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Background: The study objective was to assess potential correlates of sun protection behaviors among melanoma survivors.Methods: Participants were 441 melanoma survivors recruited from three health centers and a state cancer registry in the United States. Sun protection behaviors (sunscreen, shade, protective shirts, and hats) were assessed through an online survey, as were potential correlates (demographic, melanoma risk, knowledge and beliefs, psychological and social influence factors). Hierarchical multiple regression analyses were conducted.Results: Correlates of sun protection behaviors included education, skin cancer risk factors, melanoma knowledge and beliefs, melanoma worry and distress, physician recommendation for sun protection, injunctive norms, and pro-protection beliefs (e.g., perceived barriers, self-efficacy).Conclusions: Future efforts to improve sun safety among melanoma survivors may benefit from targeting individuals with lower education levels, and addressing sun protection social influence, barriers, and self-efficacy. [ABSTRACT FROM AUTHOR]

Melanoma represents ~5% of all cutaneous malignancies, yet accounts for the majority of skin cancer deaths due to its propensity to metastasise. To develop new therapies, novel target molecules must to be identified and the accessibility of cell surface proteins makes them attractive targets. Using CRISPR activation technology, we screened a library of guide RNAs targeting membrane protein-encoding genes to identify cell surface molecules whose upregulation enhances the metastatic pulmonary colonisation capabilities of tumour cells in vivo. We show that upregulated expression of the cell surface protein LRRN4CL led to increased pulmonary metastases in mice. Critically, LRRN4CL expression was elevated in melanoma patient samples, with high expression levels correlating with decreased survival. Collectively, our findings uncover an unappreciated role for LRRN4CL in the outcome of melanoma patients and identifies a potential therapeutic target and biomarker. Louise van der Weyden et al. report a CRISPRa screen in mice to identify membrane protein-encoding genes that, when overexpressed, enhance the metastatic potential of melanoma cells. They find that high expression of LRRN4CL in melanoma cells increases lung metastases in mice and correlates with poorer survival in melanoma patients, suggesting it could be a promising drug target. [ABSTRACT FROM AUTHOR]

The accumulation of somatic mutations contributes to ageing and cancer. Sunlight is the principal aetiological factor associated with skin cancer development. However, genetic and phenotypic factors also contribute to skin cancer risk. This study aimed at exploring the role of photoaging, as well as other well-known epidemiological risk factors, in the accumulation of somatic mutations in cancer-free human epidermis. We deeply sequenced 46 genes in normal skin biopsies from 123 healthy donors, from which phenotypic data (including age, pigmentation-related genotype and phenotype) and sun exposure habits were collected. We determined the somatic mutational burden, mutational signatures, clonal selection and frequency of driver mutations in all samples. Our results reveal an exponential accumulation of UV-related somatic mutations with age, matching skin cancer incidence. The increase of mutational burden is in turn modified by an individual's skin phototype. Somatic mutations preferentially accumulated in cutaneous squamous cell carcinoma cancer genes and clonally expanded with age, with distinct mutational processes underpinning different age groups. Our results suggest a loss of fidelity in transcription-coupled repair later in life. Our findings reveal that ageing is not only associated with an exponential increase in the number of somatic mutations accumulated in normal epidermis, but also with selection and expansion of cancer-associated mutations. Aged, sun-exposed normal skin is thus an extended mosaic of multiple clones with driver mutations, poised for the acquisition of transforming events. • As skin cancer incidence increases, UV-related somatic mutations accumulate exponentially with increasing age in normal epidermis. • UV-related mutations do not only accumulate with age, but also repair processes are less efficient in elderly individuals. • Apart from age, an individual's skin phototype is key in the build-up of somatic mutations in healthy skin. • Distinct mutational processes may operate in different age groups. • Ageing is associated with positive selection and expansion of clones with cancer mutations in sun-exposed normal skin. [ABSTRACT FROM AUTHOR]

Oxidative stress is associated with photoaging of the skin as well as with skin cancer, and is therefore, critical to monitor. Ultraweak photon emission (UPE) is extremely weak light generated during the oxidative process in the living body and has been used as a non-invasive and label-free marker for the evaluation of oxidative stress. However, the mechanism of UPE generation is not clear. Therefore, we aimed to elucidate the molecular mechanism underlying UPE generation by analyzing the spectra of UPE generated from biomolecules in the skin during ultraviolet A (UVA) exposure. The spectra of UVA-induced UPE generated from linoleic acid, linolenic acid, elastin, phospholipids, and 5,6-dihydroxyindole-2-carboxylic acid were measured, and the spectrum of human skin tissue was also obtained. The spectral patterns varied for the different biomolecules and the peaks were distinct from those of the skin tissue. These results suggested that the UPE generated from skin tissue is a collection of light emitted by biomolecules. Moreover, we proposed that UPE is generated through a photosensitization reaction and energy transfer. The identified characteristic spectral patterns of UPE can be useful to elucidate UVA-induced oxidative stress in the skin, with implications for prevention and treatment of photoaging and skin diseases. [ABSTRACT FROM AUTHOR]

Background: Skin cancer attributed to sunlight exposure has an increasing trend worldwide, resulting in increased problems for healthcare services. This study aimed to evaluate the health safety practices of high school students in Saveh, Iran according to a sun protection guideline produced locally for Iran.Method: This cross-sectional study was done in 31 government and private high schools of Saveh, a central city of Iran. A sun protection questionnaire was designed in accordance with Iran sun protection guideline which has been developed based on the World Health Organization and US Environmental Protection Agency guidelines. The questionnaire consists of four sections of demographic information, knowledge, attitude, and protection behavior. A total of 504 students were selected by simple random sampling method. Pearson correlation coefficient and multiple linear regression analysis were used to assess the correlation between knowledge, attitude and behavior of the participants.Results: The mean score of the students' knowledge, attitude, and behavior regarding harmfulness of ultraviolet radiation was 50.79 ± 14.64, 60.41 ± 15.04, and 45 ± 11.59, respectively. A significant association was observed between attitude and knowledge, behavior and knowledge as well as attitude. There was a significant correlation between sex and protective behaviors, sex and knowledge (p ≤ 0.001), and education level and knowledge (p = 0.002).Conclusion: students who protected themselves from sunlight less than others believed that their protection level was adequate. Health concerns related to sun exposure suggest the need for increasing the student's awareness in sun protection area. As behavior is influenced by cultural aspects, implementation of the current guideline can be effective in reducing the health effects of sun exposure. [ABSTRACT FROM AUTHOR]

Skin cancer is the second most common complication of organ transplantation in children. The frequency of skin cancer incidence after organ transplantation is different in paediatric and adult populations. The post-transplant lymphoproliferative disease is the most common group of malignancies after organ transplantation in paediatric population. The majority of researchers who examined children with kidney, liver, heart or lungs grafts observed that the risk of skin cancer was three times higher than in the general population whereas in adults even 200 times higher. The occurrence of skin cancer in children after transplantation is extremely rare during childhood. The risk increases in early adulthood. Malignancies occurring after solid organ transplantation result from many different factors. These include the immunological condition of the child, dose and time of immunosuppression, and oncogenic viruses. The increased risk of skin cancer following paediatric transplantation requires prevention and adequate education of children and their parents. These involve avoiding sun exposure and protection such as sunscreens and protective clothing. The early detection of cancer in transplant recipients is very important. Prevention of cancer includes regular dermatological examination. [ABSTRACT FROM AUTHOR]

