Whole-body Skin Research Articles

Hand eczema and skin complaints in particulate matter-exposed occupations - firefighters, chimney sweepers, and ferrosilicon smelter workers in Norway

BackgroundThe objective was to investigate self-reported hand eczema, and skin complaints at other skin locations among workers exposed to particulate matter, especially ultrafine particles.MethodWe conducted a cross-sectional study on workers from one ferro-silicon smelter plant, eight chimney sweeper stations and one firefighter station across Norway. Participants answered an extended version of the Nordic Occupational Skin Questionnaire (NOSQ-2022), with additional questions about whole-body skin complaints and visible dust deposition. Results are presented as descriptive data using firefighters as reference group. Odds ratio (OR) was calculated using logistic regression on lifetime prevalence of hand eczema adjusted for potential confounders and mediators. P-values were calculated using likelihood ratio test against the crude OR.ResultsA total of 186 participants answered the questionnaire: 74 chimney sweepers, 52 firefighters and 60 smelter workers. Participation rate was 95.0, 94.5 and 63.6%, respectively. Lifetime prevalence of hand eczema was 9.5, 9.6, and 28.3%, respectively. The point prevalence of hand eczema was 1.4, 1.9 and 10.0%, respectively. We estimated OR for lifetime hand eczema in smelter workers to 4.36 [95% CI: 1.31–14.43, p = 0.016] and for lifetime skin complaints in other locations to 2.25 [95% CI: 0.98–5.18, p = 0.058]. The lifetime prevalence of skin complaints at other locations was 18.9, 23.1 and 40.0%, respectively. The point prevalence was 14.9, 9.6 and 16.7%, respectively. These estimates were not statistically significant but indicates that smelter workers have more skin complaints also at other locations.ConclusionThis study reports a more than four-fold increased risk of hand eczema in smelter workers, and possibly a higher risk of skin complaints in other body locations, compared to the other occupations. Longitudinal studies with larger population are needed to verify the marked increased risk of eczema among smelters and establish causation.

Lenvatinib-induced severe generalized erythematous rash in a patient with hepatocellular carcinoma.

Lenvatinib, an oral multikinase inhibitor, is a first-line drug for the treatment of unresectable hepatocellular carcinoma. Here, we report a case of a 72-year-old man who presented with severe generalized erythematous rash (GER) approximately four weeks after the commencement of lenvatinib treatment, which he had been receiving for the treatment of unresectable lung metastases stemming from hepatocellular carcinoma. The patient had suffered from ichthyosis since his childhood, which made the diagnosis difficult. He had been diagnosed with dermatomycosis of the skin of whole body and treated by terbinafine tablets and luliconazole cream at another hospital. After remission of GER, lenvatinib was readministered because the patient’s metastatic lung tumor enlarged, which led to a recurrence of erythema with pruritus on the upper part of patient’s body. We confirmed the diagnosis of Lenvatinib-induced generalized GER based on the positive result of the patch test after the informed consent. To the best of our knowledge, this is the first detailed case of lenvatinibinduced GER. Raising physicians’ awareness of this potentially severe adverse effect is of importance because of lenvatinib’s increasing prominence as the drug of choice in cancer therapy.

Volatile organic compound emissions from the human body: Decoupling and comparison between whole-body skin and breath emissions

The human body can affect indoor air by emitting volatile organic compounds (VOCs) through breath and skin. However, studies on the quantitative characteristics of skin VOC emissions are scarce compared to those on the characteristics of breath emissions. Moreover, the species and emission rates of VOCs emitted from the breath and whole-body skin of a single person have rarely been reported. In this study, VOCs emitted from the whole-body skin and breath of 14 young adults under controlled conditions were decoupled and measured. The number of VOC species emitted from each study participant's whole-body skin and breath ranged 38–69 and 28–55, respectively, with total emission rates of all detected VOCs of 164–518 and 286–1030 μg/h, respectively. The VOCs in the high-detection rate intervals also had higher emission rates, increasing their importance in human body emissions. There were 9–26 common VOCs and 25–47 different VOCs between the skin and breath emissions. Acetone was detected in both the skin and breath emissions of all study participants, with the highest emission rate in each participant's whole-body emissions. Ketones, siloxanes, aldehydes, and alcohols contributed the most to the whole-body skin emission rates of each study participant, whereas ketones and alkenes alone accounted for most of the breath emission rates. Analysis of the generation mechanisms found that endogenous and exogenous VOCs were dominant in breath and skin emissions, respectively. These results can enrich the qualitative and quantitative characteristics of breath and skin emissions and improve understanding of emission mechanisms.

