Transplant Network Undercaptures Post-Transplant Skin Cancers

MedicalResearch.com Interview with:

Thuzar M.Shin MD, PhD Assistant Professor of Dermatology Hospital of the University of Pennsylvania

Dr. Shin

Thuzar M.Shin MD, PhD
Assistant Professor of Dermatology
Hospital of the University of Pennsylvania

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The Organ Procurement Transplant Network (OPTN) collects data on cancers that develop after organ transplantation. Previous studies have shown incomplete reporting to the OPTN for many cancers (including melanoma). Skin cancer is the most common malignancy in solid organ transplant recipients and the most common post-transplant skin cancer, cutaneous squamous cell carcinoma (cSCC), is not captured in standard cancer registries. We hypothesized that cSCC and melanoma are underreported to the OPTN. When compared to detailed medical record review obtained from the Transplant Skin Cancer Network database (JAMA Dermatol. 2017 Mar 1;153(3):296-303), we found that the sensitivity of reporting to the OPTN was only 41% for cSCC and 22% for melanoma. The specificity (99% for cSCC and 100% for melanoma) and negative predictive values (93% for cSCC and 99% for melanoma) were high. As a result, the OPTN database is unable to robustly and reliably distinguish between organ transplant recipients with and without these two skin malignancies.

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No Detectable Improvement in Photodamaged Skin From Course of Topical 5 Fluorouracil

MedicalResearch.com Interview with:

Kaveri Korgavkar, MD Department of Dermatology Brown University Providence, Rhode Island 

Dr. Korgavkar

Kaveri Korgavkar, MD
Department of Dermatology
Brown University
Providence, Rhode Island 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Photodamage refers to premature skin aging from long-term UV exposure. Topical fluorouracil cream, typically used in the treatment of actinic keratosis, has been suggested for use in treating photodamage due to clinical and histological findings. However, in our ad hoc secondary analysis of a large randomized clinical trial, a standard course of topical fluorouracil did not result in detectable improvement of photodamage.

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Could Nicotinamide Be A Tool In Fight Against Skin Cancer?

MedicalResearch.com Interview with:
Prof. Gary M. Halliday

Discipline of Dermatology, Bosch Institute
Central Clinical School
University of Sydney
Sydney, NSW, Australia

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The recently published article is a review paper- we reviewed previous laboratory studies of the effects of nicotinamide on normal pigment cells and on melanoma, and also the previous studies showing that nicotinamide can reduce rates of non-melanoma skin cancer (basal cell and squamous cell carcinoma) in high risk patients. We have not done any clinical investigations of nicotinamide as a preventive agent for melanoma.

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Iris Freckles Are A Potential Biomarker for Chronic Sun Damage

MedicalResearch.com Interview with:

Iris Freckles Credit: © Africa Studio / Fotolia

Iris Freckles
Credit: © Africa Studio / Fotolia

Dr.med.univ. Christoph Schwab
Departement of Ophthalmology
Medical University of Graz
Graz, Austria 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Knowledge about risk factors and/or pathways involved in pathogenesis is from special importance in order of preventing diseases.

The role of sunlight in several eye diseases is unclear. In our study we found a close relation between sun light exposure – evaluated by a full body skin examination and a personal questionnaire – and iris freckles. Therefore we suggest the presence of iris freckles as a novel biomarker indicating high ocular sun exposure.

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Higher HIV Viral Loads Linked to Increased Squamous Cell Cancers of Skin

MedicalResearch.com Interview with:

Maryam M. Asgari, MD, MPH Department of Dermatology, Massachusetts General Hospital, Department of Population Medicine Harvard Medical School, Boston, Massachusetts Division of Research, Kaiser Permanente Northern California, Oakland

Dr. Asgari

Maryam M. Asgari, MD, MPH
Department of Dermatology
Massachusetts General Hospital,
Department of Population Medicine
Harvard Medical School, Boston, Massachusetts
Division of Research, Kaiser Permanente
Northern California, Oakland

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Nonmelanoma skin cancer – defined as basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) – is a common malignant condition, affecting more than 2 million Americans every year. BCCs are more common than SCCs among individuals with healthy immune systems, while SCCs are more predominate than BCCs among people who are immunocompromised.

We examined how laboratory markers used to evaluate HIV disease progression may be associated with subsequent nonmelanoma skin cancer risk in white patients previously diagnosed with at least one such cancer from 1996 to 2008.  We measured CD4 count, viral load and subsequent nonmelanoma skin cancer. The study included 455 participants with HIV and 1,952 without HIV. All were members of the Kaiser Permanente Northern California health care plan.

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Clinical Perineural Invasion of Cutaneous SCC May Warrant Adjuvant Treatment

MedicalResearch.com Interview with:
Dr. Chrysalyne D. Schmults, MD, MSCE
Associate Professor of Dermatology, Harvard Medical School
Director, Mohs and Dermatologic Surgery Center and
Mr. Pritesh S. Karia, MPH
Department of Epidemiology
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

Department of Dermatology
Brigham and Women’s Faulkner Hospital
Harvard Medical School, Boston, Massachusetts
Jamaica Plain, MA 02130-3446 

MedicalResearch.com: What is the background for this study?

Response: Perineural nerve invasion (PNI) is a well-recognized risk factor for poor prognosis in patients with cutaneous squamous cell carcinoma (CSCC). Most cases of CSCC with PNI are identified on histologic examination at the time of surgery and the patient has no clinical symptoms or radiologic evidence of PNI. These cases are classified as incidental PNI (IPNI). However, some patients with PNI present with clinical symptoms and/or radiologic evidence of PNI. These cases are classified as clinical PNI (CPNI). A few studies have shown differences in disease-related outcomes between CSCC patients with IPNI and CPNI but consensus regarding adjuvant treatment and detailed guidelines on follow-up schedules have not yet materialized.

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New Cream May Lead To Non Sun-Induced Tanning

MedicalResearch.com Interview with:

David E. Fisher MD, PhD</strong> Edward Wigglesworth Professor & Chairman Dept of Dermatology Director, Melanoma Program MGH Cancer Center Director, Cutaneous Biology Research Center Massachusetts General Hospital Harvard Medical School Boston, MA 02114

Dr. Fisher

David E. Fisher MD, PhD
Edward Wigglesworth Professor & Chairman
Dept of Dermatology
Director, Melanoma Program MGH Cancer Center
Director, Cutaneous Biology Research Center
Massachusetts General Hospital
Harvard Medical School
Boston, MA 02114

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This study grew from an interest to mimic the dark pigmentation patterns in human skin which are known from epidemiology to be associated with low skin cancer risk. In the current work, a molecular inhibitor of the SIK enzyme was used to block the inhibitory action of SIK relative to melanin synthesis. The result was stimulation of dark pigmentation within human skin.

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Number Of High School Students Who Indoor Tan Dropped In Half

MedicalResearch.com Interview with:
Matthew Reynolds
Acting Team Lead, Office of Communication
Division of Cancer Prevention and Control (DCPC)
Centers for Disease Control and Prevention (CDC)
Chamblee GA

MedicalResearch.com: What is the background for this study?

