Skin Cancer Prevention Research Articles

The evolving landscape of laser-based skin cancer prevention.

In the United States, 1 in 5 Americans develop keratinocyte carcinoma (KC) by age 70, placing the disease among the five most expensive cancers based on Medicare expenditure. Current preventative measures have failed to stem rising KC rates, highlighting the need for alternative strategies. Evolving evidence indicates that lasers conventionally used to treat photoaging, may provide protective effects against the development of KC and precursor lesion, actinic keratosis (AK). This review first delves into existing evidence on fractional infrared laser-based KC and AK prevention. Next, the work discusses potential underlying mechanisms that might explain fractional infrared lasers' prophylactic effects. A comprehensive literature search of PubMed and Web of Science databases was conducted from inception to April 2024 using preselected search terms. Interventional human and animal studies, epidemiological analyses, and case reports on fractional infrared laser-based prevention of KC or AK were screened according to predefined inclusion/exclusion criteria. Included evidence demonstrates that ablative fractional lasers reduce and delay development of AK/KC, shown in two controlled trials of photodamaged patients and two murine studies (i.e. Er: YSGG and CO2 lasers). Weaker evidence of KC prevention by nonablative infrared lasers is provided by a retrospective cohort study. In the laser literature, three mechanisms are proposed to drive these prophylactic effects, including the ability of infrared lasers to (i) remove DNA-damaged epidermal cells, (ii) activate the insulin-like growth factor-1 pathway by reducing fibroblast senescence, and (iii) initiate immunomodulating effects. Based on current evidence, infrared fractional lasers show promise particularly for secondary KC prevention in photodamaged populations.

Photocarcinogenesis of the skin: Current status and future trends.

Solar radiation is essential for life on Earth but is also a major contributor to skin carcinogenesis. Solar radiation, particularly ultraviolet (UV) B (280-320 nm) and UVA (320-400 nm), induces photocarcinogenesis via various pathways. UV light can directly cause DNA damage, resulting in genetic mutations if not repaired correctly. UV light can also induce photocarcinogenesis by generating reactive oxygen species, inducing immunosuppression and inflammation. Recently, visible light (400-760 nm) has been shown to contribute to photocarcinogenesis by activating oxidative pathways. In addition to the irradiation dose (fluence, J/m2), UVB irradiance (W/m2) is also considered a factor influencing photocarcinogenesis. In this review, we summarize the mechanisms of photocarcinogenesis and provide strategies to prevent skin cancer.

Skin cancer knowledge, attitudes, beliefs, and prevention practices among beachgoers: a narrative review.

People who spend time at the beach at increased risk for ultraviolet light (UV) exposure. This review assessed skin cancer-related knowledge, attitudes, beliefs, and prevention practices among beachgoers and sunbathers at the beach. Relevant articles were search in the following electronic databases: PubMed (Medline), Cumulative Index to Nursing and Allied Health (CINAHL), ERIC, and PsycINFO. A narrative analysis of pertinent study findings was conducted. A total of 24 studies were included in this narrative review. Findings included moderate to high knowledge of sun protection as well as knowledge-based deficiencies around the type of UV light that causes sun damage, risk factors, prevention of lip damage and cancer, length of sun exposure, and risk of photoaging with increased sun protection factor value. Beachgoers and sunbathers perceive their own risk of skin cancer and skin aging as less than that of the general population. Variable sun protection behaviors were observed in this population including use of sunscreen, sunglasses, shade, hats, and protective clothing. Amongst all beachgoers and sunbathers, 21-22.8% do not use sun protection and 62% have experienced a blistering sunburn in their lives. Beachgoers would benefit from increased education on skin cancer susceptibility and the importance of sun protection strategies. Healthcare providers should provide counseling on sun protection to reduce the morbidity and mortality associated with skin cancer. Disseminating information through the media may help bring more awareness of healthy skin practices at the beach and prevent skin cancers.

Chemopreventive role of β-caryophyllene in DMBA-induced skin cancer: Modulation of apoptotic pathways and PI3K/Akt signaling in Swiss albino mice.

