Actinic Keratosis Research Articles

C1s targeting antibodies inhibit the growth of cutaneous squamous carcinoma cells

Cutaneous squamous cell carcinoma (cSCC) is the most common metastatic skin cancer. The incidence of cSCC is increasing globally and the prognosis of metastatic disease is poor. Currently there are no specific targeted therapies for advanced or metastatic cSCC. We have previously shown abundant expression of the complement classical pathway C1 complex components, serine proteases C1r and C1s in tumor cells in invasive cSCCs in vivo, whereas the expression of C1r and C1s was lower in cSCCs in situ, actinic keratoses and in normal skin. We have also shown that knockdown of C1s expression results in decreased viability and growth of cSCC cells by promoting apoptosis both in culture and in vivo. Here, we have studied the effect of specific IgG2a mouse monoclonal antibodies TNT003 and TNT005 targeting human C1s in five primary non-metastatic and three metastatic cSCC cell lines that show intracellular expression of C1s and secretion of C1s into the cell culture media. Treatment of cSCC cells with TNT003 and TNT005 significantly inhibited their growth and viability and promoted apoptosis of cSCC cells. These data indicate that TNT003 and TNT005 inhibit cSCC cell growth in culture and warrant further investigation of C1s targeted inhibition in additional in vitro and in vivo models of cSCC.

Reflectance confocal microscopy as noninvasive tool for monitoring tirbanibulin efficacy in actinic keratosis

Actinic keratosis (AK) is a common precancerous condition found on sun-damaged skin. Tirbanibulin 1 % ointment has been approved for the topical treatment of non-hyperkeratotic facial and scalp Olsen grade I AKs over a contiguous area of 25 cm2 with a daily application for 5 consecutive days. Our aim was to investigate the use of in vivo RCM in the assessment of the response of AKs treated with tirbanibulin, as it has never been described in the published Literature. A total of 10 AKs in 10 consecutive outpatients were enrolled in the present study in May 2023. The follow-up visit was scheduled after 30 days from last application of tirbanibulin ointment. At follow-up visit, a complete response was described by clinical, dermoscopic and in vivo RCM examination in 10 out of 10 lesions, with a recovery of stratum corneum, decrease in atypical honeycomb pattern and changes in dermal collagen. All patients were followed up for at least 8 months and further recurrences were not registered. Based on our experience, we confirm the efficacy and safety of tirbanibulin in treating AKs and the usefulness of RCM in vivo examination for the therapeutic monitoring of such lesions, even in a very early stage.

Invasion risk of cutaneous squamous cell carcinoma in situ by histological subtype: a retrospective cohort study

AimsCutaneous squamous cell carcinoma in situ (SCCis) can be classified histopathologically into four subtypes: full-thickness (FT), hypertrophic actinic keratosis (HAK), Bowenoid, and acantholytic types. 3%–5% of SCCis lesions progress to...

Advanced Squamous Cell Carcinoma of the Skin Induced by Long-Term Hydroxyurea Treatment in a Patient with Essential Thrombocythemia

Abstract Background and Objective SCCs represents 20-30% of the non-melanocytic skin cancers. It is the second most common skin cancer in the U.S. The main risk factors for SCCs development are: skin phototype l-ll, excessive UV-exposure, chronic inflammatory skin diseases, radiation exposure and drug usage. Hydroxyurea is a drug used for the treatment of chronic myeloid leukemia, polycythemia vera and essential thrombocythemia. The therapy is associated with development of actinic keratoses, Bowen's disease, squamous cell carcinoma and basal cell carcinoma. Patients and methods We present a 70-year-old female patient suffering from essential thrombocythemia, undergoing treatment with hydroxyurea since 2005, who developed advanced squamous cell carcinoma of the skin of the face and wrists. Results The patient was diagnosed with advanced moderately differentiated SCCs (Grade 2), stage III (T4 N0 M0). Immunotherapy with cemiplimab 350 mg i.v. every 21 days was initiated. After 6 therapeutic cycles decrease of erythema and desquamation was registered. In 2022 the patient had an ischemie stroke, decompensated heart failure and acute kidney insufficiency. Unfortunately the patient died. Conclusions Patients undergoing long-term hydroxyurea treatment are prone to develop multiple squamous cell carcinomas of the skin and are subject to regular dermatological examinations.

