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Austin, A. S.; Spiller, R. C. (2001): Inflammatory bowel disease, azathioprine and skin cancer: case report and
literature review. In: Eur J Gastroenterol Hepatol, Jg. 13, H. 2, S. 193–194.
Abstract A 42-year-old blond Caucasian woman taking azathioprine for 8 years developed
an intra-epidermal carcinoma of the shin. She regularly used a sun bed to maintain
a tan. Although the increased risk of non-melanoma skin cancer in
immunosuppressed transplant recipients is well recognized, patients with Crohn‘s
disease are not currently warned of the risk of exposure to ultraviolet light.
Individuals with inflammatory bowel disease who take azathioprine, especially those
with a fair complexion, should be informed of the potential dangers of sun bathing
and should be advised to limit sun exposure.
Schlagwörter case reports; Humans; Skin Neoplasms; Female; Immunosuppressive Agents;
Azathioprine; Sunlight; Adult; Inflammatory Bowel Diseases

Bergenmar, M.; Brandberg, Y. (2001): Sunbathing and sun-protection behaviors and attitudes of young Swedish
adults with hereditary risk for malignant melanoma. In: Cancer Nurs, Jg. 24, H. 5, S. 341–350.
Abstract The aim of the study was to describe attitudes toward sunbathing and sun
protection, to examine sun-related behaviors, and to present an effort to change
sun-related behaviors among young adults without a cancer diagnosis in
melanoma-prone families. Ten patients were interviewed, and questionnaires were
sent on 3 occasions during a 15-month period to the total population (n = 87)
meeting the inclusion criteria. Data from interviews and questionnaires showed
extensive ultraviolet-exposure behaviors in this high-risk group for melanoma,
although not always expressed in terms of sunbathing. When asked about
sunbathing, 1/3 reported sunbathing "Often" or "Very often," despite a decrease in
sunbathing during the study period. In addition, 35% reported current sun bed use.
The most important reason for sunbathing was attractiveness. The risk of getting
skin cancer was the most important reason to refrain from sunbathing. The majority
estimated their own risk for melanoma as equal or lower compared with the general
population. The planned intervention failed due to low attendance. Ultraviolet
exposure is extensive. The individual perception of personal risk and the motivation
to change behaviors are important factors to consider when designing a preventive
program. Interest for group information was low in this age group.
Schlagwörter research support, non-u.s. gov‘t; Genetic Predisposition to Disease; Humans; Skin
Neoplasms; Female; Sunburn; Male; Sweden; Melanoma; Analysis of Variance;
Adult; Health Knowledge, Attitudes, Practice

Boyd, Alan S.; Shyr, Yu; King, Lloyd E. (2002): Basal cell carcinoma in young women: an evaluation of the
association of tanning bed use and smoking. In: J Am Acad Dermatol, Jg. 46, H. 5, S. 706–709.
Abstract Basal cell carcinomas (BCCs) typically occur in middle-aged to elderly patients but
less commonly in younger ones. In our experience, most BCCs seen in patients
younger than 40 years are found in women. We evaluated 30 women with biopsy-
proven BCC and 30 control patients matched for sex, age, and skin type to
determine potential risk factors for this population. Tanning bed visits, pack-years of
cigarette smoking, recreational sun exposure, number of blistering sunburns, and
use of sunscreens were determined for both groups. Among patients with a BCC,
the histologic type of tumor, site of involvement, method of treatment, follow-up
period, incidence of recurrence, and presence of actinic keratoses were also
evaluated. Patients with a BCC had a statistically greater number of pack years of
smoking (P =.045), and a greater percentage of these women had experienced
blistering sunburns (P =.028). Although women with a BCC had, on average, almost
twice as many tanning salon visits (152.2 vs 83.1), this was not statistically
significant. Sunscreen use and amount of recreational ultraviolet light exposure
were essentially equal between the two groups. Young women with a BCC are
more likely to have a past or current history of cigarette smoking and blistering
sunburns. Repeated exposure to tanning beds may also be a contributory factor.
Sunbeds - Citavi
Schlagwörter Incidence; Attitude to Health; Biopsy, Needle; Humans; Middle Aged; Skin
Neoplasms; Risk Factors; Ultraviolet Rays; Female; Reference Values; Cohort
Studies; Heliotherapy; Case-Control Studies; Beauty Culture; Sampling Studies;
Smoking; Adult; Age Distribution; Probability; Carcinoma, Basal Cell; Adolescent

Brodthagen, H. (1982): Malignant melanoma caused by UV-A suntan bed. In: Acta Derm Venereol, Jg. 62, H. 4,
S. 356–357.
Schlagwörter case reports; Neoplasms, Radiation-Induced; Humans; Skin Neoplasms; Ultraviolet
Rays; Female; Melanoma; Skin; Adult