The skin, with its robust structural integrity and advanced immune defense system, serves as a critical protective barrier against environmental toxins and carcinogenic compounds. Despite this, it remains vulnerable to the harmful effects of certain hazardous agents. This study aimed to investigate the chemopreventive potential of β-caryophyllene (BCP) in mitigating 7,12-dimethylbenz[a]anthracene (DMBA)-induced skin carcinogenesis, focusing on the modulation of apoptosis and PI3K/AKT signaling pathways. Swiss albino mice were utilized to assess the preventive effects of BCP in DMBA-induced skin cancer. Skin carcinogenesis was initiated by topical DMBA application, followed by promotion using croton oil. To evaluate the chemopreventive efficacy of BCP, a 50 mg/kg oral dose was administered 3 times a week for 16 weeks. The BCP treatment in DMBA-induced skin cancer mice significantly reduced tumor incidence, tumor burden and the total number of papillomas compared to untreated DMBA-exposed mice. Notably, BCP administration (p < 0.05) resulted in a marked increase in body weight and improvement in antioxidant enzyme activity. Additionally, BCP treatment led to significant reductions in lipid peroxidation and enhanced detoxification enzyme function. Histological examination of DMBA-induced skin tissues revealed the presence of keratin pearls, well-differentiated tumor cells and neutrophil infiltration. In contrast, BCP-treated mice showed only mild hyperplasia, dysplasia and moderate keratosis, suggesting a lower degree of tissue damage. Furthermore, BCP demonstrated a protective effect on liver histology, counteracting the toxic effects of DMBA exposure. Gene expression analysis revealed that BCP treatment significantly (p < 0.05) upregulated the pro-apoptotic genes Bax, p53, caspase-3 and caspase-9, while downregulating the anti-apoptotic Bcl-2 expression. Additionally, BCP treatment led to a marked reduction in the expression of proliferating cell nuclear antigen (PCNA), cyclin D1 and PI3K/Akt signaling pathways, which are key regulators of cell proliferation and survival. This study provides compelling evidence that the antioxidant and pro-apoptotic effects of β-caryophyllene contribute to its chemopreventive properties in DMBA-induced skin carcinogenesis in mice. The modulation of key apoptotic signaling pathways and the suppression of the PI3K/Akt pathway by BCP underscores its potential as a therapeutic agent for preventing skin cancer. These findings pave the way for further exploration of BCP as a promising candidate for skin cancer prevention and therapy.

Illuminating the Connection: Cutaneous Vitamin D3 Synthesis and Its Role in Skin Cancer Prevention

Sunlight exposure plays an important role in human health, impacting processes such as mood, blood pressure regulation, and vitamin D3 production. Solar ultraviolet B radiation initiates vitamin D3 synthesis in the skin, which is subsequently metabolized into its biologically active form. UVB exposure plays a key role in enabling vitamin D3 synthesis, but it can also contribute to skin carcinogenesis, creating a complex interplay between its beneficial and harmful effects. Vitamin D deficiency, affecting over half the global population, is linked to a range of chronic diseases, including cancers, cardiovascular conditions, and autoimmune disorders. Simultaneously, excessive solar UVB exposure increases the risk of non-melanoma and melanoma skin cancers through mechanisms involving DNA damage and oxidative stress. This review examines the dual role of UVB radiation in health and disease, focusing on the mechanisms of cutaneous vitamin D3 synthesis, the epidemiology of skin cancer, and the protective roles of vitamin D3’s photoproducts and its active metabolite, 1,25-dihydroxyvitamin D3. Understanding these interconnections is critical for developing strategies that balance adequate sun-induced vitamin D3 production with skin cancer prevention.

Change in Metabolic Markers and the Risk of Skin Cancer: Results from the Lifelines Cohort Study in the Netherlands.