Can Artificial Intelligence "Hold" a Dermoscope?-The Evaluation of an Artificial Intelligence Chatbot to Translate the Dermoscopic Language.

This survey represents the first endeavor to assess the clarity of the dermoscopic language by a chatbot, unveiling insights into the interplay between dermatologists and AI systems within the complexity of the dermoscopic language. Given the complex, descriptive, and metaphorical aspects of the dermoscopic language, subjective interpretations often emerge. The survey evaluated the completeness and diagnostic efficacy of chatbot-generated reports, focusing on their role in facilitating accurate diagnoses and educational opportunities for novice dermatologists. A total of 30 participants were presented with hypothetical dermoscopic descriptions of skin lesions, including dermoscopic descriptions of skin cancers such as BCC, SCC, and melanoma, skin cancer mimickers such as actinic and seborrheic keratosis, dermatofibroma, and atypical nevus, and inflammatory dermatosis such as psoriasis and alopecia areata. Each description was accompanied by specific clinical information, and the participants were tasked with assessing the differential diagnosis list generated by the AI chatbot in its initial response. In each scenario, the chatbot generated an extensive list of potential differential diagnoses, exhibiting lower performance in cases of SCC and inflammatory dermatoses, albeit without statistical significance, suggesting that the participants were equally satisfied with the responses provided. Scores decreased notably when practical descriptions of dermoscopic signs were provided. Answers to BCC scenario scores in the diagnosis category (2.9 ± 0.4) were higher than those with SCC (2.6 ± 0.66, p = 0.005) and inflammatory dermatoses (2.6 ± 0.67, p = 0). Similarly, in the teaching tool usefulness category, BCC-based chatbot differential diagnosis received higher scores (2.9 ± 0.4) compared to SCC (2.6 ± 0.67, p = 0.001) and inflammatory dermatoses (2.4 ± 0.81, p = 0). The abovementioned results underscore dermatologists' familiarity with BCC dermoscopic images while highlighting the challenges associated with interpreting rigorous dermoscopic images. Moreover, by incorporating patient characteristics such as age, phototype, or immune state, the differential diagnosis list in each case was customized to include lesion types appropriate for each category, illustrating the AI's flexibility in evaluating diagnoses and highlighting its value as a resource for dermatologists.

AN UNCOMMON COMPLICATION OF EPIDERMODYSPLASIA VERRUCIFORMIS

Epidermodysplasia verruciformis (EV) is a rare autosomal recessive genetic disorder. which patients have a reduced immunological ability to defend against and eliminate certain types of human papillomavirus (HPV), resulting in persistent infection and an increased lifetime risk of developing cutaneous dysplasia and malignancy. mostly squamous cell carcinoma was seen on sunlight-exposed areas, especially on the extremities, and forehead. Malignant transformation began in the form of actinic keratosis and early micro- invasive squamous cell carcinoma of Bowens type, rarely basal cell carcinoma. We report the case of a young patient with a history of EV who presented with a basal cell carcinoma that developed over a short period of time. The patient was successfully treated surgically.

Causal relationship between genetically determined plasma metabolites and skin cancer: a two-sample Mendelian randomization study.