Response: Indoor tanning and sunburns, particularly during adolescence and young adulthood, increases the risk of developing skin cancer. Researchers examined trends in the prevalence of indoor tanning and the relationship between indoor tanning and sunburn among US high school students. Pooled cross-sectional data from the 2009, 2011, 2013, and 2015 national Youth Risk Behavior Surveys. The study included nationally representative samples of U.S. high school students.

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High Schools Less Likely To Adopt Sun Safety Practices

MedicalResearch.com Interview with:

Sherry Everett Jones PhD, MPH, JD, FASHA Health Scientist, Division of Adolescent School Health Centers for Disease Control & Prevention

Dr. Sherry Everett Jones

Sherry Everett Jones PhD, MPH, JD, FASHA
Health Scientist, Division of Adolescent School Health
Centers for Disease Control & Prevention

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Skin cancer is the most common form of cancer in the United States. Results from the School Health Policies and Practices Study found that in 2014, most schools lacked practices that could protect children and adolescents from sun exposure while at school. Positive attitudes and beliefs about sun safety behavior, which would make such behavior more likely, can be promoted and supported by school system policies and practices.

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Comparison of Posttransplant Dermatologic Diseases by Race

MedicalResearch.com Interview with:
Christina Lee Chung, MD, FAAD
Associate Professor of Dermatology
Director, Center for Transplant Patients
Drexel University College of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: It’s long been recognized immunosuppressed organ transplant recipients are at significantly increased risk for skin cancer and other types of skin disease.

But despite advances to improve skin cancer prevention for these patients, little is known about how skin conditions affect African-American, Asian and Hispanic transplant recipients. This is problematic given that, according to the U.S. Department of Health and Human Services, more than half of the 120,000 Americans on the waiting list for organs identify as nonwhite.

We compared medical records of 412 organ transplant recipients — including 154 white patients and 258 nonwhite (black, Asian or Hispanic) — who were referred to the Drexel Dermatology Center for Transplant Patients between 2011 and 2016. As one of the only models of its kind in the country, the center provides post-transplant dermatological care to every patient who is transplanted by and/or followed by the Drexel University and Hahnemann University Hospital Transplant Programs. That means that every patient, regardless of race, is screened annually for skin cancer, which provided a unique dataset for us to analyze.

Two hundred eighty-nine transplant recipients exhibited malignant, infectious or inflammatory conditions during their evaluation, but their primary acute diagnoses differed greatly by race. In 82 white patients, skin cancer was the most common acute problem requiring attention at first visit. Black and Hispanic patients, by contrast, were most often diagnosed with inflammatory or infectious processes, such as fungal infections, warts, eczema, psoriasis, and rashes that required immediate medical attention.

Overall, squamous cell carcinoma in situ was the most common type of skin cancer diagnosed in each racial or ethnic group. But the location of the cancerous lesions again depended on the race of the patient. Most lesions in white and Asian patients occurred in sun-exposed areas of the body, like the scalp, neck, chest and back. For black patients, the lesions were primarily found in the groin.  Moreover, six of the nine lesions found on black patients tested positive for high-risk HPV strains, suggesting an association between the virus and skin cancer for African Americans.

We also provided questionnaires to 66 organ transplant recipients to find out more about the patients’ awareness of skin cancer prevention. Seventy-seven percent of white patients were aware their skin cancer risk was increased, compared to 68 percent of nonwhites. Only 11 percent of nonwhite patients reported having regular dermatologic examinations, compared to 36 percent of whites. Finally, 45 percent of white patients but only 25 percent of nonwhite reported knowing the signs of skin cancer.

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Indoor Tanning By High School Students Drops By Half

MedicalResearch.com Interview with:

Gery P. Guy Jr., PhD, MPH Senior Health Economist Division of Unintentional Injury CDC

Dr. Gery Guy

Gery P. Guy Jr., PhD, MPH
Senior Health Economist
Division of Unintentional Injury
CDC

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The incidence of skin cancer is increasing in the United States, and individuals who indoor tan are at an increased risk of skin cancer. Treating skin cancer costs $8.1 billion annually.

The number of high school students who indoor tan dropped by half from 2009 to 2015. In 2015, 1.2 million high school students indoor tanned, down from 2.5 million in 2009. This is a much bigger decrease than we have seen in the past and is an encouraging finding. We also found that 82% of indoor tanners reported sunburn in the past year compared with 54% of those who did not engage in indoor tanning.

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New Compounds May Extend Efficiency of Sunscreens

MedicalResearch.com Interview with: Dr. Diego Sampedro PhD

Dr. Diego Sampedro

MedicalResearch.com Interview with:
Dr. Diego Sampedro PhD
Department of Chemistry, Centro de Investigación en Síntesis Química (CISQ)
Universidad de La Rioja
Logroño, Spain

MedicalResearch.com: What is the background for this study?

Response: Skin cancer is currently the most common type of cancer. While it implies a relatively low mortality rate, the reported cases of all types of skin cancer have been steadily increasing for the last decades. The ozone layer depletion and longer sunlight exposure times due to outdoors activities contribute to this increase. Solar light is well-known to lead to several skin cellular problems, including DNA damage, mutations, oxidative stress, sunburn and immune suppression. These deleterious effects of sunlight may be mitigated by the use of sunscreens.

Sunscreens are inorganic or organic substances that are directly applied onto the skin, designed to minimize light transmission into the skin, mainly in the ultraviolet region of the solar spectrum. However, serious concerns exist about the safety of several commercial sunscreens components, as well as several drawbacks due to the lack of stability, biodegradability and effectiveness for skin protection. Thus, the development of new (and more efficient) types of sunscreens is of critical importance with a great potential impact in public health and industrial applications.

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Sunscreen Use Beats Shade For Preventing Sunburn

MedicalResearch.com Interview with:

Hao Ou-Yang, PhD Johnson & Johnson Consumer Inc Skillman, New Jersey

Dr. Hao Ou-Yang

Hao Ou-Yang, PhD
Johnson & Johnson Consumer Inc
Skillman, New Jersey

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This is the first-ever published study to evaluate UV protection value of shade in a real-world setting.

Eighty-one subjects with Fitzpatrick skin type I to III were divided into two groups: one using only a commercially available beach umbrella (round-shaped, 80” diameter, 75” high) and the other using only Neutrogena® Ultra Sheer® SPF 100+ sunscreen. Sunscreen subjects were monitored applying the product to all exposed areas following the label directions 15 minutes before beach exposure and were instructed to re-apply at least every 2 hours or as needed. Subjects were instructed to stay at the beach for 3.5 hours but could leave or stay under a shade for up to 30 minutes for cooling or rest. Shade subjects were instructed to stay under the umbrella without wearing clothes that could block the evaluated areas during the study duration. They were allowed to leave the umbrella after covering up for up to 30 minutes.

There were significant differences between the two groups in clinically evaluated sunburn protection for all seven body sites measured. The Ultra Sheer SPF 100+ sunscreen provided excellent sunburn protection for all the body sites, as demonstrated by no significant changes in sunburn grading before and after UV exposure in any sites except for face. Of the subjects in the shade group, there were a total of 142 sunburn areas across all parts of the body in 78% of the umbrella group (vs. 17 areas among 10 people in the sunscreen group – 25%). Sunburn incidence within the sunscreen group may be due to uneven application (missed spots), failure to re-apply after sweating, and under-application. Most subjects in the sunscreen group applied roughl yhalf of the amount of sunscreen recommended to achieve the SPF value on the label.