Skin-cancers are the most common cancers in Caucasians, and their incidence is rising. Although metabolic and anthropometric markers play a role in cancer development, the relationship of metabolic and anthropometric changes with skin-cancer remains unclear. This study aimed to examine possible associations between these changes and the risk of skin-cancer. Participants without prior skin-cancer history from the Northern-Netherlands representative of the general population were included. Histopathology data were obtained from the Dutch Nationwide Pathology-Database. Adjusted-Cox-regression analyzed associations between metabolic changes and time to pathology-confirmed skin-cancer incidence over a 7-year follow-up, assessing overall skin-cancer risk and subtypes, including melanoma and non-melanoma skin-cancer. Out of 97,106 participants, 4,195 (4.3%) developed skin-cancer. Body-mass-index (BMI) decrease and increase were both associated with lower skin-cancer risk: adjusted-hazard-ratios(aHR) of 0.88(0.80-0.98) and 0.78(0.72-0.86), respectively. Triglyceride and waist-to-hip ratio (WHR)decreases were also associated with lower risk: aHR: 0.89(0.80-0.98) and 0.89(0.83-0.98), respectively. Increase in HbA1c was associated with higher risk in individuals under 45 years at baseline: aHR: 1.21(1.01-1.45). Subtype-analysis showed an increase in BMI was associated with lower melanoma risk: aHR: 0.72(0.58-0.91). Changes in BMI and decrease in triglycerides and WHR are related to lower skin-cancer risk, whereas increase in HbA1c may elevate risk in individuals younger than 45 at baseline. These findings highlight the importance of non-sunlight-related risk factors for skin-cancer prevention and the need for further research into underlying mechanisms. This study contributes to the broader understanding of how metabolic health impacts skin-cancer development, offering potential avenues for targeted prevention strategies.

Role of Community Pharmacies in the Secondary Prevention of Skin Cancer

Skin cancer prevention is a public health priority due to its high incidence and potential to cause significant morbidity and mortality. This study evaluated the effectiveness of an early skin cancer detection program in a community pharmacy, utilizing advanced technologies and interdisciplinary collaboration. 1. Early detection of melanoma and non-melanoma skin cancer in patients visiting the community pharmacy. 2. Facilitate patient referral to a dermatologist through the pharmacy. A cross-sectional observational study was conducted in a community pharmacy between June 2018 and September 2023. Adult patients concerned about skin lesions were included. After obtaining written informed consent, an interview was conducted, and photographs of the lesions were taken and electronically sent to a dermatology service for a preliminary diagnosis within 24-48 hours. A total of 41 patients were evaluated (51% men; 54% over 50 years old). Benign lesions were identified in 54% of cases, avoiding unnecessary consultations and optimizing health resources. 46% presented suspicious cancer lesions requiring detailed evaluation, with 63% of this group being over 60 years old. More than 85% of the preliminary diagnoses were accurate with the images sent. The results underscore the effectiveness of early detection programs in community pharmacies for identifying benign and suspicious lesions, optimizing resources, and facilitating early interventions. The collaboration between pharmacists and dermatologists, along with the use of advanced technologies, were key to the program's success. However, the study's limitations include the sample size and its focus on a single pharmacy. Community pharmacies can play a crucial role in the secondary prevention of skin cancer, improving healthcare system efficiency and benefiting patients through early detection and timely intervention. Future studies with larger samples are recommended to validate these findings and quantify resource optimization.

Algae extract-based nanoemulsions for photoprotection against UVB radiation: an electrical impedance spectroscopy study

