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Query: UMLS:C0025202 (melanoma)
 69,561 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The proportion of subjects recovering from skin erythema induced by a single ultraviolet radiation challenge of 6 times the minimal erythema dose during a 3-week period was lower in 47 patients with stage I cutaneous melanoma than in 48 healthy control subjects with similar risk factors of increased sensitivity to ultraviolet radiation (p = 0.045). This difference indicates that the patients with melanoma were more susceptible to prolonged ultraviolet radiation-induced skin damage than the control subjects. Prolonged erythema response was significantly associated in the melanoma group with decreased minimal erythema doses (odds ratio [OR] = 11.3) and with the presence of freckles (OR = 5.5), and was associated in the control group with light eye color (OR = 5.8). Prolonged ultraviolet radiation-induced erythema is neither a unique feature of melanoma patients nor a useful marker for identifying risk groups for cutaneous melanoma.
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PMID:The recovery from ultraviolet radiation-induced erythema and melanoma risk factors: a case-control study. 236 74

Photosensitivity disorders of children are uncommon, except for banal overexposure reactions to sunlight. Although the long-term sequelae of chronic or intense sun exposure are not often seen in children, physicians should advise patients of the harmful effects and irreversible skin damage that results from unduly prolonged sun exposure. Damage accumulates over the years to cause premature aging, senile elastosis, actinic keratoses, and squamous- and basal-cell carcinomas. Besides the pigmentary changes, wrinkles, and skin cancers--genuine sources of altered appearance and morbidity--we now know that sunburned children develop a higher incidence of melanoma, which is not a rare cause of death in young adults. In Australia, where the incidence of melanoma is highest, a strong correlation exists for melanoma in children who get sunburn before the age of 10. Also, the incidence of melanoma is 50 times as great in bikini wearers who get sunburn as in girls who wear one-piece bathing suits.
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PMID:Photosensitivity and photodermatitis in childhood. 352 76

Three hundred fifty albinos in the city of Dar-es-Salaam have been registered at the Tanzania Tumor Centre. Their skin changes were followed for at least 2 years. Chronic skin damage was evident in all albinos by the first year of life; by 20 years, the skin of every subject demonstrated subclinical malignant change, and some had clinical epitheliomas. Untreated, the latter tumors become intractable and disseminate, usually causing death in the third or fourth decade of life. Four clinical stages could be identified, each one associated with distinct pathologic changes: Stage 1, erythema; Stage 2, epidermal atrophy with dermal hypertrophy; Stage 3, solar keratosis; and Stage 4, clinical carcinoma (under 3 cm). It was found that clinical Stage 2 only occurs in those skin areas that show evidence of previous Stage 1 change. Similarly, Stage 3 occurs only in areas that have gone through Stages 1 and 2. Stage 4 cancers were only found in those areas that had gone through all of the three prior stages. During the 2-year period of this study, 104 skin cancers, both early and advanced, were recorded at the albino skin clinic. Thirty-three of the 104 cancers were advanced (over 4 cm in diameter). The median age of the latter group was 31.0 years. Whereas there was no sex bias in the distribution of clinical cancer, 28 of the 33 advanced cancers were in men. Histologically, the great majority of the advanced tumors were squamous cell carcinomas: 29 of 33. There was one melanoma and three basal cell tumors. The predominant site of advanced cancers in the study group was the head and neck region (30 patients); the other three occurred on the trunk, which is generally covered by clothes.
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PMID:The Tanzanian human albino skin. Natural history. 397 67

Evidence associating malignant melanoma with semiquantitative and questionnaire indicators of past sunlight exposure is presented from a case-control study of 511 patients and 511 matched control subjects in Western Australia. That melanoma is related to sun exposure was supported by associations with actinic skin damage graded by cutaneous microtopography, history of nonmelanotic skin cancer, duration of residence of migrants to Australia, and mean annual hours of bright sunshine received at locations where the subjects had resided. Separate analyses of histogenetic subtypes revealed that Hutchinson's melanotic freckle melanoma had the strongest associations with indicators of sunlight exposure. For superficial spreading melanoma, a specific relationship was observed with age at arrival as against duration of residence in Australia. Migrants arriving before age 10 years appeared to have a risk similar to that of native-born Australians, whereas the estimated incidence in those arriving after age 15 years was around one-quarter of the native-born rate, with arrival at later ages giving no additional advantage. Control subjects arriving in Australia before age 10 years had an increased number of nevi on their arms, suggesting that sun exposure in early life may be a factor in nevus production and, therefore, a determinant of later potential to develop superficial spreading melanoma.
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PMID:Cutaneous malignant melanoma and indicators of total accumulated exposure to the sun: an analysis separating histogenetic types. 658 37