Buckel, Tamy B. H.; Goldstein, Alisa M.; Fraser, Mary C.; Rogers, Barbara; Tucker, Margaret A. (2006): Recent
tanning bed use: a risk factor for melanoma. In: Arch Dermatol, Jg. 142, H. 4, S. 485–488.
Abstract BACKGROUND: Individuals at increased risk of melanoma should use sun-
protective measures to decrease their risk of developing melanoma.
OBSERVATION: We report a case of a 39-year-old patient with a CDKN2A
mutation who developed 3 primary melanomas within a few years of initiating
tanning bed use. CONCLUSION: Intense UV exposure as an adult likely contributed
to the development of additional primary melanomas in this individual.
Schlagwörter case reports; Humans; Shoulder; Skin Neoplasms; Risk Factors; Diagnosis,
Differential; Ultraviolet Rays; Mutation; Melanoma; Male; research support, u.s.
gov‘t, p.h.s.; Beauty Culture; Leg; Adult; Cyclin-Dependent Kinase Inhibitor p16;
Abdomen

Buljan, Marija; Bulat, Vedrana; Situm, Mirna; Mihić, Liborija Lugović; Stanić-Duktaj, Sandra (2008): Variations in
clinical presentation of basal cell carcinoma. In: Acta Clin Croat, Jg. 47, H. 1, S. 25–30.
Abstract Basal cell carcinoma (basalioma, BCC) is the most common skin cancer and the
most common human malignancy in general, with a continuously increasing
incidence. In most cases, BCC develops on chronically sun-exposed skin in elderly
people, most commonly in the head and neck region. Besides chronic UV radiation,
other risk factors for the development of BCC include sun bed use, family history of
skin cancer, skin type 1 and 2, a tendency to freckle in childhood,
immunosuppression, previous radiotherapy, and chronic exposure to certain toxic
substances such as inorganic arsenic. There are numerous variations in clinical
presentation of BCC, such as nodular BCC, ulcerating BCC, pigmented BCC,
sclerosing BCC, superficial BCC, and fibroepithelioma of Pinkus. Each varies in
terms of clinical presentation, histopathology and aggressive behavior. Treatment
modalities for BCC include surgical excision, cryosurgery, curettage,
electrodessication, radiotherapy, photodynamic therapy, topical cytostatics, and
immunomodulators. If left untreated or inadequately treated, BCC may become
invasive and locally destructive, although it very rarely metastasizes. Due to the
extremely high incidence of BCC, medical professionals should be familiar with its
manifold clinical presentations.
Schlagwörter Humans; Skin Neoplasms; review; Carcinoma, Basal Cell

(1993): Careful fun in the sun. Hospital measures UV rays and issues skin cancer advisories. M.D. Anderson
Cancer Center, Houston, TX. In: Profiles Healthc Mark, H. 54, S. 2–7.
Schlagwörter Humans; Skin Neoplasms; Budgets; Hospital Bed Capacity, 500 and over;
Ultraviolet Rays; Texas; Cancer Care Facilities; Health Education

Chan, Henry H. L.; Yang, C. H.; Leung, Joseph C. K.; Wei, W. I.; Lai, K. N. (2007): An animal study of the
effects on p16 and PCNA expression of repeated treatment with high-energy laser and intense pulsed light
exposure. In: Lasers Surg Med, Jg. 39, H. 1, S. 8–13.
Abstract BACKGROUND AND OBJECTIVE: Non-ablative skin rejuvenation treatments that
involve the use of laser/light sources together with cooling devices have gained
much popularity in recent years due to the lack of down time that is associated with
them. One important but neglected issue is long-term safety. Does the repeated use
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of non-ablative skin rejuvenation lead to photoaging? Are we creating another sun-
bed phenomenon? Recently, we performed an in vitro study to examine the effect of
sub-lethal QS 755 nm lasers on the expression of p16INK4a on melanoma cell
lines, and found that sub-lethal laser damage could increase DNA damage, which
led to an increase in p16 expression. Our objective was to assess the cutaneous
effect of repeated exposure to high-energy lasers and intense pulsed light sources
on male Institute of Cancer Research (ICR) mice. STUDY DESIGN/MATERIALS
AND METHODS: Twenty-eight male ICR mice were divided into four groups. Other
than the control group, all groups received either laser (585 nm pulsed dye laser or
1,320 nm Nd:YAG laser) or intense pulsed light (IPL) treatment. All four groups
were anesthetized with a mixture of Hypnorm/Dormicum before treatment. The
animals were irradiated twice a week for 6 months. Signs of toxicity such as
mortality and weight loss were checked once a week. Skin tumor formation was
evidenced by lesions of greater than 1 mm in diameter that persisted for 2 weeks.
At the end of the 6 months, the expression of proliferating cell nuclear antigen
(PCNA) and p16 in the mouse skin was determined by immunohistochemical
staining and immunoblotting using specific monoclonal antibodies for mouse PCNA
and p16. The results were expressed as mean +/- standard error of the mean
(SEM). Statistical difference was assessed by multiple ANOVA. A P-value of <0.05
was considered to be significant. RESULTS: At the end of the 6 months, none of
the animals had developed any signs of toxicity such as mortality or weight lost.
There was no evidence of tumor formation. There were significant elevations of p16
and PCNA in all treated groups as compared to the control group (ANOVA P <
0.05). This particularly applied to the group that was treated with the 1,320 nm
Nd:YAG laser. CONCLUSION: The repeated use of high-energy laser and intense
pulsed light source did not cause any toxicity in mice. The changes in p16 and
PCNA imply that further studies are necessary to consider the implications of
repeated exposure to longer wavelength radiation in human skin.
Schlagwörter Lasers; Animals; Genes, p16; Male; Skin; Mice, Inbred ICR; Time; Proliferating Cell
Nuclear Antigen; Laser Therapy, Low-Level; Mice; Biological Markers