We aimed to unveil the underlyingpathogenic mechanismsof skin cancer inrelation tometabolic factors and pathway mechanisms. This studyutilized the TwoSample Mendelian randomization (MR) method to investigatethe causalrelationshipbetween 1400 plasma metabolites and skin cancer. The primary method employed was the inverse variance weighting (IVW). ThroughIVW analysis, wefound 105 plasma metabolitesassociatedwith Basal Cell Carcinoma (BCC),withthe highestassociationobserved forProlylglycine levels (OR [95% CI]: 1.1902 [1.0274, 1.3788]). For Malignant Melanoma of Skin (MSS),68 plasma metabolites werelinked, with the highestcausal relationship seen for3-Hydroxybutyrate levels (OR [95% CI]: 1.0030 [1.0013, 1.0048]). Regarding actinic keratosis (AK),and the highest association observed forHexadecadienoate (16:2n6) levels (OR [95% CI]: 1.3302 [1.0333, 1.7125]).Glycerol to palmitoylcarnitine (16: n6) levels (OR [95% CI]: 1.3302 [1.0333, 1.125]) werefound to be significant for BCC and AK.Palmitoylcarnitine (C16) had themost positive causal effect for BCC (OR [95% CI]: 1.1777 [1.0493, 1.3218]),while5-hydroxy-2-methylpyridine sulfate levelshad the highest effectfor AK (OR [95% CI]:1.1788 [1.0295, 1.3498]).And 4-guanidinobutanoate levels had the largest positive causal effect (OR [95% CI]: 1.0857 [1.0417, 1.1317]) for BCC, and X-11880 levels for MSS(OR [95% CI]: 1.0013 [1.0000, 1.0025]). The study revealed a positive association betweenhereditary Glycerol to palmitoylcarnitine (C16) and 5-hydroxy-2-methylpyridine sulfate levelswith the risk of developing BCC and AK. Additionally,4-guanidinobutanoate levels and X 11880 levels werefound to bepositively associated with the risk of BCC and MMS.

Neoadjuvant Photodynamic Therapy: An Updated Therapeutic Approach for Non-Melanoma Skin Cancers.

Non-melanoma skin cancers (NMSCs) are the most common malignancy and surgical excision is considered treatment of choice for the majority of cases. However, surgery can be very extensive in cases of large, multiple, or cosmetic-sensitive tumors located on areas such as scalp and face or genital region, leading to significant functional and cosmetic deficit. Aminolaevulinic acid photodynamic therapy (ALA-PDT) has emerged as a widely used approach in a variety of skin diseases, demonstrating remarkable efficacy in treatment of actinic keratosis, Bowen disease and basal cell carcinoma. Besides, when employed as a preoperative intervention, ALA-PDT effectively reduces tumor size and minimizes subsequent local surgical morbidity. With its minimally invasive nature and proven effectiveness, ALA-PDT holds significant promise as a neoadjuvant treatment option for NMSCs. In cases where the tumor is large, invasive, multiple, or located in cosmetically and functionally sensitive areas, or when considering patient factors such as age, comorbidity, willingness to undergo surgery, and post-operative quality-of-life, surgical intervention or radiotherapy alone may be impracticable or unacceptable. In such scenarios, neoadjuvant ALA-PDT can offer remarkable outcomes. In order to further ensure the maximum benefit of patients from neoadjuvant PDT, collaboration with multidisciplinary teams and whole-process management may be in need.

Photodynamic therapy in the treatment of non-melanoma skin cancer: A literature review

Objective: The following study aims to analyze the mechanism of action, efficacy, safety and recent trends in the use of photodynamic therapy (PDT) as a therapeutic approach in the treatment of non-melanoma skin cancer. In addition, it seeks to provide a comprehensive overview of the current state of knowledge on the subject, highlighting its use and availability in the Brazilian scenario. Methods: The research was carried out using a literature review based on data published in Periódicos CAPES, Biblioteca Virtual de Saúde (BVS) and UpToDate. Results: PDT is a technique that has already been consolidated globally and has several advantages in the treatment of non-melanoma skin cancer, as well as actinic keratoses, even in comprehensive cases. PDT is considered a non-invasive, fast, safe method, with few side effects, providing rapid recovery and being well tolerated by patients. It has a significant cure rate and excellent aesthetic results, differing from other treatments often cited for their disadvantages, such as undesirable scars. Conclusion: It is crucial to further explore the benefits of PDT, considering its application in different subtypes of non-melanoma skin cancer and optimizing protocols to expand its clinical application. As a promising innovation, the technology has the prospect of contributing to improving the quality of life of patients affected by this specific type of skin cancer.

Anti-aging Effects of Tirbanibulin 1% Ointment: A Real-Life Experience.