Le risque de cancers cutanés induits par des médicaments photosensibilisants est connu. Le rôle de l'hydrochlorothiazide a été soulevé par plusieurs études épidémiologiques récentes. Une revue systématique des études cas-témoins ou de cohortes prospectives montre qu'il existe un surrisque de carcinomes épidermoïdes dans la majorité des études même si certains facteurs de confusion comme le tabac n'ont pas été pris en compte. Les données sont plus contradictoires pour les carcinomes basocellulaires et les mélanomes. Ces résultats ne remettent pas en cause le rapport bénéfice/risque de cette molécule, mais peuvent inciter à des mesures de prévention renforcées chez les malades pour lesquels une prescription d'hydrochlorothiazide est proposée : identifier les patients à risque de carcinomes cutanés, éviter si possible de prescrire cette molécule chez les patients immunodéprimés ou ayant un carcinome, effectuer un examen cutané régulier chez les malades recevant ce traitement au long cours. The risk of skin cancer induced by photosensiting drugs is well known. An association between hydrochlorothiazide use and skin cancer has been recently published in some epidemiological studies. A systematic review of case-control or prospectives cohorts showed an increased risk of cutaneous squamous cell carcinoma even if some confusing factors such as tobacco smoking was not analysed. Results are more conflicting for basal cell carcinoma or melanoma. These results do not modify the benefit/risk ratio but should lead to propose preventive mesures: identification of high risk population, avoidance of this drug if possible in immunocompromised patients or with previous skin cancer, regular skin examination in case of long term use of hydrochlorothiazide. [ABSTRACT FROM AUTHOR]

A 308‐nm excimer laser (EL) has been widely used to treat patients with localized vitiligo. However, data are rare on the influence of EL treatment on the risks of skin cancer. To evaluate the skin cancer risks after long‐term EL treatment, we performed a nationwide population‐based retrospective cohort study using the Korean National Health Insurance Claims Database. A total of 5,052 patients with vitiligo were classified into three groups according to the EL treatment sessions between 2009 and 2016: no, 50–99, and 100 or more EL treatments after 2‐year washout period (2007 and 2008). Using multivariable Cox proportional hazard models, we found that the risks of actinic keratosis, non‐melanoma skin cancers, and melanoma did not significantly differ among the groups, respectively. In conclusion, EL treatment would not increase the risks of premalignant skin lesions and skin cancers in patients with vitiligo. Based on our results, EL is likely to be a safe treatment option for patients with localized vitiligo. [ABSTRACT FROM AUTHOR]

Introduction. Previous studies on the association of vitamin D receptor (VDR) gene polymorphisms with cutaneous melanoma risk reported conflicting results. Objective. To obtain a more precise assessment of the associations, we performed a meta-analysis of previously published studies. Material and methods. We searched for eligible studies in the PubMed, Embase, and CNKI databases. A total of 40 case-control studies with 1,144 cases and 2,925 controls were included. Results. The pooled analyses suggested a significant association between the FokI C>T and BsmI G>A polymorphisms of the VDR gene and susceptibility to melanoma. However, we found that the VDR TaqI T>C, EcoRV A>G, ApaI G>T, and Cdx2 G>A polymorphisms were not associated with melanoma risk. Conclusions. The meta-analysis suggests that VDR FokI C>T and BsmI G>A polymorphisms are significantly associated with melanoma risk, while TaqI T>C, EcoRV A>G, ApaI G>T, and Cdx2 G>A polymorphisms are not associated with melanoma risk. [ABSTRACT FROM AUTHOR]

Summary: Background/purpose: Fitzpatrick phototype (FST) classification (based on ability to tan and tendency to burn) is widely used for evaluating skin cancer risk; however, it was not developed for that purpose and has been criticised scientifically. The purpose of the present study was a first approach in establishing a new skin cancer phototype (SCP) classification with direct relation to skin cancer risk, based on the questions originally proposed by Fitzpatrick. However, contrary to Fitzpatrick, the questions are in the present study kept separate. Methods: Validated information on skin cancer and answers about participants' tendency to burn (4 answers) and ability to tan (4 answers) were obtained from 2869 Danes. The 16 (4 × 4 answers) possible answers formed a matrix, on which a logistic regression was carried out. Successively, the matrix neighbours which were insignificantly different were identified; of which the neighbours with the mutual lowest difference were merged. The merging resulted in four different SCP classes. Results: There was a linear relationship between SCP classes and skin cancer risk. Further, SCP was as good a predictor of skin cancer as objectively measured skin phototype. Conclusion: As skin phototype is an important factor in skin cancer research, SCP has great potential in investigative studies of skin cancer risk. [ABSTRACT FROM AUTHOR]

The aging-associated increase of cancer risk is linked with stromal fibroblast senescence and concomitant cancer-associated fibroblast (CAF) activation. Surprisingly little is known about the role of androgen receptor (AR) signaling in this context. We have found downmodulated AR expression in dermal fibroblasts underlying premalignant skin cancer lesions (actinic keratoses and dysplastic nevi) as well as in CAFs from the 3 major skin cancer types, squamous cell carcinomas (SCCs), basal cell carcinomas, and melanomas. Functionally, decreased AR expression in primary human dermal fibroblasts (HDFs) from multiple individuals induced early steps of CAF activation, and in an orthotopic skin cancer model, AR loss in HDFs enhanced tumorigenicity of SCC and melanoma cells. Forming a complex, AR converged with CSL/RBP-Jκ in transcriptional repression of key CAF effector genes. AR and CSL were positive determinants of each other's expression, with BET inhibitors, which counteract the effects of decreased CSL, restoring AR expression and activity in CAFs. Increased AR expression in these cells overcame the consequences of CSL loss and was by itself sufficient to block the growth and tumor-enhancing effects of CAFs on neighboring cancer cells. As such, the findings establish AR as a target for stroma-focused cancer chemoprevention and treatment. [ABSTRACT FROM AUTHOR]

Background: A consensus is building that interleukin-10 (IL-10), as a multifunctional anti-inflammatory cytokine, has a critical influence in cancer development. A meta-analysis was carried out regarding the relationships among the -592 A/C, -1082 G/A, and -819 T/C IL-10 polymorphisms and their association with skin squamous cell carcinoma (sSCC), melanoma, and basal cell carcinoma (BCC). Materials and Methods: A meta-analysis was carried out to study the inter-relationships among three IL-10 SNPs and their association with sSCC, melanoma, and BCC. Results: In this analysis, a total of 11 researches, involving 2149 controls and 2128 cases, were included. No association was found between skin cancer risk and any of the alleles of either the -592A/C SNP or the 1082T/C SNP. However, a moderately decreased skin cancer risk was found in the -819 TC versus CC model (odds ratio [OR] = 0.81 and 95% confidence interval [CI] = 0.67–0.99, p = 0.04). From the subgroup analysis, a decreased risk was found between the studies of nonmelanoma skin cancers and IL-10-819T/C in the dominant model (OR = 0.60, 95% CI = 0.43–0.85, p = 0.004 for TT+TC vs. CC). Egger's and Begg's tests demonstrated that there was no significant publication bias. Conclusion: This meta-analysis showed that there is an association between risk of non-melanoma skin cancers (BCC & sSCC) and the IL-10 -819T/C polymorphism, but that IL-10 -polymorphisms -592A/C and -1082G/A are unlikely to be risk factors for any of the evaluated skin cancers including melanoma. [ABSTRACT FROM AUTHOR]

Basal cell carcinoma (BCC) is the most common cancer affecting humans. It almost has no tendency for metastasis; however it can be destructive to surrounding tissue. Patients with darker skin colors have lower risk of developing skin cancers and the clinical characteristics may differ from populations with lighter skin colors. Methods. This is a retrospective clinical study (2003–2017). Data on age, gender, and location of tumor were collected and analyzed. Results. 335 cases were identified. Males tend to get BCC at a younger age than females. Face was the most common site in both males and females. Cheeks and nose were the most likely areas of the face to be involved. Scalp was the most common extrafacial site to be involved in males; however in females scalp was much less likely to be involved. Conclusion. BCC is less common in populations with darker skin. Males were more affected and at an earlier age compared to females. Facial skin followed by scalp was the most common site affected. Skin phototype, cultural and religious dress type, and different sun exposure behavior may explain many of the clinical and demographic findings related to BCC in patients with darker skin tones. [ABSTRACT FROM AUTHOR]