Chen, Weiliang; Li, Jingsong; Yang, Zhaohui; Yongjie, Wang; Zhiquan, Wang; Wang, Youyuan (2008): SMAS
fold flap and ADM repair of the parotid bed following removal of parotid haemangiomas via pre- and
retroauricular incisions to improve cosmetic outcome and prevent Frey‘s syndrome. In: J Plast Reconstr Aesthet
Surg, Jg. 61, H. 8, S. 894-9; discussion 899-900.
Abstract The growth of parotid haemangiomas during the proliferative phase may be rapid
and unpredictable. Involution often takes many years, with attendant psychological
sequelae to the child. Although conservative management is usually proposed for
parotid haemangiomas occurring in infancy, this may not be particularly helpful and
the haemangioma difficult to conceal. The purpose of this study was to evaluate the
reliable and aesthetic benefit of using a superficial musculoaponeurotic system
(SMAS) fold flap and allograft dermal matrix (ADM) repair of the parotid bed
following parotid haemangiomas via pre- and retroauricular incision. Forty-three
paediatric patients (33 boys and 10 girls) with haemangiomas involving the parotid
gland underwent total parotidectomy using a pre- and retroauricular approach with
intraoperative placement of ADM within the parotid bed. They further underwent
repair of the parotid bed with SMAS fold flaps. A panel of three plastic surgeons
assessed the cosmetic outcomes. All of the patients were evaluated using a short
questionnaire; postoperative gustatory sweating was assessed using a modification
of Minor‘s starch-iodine test.
Schlagwörter Child, Preschool; Humans; Treatment Outcome; Esthetics; Parotid Gland;
Hemangioma; Tomography, X-Ray Computed; Female; Infant; Sweating, Gustatory;
Male; evaluation studies; Surgical Flaps; Skin Transplantation; Reconstructive
Surgical Procedures; Parotid Neoplasms

Chernoff, Karen A.; Bordone, Lindsey; Horst, Basil; Simon, Katherine; Twadell, William; Lee, Keagan et al.
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(2009): GAB2 amplifications refine molecular classification of melanoma. In: Clin Cancer Res, Jg. 15, H. 13, S.
4288–4291.
Abstract PURPOSE: Gain-of-function mutations in BRAF, NRAS, or KIT are associated with
distinct melanoma subtypes with KIT mutations and/or copy number changes
frequently observed among melanomas arising from sun-protected sites, such as
acral skin (palms, soles, and nail bed) and mucous membranes. GAB2 has recently
been implicated in melanoma pathogenesis, and increased copy numbers are found
in a subset of melanomas. We sought to determine the association of increased
copy numbers of GAB2 among melanoma subtypes in the context of genetic
alterations in BRAF, NRAS, and KIT. EXPERIMENTAL DESIGN: A total of 85
melanomas arising from sun-protected (n = 23) and sun-exposed sites (n = 62)
were analyzed for copy number changes using array-based comparative genomic
hybridization and for gain-of-function mutations in BRAF, NRAS, and KIT.
RESULTS: GAB2 amplifications were found in 9% of the cases and were
associated with melanomas arising from acral and mucosal sites (P = 0.005).
Increased copy numbers of the KIT locus were observed in 6% of the cases. The
overall mutation frequencies for BRAF and NRAS were 43.5% and 14%,
respectively, and were mutually exclusive. Among the acral and mucosal
melanomas studied, the genetic alteration frequency was 26% for GAB2, 13% for
KIT, 30% for BRAF, and 4% for NRAS. Importantly, the majority of GAB2
amplifications occurred independent from genetic events in BRAF, NRAS, and KIT.
CONCLUSIONS: GAB2 amplification is critical for melanomas arising from sun-
protected sites. Genetic alterations in GAB2 will help refine the molecular
classification of melanomas.
Schlagwörter Proto-Oncogene Proteins B-raf; Gene Dosage; Humans; Middle Aged; Skin
Neoplasms; Neoplasm Staging; Adaptor Proteins, Signal Transducing; Ultraviolet
Rays; Proto-Oncogene Proteins c-kit; Female; Genes, ras; Male; Melanoma; Gene
Frequency; DNA Mutational Analysis; research support, n.i.h., extramural; Gene
Amplification