Prevalence and associated factors of dry skin among older inpatients in hospitals and nursing homes: A multicenter cross-sectional study

Background/objectivesDry skin is a common skin problem in older persons. Aim of this study was to determine the prevalence, associated factors of dry skin in older inpatients. DesignA multicenter cross-sectional study was designed and conducted. Settings/participantsOn 31 March and 29 May in 2021 two days, fifty hospitals and two nursing homes in China participated in the study. In total, 33,769 participants were included. The mean age was 73.2 (SD 8.9) years. MethodsA whole-body skin examination and associated data collection were performed by 1067 trained nurses based on a standardized data form and methods. Descriptive and univariable analyses and multivariable logistic regressions were conducted. ResultsIn total, 11,602 participants had dry skin with a prevalence of 34.4%, mainly located on the upper and lower limbs with very severe skin dryness, 21.2% of the participants reported that their dry skin had pruritus, and 12.5% complained that sleep was affected by dry skin. The stronger predictor for dry skin was nursing homes (OR 5.07, 95% CI 3.99–6.45). Other predictors for dry skin were age, male sex, nutrition, lower activity level, skincare dependence, renal and pulmonary impairment, diabetes mellitus, varicose veins, cardiovascular diseases and Parkinsonism, diuretics, statins and antibiotics. The predictive model of area under ROC curve was 0.628(95% CI 0.622–0.634). ConclusionsThe prevalence of dry skin among Chinese older patients was at high level and was associated with multiple factors. Persons with skin dryness have a higher proportion of skin itching and poor sleep. RegistrationIt has been registered in the Chinese Clinical Trial Registry (ChiCTR2100042893).

Skin volatile organic compound emissions from 14 healthy young adults under controlled conditions

The human skin is an important source of volatile organic compounds (VOCs) in indoor environments. In this study, VOC emissions from whole-body skin of 14 healthy young adults were measured using a specially designed environmental chamber under controlled conditions. The number of VOC species in whole-body skin emissions ranged from 38 to 69 and the total emission rate of all VOCs detected in whole-body skin emissions ranged from 164 to 518 μg/h. The similarities of VOC species among different subjects were more prominent, while the emission rate of the same VOC among different subjects varied significantly. In particular, eight VOCs (acetone, 6-methyl-5-hepten-2-one (6-MHO), geranylacetone, hexanal, heptanal, octanal, nonanal, and decanal) were emitted from the skin of all subjects, most likely originating due to the reaction of ozone with human skin. These VOCs accounted for a relatively large proportion of the total emission rate, indicating that the reaction of skin with ozone was an important source for skin VOC emissions. In addition, siloxanes, aldehydes, ketones, and alcohols contributed remarkably to whole-body skin emission rates. Overall, this study showed information on the apportionments of VOC species and emission rates of whole-body skin emissions, which shed more light on the emission characteristics of human skin as a VOC source.