Risk markers for cancer are genetic or behavioral attributes that are statistically associated with increased incidence of cancer. Risk may be assessed either in case-control studies, or in cohort studies in which individuals with particular attributes are followed and cancer risk is determined by direct observation. Both of these methods have been used to determine the major risk markers for melanoma. The single most important risk marker is the presence on the skin of dysplastic nevi. Dysplastic nevi may be regarded as intermediate lesions of tumor progression, in that approximately 30% of melanomas arise in association with a precursor nevus, which is most commonly dysplastic. However, paradoxically, because they are vastly more numerous than melanoma, most dysplastic nevi are stable lesions that do not progress. Additional important melanoma risk factors include a family and/or personal history of melanoma. A third major category of risk markers includes indicators of acute and chronic exposure to the sun, including freckles, actinic skin damage, and a history of sunburn. Evaluation of these markers in oncological patients and their first-degree relatives can identify a population of individuals whose risk for melanoma ranges from several-fold to more than 100-fold greater than that of random population members. Efforts directed at early diagnosis in these individuals can result in recognition of melanomas in their early, curable stages.
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PMID:Dysplastic nevi and other risk markers for melanoma. 897 May 87

Intrinsic skin changes with advancing years include dryness, decreasing elasticity, increasing skin fragility, and more prominent vasculature. Extrinsic skin aging, caused primarily by cigarette smoking and exposure to sunlight, includes mottled pigmentation and yellow discoloration, rough leathery textural changes, and wrinkling. Major premalignant and malignant neoplasms in photodamaged skin are actinic keratosis, basal cell carcinoma, squamous cell carcinoma, and melanoma. Nonmalignant lesions include solar lentigines and seborrheic keratoses. The A, B, C, D criteria can assist in the evaluation of pigmented nevi. Physicians play an important role in educating patients about the health risks associated with excessive sun exposure and about sun protection to prevent further skin damage.
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PMID:Care of the skin at midlife: diagnosis of pigmented lesions. 926 Dec 86

This study examines the prevalence of sun-related damage to the skin in a caucasian population in north-west England. The importance of constitutional factors (complexion, skin type and age) as well as environmental and occupational exposures for the development of actinic keratosis (AK) and skin cancers was assessed in people over 40 years of age attending outpatient clinics (non-dermatology) at four centres in north-west England (Mersey region). Nine hundred and sixty-eight volunteers (531 men and 437 women) were recruited. The overall prevalence of AK was 15.4% in men and 5.9% in women. The prevalence was strongly related to age in both sexes, being 34.1% and 18.2%, respectively, in men and women aged 70 years and above, and was most strongly related to two objective signs of sun exposure, namely degree of solar elastosis and presence of solar lentigines. The prevalence of AK was higher in subjects with red hair and freckles, particularly women. There was no evidence of an increased prevalence of AK in relation to any occupation. There was a high prevalence of seborrhoeic keratosis and viral warts in both sexes, which was age-related in the case of seborrhoeic keratosis. Ten cases of basal cell carcinoma, eight cases of Bowen's disease and one case of malignant melanoma were identified. This study shows that the sun exposure received in 'normal' life in England is sufficient to cause potentially malignant skin damage in a significant proportion of the population.
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PMID:Prevalence of solar damage and actinic keratosis in a Merseyside population. 1125 1