Skin cancer is one of the most common types of cancer worldwide, with exposure to UVB radiation being a significant risk factor for its development. To prevent skin cancer, continuous research efforts have focused on finding suitable photoprotective ingredients from natural sources that are also environmentally friendly. This study aimed to develop oil-in-water photoprotective nanoemulsions containing marine macroalgae extract. A Box–Behnken experimental design was used to identify the most promising formulation composition, resulting in optimal physical properties. These properties, including droplet size, polydispersity index (PDI), and zeta potential, were evaluated using dynamic light scattering (DLS). To assess the photoprotection capacity of the formulations, electrical impedance spectroscopy (EIS) was employed to evaluate alterations in the electrical characteristics of excised pig skin membranes placed in Franz cells equipped with a 4-electrode set-up. The final composition of the nanoemulsion was caprylic/capric triglycerides 4%, Macrogolglycerol ricinoleate 30%, and algae extract 1%. The nanoemulsions had an average droplet size of 128.5 ± 8.6 nm, a PDI of 0.25 ± 0.06, and a zeta potential of 45.14 ± 0.02 mV. Compared to the control group, the photoprotective capacity of the oil-in-water nanoemulsions was statistically significant. Specifically, only a 15% reduction in the skin membrane electrical resistance following UVB exposure was observed when the formulation containing algae extract was used, whereas a 50% reduction was observed for the vehicle. In conclusion, this work demonstrates that the developed nanoemulsions based on natural ingredients show promising protective capacity against UVB exposure of the skin.

Analysis of Body Composition and Levels of Antimicrobial Peptides in Patients with Basal Cell Carcinoma: A Preliminary Study.

Background: Excessive body fatness is the basis of many diseases, especially civilization-related ones. The aim of this study is to analyze the body composition and serum levels of selected antimicrobial peptides (AMPs) in patients with basal cell carcinoma (BCC), in comparison to healthy controls (HCs), and investigate whether any specific parameter significantly increases the risk of BCC development. Methods: The body composition and measurements of serum levels of cathelicidin and human-beta-defensin-2 were analyzed in a group of 100 subjects (50 patients with BCC and 50 HCs). Results: There were statistically significant differences between the visceral fat rating (BCC 11.7 vs. control 10.1), cathelicidin (BCC 1022.6 vs. control 428.4), defensin-2 (BCC 1.2 vs. control 0.4), age (BCC 68.7 vs. control 62.4), and the visceral fat/muscle ratio (BCC 0.24 vs. control 0.21). Conclusions: It seems that excessive fat, especially visceral fat, may pose a risk of developing skin cancer. Therefore, it should be taken into account when caring for patients and they should be made aware that losing body weight may be important not only in reducing the risk of hypertension or diabetes but also cancer diseases. There are numerous well-known risk factors for developing skin cancer, but few are modifiable. Among these modifiable factors is the patient's weight and body composition, so improvaing lifestyle is crucial in the prevention of skin cancers.

Enzyme-assisted Rosa davurica mitigates UV-induced skin photodamage by modulating apoptosis through Nrf2/ARE and MAPK/NF-κB pathways.

Exposure to UV irradiation results in abnormal, extensive apoptosis of skin cells. This excessive cell death can promote inflammation and alter the microenvironment, increasing the risk of skin cancer. Despite extensive research, few materials are effective at simultaneously protecting against both UVA and UVB irradiation. This study aims to develop dual-action material using enzyme-assisted extraction of Rosa davurica Pall (RD) to prevent skin photodamage caused by UVA and UVB irradiation. Three different enzymes were used to assist the extraction of RD, followed by an analysis of the changes in active component levels. Skin photodamage models were established by exposing Normal Human Dermal Fibroblasts (NHDF) and HaCaT cells to UVA and UVB irradiation. The impact of enzyme-assisted extracted RD (ERD) on Reactive Oxygen Species (ROS) production and cell apoptosis was assessed using Flow Cytometry. The effects of ERDs on inflammatory cytokines were measured using ELISA, and RT-PCR was used to evaluate its impact on apoptotic gene expression in photodamaged cells. Furthermore, the impact of ERDs on the Nuclear factor erythroid 2-related factor 2 (Nrf2)/Antioxidant response element (ARE) and Mitogen-activated protein kinases (MAPK)/Nuclear factor-κB (NF-κB) signaling pathways was assessed through Western blot analysis. Finally, the impact of ERDs on full-thickness artificial skin tissue after UV irradiation was assessed using hematoxylin and eosin (H&E) staining. Furthermore, leveraging the experimental results, network pharmacology was utilized to explore the potential of ERDs in preventing skin cancer. Enzyme-assisted extraction enhanced the bioactive components of RD. ERDs effectively reduced ROS levels and suppressed the secretion of Tumor necrosis factor (TNF)-α, Interleukin (IL)-1β, and IL-6 by modulating the Nrf2/ARE and inhibiting the MAPK/NF-κB signaling pathways. This mechanism promoted the expression of the anti-apoptotic gene Bcl-2 and decreased the activity of proapoptotic genes BAX, caspase-3, and caspase-9, thereby countering UV-induced apoptosis. Additionally, staining results demonstrated that ERDs effectively repaired UV-induced photodamage and maintained the integrity of skin structure. ERDs provides comprehensive protection against photodamage induced by UVA and UVB irradiation, demonstrating its potential as an effective photoprotective material and possibly in preventing skin cancer.

