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The article published in the British Journal of Dermatology explores the association between prescribed oral antidiabetic medication (OADM) for type 2 diabetes mellitus and the risk of developing skin cancer. The systematic review and meta-analysis included studies from various geographical locations and ethnicities, focusing on basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (cSCC), and melanoma. The findings suggest that metformin may decrease the risk of skin cancer compared to other OADM, with a dose-response relationship observed for metformin and rosiglitazone exposure. However, the certainty of evidence remains low, indicating the need for further research to confirm causality between OADM and skin cancer risk. [Extracted from the article]

The article discusses the impact of the systemic photoprotective agent afamelanotide on the vitamin D status of patients with erythropoietic protoporphyria (EPP). EPP is a rare condition that causes severe pain when the skin is exposed to visible light. Afamelanotide has been shown to increase the length of time patients can spend in the sun without pain and improve their quality of life. However, the study found that afamelanotide had no impact on vitamin D status, suggesting that vitamin D assessment and supplementation are still necessary for patients with EPP. [Extracted from the article]

This article presents a patient's perspective on living with solar urticaria, a rare condition characterized by an extreme sensitivity to sunlight. The patient describes the progression of their symptoms over time and the impact it had on their daily life. After being diagnosed with solar urticaria, the patient tried various treatments and self-management strategies, but found limited relief. Eventually, they were approved for omalizumab therapy, which significantly improved their condition and allowed them to have more outdoor exposure without reacting. The article also includes comments from clinicians about the condition and its management. [Extracted from the article]

Background: Loss and remodelling of the dermal extracellular matrix (ECM) are key features of photodamaged human skin. Green tea catechins (GTCs) have been explored for their anti‐inflammatory and chemopreventive properties, but data on the impact of GTCs on ultraviolet radiation (UVR)‐induced changes to the dermal ECM are lacking. Aim: To investigate the effect of an inflammatory dose of solar‐simulated UVR on human dermal ECM and potential for protection by GTCs in a double‐blind randomized controlled trial. Methods: In total, 50 healthy white (Fitzpatrick skin type I–II) adults aged 18–65 years were randomized to a combination of GTCs 540 mg plus vitamin C 50 mg or to placebo twice daily for 12 weeks. The impact of solar‐simulated UVR at 3 × minimal erythema dose on the dermal collagen and elastic fibre networks was assessed by histology and immunohistochemistry in all participants at baseline. The impact of GTC supplementation on UVR‐induced effects was compared between the groups post‐supplementation. Results: The area of papillary dermis covered by collagen and elastic fibres was significantly lower (P < 0.001) in UVR‐exposed skin than in unexposed skin. Significantly lower levels of fibrillin‐rich microfibrils (P = 0.02), fibulin‐2 (P < 0.001) and fibulin‐5 (P < 0.001) were seen in UVR‐exposed than unexposed skin, while procollagen‐1 deposition was significantly higher in UVR‐exposed skin (P = 0.01). Following GTC supplementation, the UVR‐induced change in fibulin‐5 was abrogated in the active group but not the placebo group, with no difference between the two groups for other components. Conclusions: Acute UVR induced significant changes in the human dermal collagen and elastic fibre networks, whereas oral GTCs conferred specific UVR protection to fibulin‐5. Future studies could explore the impact of GTCs on the effects of repeated suberythemal UVR exposure of human skin. [ABSTRACT FROM AUTHOR]