Recently an increasing trend in skin cancer rates has been observed in various populations including those exposed to different radiation types. Risk and dose-response following prolonged radiation exposure remain unclear. The present study was aimed to assess skin melanoma (SM) and non-melanoma skin cancer (NMSC) incidence risks in a cohort of workers occupationally exposed to ionizing radiation at low dose rates over prolonged periods. The study cohort included workers of a Russian nuclear production facility, Mayak Production Association (PA), who were first employed in 1948–1982 and followed up till the end of 2013 (the total of 22,377 individuals with 25% of females). Using AMFIT module of EPICURE software, relative risk and excess relative risk per unit dose (RR and ERR/Sv) were calculated. 60 SM and 294 NMSC cases were registered in members of the study cohort. SM and NMSC incidence was dependent on sex, attained age, age at first employment at the enterprise, type of facility, education level and was not dependent on calendar period of first employment, calendar period of diagnosis, duration of employment, smoking and alcohol consumption statuses. The risk of NMSC incidence was found to be significantly increased in workers occupationally exposed to ionizing radiation at cumulative doses above 2.0 Sv (RR = 2.52; 95% CI: 1.60, 3.97) compared to a reference dose category (0–0.05 Sv). NMSC incidence was found to be significantly associated with cumulative external gamma-dose with ERR/Sv of 0.49 (95% CI: 0.22, 0.90) without an adjustment for neutron dose and 0.51 (95% CI: 0.22, 0.93) while adjusted for neutron dose. Results of the analysis did not reveal a significant association of SM incidence with cumulative dose from external gamma-rays with ERR/Sv of 0.22 (95% CI: -0.29, 1.46) not including a neutron dose adjustment and of 0.15 (95% CI: -0.41, 1.31) while adjusted for dose from neutron exposure. [ABSTRACT FROM AUTHOR]

Background: One of the main risk factors for non‐melanoma skin cancer (NMSC), the most common cancer worldwide, is solar ultraviolet radiation (UVR). This has led to the recognition of NMSC as occupational disease for outdoor workers in several countries. However, outdoor professions are a very heterogeneous group with diverse daily activities and associated UVR exposure. Objective: To compare the prevalence of NMSC and associated risk behaviour in different outdoor professions. Methods: Cross‐sectional study among outdoor workers (farmers, gardeners, mountain guides) and indoor workers (office employees) as control group using a paper‐based questionnaire on UVR exposure and protective behaviour followed by a skin examination by a dermatologist. Results: A total of 563 participants (46.9% women, 46.9 ± 13.8 years) consisting of 348 outdoor workers (38.8% farmer, 35.3% gardener, 25.9% mountain guides) and 215 indoor workers were included in the study between March and September 2017. NMSC incl. actinic keratosis was diagnosed in 33.3% of mountain guides, 27.4% of farmers, 19.5% of gardeners and in 5.6% of indoor workers. Significant differences were seen between the outdoor professions with mountain guides at highest risk compared to farmers (OR = 2.6, 95% CI = 1.2–5.7). Substantial differences between the professions were also seen in skin cancer screening attendance rates (indoor worker 61.4%, mountain guides 57.8%, farmers 31.9%, gardeners 27.6%), daily UVR exposure during work and protective behaviour such as sunscreen use during work. Conclusion: Different outdoor professions have significant different risks for NMSC and show different risk behaviour. Tailoring prevention efforts to different professions based on their individual needs could be the key to lower the global burden of (occupational) NMSC. [ABSTRACT FROM AUTHOR]

Summary: Background: Childhood solar ultraviolet radiation (UVR) exposure increases the risk of skin cancer in adulthood, which is associated with mutations caused by UVR‐induced cyclobutane pyrimidine dimers (CPD). Solar UVR is also the main source of vitamin D, essential for healthy bone development in children. Objectives: To assess the impact of a 12‐day Baltic Sea (54° N) beach holiday on serum 25‐hydroxyvitamin D3 [25(OH)D3] and CPD in 32 healthy Polish children (skin types I–IV). Methods: Blood and urine were collected before and after the holiday and assessed for 25(OH)D3 and excreted CPD, respectively, and personal UVR exposure was measured. Diaries were used to record sunbathing, sunburn and sunscreen use. Before‐ and after‐holiday skin redness and pigmentation were measured by reflectance spectroscopy. Results: The average ± SD daily exposure UVR dose was 2·4 ± 1·5 standard erythema doses (SEDs), which is borderline erythemal. The mean concentration of 25(OH)D3 increased (× 1·24 ± 0·19) from 64·7 ± 13·3 to 79·3 ± 18·7 nmol L−1 (P < 0·001). Mean CPD increased 12·6 ± 10·0‐fold from 26·9 ± 17·9 to 248·9 ± 113·4 fmol μmol−1 creatinine (P < 0·001). Increased 25(OH)D3 was accompanied by a very much greater increase in DNA damage associated with carcinogenic potential. Overall, skin type had no significant effects on behavioural, clinical or analytical outcomes, but skin types I/II had more CPD (unadjusted P = 0·0496) than skin types III/IV at the end of the holiday. Conclusions: Careful consideration must be given to the health outcomes of childhood solar exposure, and a much better understanding of the risk–benefit relationships of such exposure is required. Rigorous photoprotection is necessary for children, even in Northern Europe. What's already known about this topic? Tenerife and skiing holiday studies in adults have shown an ultraviolet (UV)B‐dependent increase in 25‐hydroxyvitamin D3 [25(OH)D3] and potentially mutagenic cyclobutane pyrimidine dimers (CPD) that may initiate skin cancer.Childhood solar UV radiation exposure increases the risk of skin cancer in adulthood, but no study has assessed the risks and benefits of solar UV radiation in children on holiday. What does this study add? Relatively low daily UV radiation doses in children at a Baltic Sea summer camp resulted in a modest but significant improvement in 25(OH)D3 (24%) but a very much greater increase in CPD (1162%).The children had the same level of CPD as adults who had higher UV radiation doses over a shorter holiday in Tenerife.These results stress the importance of rigorous photoprotection in the young. Linked Comment: Webb. Br J Dermatol 2018; 179:822–823. Respond to this article [ABSTRACT FROM AUTHOR]

Introduction: Online surveys are a valuable tool for social science research, but the perceived anonymity provided by online administration may lead to problematic behaviors from study participants. Particularly, if a study offers incentives, some participants may attempt to enroll multiple times. We propose a method to identify clusters of non-independent enrollments in a web-based study, motivated by an analysis of survey data which tests the effectiveness of an online skin-cancer risk reduction program. Methods: To identify groups of enrollments, we used a hierarchical clustering algorithm based on the Euclidean distance matrix formed by participant responses to a series of Likert-type eligibility questions. We then systematically identified clusters that are unusual in terms of both size and similarity, by repeatedly simulating datasets from the empirical distribution of responses under the assumption of independent enrollments. By performing the clustering algorithm on the simulated datasets, we determined the distribution of cluster size and similarity under independence, which is then used to identify groups of outliers in the observed data. Next, we assessed 12 other quality indicators, including previously proposed and study-specific measures. We summarized the quality measures by cluster membership, and compared the cluster groupings to those found when using the quality indicators with latent class modeling. Results and conclusions: When we excluded the clustered enrollments and/or lower-quality latent classes from the analysis of study outcomes, the estimates of the intervention effect were larger. This demonstrates how including repeat or low quality participants can introduce bias into a web-based study. As much as is possible, web-based surveys should be designed to verify participant quality. Our method can be used to verify survey quality and identify problematic groups of enrollments when necessary. [ABSTRACT FROM AUTHOR]