Kimura's disease successively affecting multiple body parts: a case-based literature review

BackgroundKimura’s disease is a rare, benign, chronic inflammatory disease that presents as painless, solid masses mainly affecting the deep subcutaneous areas of the head and neck, especially the salivary glands, parotid glands and nearby lymph nodes. It is characterized by elevated peripheral blood eosinophil and Immunoglobulin E (IgE) levels.Case presentationA 31-year-old Asian male presented with an orbital space-occupying lesion lasting for 1.5 years. Ten years prior, surgical excision of bilateral fossa cubitalis and groin masses was performed, and the pathological examination showed "lymphoproliferative disease". One year later, masses reappeared near the surgical sites; they grew slowly and shrank after glucocorticoid treatment. At this point, admission examinations showed in the peripheral blood an eosinophil proportion of 13.4%, a total IgE level of 26,900.00 IU/mL, prurigo present on the whole body, and multiple palpable masses near the bilateral fossa cubitalis and groin. The left eyeball was exophthalmic. The left elbow mass was excised, and the pathological examination confirmed Kimura’s disease. Oral glucocorticoid therapy is taken and tapering regularly. The eosinophil count returned to normal, the IgE level gradually decreased, the orbital space-occupying lesion and elbow and groin masses shrank significantly, and the whole-body skin prurigo disappeared. Currently, the patient has been in a stable condition for eighteen months.ConclusionOur case provides a novel insight that Kimura’s disease should be involved in the differential diagnosis of inflammatory lesion mass of orbit and also supports systemic regular glucocorticoid as a valuable therapy of such condition, but close follow-up and long-term observation are crucial.

Analysis of various factors influencing the development of birthmarks and cutaneous lesions in newborn infants

Cutaneous lesions are very frequent in neonates. Despite the fact that the incidence of neonatal skin disorders has been reported in several studies, very few reports address the factors that influence the appearance of birthmarks. In this cross-sectional study, we aimed to record cutaneous findings in essentially healthy, term and late preterm neonates, and to use this data to assess the associations between various factors and the appearance of birthmarks. The study was conducted on consecutive neonates born between April 2014 and April 2015 at the Department of Obstetrics and Gynecology at the University of Szeged. After the whole-body skin examination, a standardized questionnaire consisting of 50 questions was completed by the mothers. Data relating to the neonatal history of the participating neonates were obtained from the official neonatal medical charts. A total of 1629 Caucasian neonates were included in the study. Of these, 88.15% exhibited at least one skin manifestation. Significant correlations were found between the newborn gender, gestational age and weight and the presence of many skin manifestations. Furthermore, sociodemographic factors, parental phenotypic characteristics, maternal diseases and medicine-taking habits also have impact on the development of certain cutaneous lesions. By examining a large number of newborns and by providing detailed analysis of several neonatal, perinatal and parental factors, our study contributes to a deeper understanding of the development of the examined cutaneous lesions. Orv Hetil. 2022; 163(13): 513-522.

Workforce Requirements for Skin Cancer and Related Skin Tumors Continue to Increase: Clinicians Expend an Average of 1,740 Full-Time Effort Years Annually.

With an aging population, estimating workforce requirements for management of common conditions such as skin cancer will be necessary to meet the health care needs of the American people. The authors aimed to estimate the workforce requirements for managing skin cancer and other skin tumors. The authors conducted a population-based, cross-sectional analysis using data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey between the years 2007 and 2016, the most recent years available. The significance threshold was set at a p-value <.05. The full-time effort of 1,740 (95% confidence interval: 1,340-2,220) clinicians is required to care for skin cancer and other skin tumors each year. The full-time effort years necessary for management of melanoma (p = .006), keratinocytic carcinoma (p < .0001), actinic keratosis (p < .0001), and all skin cancers and tumors (p < .0001) were significantly increasing from 2007 to 2016. Clinicians expend a significant amount of time managing skin cancer and other skin tumors, and the time required for management increased over the study period. These workforce requirement trends can likely be attributed to increased prevalence and incidence rates of cutaneous malignancy secondary to an aging population and increased whole-body skin examinations.

Prevalence of skin diseases in school-age children.