High SPF products provide a margin of safety for consumers who under-apply, as shown here and in other studies.

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In Global Survey, Risks of Sun Exposure and Tanning Not Well Known

MedicalResearch.com Interview with:

Dr. Sophie Seite

Dr. Sophie Seite

Sophie Seite, Ph. D
La Roche-Posay Dermatological Laboratories
Asnières, France.

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The survey included nearly 20,000 men and women in 23 countries, ages 16-65, and was primarily conducted online. The questionnaire collected data regarding demographics, sun exposure, behaviors regarding prevention and tanning, risk knowledge, self-examination, medical advice seeking, and social attitude. This unprecedented international survey on sun exposure behaviors and skin cancer detection found that there are many imperfections and geographical inequalities in primary and secondary prevention of skin cancer.

The study was published in the Journal of the European Academy of Dermatology & Venereology by researchers from La Roche-Posay and the George Washington University (GW) Department of Dermatology. Survey results indicate that 88 percent of those questioned were aware of the risks of developing skin cancer when exposed without protection to the sun. However, just 1 in 2 respondents has ever consulted a dermatologist for a mole screening and 4 in 10 people don’t think to protect themselves from the sun outside of vacation.

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Surgery Versus 5% Imiquimod for Nodular and Superficial Basal Cell Carcinoma

MedicalResearch.com Interview with:
Hywel C. Williams DSc, FMedSci, NIHR Senior Investigator

Director of the NIHR Health Technology Assessment Programme
http://www.nets.nihr.ac.uk/programmes/hta
Professor of Dermato-Epidemiology and Co-Director of the Centre of Evidence-Based Dermatology,
http://www.nottingham.ac.uk/research/groups/cebd/index.aspx
University of Nottingham,
Queen’s Medical Centre,
Nottingham University Hospitals NHS Trust,
Nottingham UK

Hywel C. Williams

Basal Cell Skin Cancer-Wikipedia image

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our clinical trial of 5% imiquimod cream versus surgery for low risk basal carcinoma (BCC) of the skin was first prompted by a shocking lack of randomised controlled clinical trials for what is the commonest form of human cancer.

We had conducted a Cochrane systematic review prior to starting the study and found very few long term studies. An emerging literature on imiquimod cream at the time suggested that it might have a clinically useful effect for low risk BCC. All the studies were short term and industry supported, so with the support of Cancer Research UK (UK largest cancer charity), we undertook a large independent study to see how the cream compared to the reference standard of excision surgery with a 4mm margin for low risk superficial and nodular BCC.

Our three year results, published in Lancet Oncology, showed that surgery is clearly superior to imiquimod cream, with a success rate (absence of initial failure and no signs of recurrence at 3 years) of 98.4% compared to 83.6% for imiquimod. Nevertheless, the 83.6% success rate is still potentially useful, so we wanted to see whether these 3 year results were sustained. So we followed up your study participants for a total of 5 years and found that the response rates at 5 years were almost the same as those at 3 years (97.7% and 82.5% for surgery and imiquimod respectively).

Most treatment failures with imiquimod occurred early on ie in the first year of treatment. Our study shows that if initial treatment works, the benefits are sustained.

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Patients and Partners Not Embarrassed To Do Skin Cancer Examinations On Each Other

MedicalResearch.com Interview with:

June K. Robinson, MD Research Professor of Dermatology Northwestern University Feinberg School of Medicine Department of Dermatology Chicago, IL 60611

Dr. June Robinson

June K. Robinson, MD
Research Professor of Dermatology
Northwestern University Feinberg School of Medicine
Department of Dermatology
Chicago, IL 60611

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This is a secondary finding from a randomized controlled trial of a structured skills training program for melanoma patients and their skin check partners.

The pairs learned and performed skin self-examination for the early detection of melanoma. They continued to perform skin checks for 2 years and trained pairs identified more early melanoma (melanoma in situ and Stage 1A melanoma) than controls.

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Teledermatology Can Triage Many Post-Operative Skin Surgery Concerns

MedicalResearch.com Interview with:

Rajiv Nijhawan MD Department of Dermatology The University of Texas Southwestern Medical Center Dallas

Dr. Rajiv Nijhawan

Rajiv Nijhawan MD
Department of Dermatology
The University of Texas Southwestern Medical Center
Dallas

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: From a healthcare perspective, we are constantly working to improve access to patients, and telemedicine has proved to be an excellent platform for this goal especially in the field of dermatology. In regards to surgical dermatology, the role of telemedicine has been limited. The ubiquity of smartphones with photograph capability has provided an opportunity for patients to take self-acquired photographs (selfies) easily. Our experience has been that few patients who call with post-operative concerns have major issues (e.g. infection, bleeding, etc.) while the majority of concerns are minor in nature, and patients are often seeking reassurance.

Our study shows that the majority of concerns can easily be triaged and managed through patient-directed photography without burdening the patient to take time off work for another appointment, find transportation/travel (many of our patients travel hours for their visits), wait to see the provider, etc. This option of triaging a post-operative concern essentially immediately through the use of patient-directed photographs provides the opportunity for immediate feedback on the patient’s concerns and likely reduces anxiety while making the process as patient-centered as possible. In addition, it allows the physician to be as efficient as possible by not having to overbook his/her schedule to accommodate these often non-urgent concerns.

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Squamous Cell Carcinoma of Lip Predominantly Affects White Men in Their Mid-60s

MedicalResearch.com Interview with:

Albert Yoon-Kyu Han, PhD Class of 2017 Medical Scientist Training Program David Geffen School of Medicine at UCLA

Dr. Albert Han

Albert Yoon-Kyu Han, PhD
Class of 2017
Medical Scientist Training Program
David Geffen School of Medicine at UCLA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Squamous cell carcinoma (SCC) of the lip makes up a large portion of oral cancers (25%). Most of the demographic and prognostic indicators for lip SCC are only available through retrospective case series. Thus, we used the national cancer database (Surveillance, Epidemiology, and End Results, or SEER) to examine the incidence, treatment, and survival of patients with lip SCC.

The main findings of this study were that lip Squamous cell carcinoma predominantly affects white men in their mid-60s. We also found that the determinants of survival for lip SCC include age at diagnosis, primary site, T stage, and N stage. More specifically, on the primary site, SCC of the upper and lower lip had similar survival, whereas SCC of the oral commissure was associated with decreased survival.

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99% of Dermatologists Recommend Sunscreen Use to Their Family and Friends

MedicalResearch.com Interview with:
Aaron S. Farberg, MD

Department of Dermatology
Icahn School of Medicine at Mount Sinai

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Regular sunscreen use is a critical component of sun protection and has been shown to reduce skin cancer risk. However, there have often been conflicting sunscreen messages (sometimes without scientific support) that have led to confusion by the public. Controversy has also emerged surrounding the safety and possibility of adverse effects from various sunscreen ingredients. The purpose of this study was to determine US dermatologists’ actual sunscreen perceptions, potential safety concerns as well as their recommendations and personal usage.