Cicarma, Emanuela; Porojnicu, Alina Carmen; Lagunova, Zoya; Dahlback, Arne; Juzeniene, Asta; Moan, Johan
(2009): Sun and sun beds: inducers of vitamin D and skin cancer. In: Anticancer Res, Jg. 29, H. 9, S.
3495–3500.
Abstract Solar radiation is both the main cause of all types of skin cancer, including
cutaneous malignant melanoma (CMM), and the main source of vitamin D
accompanied by its beneficial effects. The dilemma lies in that increased sun
exposure could lead to an increase in skin cancers and yet is necessary for the
better prognosis of internal cancers. Solar radiation varies in intensity and spectral
composition with geographic location and time. Of central interest in the present
context is that the UVA/UVB ratio can vary. Thus, the UVA/UVB ratio increases with
decreasing solar elevation. The ratio is also larger for most sun beds than that in
the midday sun, but similar to that in the afternoon sun. This may have large health
implications, since vitamin D is exclusively generated by UVB, while UVA and UVB
likely play a role in the onset of CMM. Sun and sun beds act similarly: one quantum
of radiation at a given wavelength has the same biological effect, irrespective of the
source from which it comes. The winter levels of vitamin D are 10 to 100% lower
than the summer levels in most populations, but can be brought up to summer
levels by moderate sun bed exposure. Doses of 200 IU of vitamin D per day are not
sufficiently large to maintain a summer vitamin D status in winter. At high latitudes
(>40 degrees) the sun provides no vitamin D in winter. A number of epidemiological
studies, interventional studies, animal studies and cell experiments show that
vitamin D reduces the risk and/or prognosis of internal cancers. Populations living at
high latitudes would probably benefit from moderately increasing their exposure to
UVB to provide a good vitamin D status.
Schlagwörter research support, non-u.s. gov‘t; Neoplasms, Radiation-Induced; Sunbathing;
Humans; Vitamin D; Skin Neoplasms; Risk Factors; Skin; Sunlight
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Clough-Gorr, Kerri M.; Titus-Ernstoff, Linda; Perry, Ann E.; Spencer, Steven K.; Ernstoff, Marc S. (2008):
Exposure to sunlamps, tanning beds, and melanoma risk. In: Cancer Causes Control, Jg. 19, H. 7, S. 659–669.
Abstract OBJECTIVE: To estimate the separate effects of sunlamp and tanning bed device
use on melanoma risk. METHODS: Population-based case-control study of 423
cases of melanoma and 678 controls in the state of New Hampshire. Exposure
data, including sunlamp and tanning bed use, were collected by telephone
interview. Associations were evaluated using logistic regression analyses.
RESULTS: About 17% of participants ever used a sunlamp, and most use (89%)
occurred before 1980. The OR was 1.39 (95% CI 1.00-1.96) for ever using a
sunlamp, 1.23 (95% CI 0.81-1.88) for those starting sunlamp use <20 years, and
1.71 (95% CI 1.00-2.92) for those starting >/=20 years. Data suggested increasing
risk with number of sunlamp uses and with duration of use (tests of trend p = 0.02).
The overall prevalence of tanning bed use was 22% and most use (83%) occurred
after 1980. The OR was 1.14 (95% CI 0.80-1.61) for ever using a tanning bed; there
was no evidence that risk increased with frequency or duration of use. The OR was
1.96 (95% CI 1.06-3.61) for having used both devices. CONCLUSION: Results
suggest a modest association between sunlamp use and melanoma risk, and
increasing risk with greater frequency and duration of use. No association with
tanning bed use was found, but sufficient lag time may not have elapsed to assess
a potential effect.
Schlagwörter Neoplasms, Radiation-Induced; Humans; Middle Aged; Skin Neoplasms; Ultraviolet
Rays; Female; Male; Melanoma; Aged; Case-Control Studies; Risk; Nevus;
Sunlight; Beds; Adult; research support, n.i.h., extramural; New Hampshire