The prevalence of community-based skin diseases, especially among school-age children, depends on topography, climate, and age of population. We determined the prevalence of skin diseases among community-based primary school-age children and identified demographic characteristics in relation to particular skin conditions. This was a cross-sectional descriptive survey study of a subproject school cohort in children aged 5-14 years of 2 community-based primary schools. Demographic data and whole-body skin examination were collected. The association of individual skin conditions was analysed by using bivariate and multivariable binary logistic regression. A total of 556 children were enrolled in this study. Of these, 90.2% had at least 1 skin disease. The most common skin disease was postinflammatory hyperpigmentation (PIH) (58.3%), followed by nevus/mole (40.1%), insect bite reaction (28.0%), acanthosis nigricans (20.0%), acne (13.7%), and pityriasis alba (12.9%). There was an increase of body mass index (BMI) in PIH and acanthosis nigricans with the adjusted odds ratios of 2.01 (95% confidence interval [CI] 1.40-2.87, P < 0.001) and 1.93 (95% CI 1.49-2.49, P < 0.001), respectively. Insect bite reaction was related to PIH with the adjusted odds ratio of 5.66 (95% CI 3.15-10.17, P = 0.001). The most common skin disease in community-based primary school-age children is PIH which related to acanthosis nigricans and insect bite reaction. A decrease of BMI may lower the risk for PIH and acanthosis nigricans. Education on common skin diseases is recommended for both community-based schools and school-age children.

Molecular Mapping of Sebaceous Squalene by Ambient Mass Spectrometry.

Squalene (SQ), a highly unsaturated sebaceous lipid, plays an important role in protecting human skin. To better understand the role of SQ in clinical medicine, an efficient analytical approach is needed to comprehensively study the distribution of SQ on different parts of the skin. In this study, sebaceous lipids were collected from different epidermal areas of a volunteer with sampling probes. Thermal desorption-electrospray ionization/mass spectrometry (TD-ESI/MS) was then used to characterize the lipid species on the probes, and each TD-ESI/MS analysis was completed within a few seconds without any sample pretreatment. The molecular mapping of epidermal squalene on whole-body skin was rendered by scaling the peak area of the extracted ion current (EIC) of SQ based on a temperature color gradient, where colors were assigned to the 1357 sampling locations on a 3D map of the volunteer. The image showed a higher SQ distribution on the face than any other area of the body, indicating the role of SQ in protecting facial skin. The results were in agreement with previous studies using SQ as a marker to explore sebaceous activity. The novelty and significance of this work are concluded as two points: (1) direct and rapid detection of all major classes of sebaceous lipids, including the unsaturated hydrocarbons (SQ) and nonpolar lipids (e.g., cholesterol). The results are unique compared to other conventional and ambient ionization mass spectrometry methods and (2) this is the first study to analyze SQ distribution on the whole-body skin by a high-throughput approach.

Incidence of Non-Melanoma Skin Cancers in Patients with Chronic Lymphocytic Leukaemia: A Retrospective Study in a Bay of Plenty, New Zealand Population

Background/Aims: Chronic lymphocytic leukaemia (CLL) incurs an increased risk of developing second primary malignancies (SPMs). The pathogenesis underpinning this increased SPM risk is attributable to synergism between genetic aberrations, chronic immune suppression / dysfunction and CLL treatments. Specifically, CLL associated skin cancer is a well-documented phenomenon, with common malignancies such as squamous (SCC) and basal cell (BCC) carcinomas occurring at higher frequencies in CLL patients and are often of a more aggressive phenotype. The incidence of non-melanoma skin cancers (NMSCs) among New Zealand CLL patients is unknown, as NMSCs are not required to be reported to the New Zealand Cancer Registry. Accordingly, this study aimed to analyse the incidence of NMSC in CLL patients from the Bay of Plenty region of New Zealand.Methods: We conducted a retrospective analysis of 213 CLL patients, who were referred to Bay of Plenty District Health Board (BOPDHB) between 2015 and 2020, for the occurrence of SPMs. Clinical notes were reviewed for the demographics of sex, age at time of CLL diagnosis, CLL treatments received and occurrence and type of NMSCs. A control group of 76 patients referred to BOPDHB haematology, for anaemia or thrombocytopenia, of which the cause subsequently remained unknown and was not associated with lymphoproliferative disease, was reviewed for primary malignancy (PM), occurrence and type. NMSC incidence was also compared to a local data, on overall NMSC incidence in the general Bay of Plenty population, in 2015.Results: The predominant SPM types occurring in this CLL patient group were NMSCs. A total of 249 and 170 histological diagnoses of SCC and BCC were made in our group of CLL patients, respectively. Of the 213 CLL patients, 48.8% had a diagnosis of at least one NMSC, with median time between CLL and NMSC diagnosis of 5 years (range, -6 to 19 years). CLL patients that were diagnosed with NMSC developed a mean number of 3.93 ± 2.94 separate lesions, compared to 2.6 ± 1.7 lesions in our control population. Note: comparison of NMSC incidence data between CLL group and Bay of Plenty populationConclusion: Patients with CLL are at increased risk of developing multiple NMSC lesions. Therefore, we believe CLL patients should be assessed by dermatologists or general practitioners for whole-body skin examination, 6 monthly following their CLL diagnosis. This strategy promotes early diagnosis, and patient education on importance of sun protection strategies to reduce NMSC risk. This is essential to the ongoing care of CLL patients in a NZ context, given the increased incidence of NMSC associated with CLL, in combination with the high levels of UV exposure and skin damage among the NZ general population. This study also highlights how NMSC disease burden is likely to be significantly underestimated due to a lack of data collection on these malignancies by the New Zealand Cancer Registry. DisclosuresNo relevant conflicts of interest to declare.