Ultraviolet (UV) radiation plays a pivotal role in skin damage and photocarcinogenesis. The basic mechanism of phototoxicity lies in DNA damage, and involves mutation of tumor suppressor genes, oncogenes and genes directly involved in the control of the stability of genome, such as the mismatch repair (MR) genes. The goal of this study was to evaluate the role of p53 and hMSH2 in the UV-related carcinogenetic process. An immunohistochemical study for p53 and hMSH2 was performed in a series of 43 basal cell carcinomas (BCC) and 60 melanomas (MM) from photoexposed areas of head and neck region, comparing the findings with follow-up. A deregulated p53 expression characterized less differentiated, more aggressive BCC (BCC2) but not the well-differentiated ones (BCC1). The hMSH2 protein was present, though expressed at varying levels, in 18 out of 21 BCC1 cases and in 4 out of 22 BCC2. In the remaining 3 cases of BCC1 and 18 cases of BCC2, a complete absence of hMSH2 expression was found, correlating directly with the presence of recurrence and/or death of the disease in case of melanoma (p<0.05). Overall, the expression of hMSH2 correlated inversely with the p53 overexpression (p<0.01). In MM, p53 was found overexpressed in 81.6% of the cases, and this correlated positively with the level of infiltration and with the presence of relapses (p<0.01) or metastasis (p<0.01) and inversely with the disease-free interval (p<0.05). These results are in agreement with the reported association between p53 deregulation and a more aggressive cancer phenotype. The evaluation of the expression of p53 and hMSH2 could improve the management of patients with BCC and MM, and could have a role also in the evaluation of the early cutaneous photo-inducted damage, contributing to the identification of presymptomatic patients predisposed to the development of UV-related new skin tumors, who could become candidates for chemoprevention trials.
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PMID:P53 and hMSH2 expression in basal cell carcinomas and malignant melanomas from photoexposed areas of head and neck region. 1149 35

Promoting sunscreen use is an integral part of prevention programmes aimed at reducing ultraviolet (UV) radiation-induced skin damage and skin cancers. Protection against both UVB and UVA radiation is advocated. Most sunscreens combine chemical UV absorbing sunscreens and physical inorganic sunscreens, which reflect UV, to provide broad-spectrum protection. Newer triazole and camphor-derivative based sunscreens, also provide broad-spectrum protection and are more cosmetically acceptable than many traditional agents. Currently licensed sunscreen ingredients in common use rarely cause allergic or photoallergic reactions. Vitamin D levels are not significantly affected by regular use of a sunscreen. Sunscreen use reduces both the development of precancerous solar keratosis and the recurrence of squamous cell carcinomas. Sunscreen use early in life may be important in prevention of basal cell carcinomas. Increased melanoma risk is influenced by the behaviour patterns of regular sunscreen users, as opposed to any direct effect of sunscreens. Sun protection factor (SPF) is affected by application density, water resistance and other factors. An adequate SPF for an individual should be balanced to skin phenotype and exposure habits. The correct use of sunscreens should be combined with the avoidance of midday sun and the wearing of protective clothing and glasses, as part of an overall sun protection regimen.
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PMID:Sunscreens: safety, efficacy and appropriate use. 1197 39

Twenty-two patients with malignant melanoma were treated with boron neutron capture therapy (BNCT) using 10B-p-boronophenylalanine (BPA). The estimation of absorbed dose and optimization of treatment dose based on the pharmacokinetics of BPA in melanoma patients is described. The doses of gamma-rays were measured using small TLDs of Mg2SiO4 (Tb) and thermal neutron fluence was measured using gold foil and wire. The total absorbed dose to the tissue from BNCT was obtained by summing the primary and capture gamma-ray doses and the high LET radiation doses from 10B(n, alpha)7Li and 14N(n,p)14C reactions. The key point of the dose optimization is that the skin surrounding the tumour is always irradiated to 18 Gy-Eq, which is the maximum tolerable dose to the skin, regardless of the 10B-concentration in the tumor. The neutron fluence was optimized as follows. (1) The 10B concentration in the blood was measured 15-40 min after the start of neutron irradiation. (2) The 10B-concentration in the skin was estimated by multiplying the blood 10B value by a factor of 1.3. (3) The neutron fluence was calculated. Absorbed doses to the skin ranged from 15.7 to 37.1 Gy-Eq. Among the patients, 16 out of 22 patients exhibited tolerable skin damage. Although six patients showed skin damage that exceeded the tolerance level, three of them could be cured within a few months after BNCT and the remaining three developed severe skin damage requiring skin grafts. The absorbed doses to the tumor ranged from 15.7 to 68.5 Gy-Eq and the percentage of complete response was 73% (16/22). When BNCT is used in the treatment of malignant melanoma, based on the pharmacokinetics of BPA and radiobiological considerations, promising clinical results have been obtained, although many problems and issues remain to be solved.
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PMID:Boron neutron capture therapy (BNCT) for malignant melanoma with special reference to absorbed doses to the normal skin and tumor. 1462 47


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