Chronic Contact Dermatitis May Promote Skin Cancer Development

MedicalResearch.com Interview with:
Shawn Demehri, M.D., Ph.D. Instructor of Medicine Division of Dermatology Washington University in St. Louis andShawn Demehri, M.D., Ph.D.
Instructor of Medicine
Division of Dermatology
Washington University in St. Louis and

 

Wayne M. Yokoyama, M.D. Howard Hughes Medical Institute Rheumatology Division Washington University Medical Center St. Louis, MO 63110-1093Wayne M. Yokoyama, M.D.
Howard Hughes Medical Institute
Rheumatology Division
Washington University Medical Center
St. Louis, MO 63110-1093

MedicalResearch: What are the main findings of the study?

Research: This bedside to bench research has clearly demonstrated a cause and effect relationship between chronic allergic contact dermatitis and skin cancer development. This research originated from a clinical case of invasive skin cancer that developed in the context of chronic allergic contact dermatitis to a nickel-containing metal implant. Using animal models, we have demonstrated that chronic exposure to a contact allergen creates an inflammation that drive skin cancer development.

MedicalResearch: Were any of the findings unexpected?

Research: The finding that chronic allergic contact dermatitis drives skin cancer development is a clear shift in the field. Previously, allergic contact dermatitis was thought to prevent skin cancer formation because the studies were mainly focused on the acute phase of the disease. But now we show that in its chronic form, as seen with allergic implants, contact dermatitis has an opposite pro-tumor effect on skin cancer. In addition, our findings highlight skin cancer as a previously unrecognized severe adverse event associated with allergic metal implants.

MedicalResearch: What should clinicians and patients take away from this study?

Research: To prevent such adverse events, the potential for allergic reactions to metal implants may be assessed  in patients who have had the implants and in patients preparing to receive them using skin patch testing especially in patients with previous history of metal allergies.

MedicalResearch: What recommendations do you have for future research as a result of your study?

Research:  When we examined the cells and molecules involved in chronic allergic contact dermatitis in mice, we identified several that are linked to tumor development. Several of these cells and molecules also were present in biopsy samples from our patient. Currently, we are working to identify which of these inflammatory cells and molecules are most supportive of cancer formation in order to block them and prevent skin cancer development in chronic inflammation.

Citation:

Chronic allergic contact dermatitis promotes skin cancer

Shadmehr Demehri … David M. Sheinbein, Wayne M. Yokoyama
Published October 8, 2014
Citation Information: J Clin Invest. 2014. doi:10.1172/JCI77843.