Curtin, John A.; Busam, Klaus; Pinkel, Daniel; Bastian, Boris C. (2006): Somatic activation of KIT in distinct
subtypes of melanoma. In: J Clin Oncol, Jg. 24, H. 26, S. 4340–4346.
Abstract PURPOSE: Melanomas on mucosal membranes, acral skin (soles, palms, and nail
bed), and skin with chronic sun-induced damage have infrequent mutations in
BRAF and NRAS, genes within the mitogen-activated protein (MAP) kinase
pathway commonly mutated in melanomas on intermittently sun-exposed skin. This
raises the question of whether other aberrations are occurring in the MAP kinase
cascade in the melanoma types with infrequent mutations of BRAF and NRAS.
PATIENTS AND METHODS: We analyzed array comparative genomic hybridization
data from 102 primary melanomas (38 from mucosa, 28 from acral skin, and 18
from skin with and 18 from skin without chronic sun-induced damage) for DNA copy
number aberrations specific to melanoma subtypes where mutations in BRAF and
NRAS are infrequent. A narrow amplification on 4q12 was found, and candidate
genes within it were analyzed. RESULTS: Oncogenic mutations in KIT were found
in three of seven tumors with amplifications. Examination of all 102 primary
melanomas found mutations and/or copy number increases of KIT in 39% of
mucosal, 36% of acral, and 28% of melanomas on chronically sun-damaged skin,
but not in any (0%) melanomas on skin without chronic sun damage. Seventy-nine
percent of tumors with mutations and 53% of tumors with multiple copies of KIT
demonstrated increased KIT protein levels. CONCLUSION: KIT is an important
oncogene in melanoma. Because the majority of the KIT mutations we found in
melanoma also occur in imatinib-responsive cancers of other types, imatinib may
offer an immediate therapeutic benefit for a significant proportion of the global
melanoma burden.
Schlagwörter Nucleic Acid Hybridization; Humans; Middle Aged; Skin Neoplasms; Antineoplastic
Agents; Proto-Oncogene Proteins c-kit; Female; Piperazines; Male; Melanoma;
Aged; Tumor Markers, Biological; Adult; research support, n.i.h., extramural;
Immunohistochemistry; Microarray Analysis; Pyrimidines; Gene Expression
Regulation, Neoplastic

Del Bino, S.; Sok, J.; Bessac, E.; Bernerd, F. (2006): Relationship between skin response to ultraviolet exposure
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and skin color type. In: Pigment Cell Res, Jg. 19, H. 6, S. 606–614.
Abstract Sun exposure is responsible for detrimental damage ranging from sunburn to
photoaging and skin cancer. This damage is likely to be influenced by constitutive
pigmentation. The relationship between ultraviolet (UV) sensitivity and skin color
type was analyzed on 42 ex vivo skin samples objectively classified from light to
dark skin, based on their values of individual typology angle (ITA) determined by
colorimetric parameters. The biologically efficient dose (BED) was determined for
each sample by quantifying sunburn cells after exposure to increasing doses of UV
solar-simulated radiation. Typical UV-induced biologic markers, other than
erythema, such as DNA damage, apoptosis and p53 accumulation, were analyzed.
A statistically significant correlation was found between ITA and BED and, ITA and
DNA damage. Interestingly, DNA lesions were distributed throughout the whole
epidermal layers and the uppermost dermal cells in light, intermediate and tanned
skin while they were restricted to suprabasal epidermal layers in brown or dark skin.
Our data support, at the cellular level, the relationship between UV sensitivity and
skin color type. They emphasize the impact of DNA damage accumulation in basal
layer in relation to the prevalence of skin cancer.
Schlagwörter Humans; Epidermis; Epithelial Cells; Ultraviolet Rays; Female; Apoptosis; Skin
Pigmentation; Organ Culture Techniques; Skin; Dermis; DNA Damage; Biological
Markers; Tumor Suppressor Protein p53