Tirbanibulin 1% ointment has been licensed to treat non-hyperkeratotic actinic keratosis (AKs) on the face and scalp in adults to ensure excellent patient tolerability due to the mild side effects and the brief application time compared to other topical therapies on the market. A growing body of evidence suggests that, beyond their primary function, the treatments for AKs and the cancerization field may inadvertently confer substantial cosmetic benefits to patients. We report a single-center retrospective case series of patients referred to the Dermatology Unit of the University Hospital of Messina, Italy, between February and December 2023 seeking treatment for AKs in the context of photodamaged areas in which the application of tirbanibulin 1% ointment induced, besides clearance of AKs, anti-aging effects on both skin texture and solar lentigos. Seven patients affected by Olsen grade1-2 AKs experienced a powerful rejuvenating effect in the treated areas, with a marked efficacy in skin lightening and clearance of solar lentigo. Tirbanibulin 1% ointment seems able to improve skin aging as a desirable side effect at the site of application for AKs on chronic photodamaged skin. Such preliminary observation needs further confirmation in real-life studies on larger cohorts of patients, to explain the pathogenic mechanisms responsible for such aesthetically relevant results.

The Role of Field Cancerization in Selecting Therapies for Actinic Keratosis: An Expert Consensus Panel

Background: Actinic keratosis is a very common disease that affects over 40 million people in the United States. In addition to the clinically visible lesion, patients may present with surrounding field cancerization based on their history of ultraviolet exposure. While lesion-directed therapy such as cryosurgery can effectively treat individual actinic keratoses it does not treat subclinical lesions or field cancerization. Objective: To create consensus recommendations on the role of field cancerization in selecting appropriate therapy for actinic keratoses. Methods: A comprehensive literature search of PubMed, Google Scholar, and Embase was conducted using the keywords “actinic keratos*,” “treatment,” and “field cancerization” for English-language original research articles without date restrictions. Articles were included that either discussed the role of FC in treating AKs or compared various AK field therapies. The relevant articles were then distributed to a panel of nine dermatologists with significant expertise in managing AKs. Each panelist reviewed the articles and assigned them a level of evidence based on Strength of Recommendation Taxonomy (SORT) criteria. The panel then convened on to discuss the studies and develop consensus statements on the role of FC in selecting AK therapy. The panel utilized a modified Delphi process to approve the adoption of each statement and gave each one a strength of recommendation based on SORT criteria. Results: The initial literature search produced 243 articles that met search criteria. After a thorough screening of these articles for relevance to the research question, 21 articles were chosen to be reviewed by the panel and assigned a level of evidence. Of the 21 articles that were reviewed, the panel assigned level 1 evidence to three articles, level 2 evidence to six articles, and level 3 evidence to twelve articles. The panel created seven consensus statements related to AK management and FC. All seven statements received a unanimous (9/9) vote for adoption. Each of the statements was given a strength of recommendation according to sort criteria Conclusion: Field cancerization due to chronic ultraviolet exposure leads to subclinical AK lesions in addition to lesions that are clinically apparent. In order to address these lesions, field therapy is an important component of an adequate regimen and can be used in conjunction with lesion-directed therapy for optimal results.

Exploring the burden of actinic keratoses through development of a patient decision aid: a mixed-methods study.

Actinic keratoses (AKs) are present on sun-exposed sites and are considered precursors of cutaneous squamous cell carcinoma. A better understanding of the experiences of patients with this condition may improve patient-provider relationships and guide the introduction of shared decision-making (SDM) to treatment decisions. To develop a patient decision aid (PDA) for field treatment of multiple AKs in line with the International Patient Decision Aid Standards (IPDAS) by (i) characterizing the burden and lived experiences of patients with multiple AKs, (ii) understanding the decisional needs of patients requiring field treatment, and (iii) exploring clinician preferences regarding field treatment for multiple AKs. This mixed-methods study followed the most up-to-date guidelines set out by the IPDAS collaboration; a voluntary body that aims to enhance the quality of PDAs by developing an evidence-based systematic process for the development of unbiased and effective PDAs. Multiple AKs have a psychosocial impact on patients. Patients feel supported through the integration of evidence-based information to guide SDM. We propose that the use of a PDA for multiple AKs provides a key role in supporting informed shared patient-provider decision-making and empowers patient involvement in their prospective treatment strategy.