Our study found that dermatologists have an overall positive view of sunscreen. 97% of dermatologists agree that regular sunscreen use helps lower skin cancer risk, 100% agree that it reduces subsequent photoaging, and 99% recommend their family/friends use sunscreen. Nearly all (96%) consider FDA approved sunscreens currently available in the US to be safe and (99%) believe their patients generally under-apply sunscreen.

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Specialized Surveillance Clinic For Patients At High Risk of Melanoma Reduced Procedures and Costs

MedicalResearch.com Interview with:

Caroline Watts| Research Fellow

Dr. Caroline Watts

Caroline Watts| Research Fellow
Cancer Epidemiology and Prevention Research
Sydney School of Public Health
The University of Sydney 

MedicalResearch.com: What is the background for this study?

Response: A clinic for people at high risk of melanoma was established at the Royal Prince Alfred Hospital, Sydney in 2006 as part of a research project to look at the impact of surveillance regime which included regular full body skin examination supported by dermoscopy and total body photography at 6 monthly intervals. If a suspicious lesion was identified, the lesion was either removed or an image of the lesion was captured using digital dermoscopy and the patient returned in 3 months for review.

This study aimed to estimate the costs and benefits from a health system perspective associated with specialised surveillance compared with current routine care high risk people would receive in the community.  Continue reading

Not Enough Evidence To Determine If Skin Cancer Screening Saves Lives

MedicalResearch.com Interview with:

Dr. Michael Pignone MD MPH Task Force member Professor of medicine and Inaugural Chair Department of Internal Medicine at the Dell Medical School The University of Texas at Austin. Editor’s note: Dr. Pignone discusses the recent US Preventive Services Task Force Recommendation Statement on the effectiveness of screening for skin cancer with a clinical visual skin examination

Dr. Michael Pignone

Dr. Michael Pignone MD MPH
Task Force member
Professor of medicine and Inaugural Chair
Department of Internal Medicine
Dell Medical School
The University of Texas at Austin.
Editor’s note: Dr. Pignone discusses the recent US Preventive Services Task Force Recommendation Statement on the effectiveness of screening for skin cancer with a clinical visual skin examination

MedicalResearch.com: What is the background for this recommendation?
How Does the USPSTF Grade Preventive Services?

Response: The Task Force’s primary concern is the health of Americans, and all of our recommendations are based on an assessment of the evidence of both the benefits and harms of a particular preventive service. For this recommendation statement, we looked at all available evidence on a visual skin exam, including studies of exams conducted by both primary care clinicians and dermatologists, to see how effective this exam was at preventing death from skin cancer. Unfortunately, there is not enough evidence to know with certainty whether or not a visual skin exam leads to a reduction in death from skin cancer, which resulted in the Task Force issuing an I statement. The Task Force encourages more research that could provide future evidence on the effectiveness of visual screening to prevent death from skin cancer.

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OCT Technology Improves Diagnosis of Skin Cancer

MedicalResearch.com Interview with:

Orit Markowitz, MD Director of Pigmented Lesions and Skin Cancer The Mount Sinai Hospital and Assistant Professor of Dermatology Icahn School of Medicine at Mount Sinai Director of Pigmented lesions clinic Brooklyn VA, Brooklyn, NY Adjunct Professor, Dermatology SUNY Downstate Medical Center, Brooklyn, NY Chief of Dermatology Queens General Hospital, Jamaica, NY

Dr. Orit Markowitz

Orit Markowitz, MD
Director of Pigmented Lesions and Skin Cancer
The Mount Sinai Hospital and
Assistant Professor of Dermatology
Icahn School of Medicine at Mount Sinai
Director of Pigmented lesions clinic
Brooklyn VA,
Adjunct Professor, Dermatology
SUNY Downstate Medical Center, Brooklyn, NY
Chief of Dermatology
Queens General Hospital, Jamaica, NY

MedicalResearch.com Editors’ Note: As part of an ongoing series of occasional article on cancer prevention, Dr. Markowitz from The Mount Sinai Hospital discusses skin cancer and the use Optical Coherence Tomography in skin cancer diagnosis and treatment.

MedicalResearch.com: How common is the problem of non-melanoma skin cancer? Are they difficult to detect and treat?

Dr. Markowitz: Skin cancer is the most commonly diagnosed cancer in the United States. Non melanoma skin cancers, including basal cell carcinomas and squamous cell carcinomas, are the most common malignancies of the skin, constituting around 80 percent of all skin cancers. The annual cost of treating skin cancers in the U.S. is estimated at $8.1 billion, with $3.3 billion for melanoma.

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NYU Dermatologist Discusses Skin Cancer Diagnosis and Treatment

MedicalResearch.com Interview with:

MedicalResearch.com Interview with: Melissa A. Wilson, MD, PhD Assistant professor of Medical Oncology NYU Langone Perlmutter Cancer Center

Dr. Melissa Wilson

Melissa A. Wilson, MD, PhD
Assistant professor of Medical Oncology
NYU Langone Perlmutter Cancer Center

MedicalResearch.com: What are the most common types of skin cancer?

Dr. Wilson: Basal cell carcinoma, squamous cell carcinoma and melanoma. With rare exception, all are related to sun exposure.

MedicalResearch.com: Are some types of skin cancer more serious than others?

Dr. Wilson: Melanoma is the most serious form of skin cancer, with the highest risk of developing into metastatic disease. Most basal cell and squamous cell carcinomas are superficial and not as invasive, so removal is the treatment. Rarely, these can cause invasive and metastatic disease, but this occurs infrequently. Melanoma is much more serious. Of course, the earlier melanoma is detected and the earlier stage that it is, is more predictive of a favorable outcome.

MedicalResearch.com: Who is most prone to skin cancer?

Dr. Wilson: Persons with excessive sun exposure, fair skin, light hair and blue eyes – although it can certainly occur in anyone.

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Mount Sinai Dermatologist Discusses Surgery for Skin Cancer

MedicalResearch.com Interview with:

Desiree Ratner, MD Director, Comprehensive Skin Cancer Program, Mount Sinai Beth Israel and Professor of Dermatology Icahn School of Medicine at Mount Sinai

Dr. Desiree Ratner

Desiree Ratner, MD
Director, Comprehensive Skin Cancer Program,
Mount Sinai Beth Israel and Professor of Dermatology
Icahn School of Medicine at Mount Sinai

MedicalResearch.com: How big is the problem of skin cancer in the US? 

Dr. Ratner: Skin cancer is an enormous problem in the United States and the numbers are increasing every year.  There are over 2 million cases of basal cell carcinoma per year, over 700,000 cases of squamous cell carcinoma per year, and over 140,000 cases of melanoma per year in the U.S. alone.

MedicalResearch.com: What type of patients do you evaluate and treat?

Dr. Ratner: My practice is limited to skin cancer, so most of my patients are referred to me by general dermatologists for surgery.  I see patients who require Mohs surgery for non-melanoma skin cancers, excisions for non-melanoma skin cancers, and other surgical procedures for a variety of other benign and malignant lesions.