Geller, Alan C.; Brooks, Daniel R.; Colditz, Graham A.; Koh, Howard K.; Frazier, A. Lindsay (2006): Sun
protection practices among offspring of women with personal or family history of skin cancer. In: Pediatrics, Jg.
117, H. 4, S. e688-94.
Abstract OBJECTIVE: Family history of skin cancer is an important determinant of skin
cancer risk for offspring. No previous study of the effect of personal or family history
of skin cancer on the sun protection behaviors of the offspring has been published.
METHODS: A retrospective study was conducted of the sun protection behaviors of
the adolescent participants in the Growing Up Today Study (GUTS), who were
offspring of mothers from the Nurses Health Study II. Adolescents‘ surveys were
matched with their mothers‘ reports of a personal or family history of skin cancer
and compared with adolescents whose mothers did not report a personal or family
history of skin cancer. The outcome measures were (1) occurrence of frequent
sunburns during the past summer, (2) use of a tanning bed during the past year,
and (3) routine use of sunscreen. Frequent sunburns were defined as the report of
> or = 3 sunburns during the past summer. We compared those who reported
having used a tanning bed in the past year at least once with those who reported no
tanning bed use in the past year. Routine use of sunscreen was defined as a
respondent who replied that he or she "always" or "often" used sunscreen with sun
protection factor of 15 or more when he or she was outside for > 15 minutes on a
sunny day during the past summer. General estimating equations were used to
calculate odds ratios and 95% confidence intervals adjusted for gender, age, color
of untanned skin, and number of friends who were tanned. We also conducted an
additional analysis restricted to children whose mothers had received a diagnosis of
skin cancer in which we assessed sun protection behaviors according to the child‘s
age and mother‘s age at the time of the mother‘s diagnosis and the number of years
that had passed since the diagnosis of the mother‘s skin cancer. RESULTS: In
1999, 9943 children reported their sun protection behaviors; 8697 of their mothers
had not received a diagnosis of skin cancer or reported a family history of
melanoma, 463 participants‘ mothers had received a diagnosis of skin cancer, and
783 participants‘ mothers reported a family history of melanoma. Between 1989 and
1999, 371 mothers of GUTS participants received a diagnosis of skin cancer:
melanoma (n = 44), squamous cell (n = 39), and basal cell cancer (n = 311); 23
mothers received a diagnosis of > 1 type of skin cancer. Because GUTS includes
siblings from the same family, the 371 mothers with skin cancer had 463 offspring in
GUTS. Offspring of mothers with skin cancer were slightly more likely to report
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frequent sunburns in the past year compared with those with neither maternal
diagnosis nor family history (39% vs 36%). Tanning bed use was not significantly
different among those with either a maternal diagnosis of skin cancer or family
history of melanoma as compared with nonaffected adolescents (8% vs 9% vs
10%). Sunscreen use among offspring of mothers with skin cancer was higher than
among those whose mothers had a family history of melanoma or mothers with no
personal history of skin cancer (42% vs 33% vs 34%). Tan-promoting attitudes were
also similar across all groups. Only 25% thought that a natural skin color was most
attractive, and on average, 25% in each group agreed that it was worth burning to
get a tan. Children of mothers who had received a diagnosis > 2 years in the past
were less likely to use sunscreen, more likely to sunburn, and more likely to use
tanning beds than children of mothers with a more recent diagnosis, although the
results did not reach statistical significance. CONCLUSION: Frequent sunburns,
suboptimal sunscreen use, and high rates of tanning bed use are commonplace
even among the children of health professionals who are at risk for developing skin
cancer themselves as a result of personal or family history. With new information on
family risk, pediatricians can use the potential of a teachable moment to ensure
optimal sun protection for children who are at risk.
Schlagwörter research support, non-u.s. gov‘t; Attitude to Health; Humans; Skin Neoplasms;
Radiation Protection; Child; Health Behavior; Skin Pigmentation; Female; Sunburn;
Melanoma; Male; Beauty Culture; research support, n.i.h., extramural;
Sunscreening Agents; Adolescent Behavior; Adolescent

Geller, Alan C.; Colditz, Graham; Oliveria, Susan; Emmons, Karen; Jorgensen, Cynthia; Aweh, Gideon N.;
Frazier, A. Lindsay (2002): Use of sunscreen, sunburning rates, and tanning bed use among more than 10 000
US children and adolescents. In: Pediatrics, Jg. 109, H. 6, S. 1009–1014.
Abstract OBJECTIVES: To describe the association of sunscreen use, sunburning, and
tanning bed use by age, sex, residence, and psychosocial variables associated with
tan-seeking behaviors, and to compare these findings with sun protection
recommendations from federal agencies and cancer organizations. METHODS: A
cross-sectional study, from all 50 states, of 10 079 boys and girls 12 to 18 years of
age in 1999. Data were collected from self-report questionnaires with the children of
the participants from the Nurses Health Study (Growing Up Today Study).
RESULTS: The prevalence of sunscreen use was 34.4% with girls more likely to
use sunscreen than boys (40.0 vs 26.4, odds ratio: 1.86; 95% confidence interval:
1.70-2.03). Eighty-three percent of respondents had at least 1 sunburn during the
previous summer, and 36% had 3 or more sunburns. Nearly 10% of respondents
used a tanning bed during the previous year. Girls were far more likely than boys to
report tanning bed use (14.4 vs 2.4), and older girls (ages 15-18) were far more
likely than younger girls (ages 12-14) to report tanning bed use (24.6% vs 4.7).
Tanning bed use increased from 7% among 14-year-old girls to 16% by age 15, and
more than doubled again by age 17 (35%; N = 244). Multivariate analysis
demonstrated that attitudes associated with tanning, such as the preference for
tanned skin, having many friends who were tanned, and belief in the worth of
burning to get a tan, were generally associated with sporadic sunscreen use, more
frequent sunburns, and increased use of tanning beds. CONCLUSIONS: Our
findings suggest that many children are at subsequent risk of skin cancer because
of suboptimal sunscreen use, high rates of sunburning, and tanning bed use.
Recommendations in the United States for improved sun protection and avoidance
of tanning beds and sunburning, which began in the early 1990s, have been
primarily unheeded. Nationally coordinated campaigns with strong policy
components must be developed and sustained to prevent skin cancer in a new
generation of children and adolescents.
Schlagwörter research support, non-u.s. gov‘t; Cross-Sectional Studies; Humans; Skin
Neoplasms; Prevalence; Child; Ultraviolet Rays; Female; United States; Sex
Factors; Sunburn; Male; Melanoma; Health Education; research support, u.s. gov‘t,
Sunbeds - Citavi
p.h.s.; Beauty Culture; Age Factors; Sunscreening Agents; Adolescent