142 Transcriptome Analysis Captures Radiation Exposure in a Dose-sensitive Manner and Predicts Short-term Survival in a Mouse Model

Abstract Introduction A mass exposure to irradiation would be a challenge to health care systems. A simple tool or test that indicates the intensity of the absorbed radiation or the chances of survivability would be invaluable in this scenario. To identify biomarkers that potentially could provide novel biodosimetry tools, we have conducted a radiation dose-response and time-course experiment in mice that includes an assessment of the transcriptome of the skin. Methods Groups of mice (n=5) received whole-body X-ray exposures (0, 1, 3, 6, or 20Gy) and skin biopsies were obtained from each animal at times post-irradiation (h2, Days 4, 7, 21, 28). Biopsies were collected from the 20Gy cohort for only days 0, 4, and 7. Total RNA was isolated and microarrays were performed and analyzed using custom R scripts to obtain lists of probe sets differentially expressed. Changes in gene expression at Benjamini-Hochberg FDR adjusted P &amp;lt; 0.05 and FC &amp;gt;2 were deemed significant. Analyses were performed comparing the different doses of X-ray exposure over all time points. Results Mice in the 20Gy group were euthanized by d7 and the dose was considered lethal. Animals in 1, 3, and 6Gy groups completed the full experiment to d28. Sammon plot analysis of transcriptomes showed clear separation of samples based on the irradiation levels and time after exposure. The clearest separation was between samples of lethal and sublethal doses. Samples from animals exposed to sublethal doses separated more based on timepoints rather than the IR dose suggesting a level of similarity in the progression of the response to sublethal doses. Downregulation was the dominant modulation in the significantly differentially transcribed genes (SDTGs) in the 20Gy group. Temporal changes in ratios of upregulated/downregulated SDTGs (P &amp;lt; 0.05 and FC &amp;gt; 2) revealed further the difference between of transcriptome responses after exposure to lethal and sublethal doses and indicated a delayed peaks response with increasing IR doses within the sublethal range. About 59% of the SDTGs in 20gy were common to all timepoints while no more than 11% were common at the same duration in the other groups. Ratios of the number of SDTGs at h2 to those common to all TPs decreased in a dose-dependent manner with potential radiation dosimetric applications. Conclusions These results demonstrate a solid ability in detecting IR exposure, differentiating lethal and sublethal exposures, and differentiating among the exposure to sublethal doses.

Cooling Between Exercise Bouts and Post-exercise With the Fan Cooling Jacket on Thermal Strain in Hot-Humid Environments.