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Polyomaviruses May Raise Risk of Skin Cancer In Patients of Risk of Squamous Cell Carcinoma

MedicalResearch.com Interview with:
Anala Gossai BSc, MPH PhD candidate
Department of Epidemiology
Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
and co-authors

MedicalResearch.com: What is the background for this study? What are the main findings?

Gossai et al: Polyomaviruses (PyV) are potentially tumorigenic viruses in humans. However, limited data exists on the population seroprevalence or longitudinal serostability of PyVs, and individual characteristics that relate to seropositivity. Further, PyVs may be associated with the occurrence of cutaneous squamous cell carcinoma (SCC) – one of the most common malignancies in humans with increasing incidence reported in the US.

In a US nested case-control study, BK and JC seroreactivity was measured on 113 SCC cases and 229 matched controls who had a prior keratinocyte cancer. Repeated serum samples from controls, and both pre- and post-diagnosis samples from a subset ofsquamous cell carcinoma cases, were also assayed. Antibody response against each PyV type was measured using multiplex serology of recombinantly expressed VP1 capsid proteins. Among controls, BK and JC seroreactivity was stable over time, and there was little evidence of seroconversion following SCC diagnosis among cases. Odds of squamous cell carcinoma  associated with seropositivity to each PyV type were estimated using conditional logistic regression. JC seropositivity prior to diagnosis was associated with an elevated risk of SCC (OR=2.5, 95% CI: 1.2-5.2). 
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Biomarker Expression Linked to Aggressive Basal Cell Skin Cancer

MedicalResearch.com Interview with:

Alon Kahana, MD, PhD Associate Professor Kellogg Eye Center University of Michigan

Dr. Alon Kahana

Alon Kahana, MD, PhD
Associate Professor
Kellogg Eye Center
University of Michigan

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Kahana:
Basal cell carcinoma is the most common cancer – more common than all other cancers combined. Fortunately, it is usually not aggressive, and can be easily treated surgically. However, when it is on the face, or when it has grown to a large size, it can become very disfiguring and even deadly. Basal cell carcinoma is diagnosed histopathologically, yet molecular diagnostics have proven value in a variety of cancers. In order to improve diagnosis and care, we set out to test whether histologically aggressive forms of basal cell carcinoma are associated with increased cell proliferation.

Furthermore, we tested whether expression of the epigenetic regulator Ezh2 is associated with higher-grade carcinoma and/or with increased proliferation. The breakthrough discovery is that expression of Ezh2 correlates with high proliferation and with aggressive histologic features, suggesting that epigenetic regulators can be used both as markers of disease severity and targets of novel therapy. Continue reading

Transplantation Patients With Skin Cancer: Fewer New Tumors With Sirolimus

More on Dermatology from MedicalResearch.com 

Pritesh S. Karia, MPH Manager-Dermatologic Oncology Research Program Mohs and Dermatologic Surgery Center Brigham and Women's Hospital Boston, MA 02130

Pritesh Karia

MedicalResearch.com Interview with:
Pritesh S. Karia, MPH
Manager-Dermatologic Oncology Research Program
Mohs and Dermatologic Surgery Center
Brigham and Women’s Hospital
Boston, MA 02130 

Medical Research: What is the background for this study?

Response: Several recent studies have shown a reduced incidence of skin cancer in organ transplant recipients (OTR) treated with sirolimus as first-time therapy and those converted from calcineurin inhibitors to sirolimus. Although cancer formation is one of the main reasons for conversion to sirolimus, studies examining the effect of sirolimus on the risk of subsequent cancer formation in organ transplant recipients who have already been diagnosed with a post-transplant cancer are limited.
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Brachytherapy Offers Alternative Treatment of Difficult Non Melanoma Skin Cancer

Radiation Oncologist Redical director of 21st Century Oncology of Arizona

Dr. Ajay Bhatnagar

MedicalResearch.com Interview with
Dr. Ajay Bhatnagar MD
Radiation Oncologist
Medical director of 21st Century Oncology of Arizona

MedicalResearch.com: What is the background for this report? What are the main findings?

Dr. Bhatnagar: I recently presented updated data regarding my research at the American Society for Radiation Oncology (ASTRO) annual meeting in a poster titled “Electronic brachytherapy for the treatment of Non-Melanoma Skin Cancer: Results up to 5 years.”

For this clinical study, I have been using the Xoft® Axxent® Electronic Brachytherapy (eBx®) System® which is FDA cleared, CE marked and licensed in Canada for the treatment of cancer anywhere in the body, including early-stage breast cancer, gynecological cancers, and nonmelanoma skin cancer (NMSC) including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).

For the treatment of nonmelanoma skin cancer, the Xoft System uses a proprietary, miniaturized x-ray source to deliver a precise dose of targeted radiation directly to the surface lesion. This treatment uses electronic brachytherapy (eBx) to target cancerous cells while sparing healthy tissue. It is painless, non-invasive and offers a number of patient benefits, including fewer treatments than traditional radiation therapy.

According to my findings, the Xoft System is safe and effective for the treatment of nonmelanoma skin cancer, with low rates of recurrence and excellent clinical outcomes.

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Menopausal Hormone Therapy May Raise Risk Of Basal Cell Carcinoma

MedicalResearch.com Interview with:
Elizabeth K. Cahoon, PhD
Radiation Epidemiology Branch
Division of Cancer Epidemiology and Genetics, National Cancer Institute
National Institutes of Health
Department of Health and Human Services
Bethesda, MD

Medical Research: What is the background for this study? What are the main findings?

Dr. Cahoon: Although basal cell carcinoma (BCC) is the most common cancer in the United States, there is relatively little research on risk factors since few population-based cancer registries do not capture information on this malignancy.

Sun exposure (in particular ultraviolet radiation) is the primary risk factor for basal cell carcinoma, but less is known about other factors that may affect this risk. A previous study found a relationship between menopausal hormone therapy (MHT) use and increased risk of BCC in a population of Danish women.

In our study we looked to see if factors related to estrogen exposure from multiple sources was associated with basal cell carcinoma risk in a large, nationwide, prospective study. These included use of oral contraceptives or menopausal hormone therapy, but also reproductive factors (like age at menarche and menopause).

We observed that women who experienced natural menopause later in life were more likely to develop basal cell carcinoma compared to women who had natural menopause at a younger age.

In addition, women who reported using menopausal hormone therapy for one year or longer were more likely to develop basal cell carcinoma compared to women who did not report MHT use.

Women who reported natural menopause and menopausal hormone therapy use for 10 or more years had the highest risk of basal cell carcinoma, compared to women with no menopausal hormone therapy use.
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Alcohol Linked To Increased Basal Cell Carcinoma Skin Cancer Risk

Shaowei Wu, MD, PhD Department of Dermatology, Warren Alpert Medical School Brown University, Providence, Rhode Island Department of Dermatology Brigham and Women’s Hospital and Harvard Medical School Boston, Massachusetts

Dr. Shaowei Wu

MedicalResearch.com Interview with:
Shaowei WuMDPhD
Department of Dermatology, Warren Alpert Medical School
Brown University, Providence, Rhode Island
Department of Dermatology
Brigham and Women’s Hospital and Harvard Medical School
Boston, Massachusetts

Medical Research: What is the background for this study? What are the main findings?