A Summarized Review of Formulation, in Vitro Evaluation of Sunscreen

The efficacy and safety of sunscreens are diminished when their agents permeate the skin, resulting in systemic circulation and unidentified negative effects. The filters in sunscreens muster main on the skin's surface with minimal penetration through the dermis in order to preserve their safety and efficacy. Sunscreen should always be worn, even in the event that filters manage get through. Damage like as erythema, the production of free radicals, aging of the skin, and skin cancer brought on by UV radiation. Research is being done to limit skin penetration, assess sun protection factor (SPF), and improve formulation properties and stability in order to target potential negative effects caused by topical absorption of sunscreens. In vitro or in vivo investigations are used in current assays to determine sunscreen penetration since they mimic the physiological conditions of use. This review objectives are to reexamine data on sunscreen skin penetration over the last ten years and identify variables that may increase skin penetration or boost sunscreen efficacy. Sunburn is caused by ultraviolet B radiation, but ultraviolet A may be more damaging to the skin. Sunscreens should ideally block both wavebands. A sunscreen sun protection factor is mostly determined by how well it blocks ultraviolet B. The efficiency of preventing ultraviolet A is not measured. Sunscreens may be organic or inorganic chemicals. If metal oxide sunscreens are made into nanoparticles, their cosmetic acceptance might increase. It doesn’t seem that absorbing organic sunscreens and nanoparticles has any appreciable systemic effects. Frequent use of sunscreen prevents melanoma, squamous cell carcinoma, and actinic keratosis from developing.

Niacinamide: a review on dermal delivery strategies and clinical evidence.

Niacinamide, an active form of vitamin B3, is recognised for its significant dermal benefits including skin brightening, anti-ageing properties and the protection of the skin barrier. Its widespread incorporation into cosmetic products, ranging from cleansers to serums, is attributed to its safety profile and proven efficacy. Recently, topical niacinamide has also been explored for other pharmaceutical applications, including skin cancers. Therefore, a fundamental understanding of the skin permeation behaviour of niacinamide becomes crucial for formulation design. Given the paucity of a comprehensive review on this aspect, we provide insights into the mechanisms of action of topically applied niacinamide and share the current strategies used to enhance its skin permeation. This review also consolidates clinical evidence of topical niacinamide for its cosmeceutical uses and as treatment for some skin disorders, including dermatitis, acne vulgaris and actinic keratosis. We also emphasise the current exploration and perspectives on the delivery designs of topical niacinamide, highlighting the potential development of formulations focused on enhancing skin permeation, particularly for clinical benefits.

A Method of Skin Disease Detection Using Image Processing and Machine Learning

Skin conditions are prevalent health issues globally. The dangers posed by these infections are unseen, leading to physical discomfort and mental anguish. In severe cases, skin diseases can even progress to skin cancer. Consequently, the identification of skin diseases from clinical images remains a significant challenge in medical image analysis. Furthermore, manual diagnosis by medical professionals is time-consuming and subjective. Therefore, there is a need for automated skin disease prediction to expedite treatment planning for both patients and dermatologists. These studies presents a digital hair removal method and de-blurs or denoise the images. To extract essential patterns from the skin imagesand statistical features techniques are utilized. Two efficient machine learning algorithms, namely Support Vector Machine (SVM), and Convolutional Neural Network (CNN) classifiers, are employed with the extracted features to accurately classify skin images as melanoma (MEL), melanocytic nevus (NV), basal cell carcinoma (BCC), actinic keratosis (AK), benign keratosis (BKL), dermatofibroma (DF), vascular lesion (VASC), and Squamous cell carcinoma (SCC). The models are validated using the ISIC 2019 challenge and HAM10000 datasets, with SVM demonstrating slightly superior performance compared to the other classifiers. Furthermore, a comparison with state-of-the-art methods is conducted to evaluate the effectiveness of the proposed approach.