This study investigated the effects of cooling between exercise bouts and post-exercise with a commercially available fan cooling jacket on thermal and perceptual responses during and following exercise in hot-humid environments. Ten male athletes completed two 30 min cycling bouts at a constant workload (1.4 watts⋅kg–1 of body mass) with a 5 min recovery period in between. Exercise was followed by a 10 min recovery period. In an environmental chamber (33°C, 65% relative humidity), participants performed two trials with (FCJ) or without (CON) the fan cooling jacket on a T-shirt during the 5 min inter-exercise and 10 min post-exercise recovery periods. Mean, chest and upper arm skin temperatures, and thermal sensation and comfort were lower in FCJ than CON trial during and following exercise (P < 0.05). Thigh and calf skin temperatures, infrared tympanic temperature and heart rate were lower in FCJ than CON trial during the experimental trials (P < 0.05). The rates of fall in mean, chest and upper arm skin temperatures, infrared tympanic temperature and thermal sensation and comfort were faster in FCJ than CON trial during both recovery periods (P < 0.05). There were faster rates of fall in thigh and calf skin temperatures and heart rate in FCJ than CON trial during the post-exercise recovery period (P < 0.05). No difference was observed between trials in the rating of perceived exertion (P > 0.05). This study indicates that cooling between exercise bouts and post-exercise with the fan cooling jacket would effectively mitigate thermal strain and perception/discomfort during and following exercise in hot-humid environments. This garment would reduce whole-body skin temperature quickly while promoting falls in lower-body as well as upper-body skin temperatures.

Prevalence of skin examination behaviours among Australians over time

BackgroundWe aimed to examine the prevalence and correlates of opportunistic skin check behaviours among Australians and whether changes over time might explain increasing underlying rates of melanoma in situ. MethodsThe National Sun Protection Survey involved periodic telephone-based cross-sectional surveys during summer since 2003. Skin checks by a doctor in the past 12 months was asked in four summers over 2006–2017, and responses from 23,374 Australians aged 12–69 years were analysed. Prevalence estimates were weighted to be representative of the Australian population. Chi-square tests compared the prevalence over time and by characteristics. ResultsThe overall proportion reporting whole-body skin checks in the past 12 months was 20 % in 2006−07 and 2010−11, 21 % in 2013−14, and 22 % in 2016−17; but increased from 29 % in 2006−07 to 37 % in 2016−17 for those aged 45–69 years (p < 0.0001). In 2016−17, 5% reported a skin check of part-body and 9% for a specific mole or spot. The proportion reporting no skin checks increased from 61 % to 64 % over time (p < 0.0001). Whole-body skin checks were more common among older respondents, females, and also varied by residence location, skin sensitivity, skin colour, risk perception, and socio-economic index (all p < 0.001). ConclusionApproximately one third of Australians had their skin checked by a doctor within a 12-month period, but this varied across population sub-groups. Skin check behaviours were relatively stable over time, with modest increases in the prevalence of skin checks for those aged 45–69 years. These findings do not explain underlying large increases in rates of melanoma in situ.

Abstract PO-251: Examining facilitators and barriers to cancer screening among Black firefighters in South Florida