Response: Basal cell carcinoma (BCC) of the skin is the most prevalent cancer in the US, and is responsible for substantial morbidity and billions of dollars of health care expenditures. Knowledge on the modifiable risk factors of BCC is required for targeted prevention of cancer incidence. Alcohol consumption is a well-known risk factor for human cancer and has been linked to a number of cancers, including breast, prostate, pancreatic, and colon cancers. Interestingly, a large epidemiological study has reported a positive association between alcohol consumption and increased prevalence of severe sunburn, an established skin cancer risk factor. It is hypothesized that metabolites of alcohol (e.g., acetaldehyde) can serve as photosensitizers and promote skin carcinogenicity in the presence of UV radiation. However, epidemiological evidence for the association between alcohol consumption and BCC risk has been limited and a few previous studies on this topic have yielded conflicting results. Therefore we conducted a comprehensive prospective study to investigate this question using data from three large cohorts including the Nurses’ Health Study (1984-2010), Nurses’ Health Study II (1989-2011), and Health Professionals Follow-up Study (1986-2010).

We documented a total of 28,951 incident Basal cell carcinoma cases over the study follow-up. We found that increasing alcohol intake was associated with an increased Basal cell carcinoma risk in both women and men. In the combined analysis with all 3 cohorts, those who consumed 30 grams or more alcohol per day had a 22% higher risk of developing BCC when compared to nondrinkers. This increased risk was consistent in people with different levels of sun exposure. We also found that BCC risk was associated with alcohol intake levels more than a decade ago, suggesting that alcohol may have a lagged effect that can persist for a long-term period. Among the individual alcoholic beverages, white wine and liquor were positively associated with Basal cell carcinoma risk whereas red wine and beer were not associated with BCC risk. This difference may be due to some other chemicals accompanying alcohol in the specific beverages. For example, red wine contains higher amounts of phenolic compounds compared to white wine, and these compounds have antioxidant activities which may be beneficial for counteracting the potential carcinogenic properties of alcohol and its metabolites.

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Can NSAIDs Prevent Some Basal Cell Skin Cancers?

Nirmala Pandeya, PhD Post Doctoral Research Fellow Faculty of Medicine and Biomedical Sciences, School of Public Health Herston campus The University of QueenslandMedicalResearch.com Interview with:
Nirmala Pandeya, PhD

Post Doctoral Research Fellow
Faculty of Medicine and Biomedical Sciences, School of Public Health
Herston campus The University of Queensland

Medical Research: What is the background for this study?

Dr. Pandeya: Basal cell carcinoma (BCC) is the most common cancer. Although BCC is curable and has low mortality, its high occurrence in the population causes significant healthcare and financial burdens to the community. Hence exploring preventive strategies for this cancer is important in reducing the burden. To date few chemopreventives for BCC have been identified.

In many cancer cells, inflammatory biomarkers such as cyclooxygenase-2 (COX-2) and its product prostaglandin E2 are increased and basal cell carcinoma is no exception. Anti-inflammatory drugs, suppressing COX-2 activity, have been shown to reduce the risk of various cancers including squamous cell carcinoma of the skin, so they also have a potential to prevent BCC. But to date research evidence on the benefit of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) on basal cell carcinoma has been inconsistent. So we reviewed and synthesized all published epidemiological studies on NSAIDs and BCC to combine results and estimate the overall pooled effect.

Medical Research: What are the main findings?

Dr. Pandeya: After thorough evaluation, we identified eleven studies that were relevant and pooling showed a 10% reduction in risk of BCC among those using any kind of NSAIDs. Aspirin and non-aspirin NSAIDs analysed separately suggested a reduced risk of basal cell carcinoma, but were not statistically significant likely due to lack of power. Our research found strongest risk reduction of BCC by the use of NSAIDs among those with either a history of skin cancers or high prevalence of actinic keratosis.

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Sun Sensitive, Skin Cancer Prone Patients Responsive To Prevention Messages

Catherine M. Olsen, PhD Population Health Department QIMR Berghofer Medical Research Institute Queensland, Australia

MedicalResearch.com Interview with:
Catherine M. Olsen, PhD

Population Health Department
QIMR Berghofer Medical Research Institute
Queensland, Australia

MedicalResearch: What is the background for this study?

Dr. Olsen: Effective skin cancer control requires two strategies: regular sun protection to prevent new cancers from occurring and early detection assisted by periodic skin examinations. The aim of our study was to describe the prevalence and predictive factors for sun protection and skin examination practices of adults in Queensland, Australia, a region that experiences the highest rates of skin cancer in the world. We were particularly interested in whether sun protection and skin examination practices differed between those with and without a previously confirmed melanoma and/or treatment for other skin lesions.

MedicalResearch: What are the main findings?

Dr. Olsen: The prevalence of both sun protection and skin examination practices was generally high in this large cohort of people who experience high levels of ambient sun exposure.

People who had been diagnosed with a melanoma or other skin lesion were more likely than those without to report sun protection practices including regular use of sunscreen and wearing hats.

The strongest predictor of sun protection practices was having a sun-sensitive skin type, and the strongest predictor of skin examination practices was having many moles and/or a family history of melanoma.
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Sunsmart Mass Media Campaign Encourages Sun Protection

MedicalResearch.com Interview with: Suzanne Dobbinson PhD Senior Research Fellow Centre for Behavioural Research in Cancer Cancer Council Victoria  Melbourne AustraliaMedicalResearch.com Interview with:
Suzanne Dobbinson PhD

Senior Research Fellow
Centre for Behavioural Research in Cancer
Cancer Council Victoria  Melbourne Australia

MedicalResearch: What is the background for this study? What are the main findings?

Dr. Dobbinson: Australia has one of the highest skin cancer rates in the world due to the country’s high levels of ultraviolet (UV) radiation and a population with susceptible skin types. Two in three Australians will be diagnosed with skin cancer by the age of 70, with more than 40,000 new cases annually in the state of Victoria alone.

Since the 1980s there have been broad public education programs to raise awareness of skin cancer. Television campaigns have been central to these multi-component prevention programs, including SunSmart, which is the longest-running program in Victoria.

This study examined SunSmart television advertisements broadcast over summers between 1987 to 2011 to determine what effect – if any – these advertisements had on people’s sun protection attitudes and behaviours.

Cross-sectional weekly telephone surveys of Melbourne residents were conducted over summers during the study period. Population exposure to campaign TV advertisements was also measured as cumulated weekly target audience rating points (TARPs) for 4 weeks prior to interview. Using multiple logistic and linear regression models, we examined whether there was a relationship between the TARPs and responses of the surveys.

We found that increasing TARPs were related to an increased preference for no tan, increased sunscreen use and overall reduced mean percentage of skin exposed to the sun. Also of note was that this behavioural impact was consistent across all age groups.

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More Asians and Hispanics Developing Non-Melanoma Skin Cancer

MedicalResearch.com Interview with:
Arisa Ortiz, MD, FAAD Assistant Clinical Professor
Director, Laser and Cosmetic Dermatology
Senior author: Brian Jiang, MD and
First author Tiffany Loh, BS
Department of Dermatology UC San Diego

Medical Research: What is the background for this study? What are the main findings?