Pilomatrix (pilomatrical) carcinoma is a rare cutaneous adnexal tumor with matrical differentiation and recurrent and metastatic potential. Sarcomatoid pilomatrix carcinoma is a rare variant which shows a sarcomatoid component intermingling with the epithelial one. There are only 4 cases previously published. We present an additional case on the hand of a 78 year‐old man which appeared as a 6 mm hyperkeratotic, focally ulcerated plaque. A shave biopsy demonstrated a dermal infiltrative neoplasm, composed of markedly atypical‐appearing basaloid cells with focal necrotic/ghost cells, as well as an intimately associated population of atypical oval to spindle‐shaped cells. Both the epithelial and the sarcomatoid components expressed cytokeratins (CKs) AE1/AE3, CK 5/6 and CAM 5.2, as well as beta‐catenin and LEF‐1. The tumor failed to express CK7, CK20, S100, thyroid transcription factor 1 (TTF1), CDX2, prostate‐specific antigen (PSA) and CD34. The tumor was completely excised with Mohs surgery, and there has been no recurrence in the 8 months of follow‐up to date. [ABSTRACT FROM AUTHOR]

Summary: Background: The major risk factor for skin cancers is exposure to solar and artificial ultraviolet radiation, in particular during childhood and adolescence. In France, a law was restricted for tanning‐bed access to adults (≥18 years) since 1997. Objective: To evaluate teenagers’ artificial tanning behaviour in 2016 and to compare results with those obtained in a similar survey performed in 2011. Methods: The SOLADO 2011 and 2016 surveys were conducted in a general school in Antony and a technical school in Fontenay‐aux‐Roses (Paris suburb). Results: In 2016, 630 teenagers (mean age: 14.2 ± 1.9 y: Males/Females: 301/329) completed the questionnaire, 1.3% of teenagers reported using tanning beds, 1.1% tanning pills and 8.9% tanning creams. Between 2011 and 2016, the use of tanning beds decreased from 1.4% to 0.7% in Antony (P = .26) and from 9.5% to 4.8% in Fontenay‐aux‐Roses (P = .01), and the use of tanning creams from 39.8% to 17.6% in Fontenay‐aux‐Rose (P = .0007). The incidence of sunburn decreased from 60.5% to 54.0% in Antony (P = .02) and from 55.4% to 42.4% in Fontenay‐aux‐Roses (P = .05). Conclusion: As compared to 2011, teenagers used artificial tanning methods less frequently in 2016. In particular, they used tanning beds less frequently, suggesting that the new stricter legislation has been effective. [ABSTRACT FROM AUTHOR]

Introduction An increased risk of skin cancer is particularly important in patients undergoing maintenance hemodialysis (HD), who are potential transplant recipients. In transplant recipients who are exposed to immunosuppressive therapy, neoplastic skin disease my take a more aggressive course. Increased exposure to photoradiation, elderly age, a low skin phototype, sunburn during childhood, and a history of smoking are the main factors contributing to the development of skin neoplasms. Knowledge of these risk factors as well as education on sun protection should be important for such patients. Patients and methods We studied 105 HD patients (57 men, 48 women) with a mean age of 60.8 (range 25–94) years. Knowledge of skin cancer risk factors was assessed on the basis of a questionnaire regarding skin cancer risk factors. Results In the study group, 23.8% of patients claimed that they frequently and intensively engage in sunlight exposure. However, only 11.4% have started to apply sunblockers recently. Sunburn during adolescence was reported by 12.4% patients. Among the patients studied, 65.7% had skin phototype I or II, and only 34.3% had phototype III. In the investigated study group, 55.2% admitted smoking: 30.5% smoked more than 20 pack-years. Among the patients studied only 2.86% could name 3 skin cancer risk factors, 29.5% 2 risk factors, 60% 1 risk factor, and 7.6% could not name any risk factor. Conclusions The results presented prove that patients undergoing HD lack knowledge regarding skin cancer risk factors, which explains the necessity of education, particularly on the dangers of sun radiation. [ABSTRACT FROM AUTHOR]

Abstract: Sclerodermatous graft‐versus‐host disease is a subtype of cutaneous chronic graft‐versus‐host disease that is characterized by sclerosis of the skin and subcutaneous tissue, resulting in debilitating contractures, among other life‐threatening complications. Children with sclerodermatous graft‐versus‐host disease are at high risk of developing nonmelanoma skin cancer because of several risk factors, including young age at transplantation, prolonged immunosuppression, and exposure to photosensitizing antimicrobial prophylaxis such as voriconazole. The immunosuppression required to treat sclerodermatous graft‐versus‐host disease makes effectively treating nonmelanoma skin cancer and sclerodermatous graft‐versus‐host disease in the same patient challenging. We describe a challenging case of a 6‐year‐old boy with a history of sclerodermatous graft‐versus‐host disease and voriconazole exposure presenting with squamous cell carcinoma in situ on the left temple and actinic keratoses on the scalp treated with topical chemotherapy agents. [ABSTRACT FROM AUTHOR]

Purpose Previous western studies have found Caucasians with skin cancer, either melanoma or nonmelanoma skin cancer (NMSC), have an elevated risk of second primary cancer. Our objective was to assess the risk of second primary cancer in Taiwanese with NMSC. Materials and Methods By using data from Taiwan's National Health Insurance Research Database, we conducted a population-based cohort study to assess the risk of incident second primary cancer in Taiwanese affected by NMSC. Results We identified 505 subjects with NMSC and 2,020 matched controls. After adjustment for potential confounders including age, sex, urbanization, and Charlson Comorbidity Index, people who had NMSC had a 1.43-fold (95% confidence interval [CI], 1.05 to 1.96) risk for the development of second primary cancer as compared with control group. Men with NMSC had a 2.99-fold (95% CI, 1.00 to 9.10) risk for second primary cancer involving the lip, oral cavity, and pharynx and a 3.51-fold (95% CI, 1.21 to 10.17) risk for second primary cancer involving the genitourinary organs when compared to the control group. By contrast, women with NMSC did not have an increased risk of second primary cancer. Conclusion This study revealed Asians with NMSC have an increased risk of second primary cancer. Our findings can be a useful reference for health care for people diagnosed with NMSC. [ABSTRACT FROM AUTHOR]

Background Several new members of the human polyomavirus (HPyV) family that infect human skin and are potentially oncogenic have been identified in the last decade. Objectives To investigate prospectively the seroprevalence and stability of 13 PyVs, and possible associations with different risk factors and cutaneous squamous cell carcinoma (cSCC). Study design In this Australian population-based longitudinal study sera were collected at baseline in 1992 or during the next 4 years from 688 people. Of the 688, 226 developed a new cSCC between blood collection and the final follow up in 2003. The remaining 462 served as controls. Among the 462 controls, 161 had a second serum sample from 2003 analysed. Seroprevalence of 10 human PyVs (BKV, JCV, KIV, WUV, MCV, TSV, HPyV6, HPyV7, HPyV9 and HPyV10) and three non-human PyVs (SV40, LPV and ChPyV) was assessed using multiplex serology. Results There was no significant difference in PyV seroprevalence between people who developed cSCC during follow-up compared to those who did not. WUV and HPyV10 showed the highest serostability (93%) and JCV VP1 and SV40 VP1 the lowest (84%) over a 9-year time period (range 7–11 years). Conclusions We found no evidence that HPyV seroprevalence is associated with subsequent development of cSCC and observed variable stability of antibodies to polyomaviruses. [ABSTRACT FROM AUTHOR]

Polychlorinated biphenyls (PCB) have been classified by the International Agency for Research on Cancer (IARC) in Group 1 as carcinogenic to human, based on sufficient evidence in humans of an increased risk of cutaneous malignant melanoma (CMM), however few studies have been done in the general population. This study examined the relationship between PCB plasma levels and risk of CMM adjusting for sun sensitivity and sun exposure in a province of Northern Italy (Brescia), where a chemical factory produced PCBs from 1938 to 1984 causing human contamination. A case–control study of 205 CMM patients and 205 control subjects was conducted. Cases and controls were assayed for plasma levels of 33 PCB congeners. No associations was found between risk of CMM and plasma levels of total PCB (OR = 0.81; 95% CI: 0.34–1.96 for highest vs lowest quartile) or specific congeners. The study confirmed the association with light skin colour (OR = 3.00; 95% CI: 1.91–4.73), cumulative lifetime UV exposure (OR = 2.56; 95% CI: 1.35–4.85) and high level of education (OR = 1.45; 95% CI: 1.03–2.05). This case-control study does not support the hypothesis of an association between current plasma levels of PCBs and CMM development in the general population. [ABSTRACT FROM AUTHOR]

