Carlos González-Cruz
- Department of Dermatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Adrián Diago
- Department of Dermatology, Hospital Universitario Miguel Servet, IIS Aragón, Universidad de Zaragoza, Zaragoza, Spain
| | | | | | - María Colmenero
- Department of Dermatology, Hospital Costa del Sol, Marbella, Spain
| | - Jose Bañuls
- Department of Dermatology, Hospital General Universitario de Alicante, ISABIAL, Alicante, Spain
| | - Salvador Arias-Santiago
- Department of Dermatology, Hospital Universitario Virgen de las Nieves, Instituto de investigación IBS, Granada, Spain
| | | | - Manuel Almenara-Blasco
- Department of Dermatology, Hospital Universitario Miguel Servet, IIS Aragón, Universidad de Zaragoza, Zaragoza, Spain
| | - Pedro Gil-Pallares
- Department of Dermatology, Complejo Hospitalario Universitario de Ferrol, Universidad de Santiago de Compostela, A Coruña, Spain
| | - Yolanda Gilaberte
- Department of Dermatology, Hospital Universitario Miguel Servet, IIS Aragón, Universidad de Zaragoza, Zaragoza, Spain
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Monte-Boquet E, Florez Á, Alcaín Martínez GJ, Sellas A. Consensus statement on the use of biosimilar drugs in immune-mediated diseases in Spain. Reumatol Clin (Engl Ed) 2023; 19:446-454. [PMID: 37805258 DOI: 10.1016/j.reumae.2022.12.004] [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: 10/03/2022] [Accepted: 12/20/2022] [Indexed: 10/09/2023]
Abstract
OBJECTIVE To improve knowledge about biosimilar medicines and to generate a consensus framework on their use. METHODS Qualitative study. A multidisciplinary group of experts in biosimilar medicines was established (1dermatologist, 1hospital pharmacist, 1rheumatologist, and 1gastroenterologist) who defined the sections and topics of the document. A narrative literature review was performed in Medline to identify articles on biosimilar medicines. Systematic reviews, controlled, pre-clinical, clinical, and real-life studies were selected. Based on the results of the review, several general principles and recommendations were generated. The level of agreement was tested in a Delphi that was extended to 66 health professionals who voted from 1 (totally disagree) to 10 (totally agree). Agreement was defined if at least 70% of the participants voted ≥7. RESULTS The literature review included 555 articles. A total of 10 general principles and recommendations were voted upon. All reached the level of agreement established. The document includes data on the main characteristics of biosimilar medicines (definition, development, approval, indication extrapolation, interchangeability, financing, and traceability); published evidence (biosimilarity, efficacy, effectiveness, safety, immunogenicity, efficiency, switch); barriers and facilitators to its use; and data on information for patients. CONCLUSIONS Authorized biosimilar medicines meet all the characteristics of quality, efficacy, and safety. They also significantly help improve patient access to biological therapies and contribute to health system sustainability.
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Affiliation(s)
- Emilio Monte-Boquet
- Servicio de Farmacia, Hospital Universitario y Politécnico La Fe, Valencia, España.
| | - Ángeles Florez
- Servicio de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, España
| | | | - Agustí Sellas
- Servicio de Reumatología, Hospital Universitari Arnau de Vilanova, Lleida, España
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Navarro-Bielsa A, Gracia-Cazaña T, Almagro M, Fuente-Meira SDL, Florez Á, Yélamos O, Montero-Vilchez T, González-Cruz C, Diago A, Abadías-Granado I, Fuentelsaz V, Colmenero M, Bañuls J, Arias-Santiago S, Buendía-Eisman A, Almenara-Blasco M, Gil-Pallares P, Gilaberte Y. A multicenter case-control study comparing sun exposure habits and use of photoprotection measures in patients diagnosed with different types of skin cancer. Photodermatol Photoimmunol Photomed 2023; 39:457-465. [PMID: 37130164 DOI: 10.1111/phpp.12878] [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: 02/10/2023] [Revised: 04/11/2023] [Accepted: 04/20/2023] [Indexed: 05/04/2023]
Abstract
BACKGROUND While skin cancer awareness programs have significantly furthered public understanding about the harmful effects of the sun, there is a disparity between photoprotection knowledge and protection practices. OBJECTIVE To compare sun exposure habits and photoprotection measures in patients diagnosed with basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma versus controls. METHODS Multicentre case-control observational study carried out by 13 Spanish dermatologists between April 2020 and August 2022. Patients diagnosed with BCC, SCC, or melanoma were considered cases. The control group consisted of individuals with no history of skin cancer. RESULTS Of the 254 cases (56.2% female; mean age, 62.67 ± 15.65), 119 (31.2%) had BCC, 62 (16.27%) SCC, and 73 (19.1%) melanoma. The control group consisted of 127 (33.33%) individuals. Avoiding sun exposure between 12:00 and 16:00 was the most commonly used photoprotection measure (habitually/always: 63.1%), followed by the use of sunscreen (habitually/always: 58.9%). Patients with melanoma were less likely to use clothing and shade to avoid sun exposure (p < .05), whereas those with BCC and SCC reported greater use of head coverings (p = .01). BCC and SCC groups reported greater sun exposure 15 years prior, whereas controls reported greater use of sunscreen. However, at the time of this study all groups reported using SPF ≥ 21, and the majority SPF > 50. No differences were observed in photoprotection measures between people with and without a previous history of skin cancer. CONCLUSIONS We describe differences in photoprotection measures and sun exposure patterns among patients diagnosed with different skin tumor types. Whether these differences may influence the type of tumor each developed will require further investigation.
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Affiliation(s)
- Alba Navarro-Bielsa
- Department of Dermatology, Miguel Servet University Hospital, IIS Aragón, Universidad de Zaragoza, Zaragoza, Spain
| | - Tamara Gracia-Cazaña
- Department of Dermatology, Miguel Servet University Hospital, IIS Aragón, Universidad de Zaragoza, Zaragoza, Spain
| | - Manuel Almagro
- Department of Dermatology, Complejo Hospitalario Universitario, A Coruña, Spain
| | | | - Ángeles Florez
- Department of Dermatology, University Hospital of Pontevedra, Pontevedra, Spain
| | - Oriol Yélamos
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, IIB SANT PAU, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Carlos González-Cruz
- Department of Dermatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Adrián Diago
- Department of Dermatology, Miguel Servet University Hospital, IIS Aragón, Universidad de Zaragoza, Zaragoza, Spain
| | | | | | - María Colmenero
- Department of Dermatology, Hospital Costa del Sol, Marbella, Spain
| | - José Bañuls
- Departmment of Dermatology, Hospital General Universitario de Alicante, ISABIAL, Alicante, Spain
| | | | | | - Manuel Almenara-Blasco
- Department of Dermatology, Miguel Servet University Hospital, IIS Aragón, Universidad de Zaragoza, Zaragoza, Spain
| | - Pedro Gil-Pallares
- Department of Dermatology, Complejo Hospitalario Universitario de Ferrol, A Coruña, Spain
| | - Yolanda Gilaberte
- Department of Dermatology, Miguel Servet University Hospital, IIS Aragón, Universidad de Zaragoza, Zaragoza, Spain
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