Response: Non-melanoma skin cancers (NMSCs) are the most common type of malignancy in the United States, affecting an estimated 3.5 million people each year. Previous perception has remained that skin cancer risk in Hispanics and Asians is lower than that of Caucasians. However, despite historically lower rates of skin cancer, in recent years, the incidence of skin cancer in these groups has reportedly been increasing in the United States. As Hispanics and Asians constitute two of the most rapidly expanding ethnic groups in the US, the rise in NMSCs in these populations is particularly concerning.

The finding from our study were as follows: Hispanic patients were significantly younger than Caucasians and Asians (p=0.003, 0.023 respectively). The majority of Non-melanoma skin cancers in Caucasians occurred in men, while this gender ratio was reversed for both Hispanics and Asians. There were significantly more cases of Non-melanoma skin cancers occurring in the “central face” area in Hispanics. Race was not a significant predictor for specific NMSC type (BCC or SCC).

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Chinese Licorice May Enhance Skin Protection From Sun Exposure

MedicalResearch.com interview with:
J. Kühnl, D. Roggenkamp, G. Neufang
.
Research & Development, Beiersdorf AG, Hamburg

MedicalResearch:What is the background for this study? What are the main findings?

Response: The skin is constantly challenged by environmental stressors that induce inflammatory processes, resulting in skin damage and –in the long term- consequently aging processes. UV-irradiation is an important exogeneous stressor. Even the best filter systems do not completely abolish the impact of UV radiation. For example, after application of a SPF50+ sun lotion, about 2% of UV-rays still reach the skin. However, the skin developed strategies to cope with exogenous stressors: Intracellular thiols quench harmful UV-derived free radicals and a multitude of detoxifying enzymes convert noxious compounds and metabolites into harmless species.

We strived to specifically stimulate these cytoprotective cellular systems in order to tip the balance in favor of more robust skin cells.

Previous studies showed that the root extract of the plant Glycyrrhiza inflata (Chinese Licorice) exhibits anti-inflammatory and anti-microbial effects. The major phenolic constituent of the licorice extract is Licochalcone A (LicA) and this compound is largely responsible for the beneficial effects. This was explained by LicA´s inhibitory effect on the pro-inflammatory transcription factor NFkB and its antioxidant properties.

However, in this study, we could add another facet of LicA´s efficacy: by activating the transcription factor Nrf2, LicA stimulates the expression of cytoprotective enzymes such as heme oxygenase I and the key enzyme of glutathione synthesis, resulting in increased intracellular thiols concentrations. Consequently, when pre-incubated with LicA, isolated human skin cells were more robust against solar simulated light-induced cellular damage, indicated by a significantly decrease in the generation of free radicals in vitro. In a translational approach, we conducted a study with healthy volunteers demonstrating that the application of a lotion containing LicA-rich root extract on the inner forearms for two weeks protected the skin from UV-provoked oxidative stress.

Thus the cellular effects of licorice are able to provide a protective shield from sun exposure, supporting and going beyond the action of sunscreens regarding sun protection. Continue reading

Skin Damaged by Sunlight Even When Out of the Sun

Douglas E. Brash, PhD Professor of Therapeutic Radiology and Dermatology Yale School of Medicine New Haven, CTMedicalResearch.com Interview with:
Douglas E. Brash, PhD

Professor of Therapeutic Radiology and Dermatology
Yale School of Medicine New Haven, CT

MedicalResearch: What is the background for this study? What are the main findings?

Dr. Brash: We wanted to know whether the origin of melanoma differed from other cancers because of the melanin. It has long been known that blondes and redheads are sensitive to sunlight, but the prevailing view was that this was because their skin is light. But there are light-skinned, dark-haired people in countries near the equator and they don’t have the high skin cancer incidence seen in Australia. Several labs, including ours, had irradiated cells or mice with UV and found more cell death in cells containing melanin than cells lacking melanin. In the last couple of years, two papers have focused attention on the issue; one study found that irradiating mice with UVA only gave melanomas if the skin contained melanin and the other study found that mice genetically predisposed to UV-induced melanoma developed melanomas even without UV if they also had red melanin.

The most important findings are:

First, our skin continues to be damaged by sunlight even when we’re out of the sun.

Second, the melanin pigment in your skin is bad for you as well as good: it may be carcinogenic as well as protective.

Third, the chemistry underlying these events, chemical excitation of electrons, has not been seen in mammals before. Continue reading

Study Examines Malpractice Risk Of Mohs Surgery For Skin Cancer

Omar A. Ibrahimi, M.D., Ph.D Connecticut Skin Institute Founding Medical Director Stamford, CT 06905MedicalResearch.com Interview with:
Omar A. Ibrahimi, M.D., Ph.D

Connecticut Skin Institute
Founding Medical Director
Stamford, CT 06905
www.ctskindoc.com

Medical Research: What is the background for this study? What are the main findings?

Dr. Ibrahimi: The delivery of healthcare in a efficient and cost effective fashion is one of the largest themes in medicine today. Malpractice lawsuits have steadily increased with the cost of healthcare delivery. Mohs surgery involves the surgical removal, the tissue analysis and the reconstruction of a skin cancer all in a single visit that bundles multiple procedures in a cost effective manner that is proposed to be the gold standard for treating certain skin cancers.

Information regarding malpractice involving Mohs surgery is lacking. The only previous study that has been done was a survey of Mohs surgeons looking at how many had been involved in lawsuits and the reasons for being involved. Our study examined a legal database to identify all the lawsuits involving Mohs surgery and skin cancer. We were surprised to find that the majority of lawsuits involved non-Mohs surgeons as the primary defendant, mostly due to a delay of or failure in diagnosis, cosmetic outcome issues, lack of informed consent, and a delay of or failure in referral to a Mohs surgeon.
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Twist1 Necessary For Squamous Cell Tumor Formation and Progression

MedicalResearch.com Interview with :
Cédric Blanpain, MD, PhD

Professor of Stem Cell and Developmental Biology
WELBIO, Interdisciplinary Research Institute (IRIBHM)
Université Libre de Bruxelles
Belgium

MedicalResearch.com : What is the background for this study? What are the main findings?

Dr. Blanpain: Squamous cell carcinoma (SCC) represents the second most frequent skin cancer with more than half million new patients affected every year in the world. Cancer stem cells (CSCs) are a population of cancer cells that have been described in many different cancers including skin SCCs and that feed tumor growth. These cells could be resistant to therapy thus being responsible for tumor relapse after therapy. However, still very little is known about the mechanisms that regulate Cancer stem cells functions.

In a new study published and making the cover of Cell Stem Cell, researchers led by Pr. Cédric Blanpain, MD/PhD, professor and WELBIO investigator at the IRIBHM, Université libre de Bruxelles, Belgium, report the mechanisms regulating the different functions of Twist1 controlling skin tumour initiation, cancer stem cell function and tumor progression.