Gorell, Emily; Lee, Carolyn; Muñoz, Claudia; Chang, Anne Lynn S. (2009): Adoption of Western culture by
Californian Asian Americans: attitudes and practices promoting sun exposure. In: Arch Dermatol, Jg. 145, H. 5,
S. 552–556.
Abstract OBJECTIVE: To investigate whether the adoption of Western culture is associated
with attitudes and practices promoting sun exposure among Asian Americans.
DESIGN: Survey conducted from November 28, 2007, to January 28, 2008.
SETTING: Primarily northern California community groups via online survey.
PARTICIPANTS: Adult volunteers who self-identified as Asian American. MAIN
OUTCOME MEASURES: Results based on 546 questionnaires returned.
RESULTS: The overall response rate was 74.4%. Multivariate regression analysis
controlling for age and skin type showed that westernization (as determined by
generation in the United States, location raised, or self-rated acculturation) was
associated with attitudes and behaviors promoting sun exposure (including the
belief that having a tan is attractive, negative attitudes toward use of sunscreen and
sun protective clothing, and increased weekend sun exposure, lying out to get a
tan, and tanning bed use) at a level of P < .05. CONCLUSIONS: Our data suggest
that adoption of Western culture may be associated with attitudes and behaviors
promoting sun exposure among Asian Americans. This group should be targeted by
dermatologists for increased education regarding sun protection, solar damage, and
skin cancer prevention and detection.
Schlagwörter California; Attitude to Health; Humans; comparative study; Skin Neoplasms;
Prevalence; Acculturation; Female; Sex Distribution; Sunburn; Male; Health
Education; Sunlight; Asian Americans; Adult; Questionnaires

Greene, Kathryn; Brinn, Laura S. (2003): Messages influencing college women‘s tanning bed use: statistical
versus narrative evidence format and a self-assessment to increase perceived susceptibility. In: J Health
Commun, Jg. 8, H. 5, S. 443–461.
Abstract Understanding the effect of messages and other influences on health decision-
making has the potential to decrease risky behavior such as tanning bed use. This
study explores the effect of type of evidence, self-assessments of risk for skin
cancer, and personality factors on intention to use and use of tanning beds among
Caucasian female college students. Specifically, it targeted the perceived
susceptibility component of the Health Belief Model and its impact on intention to
tan as well as changes in actual tanning behavior. College students (N=141) in the
southeast United States read randomly assigned messages and self-assessments,
filled out surveys, and were later contacted for a follow-up telephone survey. The
statistical message was rated higher on information value and also resulted in
decreased intention to tan, decreased tanning behavior, and increased perceived
susceptibility to skin cancer. The narrative message, in contrast, increased
perceptions of realism and also worked to decrease intentions to tan. Additionally,
the self-assessment manipulation resulted in increased susceptibility and
decreased intention to tan and post tanning behavior. Personality factors explained
small portions of variance. Key limitations and directions for future research are also
addressed.
Schlagwörter research support, non-u.s. gov‘t; Risk Assessment; Humans; comparative study;
Skin Neoplasms; Risk Factors; Ultraviolet Rays; Southeastern United States; Health
Behavior; Intention; Female; European Continental Ancestry Group; randomized
controlled trial; clinical trial; Students; Communication; Beauty Culture; Adult;
Universities; Questionnaires; Health Knowledge, Attitudes, Practice; Social
Marketing

Hussein, Mahmoud R.; Elsers, Dalia A.; Fadel, Sabah A.; Omar, Abd-Elhady M. E. (2006): Clinicopathological
features of melanocytic skin lesions in Egypt. In: Eur J Cancer Prev, Jg. 15, H. 1, S. 64–68.
Abstract Although melanocytic skin lesions have been recognized since antiquity, their
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literature was limited to Caucasians. To date, the clinicopathologic features of these
lesions in Egyptians are still unknown. To define these features, diagnostic records
of the melanocytic skin lesions received at the Pathology Department, Assuit
University Hospitals (1989-2004) were reviewed. The lesions examined included 12
benign naevi (BN), 10 dysplastic naevi (DN), and 21 cutaneous malignant
melanomas (CMMs). The DN and CMMs were more common in men than in
women (2 : 1 and 1.5 : 1, respectively) while BN were more common in women (2 :
1). The average age incidence was 33+/-5, 38+/-7 and 54+/-3 years, for BN, DN
and CMM, respectively. The lower limb (13/21, 62%), head and neck (7/21, 33%)
were the most common sites for CMMs. The average size (mm) was 2+/-0.3, 4+/-
0.6 and 21+/-0.3 for BN, DN and CMMs, respectively. Recurrence occurred in 10%
of CMMs. Histologically, CMMs were of nodular type and composed of epithelioid
(7/21, 33%), spindle cells (1/21, 5%), or mixed cells (13/21, 62%). The mean
tumour thickness (Breslow) was 6+/-0.5 mm. CMMs included two of 21(9%), three
of 21(14%), six of 21(38%), and 10 of 21(38%) with Clark level II, III, IV and V. In
Egypt, CMM is the third most common cutaneous neoplasm following squamous
and basal cell carcinomas. Compared with Western societies, melanoma has a
male sex predilection, similar histological features but different topographical
distribution and rare incidence. The striking difference from Western series is the
incidence of nodular melanoma - in the West this represents 15-30% of
melanomas, with superficial spreading being the majority. Another key difference
from the West is the ‘sun-bed‘ culture of the West and the desire to have suntans.
This is the first study that reports the clinicopathologic features of melanocytic skin
lesions in Egypt.
Schlagwörter Humans; Middle Aged; Skin Neoplasms; Ultraviolet Rays; Female; Sex Distribution;
European Continental Ancestry Group; Male; Melanoma; Nevus, Pigmented;
Retrospective Studies; Adult; Age Distribution; Dysplastic Nevus Syndrome; Arabs