Ocular Surface Squamous Neoplasia with Coexistent Pterygia: A Study of 14 Cases and Review of Literature

ABSTRACT Purpose To report the clinical presentation, anterior segment optical coherence tomography features, treatment, and outcomes of ocular surface squamous neoplasia (OSSN) associated with pterygium. Methods Retrospective interventional series of 14 cases in a 28-month study period. Results OSSN was coexistent with pterygium (n = 14) in < 1% of all pterygia (n = 7384). The mean age at the presentation of OSSN with pterygium was 49 years (median, 49 years; range, 36 to 71 years). Referral diagnosis included pterygium sans OSSN (n = 7, 50%), granuloma (n = 1, 7%), actinic keratosis (n = 1, 7%), and conjunctivitis (n = 1, 7%). All OSSNs were unilateral, and six patients (43%) had bilateral pterygia. Tumors arose from the nasal (n = 8, 57%), or temporal (n = 6, 43%) quadrants. The mean tumor diameter was 4 mm (median, 4 mm; range, 2 to 6 mm), and the mean thickness was 2 mm (median, 1 mm; range, 1 to 3 mm). The delineation between OSSN and pterygium could be identified on anterior segment optical coherence tomography (AS-OCT) in all (100%) cases. All patients received 1% topical 5-fluorouracil (5-FU), and complete tumor regression was achieved in 13 (93%) cases with a mean number of 2 cycles (median, two cycles; range, 1 to 4 cycles). There were no significant adverse effects. No tumor recurrence was noted over a mean follow-up period of 11 months (median 12 months; range, 1 to 4 months) Conclusion AS-OCT allows accurate detection and mapping of tumor extent in OSSN with coexistent pterygium, and topical 5-FU yields excellent tumor control.

Patient- and Clinician-Reported Outcomes for Tirbanibulin in Actinic Keratosis in Clinical Practice Across the United States (PROAK).

The Patient-Reported Outcomes in Actinic Keratosis (PROAK) study evaluated patient- and clinician-reported outcomes (PRO; ClinRO) during 24 weeks of follow-up among adult patients with actinic keratosis (AK) on the face or scalp who were administered tirbanibulin 1% ointment in real-world community practices in the United States.&nbsp; Methods: Quality of life (QoL) was assessed by Skindex-16 at week (W) 8. Additionally, effectiveness (Investigator Global Assessment [IGA]), PRO and ClinRO (Treatment Satisfaction Questionnaire for Medication and Expert Panel Questionnaire), safety, and tolerability were assessed at W8 and W24. The safety population included 300 patients; the full analysis set included 290 patients (278 patients at W24). At W8, a statistically significant difference (P&lt;0.03) was observed for Skindex-16 domains in all assessed subgroups. Clinicians and patients reported high global satisfaction (mean [SD] scores of 74.9 [23.9] and 72.0 [24.6], respectively) at W24. Overall skin appearance improved from baseline to W24 (83.6% clinicians; 78.5% patients). IGA success (IGA score of 0-1) was achieved by 71.9% of patients at W24 with a similar % at W8 (73.8%) suggesting a stable effectiveness over time. About 5% of patients reported at least one adverse event, 4% reported at least one serious adverse event and no patients reported serious adverse drug reactions. At W8, the most frequently reported local skin reactions were mild/moderate erythema (47.6%) and flaking/scaling (49.6%). Treatment with tirbanibulin demonstrated effectiveness in the management of AK lesions and a favorable safety and tolerability profile. Furthermore, QoL was improved as early as W8, and both patients and clinicians reported high levels of treatment satisfaction, independently of patients' characteristics. J Drugs Dermatol. 2024;23(5):338-346. doi:10.36849/JDD.8264.

Diagnose und Therapie aktinischer Keratosen

Actinic keratosis (AK) is considered a chronic and recurring in situ skin neoplasia, with a possible transformation into invasive squamous cell carcinoma (SCC). Among others, predominant risk factors for development of AK are UV-light exposure and immunosuppression. Basal epidermal keratinocyte atypia (AK I) and proliferation (PRO Score) seem to drive malignant turnover, rather than clinical appearance of AK (Olsen I-III). Due to the invasiveness of punch biopsy, those histological criteria are not regularly assessed. Non-invasive imaging techniques, such as optical coherence tomography (OCT), reflectance confocal microscopy (RCM) and line-field confocal OCT (LC-OCT) are helpful to distinguish complex cases of AK, Bowen's disease and SCC. Moreover, LC-OCT can visualize the epidermis and the papillary dermis at cellular resolution, allowing real-time PRO Score assessment. The decision-making for implementation of therapy is still based on clinical risk factors, ranging from lesion- to field-targeted and ablative to non-ablative regimes, but in approximately 85% of the cases a recurrence of AK can be observed after a 1-year follow-up. The possible beneficial use of imaging techniques for a non-invasive follow-up of AK to detect recurrence or invasive progression early on should be subject to critical evaluation in further studies.