Abstract Purpose: Epidemiologic studies of cancer among U.S. firefighters suggest a disproportionate burden of select cancer types including respiratory, gastrointestinal, skin, and kidney when compared to the general population. Although routine colorectal and whole-body skin cancer screening is widely recommended, screening rates among firefighters remain low. The National Fire Protection Association estimates a 1.1 million firefighter workforce, most of whom are Caucasian male, however, sub-groups of women, Hispanic, sexual minority, and Black firefighters are growing. In the present study we describe facilitators and barriers to cancer screening among Black firefighters. Method: A semi-structured interview script was used to conduct five focus group sessions of 45 to 60-minute duration with a total of 22 Black firefighters in South Florida between December 2019 and June 2020. A 20-item demographic survey was administered prior to the start of the interview. Data analysis was conducted using a grounded theory approach and NVIVO 12 software. Qualitative data was analyzed for themes and patterns. Results: Among participating Black firefighters, 90.9% were male, 4.6% Hispanic, 77.3% married, 68.1% with college/master’s educational attainment, 72.7% with private health insurance, 72.7% had a personal doctor, and a group mean age was 44 years (SD ± 8.7 years). Across all focus group sessions, the following three major themes emerged as facilitators and barriers to cancer screening: 1) societal culture of machismo and familial culture; 2) cancer education and cancer awareness; and 3) individual faith. Black firefighters describe culture as influencing health decisions and behaviors throughout their lives, including food choices, receiving a health screening, or visiting a doctor. A second prevalent theme focused on education and cancer awareness; specifically, Black firefighters did not feel comfortable with doctors, particularly because they were Black and firefighters. Many felt that their doctors are not as aware of racial health differences as they should be, and they had to bring information to their doctors about firefighters’ unique job exposures. Lastly, a third theme describing individual faith influencing cancer screening practices frequently emerged. Many participants reported faith as being very important to them, however, they would not let religious beliefs prevent them from seeking medical interventions when needed. Conclusion: Black societal culture of machismo, cancer education and awareness, and individual faith were identified as facilitators and barriers of cancer screening among Black firefighters in South Florida. Strategies to improve cancer screening and prevention for Black firefighters should consider these factors in the design of workplace cancer interventions for this unique minority occupational subgroup. Citation Format: Kemi Ogunsina, Natasha Solle, Lauren A. Murphy, Debi Brannan, Keith Bell, William McAlister, Erin Kobetz, Alberto Caban- Martinez. Examining facilitators and barriers to cancer screening among Black firefighters in South Florida [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-251.

The High Prevalence of Skin Diseases in Adults Aged 70 and Older.

To determine the prevalence of skin findings and skin diseases in adults aged 70 and older, and to study the association between cutaneous diseases and socioeconomic status (SES), sex, and living status in the older population. Cross-sectional study of Finnish adults aged 70 to 93 as part of the Northern Finland Birth Cohort 1966 Study. Skin examination data were available for 552 adults. A whole-body skin examination was performed by dermatologists. The associations between skin diseases and SES, sex, and living status were analyzed. Nearly 80% of the adults had at least one skin disease that required further treatment or follow-up. More than one-third of the study cases (39.1%) had three or more simultaneous skin diseases. Skin diseases were more common in men than in women (P < .001). The most common skin diseases were tinea pedis (48.6%), onychomycosis (29.9%), rosacea (25.6%), actinic keratosis (22.3%), and asteatotic eczema (20.8%). Some association was found between skin diseases and SES and living status. A whole-body clinical skin examination is important because it reveals important diagnoses.

An experimental method for measuring VOC emissions from individual human whole-body skin under controlled conditions

The human body is an important source of volatile organic compounds (VOCs), especially in densely occupied environments. This research provides an experimental method for separately measuring the whole-body skin emissions of an individual person under controlled conditions. The designed experimental device consisted of a 1.5 m3 stainless steel test chamber and a transition chamber surrounding it. The environmental parameters such as temperature and background concentrations were controlled in both the test chamber and the transition chamber. During measurement, a human subject with standard clothing sat calmly in the test chamber operating in an airtight mode, and breathed through the respiratory channel with a mask tightly covering the face. A male subject was tested to verify the feasibility and repeatability of this experimental method. The results showed that VOCs emitted from the whole-body skin had accumulated in the test chamber air and changed linearly, indicating that the whole-body skin was a nearly stable source of VOCs during the experimental period. The 37 VOCs emitted from this subject's skin showed clear qualitative results, including alcohols, aldehydes, ketones, alkanes, aromatics, esters, alkenes, and acids, and the first three kinds contributed the most to the emissions. The reported VOC emission rates ranged from 0.8 to 86.3 μg/h, and were highly consistent in magnitude with those of the same compounds in the literature. The high repeatability of this experimental method suggested its applicability to explore human skin emissions of more subjects and under various conditions in the future.

A cross-sectional study of skin cancer secondary prevention in rural general practice.