Effectiveness of cross-sector collaboration in strategy implementation and impact: Evaluation of the NSW Skin Cancer Prevention Strategy 2016-2022.

Australia continues to have one of the highest rates of skin cancer in the world. In NSW, melanoma is the third most common cancer diagnosed. At least 95% of skin cancers are caused by overexposure to ultraviolet radiation (UVR) from the sun, making it a highly preventable cancer. The NSW Skin Cancer Prevention Strategy (the Strategy) aims to reduce overexposure to UVR through collaborative efforts across government and non-government partners and the private sector. An evaluation was required to inform the Skin Cancer Prevention Strategy 2023-2030 development and implementation. The Strategy was evaluated using a mixed-methods approach, which included both process and outcome evaluation measures. Measures included population and campaign tracking surveys, administrative datasets, a document review of progress reports and meeting minutes, and semi-structured interviews and workshops with stakeholders. The evaluation outlined activities and achievements under each of the Strategy goals. Findings demonstrated improved understanding and awareness of sun protection policies and guidelines, improved access to adequate shade, increased measurability of shade availability and adequacy, and increased adoption of sun protection behaviours. Cross-agency collaboration and commitment were a key strength of the Strategy. The continued prioritisation of settings (e.g. schools, workplaces, etc.) and populations outlined in the Strategy were supported by the evaluation's findings. Additional focus areas for the new Strategy were highlighted, including secondary prevention or early detection. Continued skin cancer prevention activities, including social marketing campaigns and public education programs, are essential to ensure the adoption of sun protection behaviours by priority populations.

Personalized Photoprotection: Expert Consensus and Recommendations From a Delphi Study Among Dermatologists.

Recommending comprehensive personalized photoprotection requires an accurate assessment of the patient's skin, including phototype, lifestyle, exposure conditions, environmental factors, and concomitant cutaneous conditions as well as deep knowledge of the available options: sunscreen ingredients (type of filters, spectrum coverage, sun protection factor, enhanced active ingredients), oral photoprotection, and other methods of sun protection and avoidance. To establish consensus-based recommendations endorsed by an international panel of experts for personalized medical photoprotection recommendations that are applicable globally. A two-round Delphi study was designed to determine the degree of agreement and relevance of aspects related to personalized medical photoprotection. Items with ≥ 80% agreement and relevance were considered approved. A list of 28 recommendations for personalized medical photoprotection was approved by a panel of dermatology professionals from seven different countries. Recommendations were categorized as: (1) updated perspectives in photoprotection, (2) clinical management, (3) skin cancer prevention, (4) dark skin phototypes and skin prone to hyperpigmentation, and (5) age and lifestyle. This study established recommendations for the implementation of personalized medical photoprotection worldwide, highlighting areas needing further scientific and clinical evidence.

Guardians of the Game: UV-Specific Skin Cancer Prevention by Coaches in Outdoor Sports.