Novel insights into rosacea's role in cancer risk: A Mendelian randomization approach.

Chronic inflammation has been shown to promote cancer progression. Rosacea is indeed a long-term inflammatory skin condition and had been reported to link with increased risk for several types of malignancies, but evidence for causality is lacking. To systematically estimate the causal relationship between rosacea and several types of cancer, including cutaneous malignant melanoma (CMM), cutaneous squamous cell carcinoma (cSCC), basal cell carcinoma (BCC), actinic keratosis (AK), thyroid cancer, breast cancer, glioma and hepatic cancer, as well as explore the potential underlying pathogenesis. We conducted a bidirectional two-sample Mendelian randomization study to probe the potential causal relationships between rosacea and several types of cancer. Instrumental variables were established using genome-wide significant single nucleotide polymorphisms associated with rosacea and cancers. The assessment of causality was carried out through multiple methods, and the robustness of the results was evaluated via sensitivity analyses. There was no significant indication of causal effects of rosacea on CMM (pivw=0.71), cSCC (pivw=0.45), BCC (pivw=0.90), AK (pivw=0.73), thyroid cancer (pivw=0.59), glioma (pivw=0.15), and hepatic cancer (pivw=0.07), but the genetic risk of rosacea was associated with an increased susceptibility to human epidermal growth factor receptor (HER)-negative malignant neoplasm of breast (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.02-1.18; pivw=0.01). TANK (TRAF family member associated nuclear factor kappa B (NFKB) activator) was identified as a common protective gene for both rosacea (OR, 0.90; 95% CI, 0.82-0.99; pivw=0.048) and HER-negative malignant neoplasm of the breast (OR, 0.86; 95% CI, 0.75-0.98; pivw=0.032), which was primarily enriched in the negative regulation of NF-κB signal transduction and may contribute to the genetic links between rosacea and this subtype of breast cancer. Our findings provide suggestive evidence for causal links between rosacea and HER-negative malignant neoplasm of the breast risk.

Photoprotection and dermatological profile of persons with albinism in Plateau state, Nigeria: findings from a collaborative awareness and screening outreach program

Introduction As a result of genetically being deficient of melanin, albinos are particularly susceptible to skin damage from ultraviolet rays leading to photodermatoses such as sunburns, dermatoheliosis, and cutaneous cancers. These negatively affects quality of life and cause premature death. Little is known of the photoprotective measures available to and dermatological profile of persons with albinism in Plateau state, North Central Nigeria. Objective To describe the dermatological profile of albinos in Plateau state, Nigeria, photo exposure levels, photoprotection strategies, and factors associated with presence of photodermatoses. Patients and methods Consenting individuals with albinism attending the sensitization event hosted by the Centre for Albinism Right and Empowerment Network were recruited. Demographic information, occupational history, solar exposure, photoprotective practices, and perceived sun exposure were all documented using semistructured questionnaires. Physical and dermatological examination, dermoscopy, and laboratory investigations were used to make diagnosis. Statistical package for social sciences, version 26, was used to carry out univariate and bivariate analysis. Results While a wide spectrum of skin diseases was observed among the 59 albinos that participated. Photodermatoses were three times more than nonphotodermatoses. The commonest photodermatoses were solar elastosis (55.9%), solar lentigines (44.1%), actinic keratosis (27.1%), and sunburn (25.4%). Skin cancers affected 10.2% of all patients and 16.6% of persons more than or equal to 20 years. Generally, the presence of photodermatoses was associated with age and occupation while actinic keratotic changes specifically was associated with living in rural areas (P=0.035). Despite this, only seven (11.9%) owned sunscreen at the time of study with more than a third (35.2%) being ignorant of existence of sunscreen lotions. Conclusion Continuous multifaceted programs that involve tracking, education, prevention, early detection, and treatment of photodermatoses will be planned to be targeted towards persons with albinism living in Plateau state.