As a result of the lack of evidence ofreduction in mortality, secondary prevention of melanoma and keratinocyte skin cancers (KSCs) with active screening is not recommended except for individuals at high risk. Limited access to medical professionals for diagnosis and specialised treatment of skin cancers are related to poorer health outcomes for Australians living in rural areas. The aim of this study was to evaluate the secondary prevention of skin cancer in general practice. A clinical audit of 317 melanomas and 5463 KSCs was conducted, examining the nature of consultation and stage of cancer at diagnosis. It was more common for an uncomplicated melanoma ≤1 mm in size to be identified by a general practitioner (GP) during a planned whole-body skin examination than to be the presenting complaint found by the patient (χ2 = 4.2, P <0.05). Half (49%) of KSCs found were the presenting complaint, with 21% an incidental diagnosis during another presentation and 30% found during whole-body skin examinations. Half of all squamous cell carcinomas found were at the intra-epidermal stage. Secondary prevention of skin cancer by GPs is a value proposition for rural populations.

Atopic dermatitis shows significant cutaneous comorbidity: results from large-scale investigations in the working population.

Atopic dermatitis (AD) is one of the most common chronic inflammatory diseases of the skin. Rare large-scale data have been published on the prevalence of concomitant dermatoses. To analyse the prevalence and cutaneous comorbidity of AD in Germany. A cross-sectional study on voluntary whole-body skin checks by trained dermatologists in over 400 companies throughout Germany reflecting the adult working population was conducted. Prevalence ratios (PR) were calculated to compare dermatological comorbidity in employees with and without current AD. A logistic regression analysis controlling for age, sex and skin type revealed odds ratios (OR) of the occurrence of skin diseases in AD. A total of N=118939 people were examined between 2006 and 2017 (43.2% female, mean age 43.2±10.7years, min. age 16years, max. age 70years). AD (point prevalence) was identified in 1.45% (men: 1.50%, women 1.39%) and decreased significantly with age. Self-reported lifetime prevalence of AD was 4.95% (men: 3.72%, women: 6.55%). The following skin diseases were significantly more frequent in people with current AD: Contact dermatitis (PR: 3.38), hand eczema (PR: 4.62), exsiccation dermatosis (PR: 2.19), folliculitis (PR: 1.95) and port-wine stains (PR: 1.49). Among those, folliculitis was the most frequent (prevalence in AD 16.42%). Controlled for age, sex and skin type, AD was significantly associated with - among others - hand eczema (OR: 3.96; 95% CI: 2.95-5.32), contact dermatitis (OR: 2.97; 95% CI: 1.50-5.88) and exsiccation dermatosis (OR: 1.78; 95% CI: 1.30-2.44). Psoriasis was significantly less frequent in people with AD (OR: 0.61; 95% CI: 0.39-0.94). In summary, cutaneous comorbidity is frequent and of great importance in people with AD, suggesting the need for comprehensive, dermatologically guided diagnostics in AD.

Skin Cancer Early Detection Practices among Adult Survivors of Childhood Cancer Treated with Radiation

Because rates of skin cancer are greater among adult survivors of childhood cancer who received radiation therapy than among the general population, the National Cancer Institute recommends skin self-examinations and annual physician examination. There has been no comprehensive assessment of survivors' adherence to the skin cancer screening guidelines associated with skin self-examination (SSE) and physician whole-body skin examination (PSE). We conducted a cross-sectional survey of radiation-treated, adult 5-year survivors of childhood cancer, diagnosed between 1970 and 1986, in the Childhood Cancer Survivor Study cohort. Multivariate multinomial logit regression investigated the association between demographic, cancer diagnosis, patient activation, cancer treatment characteristics, and skin cancer screening practice. Among 728 survivors, 13.1% reported performing SSE in the prior 2 months plus receiving PSE in the prior 12 months, and 16.4% and 11.0% reported performing only an SSE or a PSE, respectively; 59.5% of survivors reported having had neither. Participants at the highest patient activation score were most likely to report SSE plus PSE compared with neither (adjusted relative risk ratio= 4.16, 95% confidence interval= 1.34-12.85). Most adult survivors of childhood cancer who had radiation therapy do not practice strategies that promote early detection of skin cancer. Interventions designed to activate survivors to increase their participation in screening are needed.