Due to the global rise in UV radiation, the prevalence of skin cancer is increasing significantly, with outdoor athletes being identified as a particularly vulnerable population group. This nationwide, cross-sectional study was conducted among adult coaches from the 10 largest outdoor sports associations in Germany. Their applied prevention measures and the potential for further improvement in prevention were evaluated by guideline based scores (range [0-100]). Additionally, sport-, coach-, and club-specific variables were analysed and barriers that prevent comprehensive UV prevention were identified. The UV prevention practice of the 1200 participating coaches averaged 53.43 ± 16.37 [0.00-95.31], while the potential UV prevention options were assessed at a comparatively higher value of 58.82 ± 17.53 [0-100]. Notably, the proper use of sunscreen emerged as the most neglected preventive measure. Coaches identified the greatest potential for improvement in sunscreen renewal, water-resistant sun protection products and sunglasses. The study also revealed significant differences in UV protection practices between different sports, with soccer, tennis, and swimming exhibiting the most pronounced deficits. Factors such as coach qualification and experience, as well as club size and the size of training groups influenced the level of UV protection implemented. Many coaches cited various implementation obstacles such as fixed training times and resource constraints. The study highlights specific areas for improvement in UV protection practices in outdoor sports, considering differences on sport, coach, and club levels. The significant number of active athletes in these sports underscores the public health importance of addressing UV protection in this field.

Treatment and Prevention of HPV-Associated Skin Tumors by HPV Vaccination.

HPV-associated dermatological diseases include benign lesions like cutaneous warts and external genital warts. In addition, HPV infection is associated with the development of epithelial skin cancers, in particular cutaneous squamous cell carcinoma (cSCC). In contrast to anogenital and oropharyngeal cancers caused by mucosal HPV types of genus alpha papillomavirus, cSCC-associated HPV types belong to the genus beta papillomavirus. Currently available HPV vaccines that target mucosal HPV types associated with anogenital cancer and genital warts are type-specific and provide no cross-protection against beta HPV. When implementing vaccination to beta HPV to prevent skin tumors, it must be considered that acquisition of these HPV types occurs early in childhood and that the risk for cSCC increases with growing age and decreasing immune surveillance. Thus, individuals considered for beta HPV vaccination usually have pre-existing infection and are largely immunocompromised. On the other hand, worldwide increasing incidence rates of epithelial skin cancer reflect an urgent need for skin cancer prevention measures. Based on the pathogenic involvement of beta HPV, vaccination may represent a promising prevention strategy. Indeed, various procedures of prophylactic and therapeutic vaccination have been developed, and some of them have shown efficiency in animal models. Thus far, however, none of these vaccine candidates has been approved for application in humans.

Investigating Skin Cancer Risk and Sun Safety Practices Among LGBTQ+ Communities in Canada.

Skin cancer prevention relies on effective sun safety practices. Previous studies have shown that LGBTQ+ individuals exhibit lower sunscreen use and higher tanning bed usage compared to their non-LGBTQ+ counterparts. This study is the first to assess skin cancer risk factors, sun-protective behaviors, and skin cancer concerns among LGBTQ+ individuals across Canada. A national survey study was conducted between July 2020 and March 2024 and included LGBTQ+ respondents aged ≥ 16 years who had completed the survey. Responses were summarized using frequency counts/percentages for categorical variables and means/standard deviations for continuous variables. Logistic regression models were used to calculate age- and gender-adjusted odds ratios for subgroup analyses. Of the 700 LGBTQ+ participants included (59.3% women; median age 38 years), the majority had a Fitzpatrick skin phototype (FSP) I-III (76.4%). Concerningly, 60% reported >10 lifetime sunburns, 58% reported ≥1 blistering sunburn, 34% had used a tanning bed ≥1 time in their lifetime, and 69% reported having a tan in the last 12 months. Sunscreen was worn regularly by only half of the respondents, and half of the participants agreed or strongly agreed with "I look better and/or healthier with a tan". Additional comparisons are presented based on gender, FSP, education, and income. The findings of this study highlight the need for public health campaigns tailored to the LGBTQ+ community, emphasizing culturally sensitive sun safety education, particularly for LGBTQ+ men, individuals with FSP IV-VI, and those with lower education levels, to help reduce future skin cancer risk.