Benjamin Beck and colleagues used state of the art genetic mouse models to dissect, the functional role and molecular mechanisms by which Twist1 controls tumor initiation, cancer stem cell function and tumor progression. In collaboration with Dr Sandrine Rorive and Pr Isabelle Salmon from the department of Pathology at the Erasme Hospital, ULB and the group of Jean-Christophe Marine (VIB, KUL Leuven), they demonstrated that while Twist1 is not expressed in the normal skin, Twist1 deletion prevents skin cancer formation demonstrating the essential role of Twist1 during tumorigenesis.

The authors demonstrate that different levels of Twist1 are necessary for tumor initiation and progression. Low level of Twist1 is required for the initiation of benign tumors, while higher level of Twist1 is necessary for tumor progression. They also demonstrate that Twist1 is essential for tumor maintenance and the regulation of cancer stem cell function. The researchers also uncovered that the different functions of Twist1 are regulated by different molecular mechanisms, and identified a p53 independent role of Twist1 in regulating cancer stem cell functions. Continue reading

NSAIDS May Prevent Some Squamous Cell Skin Cancers

Dr Catherine Olsen  |  Senior Research Officer QIMR Berghofer Medical Research Institute Royal Brisbane Hospital, QLD 4029MedicalResearch.com Interview with:
Dr Catherine Olsen  |  Senior Research Officer
QIMR Berghofer Medical Research Institute
Royal Brisbane Hospital, QLD 4029

Medical Research: What is the background for this study? What are the main findings?

Response: Squamous cell carcinomas (SCCs)are the second most common skin cancer occurring in white skinned populations. They cause significant morbidity as they can invade local structures (often the nose or ears) and they also have the potential to metastasize although most are successfully treated before any spread occurs. They are also very expensive cancers to treat because they are so common, posing a significant burden on health care budgets. NSAIDS have been shown to be protective for other cancers (e.g. colorectal and oesophageal cancer). This prompted use to evaluate all of the available evidence on NSAIDs use and SCC by conducting a systematic review and meta-analysis of the association.
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Pilots and Cabin Crew Fly With Greater Risk of Melanoma

Martina Sanlorenzo, MD Department of Dermatology Mount Zion Cancer Research Center University of California, San FranciscoMedicalResearch.com Interview with:
Martina Sanlorenzo, MD
Department of Dermatology
Mount Zion Cancer Research Center
University of California, San Francisco


Medical Research: What is the background for this study?

Dr. Sanlorenzo: We recently performed a meta-analysis and found an increased risk of melanoma in pilots and cabin crew. One of the possible occupational hazards responsible for this risk is UV radiation.

Medical Research: What are the main findings?

Dr. Sanlorenzo: We performed UV measurements in airplane cockpits during flight and we found that windshields blocked UV-B but allowed UV-A transmission. We compared the UV-A dose in airplanes with the UV-A dose in tanning beds, whose use is a known risk factor for melanoma. Pilots flying for 56.6 minutes at 30,000 feet received the same amount of UV-A carcinogenic effective radiation of a 20-minute tanning beds session.
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Skin Cancer Lesions Not Affected By Agent Orange Exposure

MedicalResearch.com Interview with:
Naveed Nosrati MD

Indiana University School of Medicine
Staff Surgeon, Roudebush VAMC

Medical Research: What is the background for this study?

Dr. Nosrati: We originally began this study as a broader project investigating the effect of trauma induced by biopsies on the spontaneous clearance of a non-melanoma skin cancer. As part of that, we created a large database with many patient variables. Since we undertook this project at our local VA hospital, one of the variables available to us was Agent Orange exposure.

Shortly after completing the study, Clemens et al published their study linking Agent Orange exposure to higher rates of invasive non-melanoma skin cancer. Their study was a pilot study of only 100 patients. As we had well over 1,000 patients, we decided to pursue a side project of how Agent Orange specifically affects our results.

Our study was operating under the hypothesis that trauma induced by biopsies led to an inflammatory response that often led to the immunologic clearance of the remaining skin cancer. We actually coined the term “SCORCH” lesion, or spontaneous clearance of residual carcinoma histologically, for this phenomenon. With that mind, we would expect patients exposed to Agent Orange to theoretically have a more invasive form of malignancy and thus have lower rates of spontaneous clearance.
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US Skin Cancer Costs Top $8 Billion Annually

Gery P. Guy Jr., PhD, MPH, Health economist CDC: Division of Cancer Prevention and Control’s Epidemiology and Applied Research Branch.Medical Research.com Interview with:
Gery P. Guy Jr., PhD, MPH, Health economist
CDC: Division of Cancer Prevention and Control’s Epidemiology and Applied Research Branch.

Medical Research: What is the background for this study?

Dr. Guy: Skin cancer is the most commonly diagnosed cancer in the United States and is a growing public health problem. Melanoma, the deadliest form of skin cancer, is responsible for more than 12,000 deaths each year and is diagnosed in over 70,000 people per year. The number of skin cancer cases continues to increase every year, however little is known about the economic burden of treatment. The purpose of our study was to examine trends in the number of people treated for skin cancer and the cost of treatment.

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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.
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Photodynamic Therapy Removed More Actinic Keratoses Than Cryotherapy

MedicalResearch.com Interview with: Gayatri Patel, MD, MPH Division of General Medicine UC Davis Medical CenterMedicalResearch.com Interview with:
Gayatri Patel, MD, MPH
Division of General Medicine
UC Davis Medical Center

Medical Research: What are the main findings of the study?

Dr. Patel: In this systematic review and meta-analysis, we sought to determine the effectiveness of photodynamic therapy (PDT) for the treatment of actinic keratoses relative to other common treatments. We included only randomized controlled trials and preformed a meta-analysis on homogenous studies. The primary finding of the study was that PDT has a better chance of removing actinic keratoses on the face or scalp than treatment with cryotherapy.
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How Closely Is Melanoma Survival Linked To Sun Exposure?

Marianne Berwick, PhD, MPH for the GEM Study Team Professor, Division of Epidemiology University of New Mexico, Department of Internal Medicine New Mexico Cancer Research Facility University of New Mexico, Albuquerque, NM 87131MedicalResearch.com Interview with:
Marianne Berwick, PhD, MPH for the GEM Study Team
Professor, Division of Epidemiology
University of New Mexico, Department of Internal Medicine
New Mexico Cancer Research Facility
University of New Mexico, Albuquerque, NM 87131

Medical Research: What are the main findings of this study?

Dr. Berwick: In our study of Sun Exposure and Melanoma Survival: A GEM Study we found that there is little strong evidence that sun exposure at any time in life influences melanoma-specific survival. This study took place in Australia, Italy, Canada and the United States among 3,578 individuals newly diagnosed with melanoma, who we followed for a mean of 7.4 years.

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Do Dermatologists Find Thinner Melanomas?

MedicalResearch.com Interview with:
Estee L. Williams, MD
SUNY Downstate Medical Center, Brooklyn, New York
Madfes Integrated Dermatology, New York, New York
williams.estee@gmail.com

Medical Research: What are the main findings of the study?

Dr. Williams: In our retrospective review of all melanomas diagnosed at the Veterans’ Affairs Hospital in Brooklyn since 2000, we discovered that although a majority of the melanomas (63%) were found by the dermatologist during a yearly “full body” screening examination (versus detection by the patient), melanomas found by the dermatologist were not necessarily thinner (hence, earlier, more curable) than those found by the patient.
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