Epidermal cancers include keratinocyte cancer, melanocyte cancer, and Merkel cell carcinoma. These cancers account for the vast majority of new cancers diagnosed in Australia, North America, and Europe. Keratinocyte cancer is the most common epidermal cancer and accounts for 7 out of 8 new cancers diagnosed in Australia. Melanoma and Merkel cell carcinoma are less common than keratinocyte carcinoma but are more important causes of mortality in Australia. Keratinocyte cancer has also been demonstrated to be a marker of cancer-prone phenotype. Risk factors for epidermal cancer include intrinsic and environmental factors, in particular exposure to ultraviolet radiation and advanced age. Actinic keratosis has an approximate prevalence of 79% of men and 68% of women between 60 and 69 years of age, and has a low risk of malignant transformation into squamous cell carcinoma. Basal cell carcinoma is the most common malignancy in Caucasians worldwide, with the incidence increasing by 2% per year in Australia. Squamous cell carcinoma is the second most common epidermal cancer, with an incidence of approximately 1035 or 472 per 100,000 person-years in men and women, respectively. Primary risk factors for both basal cell carcinoma and squamous cell carcinoma include light skin color, UV radiation exposure, and chronic immunosuppression. Although the rate of melanoma is increasing, the mortality in Australia is reducing and is currently 9%. The overall incidence of melanoma in Australia is approximately 50 cases per 100,000 persons (62 for men and 40 for women). Keratinocyte carcinoma and melanoma are risk factors for developing further skin cancer and primary malignancy. This contribution reviews the incidence, prevalence, and risk factors associated with the development of epidermal cancer and premalignant epidermal neoplasia. [ABSTRACT FROM AUTHOR]

The article discusses methods for skin cancer monitoring for patients with chronic lymphocytic leukemia. It states that patients chronic lymphocytic leukemia (CLL) are at risk of higher rates of skin cancer, and skin cancers have been found to be more aggressive in this population, and mentions guidelines from International Transplant-Skin Cancer Collaborative and the European Skin Cancer in Organ Transplant Patients. It notes other methods like dermatological skin examinations.

Summary: Background: Given the evidence for increased skin cancer risk due to the sunbed use, a regulation of hazardous artificial ultraviolet radiation (UVR regulation) was passed in Germany in 2012. The aim of this study was to explore the advisory services in tanning studios as reported by sunbed users and to evaluate the information provided by the personnel of tanning salons after the UVR regulation was enacted. Methods: The first wave of the representative National Cancer Aid Monitoring on Sunbed Use included a subgroup of 357 German citizens between 14 and 45 years who had used sunbeds since the UVR regulation was implemented. The participants provided data on sunbed use and related issues in telephone interviews. Results: Although sunbed operators are mandated to offer their customers certain services at least once since the implementation of the UVR regulation, 15.4% of sunbed users were never advised to use protective eyewear during tanning and 13.1% were not provided with eyewear during their last sunbed use. Overall, 66.0% were never offered to develop a tanning schedule, 56.9% were never advised on the risks of UVR, 43.4% were never offered a determination of their skin type and 40.0% of users were never advised on how to use a sunbed safely. Conclusions: The data showed that 3 years after the UVR regulation was enacted, compliance with this legislation is still not optimal. Binding wording in the legal text and making them applicable to unsupervised sunbeds as well is necessary to extend the impact of this legislation. [ABSTRACT FROM AUTHOR]

Summary: Background: Painful sunburns at any age are one of the main risk factors for skin cancer. Objectives: To determine the prevalence and predictors of sunburn among beachgoers. Methods: A cross‐sectional health survey was conducted at the beach during the summer. Adults >18 years with an understanding of Spanish were interviewed using a questionnaire about behaviours, attitudes and knowledge related to sun exposure at the beach. A descriptive analysis was performed, and a log‐binomial regression model was used to determine predictors of sunburn. Results: The survey was completed by 1054 beachgoers, with a mean age of 43.8 (SD: 18.7) years, 61.2% women, skin phototypes i (13.6%), ii (22.3%), iii (34.0%) and iv (30.2%). 46.9% of responders reported at least one painful sunburn during the previous summer. Age, sex, education, skin phototype, midday sun exposure, sun protection habits, attitudes towards tanning and knowledge about skin cancer were identified as independent predictors of sunburn. Conclusions: It is necessary to develop photoprotection campaigns aimed at beachgoers, particularly in young people, men, those with skin phototypes I‐III and secondary or university education. Educational strategies should be aimed at discouraging sun exposure at midday, changing attitudes towards tanning and improving knowledge about skin cancer. [ABSTRACT FROM AUTHOR]

Introduction Several anti-hypertensive drugs have photosensitizing properties, however it remains unclear whether long-term users of these drugs are also at increased risk of skin malignancies. We conducted a literature review and meta-analysis on the association between use of anti-hypertensive drugs and the risk of cutaneous melanoma and non-melanoma skin cancer (NMSC). Methods We searched PubMed, EMBASE, Google Scholar and the Cochrane Library, and included observational and experimental epidemiological studies published until February 28th, 2017. We calculated summary relative risk (SRR) and 95% confidence intervals (95% CI) through random effect models to estimate the risk of skin malignancies among users of the following classes of anti-hypertensive drugs: thiazide diuretics, angiotensin converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARB), calcium channel blockers (CCB) and β-blockers. We conducted sub-group and sensitivity analysis to explore causes of between-studies heterogeneity, and assessed publication bias using a funnel-plot based approach. Results Nineteen independent studies were included in the meta-analysis. CCB users were at increased skin cancer risk (SRR 1.14, 95% CI 1.07–1.21), and β-blockers users were at increased risk of developing cutaneous melanoma (SRR 1.21, 95% CI 1.05–1.40), with acceptable between-studies heterogeneity (I 2  < 50%). There was no association between thiazide diuretics, ACEi or ARB use and skin cancer risk. We found no evidence of publication bias affecting the results. Conclusion Family doctors and clinicians should inform their patients about the increased risk of skin cancer associated with the use of CCB and β-blockers and instruct them to perform periodic skin self-examination. Further studies are warranted to elucidate the observed associations. [ABSTRACT FROM AUTHOR]

Summary: Aim: To review the efficacy of perioperative antibiotics in reducing the risk of surgical‐site infections (SSIs) following excision of ulcerated skin cancers. Setting and design: Study selection, data extraction and analysis were carried out independently by four authors. Only randomized controlled trials (RCTs) reported in the English language were included. Included studies: RCTs in the English language in which patients received perioperative topical, intralesional or oral antibiotics for dermatological surgery, including Mohs micrographic surgery in general practice, dermatology or plastic surgery departments, were included. Outcome: The proportion of participants developing SSI following excision of skin lesions. Results: Thirteen RCTs were identified from our literature search of PubMed and Embase, which evaluated SSI following use of topical (n = 5), oral (n = 3), intramuscular (n = 2), intravenous (n = 1) and intralesional antibiotics (n = 2) in dermatological surgery. Two RCTs specifically investigated SSIs in ulcerated skin cancer excisions; one RCT investigated the SSI rate following surgical treatment specifically for ulcerated skin cancers in individuals randomized to topical antibiotics vs. oral cephalexin; and one RCT compared intravenous cefazolin with no antibiotic, demonstrating significant reduction in SSI rates for ulcerated tumours (P = 0·04). Conclusions: The heterogeneity of the RCTs included in this study makes it difficult to make a direct comparison of the outcomes measured. High‐quality evidence demonstrating a beneficial effect of the use of perioperative antibiotics to prevent SSI following excision of ulcerated skin cancers is lacking. In the absence of an evidence base, we propose that a well‐designed multicentre RCT could evaluate the effect of perioperative antibiotics following excision of ulcerated tumours, and potentially reduce inappropriate antibiotic prescription. [ABSTRACT FROM AUTHOR]