Uso irregular de protetor solar e fatores associados em adultos e idosos: estudo de base populacional no Sul do Brasil

Introduction: The southern region leads skin cancer statistics in Brazil, with multiple factors related to this predisposition. Ultraviolet radiation is the main modifiable risk factor, and regular use of sunscreens has proven effective in reducing risk. Despite this, the prevalence of irregular sunscreen use has been higher than desired. Objective: To evaluate the association between irregular sunscreen use and sociodemographic, behavioral, and health characteristics in adults and older individuals. Method: A cross-sectional population-based study conducted in 2019 with adult residents in the urban area of Criciúma, state of Santa Catarina, Brazil. The outcome variable was irregular use of sunscreens. Exposure variables included sex, age, skin color, education, income, paid work, smoking, household registration in a Primary Health Care unit, access to supplementary health insurance, preventive medical and dental visits in the last year, walking in leisure time, commuting on foot or by bicycle, sufficient physical activity, personal history of cancer of any organ and the skin. To assess the association between irregular sunscreen use and these variables, crude and adjusted analyses were performed using Poisson Regression with a significance level of 5%. Results: In total, 820 individuals were studied. The prevalence of irregular sunscreen use was 52.8%. Factors associated with an increased prevalence of irregular sunscreen use were: male sex (PR 1.57; 95%CI 1.39-1.77), smoking (PR 1.19; 95%CI 1.03-1.37), being 60 years or older (PR 1.62; 95%CI 1.26-2.09), and lower education (inverse linear trend: p&lt;0.001). On the other hand, having supplementary health insurance (PR 0.84; 95%CI 0.71-0.99) and walking in leisure time (PR 0.76; 95%CI 0.64-0.90) were protective factors. Conclusion: This study allowed us to identify the profile of individuals at higher risk of irregular sunscreen use, representing a potential health benefit by better targeting strategies for preventing skin cancer in older populations and adults.

Transcriptional and functional regulation of cell cycle andUV response by PPARβ in human skin epidermal cells.

Solar radiation is the main source of human exposure to UV rays, which is the major carcinogen in skin cancers by inducing DNA damage. Skin cells repair these damages by activating the DNA damage response (DDR) to safeguard genome integrity, thereby preventing skin cancers. Peroxisome proliferator-activated receptor beta (PPARβ), a druggable transcription factor, is involved in the development of UV-dependent skin cancers, although its role is not mechanistically elucidated. We showed previously that PPARβ knockout (KO) mice are less prone to UV-induced skin cancers. Here, we report that PPARβ directly regulates gene expression programs associated with cell cycle and DNA repair pathways in normal human epidermal keratinocytes (NHEK). The loss of function of PPARβ in human keratinocytes led to a downregulation in the expression of key cell cycle regulators, including cyclins and cyclin-dependent kinases (CDKs). Simultaneously, it upregulated the expression of p21 protein, a known CDK inhibitor. These molecular alterations resulted in a significant reduction in cell proliferation and induced cell cycle arrest at the G2/M phase. Moreover, the absence of functional PPARβ disrupted the expression and activation of the ataxia telangiectasia and Rad3-related (ATR) pathway, a critical component of the cellular response to UV-induced DNA damage. The alterations in the ATR pathway likely contributed to an increased apoptotic response of NHEK to UV radiation. Using a mouse melanoma model, we demonstrated that the depletion of PPARβ decreases tumorigenicity of melanoma cells and delays tumor formation. Our data suggest that PPARβ inhibition could be considered as a therapeutic target for the prevention of UV-induced skin cancers, by regulating cell proliferation, attenuating DDR, and eliminating skin cells with high UV-induced mutational burden.

Is There a Need for Vitamin D Supplements During Summer Time in Northern Germany? A Study of Hospitalised Fracture Patients.