Background: The use of indoor tanning devices causes melanoma and other skin cancers with resulting morbidity, mortality and increased healthcare costs. Policymakers require robust economic evidence to inform decisions about a possible ban of such devices to mitigate these burdens. Objectives: To assess the health costs and consequences of introducing a policy‐based intervention across England to ban commercial indoor tanning with an accompanying public information campaign. Methods: A cost‐effectiveness analysis, adopting a healthcare system perspective, was conducted using a decision model to track a national cohort of 18‐year‐olds over a lifetime time horizon. A nationwide ban on commercial indoor tanning combined with a public information campaign (the policy‐based intervention) was compared with the status quo of availability of commercial indoor tanning. The expected costs (currency, GBP; price year, 2019) and quality‐adjusted life‐years (QALYs) were calculated. Net monetary benefit (NMB) (net benefit measured in cost compared with an accepted threshold) and net health benefit (NHB) (net gain in QALYs compared with an accepted threshold) of implementation were calculated. A probabilistic sensitivity analysis was used to calculate the probability that the intervention was cost‐effective. Results: Compared with the current situation, a ban on commercial indoor tanning combined with a public information campaign would result in 1206 avoided cases of melanoma, 207 fewer melanoma deaths and 3987 averted cases of keratinocyte cancers over the lifetime of all 18‐year‐olds (n = 618 873) living in England in 2019. An additional 497 QALYs would be realized along with healthcare cost‐savings of £697 858. This intervention would result in an NMB of £10.6m and an NHB of 530 QALYS. Multiple sensitivity analyses confirmed the robustness of the findings. At a cost‐effectiveness threshold of £20 000, there is a 99% likelihood of this policy‐based intervention being cost‐effective. Conclusions: The implementation of a ban on commercial indoor tanning across England with an accompanying public information campaign would be an effective use of healthcare resources. [ABSTRACT FROM AUTHOR]

While we agree that adequate vitamin D is essential for health, clearly sunbeds are not a viable source of vitamin D production in the skin given that the same emitted ultraviolet B wavelengths that promote vitamin D also cause skin cancer.[[6]] The World Health Organization has classified indoor tanning devices as carcinogenic[7] and has recommended that interventions be applied to curtail their use.[8] We assessed the potential impact of a policy-based intervention to reduce skin cancer using evidence from meta-analyses[[9]] that have quantified the increased risk of skin cancer from indoor tanning. Dear Editor, Lindqvist I et al i .[1] claim that our model-based economic evaluation does not account for beneficial effects of indoor tanning.[2] Their contention that indoor tanning is associated with reduced mortality is based on a prospective cohort study conducted by them. Cost-effectiveness of a policy-based intervention to reduce melanoma and other skin cancers associated with indoor tanning. [Extracted from the article]

Skin exposure to ultraviolet radiation (UVR) triggers conversion of precursor 7-dehydrocholesterol (7DHC) to vitamin D3, which then enters the bloodstream. The aim of this study was to assess if skin 7DHC concentration differs between younger and older adults, and to explore the impact of solar-simulated UVR (SSR) on 7DHC (in skin) and vitamin D3 (cholecalciferol; in serum) in these age groups. Younger (n = 10, 18–40 years) and older (n = 11; 65–89 years) adults of skin phototype I–III were exposed to a suberythemal dose of SSR (95% UVA, 5% UVB, 1.3 standard erythemal dose) over 35% body surface area in the UK winter. Six 5-mm buttock skin punch biopsies were taken: two from unexposed skin, two immediately post-UVR and two at 24 h post-UVR. Blood was taken at baseline, 24 h and 7 days post-UVR. Skin and serum samples were assayed using high-performance liquid chromatography–tandem mass spectrometry. Baseline mean (SD) 7DHC concentrations were 0.22 (0.07) µg mg–1 and 0.25 (0.08) µg mg–1 in younger and older adults, respectively. Immediately post-UVR, 7DHC concentrations were 0.27 (0.10) µg mg–1 and 0.22 (0.08) µg mg–1 in younger and older adults, respectively, and 24 h post-UVR they were 0.27 (0.08) µg mg–1 and 0.28 (0.13) µg mg–1, respectively. Baseline serum vitamin D3 concentrations in younger adults were 1.5 (1.5) nmol L–1 vs. 1.5 (1.7) nmol L–1 in older adults; 24 h post-UVR they were 3.1 (2.0) nmol L–1 in younger adults vs. 2.5 (2.0) nmol L–1 in older adults and 7 days post-UVR they were 2.0 (2.1) vs. 1.7 (1.2) nmol L–1, respectively. No significant difference was seen in any parameter between age groups. Thus, in contrast to previous assumptions, skin 7DHC concentration is not a limiting factor for vitamin D3 synthesis in healthy older adults relative to younger adults. The early vitamin D3 biosynthetic pathway does not appear to differ between these age groups. [ABSTRACT FROM AUTHOR]