Objectives. Despite the substantial solar ultraviolet radiation experienced by Latino day laborers, little attention has been given to factors that are associated with sun protective behaviors. The purpose of this study was to examine psychological and nonpsychological predictors of sun protective behaviors among Latino day laborers. Methods. This cross-sectional study included a nonrandom sample of 137 Latino day laborers recruited from Mississippi and Illinois. Participants completed a self-report survey instrument, available in English and Spanish, on sun protective behaviors. Results. Multivariate regression results showed that sun protective behaviors were significantly greater among Latino day laborers: (a) who had greater perceptions that their supervisor also engaged in sun protective behaviors (β=0.25, p≤0.01); (b) who reported higher levels of health literacy (β=0.23, p≤0.001); (c) who have greater knowledge of skin cancer risk factors (β=0.21, p≤0.01); and (d) who have skin tone that was self-perceived to be more prone to sunburns (β=0.19, p≤0.01). Conclusions. Latino day laborers possess marginal levels of skin cancer knowledge and engage minimally in sun protective behaviors. Skin cancer prevention interventions are warranted for this high-risk group, particularly in the locations in which Latino day laborers work. [ABSTRACT FROM AUTHOR]

Objectives: In this study, we attempt to describe the profile of sunbed users among cancer-free French women. Methods: E3N is a prospective cohort including 98,995 French women aged 40-65 years in 1990. In 2008, a specific UV questionnaire was sent to all reported skin cancer cases and 3 controls per case, matched on age, county of birth, and education. We used logistic regression models adjusted for pigmentary traits. Results: Compared with non-users, ever-users of sunbeds were younger (ptrend < .0001), had higher levels of education (ptrend = .0004) and income (ptrend = .002), and were more likely to be divorced/separated (OR = 1.58). They were more likely to be smokers (OR = 1.59) or former smokers (OR = 1.64), had higher alcohol intakes (ptrend = .001), and lower physical activity levels (OR = 0.54), although they had a lower BMI (ptrend = .004) and a thinner body shape (ptrend = .006). Sunbed users were also more likely to report many freckles (ptrend = .01) and sunburns in adulthood (ptrend= .008), to use sunscreen (SPF<8: OR = 2.15), and to renew sunscreen application (sometimes: OR = 1.49). Conclusions: Sunbed use is associated with intentional sun exposure and several unhealthy behaviors. Our findings call for further research towards the development of targeted prevention campaigns to reduce sunbed use. [ABSTRACT FROM AUTHOR]

Objectives. To test whether shade sails will increase the use of passive recreation areas (PRAs). Methods. We conducted a stratified randomized pretest–posttest controlled design study in Melbourne, Australia, and Denver, Colorado, in 2010 to 2014. We randomized a sample of 144 public parks with 2 PRAs in full sun in a 1:3 ratio to treatment or control. Shade sails were built at 1 PRA per treatment park. The outcome was any use of the study PRA (n = 576 pretest and n = 576 posttest observations; 100% follow-up). Results. Compared with control PRAs (adjusted probability of use: pretest = 0.14, posttest = 0.17), use of treatment PRAs (pretest = 0.10, posttest = 0.32) was higher at posttest (odds ratio [OR] = 3.91; 95% confidence interval [CI] = 1.71, 8.94). Shade increased use of PRAs in Denver (control: pretest = 0.18, posttest = 0.19; treatment: pretest = 0.16, posttest = 0.47) more than Melbourne (control: pretest = 0.11, posttest = 0.14; shaded: pretest = 0.06, posttest = 0.19; OR = 2.98; 95% CI = 1.09, 8.14). Conclusions. Public investment in shade is warranted for skin cancer prevention and may be especially useful in the United States. [ABSTRACT FROM AUTHOR]

Regulatory T cells (Tregs) represent a cell type that promotes immune tolerance to autologous components and maintains immune system homeostasis. The abnormal function of Tregs is relevant to the pathogenesis of several skin diseases like psoriasis, atopic dermatitis, systemic lupus erythematosus, cutaneous T-cell lymphomas, and skin cancer and is also important in rheumatoid arthritis, diabetes and other autoimmune diseases. In this review, we will summarize the role of mutations and/or polymorphisms of genes involved in Tregs development, and functions in the pathogenesis of selected skin diseases. [ABSTRACT FROM AUTHOR]

This study investigated the risk of non-melanoma skin cancer (NMSC) in pre-dialysis patients with chronic kidney disease (CKD) and explored associated risk factors. A population-based cohort of 1,515,858 Taiwanese CKD patients was included. The standardized incidence ratio (SIR) for incident NMSC was determined. Compared with the general population, a 1.14- fold risk of NMSC was found in the CKD cohort. NMSC risk was significant in patients with pre-dialysis stage 5 CKD and anaemia (1.48-fold), and in those with uraemic pruritus after long-term antihistamine treatment (1.38-fold). A higher SIR for NMSC was found in younger patients with CKD (age < 70 years, 1.34-fold; age 20-39 years, 1.63-fold), stage 5 CKD with anaemia (age < 70 years, 2.09-fold), and uraemic pruritus (age <70 years, 2.22-fold). Pre-dialysis patients with CKD are at higher risk of NMSC, especially those with advanced-stage CKD, and those with uraemic pruritus. [ABSTRACT FROM AUTHOR]

Objectives: Arc welding produces the full spectrum of ultraviolet radiation and may be a contributory cause of skin cancer; however, there has been little research into this occupational hazard. The aim of this study is to explore if metal arc welding increases the risk of malignant melanoma and/or basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) on skin areas which may possibly be exposed (neck, head, and upper extremities). Method: A Danish national company-based historic cohort of 4333 male metal arc welders was followed from 1987 through 2012 to identify the risk of skin cancer. An external reference group was established including all Danish skilled and unskilled male workers with similar age distribution. Occupational histories were gathered by questionnaires in 1986 and information about skin cancer diagnoses [BCC, SCC, cutaneous malignant melanoma (CMM), and precancerous conditions, actinic keratosis (AK)] were gathered from the Danish Cancer Registry supplemented by the data from the Danish Pathology Register. Hazard ratios (HRs) were calculated in the follow-up period from 1987 until 2012 using Cox regression analysis and adjusted for baseline data regarding age and social group. Results: The adjusted HR and 95% confidence interval (CI) for skin cancer (all types) were 0.99 (CI 0.94-1.04) for welders. The adjusted HR for AK and BCC located only at neck was 2.49 (CI 1.03-5.99) for welders exposed >20 years ( n = 5) and 2.46 (CI 1.02-5.94), respectively, for welders exposed >30 years ( n = 5). No statistically significant difference was observed for SCC. The risk of CMM at the neck was also significantly elevated after 30 years of welding, but this is based upon only one exposed case. Conclusion: This study indicates that long-term exposure to metal arc welding may be related to increased risk of BCC and AK located exclusively at the neck. The study provides no support for the hypothesis that welding exposure increases the risk for skin cancer at other locations. [ABSTRACT FROM AUTHOR]

The use of tanning beds has been identified as being among the most significant causes of melanoma and nonmelanoma skin cancer. Accordingly, the activity is properly seen as one that involves profound harm to self. The article examines paternalistic reasons for restricting sunbed usage. We argue that both so-called soft and hard paternalistic arguments support prohibiting the use of sunbeds. We make the following three arguments: (i) an argument from oppressive patterns of socialization suggesting that the autonomous nature of the conduct in question is questionable; (ii) an argument from so-called evaluative delusions in which individuals attach incorrect weights to some of their values; (iii) a strictly hard paternalistic argument appealing to the harm in itself (as opposed to failures of rationality or agency) pertaining to the use of sunbeds. [ABSTRACT FROM AUTHOR]