Vitamin D is a key factor in bone metabolism, especially in patients who have suffered fractures, a group in need of a healthy bone metabolism. In Germany, a 70-year-old person requires 20 min of sun exposure daily for sufficient endogenous production in April. While this appears to be a sufficient period on paper, it raises the question of whether sufficient synthesis is achieved, given the time and the implementation of skin cancer prevention. Furthermore, it is necessary to determine whether self-medication is a safe option. This was an analysis of vitamin D levels in patients with fractures over a one-year period. To avoid bias due to vitamin D intake, patients were divided into groups (self-medication, without, prescribed). The differences due to age, gender, fracture type and fluctuation over the year were analysed. 613 patients with a mean age of 73 years (45-97) were enrolled. The mean vitamin D level across all groups was 51 nmol/L, with a mean of 40 nmol/L for patients without supplementation (n = 449). Monthly comparisons revealed significant differences between January/February and August/September. Similarly, a comparison by gender showed a significant difference (p = 0.028). However, there were no significant differences between osteoporosis-associated and non-osteoporosis-associated fractures. The majority of patients did not achieve sufficient vitamin D levels through endogenous synthesis and substitution did not lead to toxic levels. This suggests that substitution is reasonable and safe even during the summer months.

Evaluating Difluoromethylornithine Safety and Efficacy for Non-Melanoma Skin Cancer Chemoprevention: A Systematic Review.

Recent FDA approval of difluoromethylornithine (DFMO), an inhibitor of ornithine decarboxylase for the prevention of neuroblastoma in children, has renewed interest in this medication for the prevention of other cancers including keratinocyte carcinomas (KCs). It has been investigated for cancer chemoprevention, including neoplasms of the colon, breast, and prostate. We assessed the current body of literature that determines DFMO efficacy and safety in non-melanoma skin cancer prevention. A systematic search of PubMed Central, and Web of Sciences was performed. In this analysis, 12 studies were included evaluating 1618 patients. Most patients were Caucasian 90% (1452/1618) with a mean age of 61 years, and 73% (1214/1618) had previously been diagnosed with KC. For oral DFMO, reduction in KC was significant in 24% (291/1214) of patients. Nonsignificant reduction was observed in 17% (207/1214) of patients. The remaining studies, representing 59% (716/1214) of patients explored DFMO's pharmacological/biological effects without elucidating its direct impact on KC. Topical DFMO shows modest efficacy in reducing the number of actinic keratosis (AK), as indicated in 4 studies representing 38.12% (154/404) of patients. For patients taking the oral eflornithine, the most frequently reported adverse events included reversible ototoxicity (11% of patients) gastrointestinal disturbances (10.39%). For the topical DFMO transient local cutaneous eruptions were common impacting 28.76% (111/386) of patients. Current evidence highlights the lack of conclusive data supporting the efficacy of oral DFMO, making it difficult to recommend its use. Conversely, topical DFMO demonstrates more promising outcomes in preventing AKs, presenting a potentially useful alternative in select patients.

A Review on Knowledge, Perception, Practice and Associated Factors of Sunscreen Usage among the Population

Background: The use of sunscreen is a critical component of skin cancer prevention and overall skin health. Nevertheless, inconsistencies in sunscreen knowledge, perceptions, and practices persist among different populations, which are influenced by various factors. This review aims to synthesise and analyse the existing literature on the knowledge, perceptions, and practices related to sunscreen use across different populations and regions. It explores the factors influencing sunscreen application and the barriers to proper sunscreen use. Methods: A comprehensive review of studies published between 2015 and 2023 was conducted, focusing on quantitative research on sunscreen knowledge, perceptions, and practices. Journals were obtained from EBSCo, Scopus and Mendeley databases. Results: The initial article obtained from databases was 1250 articles, and the final articles chosen for review is 32 articles. This review highlights significant knowledge gaps about sunscreen use, particularly the need for sunscreen on cloudy days and understanding SPF values. Despite high awareness of UV radiation's harmful effects, actual use remains inconsistent. Common misconceptions, such as believing sunscreen is unnecessary in winter or indoors, persist across demographics. Perceptions of sunscreen's efficacy vary. Factors like sex, skin phototype, age, and education level significantly influence use, with barriers including forgetfulness, discomfort, cost, and lack of habit. Conclusion: The findings underscore the need for enhanced educational campaigns to correct misconceptions and promote consistent sunscreen use. Targeted interventions should address specific barriers and tailor messages to different demographic groups to improve sunscreen practices and reduce the risk of UV-induced skin damage.