Ultraviolet radiation (UVR) induces skin cancer. The combination of UVR and red tattoos may be associated with increased risk of skin cancer due to potential carcinogens in tattoo inks. This combination has not been studied previously. Immunocompetent C3.Cg/TifBomTac hairless mice (n=99) were tattooed on their back with a popular red tattoo ink. This often used ink is banned for use on humans because of high content of the potential carcinogen 2-anisidine. Half of the mice were irradiated with three standard erythema doses UVR thrice weekly. Time to induction of first, second and third squamous cell carcinoma (SCC) was measured. All UV-irradiated mice developed SCCs. The time to the onset of the first and second tumor was identical in the red-tattooed group compared with the control group (182 vs 186 days and 196 vs 203 days, P=ns). Statistically, the third tumor appeared slightly faster in the red-tattooed group than in the controls (214 vs 224 days, P=.043). For the second and third tumor, the growth rate was faster in the red-tattooed group compared with the control (31 vs 49 days, P=.009 and 30 vs 38 days, P=.036). In conclusion, no spontaneous cancers were observed in skin tattooed with a red ink containing 2-anisidine. However, red tattoos exposed to UVR showed faster tumor onset regarding the third tumor, and faster growth rate of the second and third tumor indicating red ink acts as a cocarcinogen with UVR. The cocarcinogenic effect was weak and may not be clinically relevant. [ABSTRACT FROM AUTHOR]

Chronic lymphocytic leukaemia (CLL) is a non-Hodgkin lymphoma commonly occurring in older adults. Many people with CLL can go for years without requiring treatment. However, they have an increased risk of secondary cancers, specifically melanoma and non-melanoma skin cancers. Furthermore, these secondary cancers are frequently more aggressive in this cohort of patients. Health professionals working in haematology, dermatology and general practice have an opportunity to educate patients about risk factors and measures to aid prevention. Modern technology may assist patients and professionals in the early detection of secondary skin cancers, which will lead to expedited treatment and better survival outcomes. [ABSTRACT FROM AUTHOR]

Background: Exposure to solar ultraviolet radiation is a well-known cause of skin cancer. This is problematic for outdoor workers. In Denmark alone, occupational skin cancer poses a significant health and safety risk for around 400,000 outdoor workers. Objective measures of solar ultraviolet radiation exposure are needed to help resolve this problem. This can be done using personal ultraviolet radiation dosimeters.Methods: We consider technical and practical feasibility of measuring individual solar ultraviolet exposure at work and leisure in professions with different á priori temporal high-level outdoor worktime, using aluminium gallium nitride (AlGaN) photodiode detector based personal UV-B dosimeters. Essential technical specifications including the spectral and angular responsivity of the dosimeters are described and pre-campaign dosimeter calibration applicability is verified. The scale and conduct of dosimeter deployment and campaign in-field measurements including failures and shortcomings affecting overall data collection are presented.Results: Nationwide measurements for more than three hundred and fifty workers from several different professions were collected in the summer of 2016. On average, each worker's exposure was measured for a 2-week period, which included both work and leisure. Data samples of exposure at work during a Midsummer day show differences across professions. A construction worker received high-level occupational UV exposure most of the working day, except during lunch hour, accumulating to 5.1 SED. A postal service worker was exposed intermittently around noon and in the afternoon, preceded by no exposure forenoon when packing mail, accumulating to 1.6 SED. A crane fitter was exposed only during lunch hour, accumulating to 0.7 SED. These findings are in line with our specialist knowledge as occupational physicians.Conclusions: Large-scale use of personal UV-B dosimeters for measurement of solar ultraviolet radiation exposure at work and leisure in Denmark is indeed feasible from a technical and practical viewpoint. Samples of exposure data shown support the presumption that the Danish campaign UV-B dosimeter measurement dataset can be used to sum and compare exposure between groups of professions with reliable results to be used in future analysis with clinical as well as epidemiological/questionnaire data. This was despite some dosimeter failures and shortcomings. [ABSTRACT FROM AUTHOR]

Background It is unclear whether incidence of detected skin cancer in patients evaluated by store-and-forward teledermatology ( SAF) vs. face-to-face consultation (F2F) significantly differs, and whether such differences are because of variations in patient demographics, diagnostic accuracy, or both. Methods This retrospective cohort study compares patient skin cancer risk profile, pre-post biopsy diagnostic accuracy, and detection rates of any skin cancer, melanoma, and keratinocytic carcinoma between all SAF teledermatology patients and a subset of randomly selected F2F consultations at VA-Boston Healthcare System in 2014. Results Patients in the teledermatology ( n = 434) and F2F visit cohorts ( n = 587) had similar baseline demographics except a higher proportion of F2F patients had prior history of skin cancer, 22% (131/587) vs. 10% (45/434), P < 0.001, and received biopsies, 27.2% (160/587) vs. 11.5% (50/434), P < 0.001. When adjusted for age, immunosuppression, and personal and family history of skin cancer, there were no significant differences between the two cohorts in detection rates for any skin cancer (9.5% vs. 5.8%, P = 0.3), melanoma (0.6% vs. 0%, P = N/A), or keratinocytic carcinoma (8.5% vs. 5.5%, P = 0.7). The two cohorts also had similar pre-post biopsy perfect diagnostic concordance, time from initial consult request to biopsy (45.5 d vs. 47.3 d, P = 0.8), and time from biopsy to definitive treatment (67.5 d vs. 65.4 d, P = 0.8). Conclusion F2F patients were more likely to have prior history of skin cancer and receive biopsies. When adjusted for presence of skin cancer risk factors, incidence of detected melanoma, keratinocytic carcinoma, and any skin cancer was similar between SAF teledermatology and F2F patients. [ABSTRACT FROM AUTHOR]

Background Non-melanoma skin cancer ( NMSC) was officially recognized in 2015 as an occupational disease for outdoor workers in Germany. Together with the enormous socioeconomic impact of NMSC, this has led to the continuous demand of evidence-based prevention. However, studies assessing the perceptions and beliefs along with risk behaviour of outdoor workers as an essential prerequisite for prevention are rare. Objective To assess perceptions, beliefs, barriers, risk and preventive behaviours towards non-melanoma skin cancer among different outdoor groups as a basis for the development of sustainable prevention programmes. Patients and Methods Cross-sectional study among outdoor workers of three different occupational groups (farmer, gardener, roofer) using a 20-question online survey on NMSC awareness, risk and preventive behaviours. Results Between March and April 2016, 353 outdoor workers participated in the study. Of these, 153 (43.4%) reported never to use sunscreen during work. Wearing headgear and long pants were the most common sun protection measures. Poor use of sunscreen was more likely in males and farmers. A low perceived skin cancer risk was significantly associated with poor use of sunscreen, long-sleeved shirts, sunglasses and headgear. Conclusions Despite great evidence on NMSC risk in outdoor professions throughout the literature, high-risk groups in fact are not yet aware of the topic. Sustainable target group-oriented awareness prevention programmes are needed to lower the immense burden of NMSC. [ABSTRACT FROM AUTHOR]

The development of many sporadic cancers is directly initiated by carcinogen exposure. Carcinogens induce malignancies by creating DNA lesions (i.e., adducts) that can result in mutations if left unrepaired. Despite this knowledge, there has been remarkably little investigation into the regulation of susceptibility to acquire DNA lesions. In this study, we present the first quantitative human genome-wide map of DNA lesions induced by ultraviolet (UV) radiation, the ubiquitous carcinogen in sunlight that causes skin cancer. Remarkably, the pattern of carcinogen susceptibility across the genome of primary cells significantly reflects mutation frequency in malignant melanoma. Surprisingly, DNase-accessible euchromatin is protected from UV, while lamina-associated heterochromatin at the nuclear periphery is vulnerable. Many cancer driver genes have an intrinsic increase in carcinogen susceptibility, including the BRAF oncogene that has the highest mutation frequency in melanoma. These findings provide a genome-wide snapshot of DNA injuries at the earliest stage of carcinogenesis. Furthermore, they identify carcinogen susceptibility as an origin of genome instability that is regulated by nuclear architecture and mirrors mutagenesis in cancer. [ABSTRACT FROM AUTHOR]

Background Excess skin cancer mortality and incidence have been reported among both land-based and offshore petroleum workers. The association between skin cancer and ultraviolet radiation (UVR) exposure has not been examined in these workers, although they have long off-duty periods and high average income that may allow travelling to sunny destinations. In addition, they have access to solariums free of charge on many accommodation platforms. Aims To prospectively examine risk of incident cutaneous melanoma (CM) and non-melanoma skin cancer (NMSC), according to sun-tanning habits with adjustment for aromatic hydrocarbon exposure. Methods A cohort of men employed offshore from 1965 to 1999 was linked through the Cancer Registry of Norway 1999-2012. Cox regression adapted to a stratified case-cohort design was used to estimate hazard ratios with 95% confidence intervals. Results The cohort included 24 917 men. During 13.5 years of follow-up, 112 CMs and 70 NMSCs occurred. A positive dose-response relationship was seen between sunburn frequency and risk of CM (Ptrend < 0.05) and NMSC (Ptrend < 0.01). Solarium use both before and after age 20 was related to increased risk of NMSC. Sunscreen use was associated with increased risk of NMSC (Ptrend < 0.001). Conclusions UVR exposure seems to be a significant contributor to the elevated risk of skin cancer observed in North Sea offshore workers. The positive association between solarium use and NMSC risk adds to the growing body of literature on artificial UV devices as carcinogenic. [ABSTRACT FROM AUTHOR]

Although the sun is very beneficial and essential for life, exposing ourselves too much to sunlight might lead to detrimental health effects such as skin cancer. Eight percent of the total different electromagnetic radiation that regularly irradiates the earth is classified as ultraviolet (UV) radiation. The ozone layer absorbs the most energetic UV rays; consequently, UV-A and UV-B reach the earth surface. UV-A rays heavily contribute to both premature skin aging and skin cancer, while UV-B rays cause sunburn. Hence, the use of sunscreen is strongly encouraged by many healthcare practitioners in order to minimize or possibly eradicate the harmful effects of UV rays on our skin, keeping in mind, that about 90% of all skin cancers are associated with exposure to the sun's harmful radiation. Unfortunately, inaccurate information is currently roaming the media and the Internet regarding the safety, toxicity, and acute side effects of the active ingredients currently used in sunscreens, therefore discouraging people from using sunscreens. In this review article, it is concluded based on the scientific published literature that the sunscreen ingredients are safe and there are no related potential hazardous health risks associated with their use. In addition, at present, sunscreens are very useful in preventing sunburn and probably skin cancer and photoaging and their regular use can have a positive and a significant impact on public health as means or instruments implemented to reduce exposure to UV radiation. [ABSTRACT FROM AUTHOR]

Oxidative stress is a universal response of the skin cell damage of various origins. Sodium dodecyl sulfate (SDS, sodium lauryl sulfate) is an anionic surfactant commonly used as an emulsifying detergent in household cleaners. Sodium dodecyl sulfate is the reference compound for testing toxicity on cellular skin models. The effect of sodium dodecyl sulfate in sub toxic dose 25 μg/mL during 48 h on the protein profile of human keratinocytes HaCaT was studied by tandem mass spectrometry with electrospray ionization. In total, 1064 proteins were found in immortalized human keratinocytes HaCaT, of which about 80% were identified by two or more peptides. The change of the 217 proteins content was revealed, among them 39 according to Gene Ontology are associated with oxidative stress. It has been found that sodium dodecyl sulfate leads to a decrease in the number of proteins/peptides containing carboxymethylated and/or carboxyethylated lysine. We concluded about the promising of the cells redox-balance analysis at testing chemicals in the doses, which do not lead to a decrease in their viability. Possible involvement of sodium dodecyl sulfate in the development of cutaneous neoplasia is discussed. [ABSTRACT FROM AUTHOR]

Among skin cancers if not diagnosed early the highest death rate is for malign melanoma. Many studies has showed that multipl nevi lead to an increased risk of melanoma. It is a good option to take photos of patients in periodic intervals. In our study, we calculated the risk of melanoma in patients with acquired melanocytic nevi with 3-point checklist and digital dermoscopy and we aimed to compare the results and their advantages to each other. We enrolled 300 patients with acquired melanocytic nevi in our study. Cases we enrolled in our study were recorded in the pre-prepared patient follow-up form. In this study Fotofinder HD (Germany) digital dermoscopy instruments were used. Lesions that were regarded as malign by 3-point scoring method were excised and histopathologically evaluated. In statistical calculations significance level of 5% was used and calculations were made with SPSS (ver: 13) statistical package program. 157 of our patients were male (52.3%) and 143 (47.7%) were female. Sensitivity of digital dermoscopy was determined as 86% according to the 3-point checklist. 6 Of the 300 patients were diagnosed as malign melanoma. Sensitivity of the 3-point checklist was determined as 97%. In our study, the results of 3-point checklist were detected higher than previous studies. Since digital dermoscopy is easy to use, this method is convenient especially for inexperienced physicians in the diagnosis of malignancy. But dermoscopic algorithms remain as the first choice for specialist physicians. [ABSTRACT FROM AUTHOR]

Basal cell carcinoma (BCC) is the most common form of cancer worldwide. Exposure of the skin to ultraviolet (UV) radiation, from sunlight and other sources, is the most important risk factor. The aim of this largescale case-control study was to determine which occupations are associated with increased risk of BCC in Sweden. The case cohort comprised 74,247 patients with BCC and the control cohort comprised 574,055 subjects linked to population-based registers. Compared with the occupational category of farmers, foresters and gardeners we observed elevated risks of BCC for almost all occupational categories studied. Legal workers with odds ratio (OR) 2.69 (95% confidence interval (CI) 2.36-3.06), dentists OR 2.69 (95% CI 2.35-3.08) and physicians OR 2.47 (95% CI 2.24-2.74) had the highest risk for both sexes taken together. In conclusion, there appears to have been a change in the risk of BCC from outdoor to indoor occupations in Sweden, possibly related to exposure to UV radiation during leisure activities exceeding occupational sun exposure as the main cause of BCC in Sweden. [ABSTRACT FROM AUTHOR]

Sunbed use is associated with an increased risk for skin cancer and is particularly dangerous for younger persons. The objective of this study was to assess how demographic factors, health-related behaviours and appearance-related factors are associated with sunbed use. Cross-sectional data from the Danish National Youth Study collected by the National Institute of Public Health during 2014 was used. A total of 64,382 students aged 15-25years were included in the present study. Multilevel logistic regression analyses were used to determine associations. Sunbed use during the past 12months was reported by 22% of students, with a higher proportion among females (29%) than males (12%). Factors associated with sunbed use were older age, studying at a vocational college or a higher preparatory examination school compared to upper secondary school, and lower parental education. Furthermore, being a smoker, been binge-drinking, longer duration of exercise and been dieting were also associated with sunbed use. For females, poor dietary habits were also associated with sunbed use. Feeling overweight was associated with lower odds for sunbed use for males, but with higher odds for females. Lower body satisfaction was associated with higher odds of sunbed use, except for overweight males. Students who were underweight had lower odds for sunbed use, than normal weight students. Conclusively, we found evidence of associations between demographic factors, health-related behaviours and appearance-related factors and sunbed use. Understanding these relations could help to identify high-risk groups and guide preventive strategies for sunbed use and skin cancer prevention. [ABSTRACT FROM AUTHOR]