Jerkegren, E.; Sandrieser, L.; Brandberg, Y.; Rosdahl, I. (1999): Sun-related behaviour and melanoma
awareness among Swedish university students. In: Eur J Cancer Prev, Jg. 8, H. 1, S. 27–34.
Abstract The relationship between knowledge, attitude and sun-related behaviour among
Swedish students was examined in the present study. A total of 296 of 305
questionnaires, distributed among university students (medical school and economy
programme) were analysed (157 men, 139 women, mean age 24 years). The
percentage of students sunbathing with the intention of getting a tan was 75%.
Thirteen per cent reported having experienced at least one painful sunburn every
year and 93% stated at least one burn during the last ten years. The majority of the
students had used a sun bed, 12% more than ten times during the last year.
Subjects with high frequency of sun bed use also scored high on sunbathing and
sunburns. Significantly more women (70%) than men (51%) used sunscreen. The
overall knowledge of melanoma was high. No difference in knowledge was found
between the high- and low-exposure group. Medical students scored higher on
knowledge than economy students, but did not differ in exposure score. Our
findings reveal an excessive sun exposure among university students. A high level
of knowledge of risk does not lead to a sun-protective behaviour. Future
preventative campaigns targeting young people must focus on strategies to change
attitudes towards tanning as being healthy and attractive.
Schlagwörter research support, non-u.s. gov‘t; Attitude to Health; Humans; Skin Neoplasms; Risk
Factors; Ultraviolet Rays; Health Behavior; Female; Sex Factors; Sunburn; Male;
Sweden; Students; Melanoma; Sunlight; Adult; Environmental Exposure;
Questionnaires; Students, Medical; Health Knowledge, Attitudes, Practice;
Sunscreening Agents

Jopson, Janet A.; Reeder, Anthony I. (2008): An audit of Yellow Pages telephone directory listings of indoor
tanning facilities and services in New Zealand, 1992‐2006. In: Aust N Z J Public Health, Jg. 32, H. 4, S.
372–377.
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Abstract OBJECTIVE: To document the number and variety of indoor tanning facilities and
services in New Zealand, and to analyse changes from 1992 to 2006. METHOD:
Hard copies of the Yellow Pages telephone directory listings of all 18 New Zealand
regions for 1992, 1996, 2001 and 2006 were examined. Entries under solaria and
sun bed headings were supplemented with entries where sun bed/indoor tanning
services were explicitly advertised under hairdressing, beauty therapy/supplies, and
health and fitness centre categories. Duplicate listings were eliminated. RESULTS:
From 1992 to 2006, inclusive, there was a 241% increase in the number of
businesses that advertised some form of indoor tanning service in the NZ Yellow
Pages telephone directories. There was a 525% increase in the number of
wholesale trade providers, indicative of expansion in the industry, overall. Hire
services also increased. The reported findings are likely to represent an
underestimate of the total numbers of facilities and providers. CONCLUSION:
Substantial growth in indoor tanning facilities and services in New Zealand has
occurred since 1992. IMPLICATIONS: The evidence of potential serious health
risks from sunbed use, in conjunction with evidence of irresponsibility among some
providers, suggests a need for regulatory controls to strengthen existing voluntary
guidelines. With legislation recently introduced for the states of Victoria and South
Australia, and proposed in Queensland and Western Australia before the end of
2008; it would be timely for New Zealand authorities to collaborate with those
drafting that legislation.
Schlagwörter research support, non-u.s. gov‘t; Risk Assessment; Neoplasms, Radiation-Induced;
Access to Information; Humans; Skin Neoplasms; Pilot Projects; Ultraviolet Rays;
Government Regulation; Sunburn; Telephone; Sunlight; Public Health; New
Zealand; Sunscreening Agents; Advertising as Topic; Beauty; Population
Surveillance

Lautenschlager, S.; Itin, P. H. (1998): Reticulate, patchy and mottled pigmentation of the neck. Acquired forms.
In: Dermatology, Jg. 197, H. 3, S. 291–296.
Abstract Besides the inherited forms of mottled and reticulate pigmentation, a vast number of
diseases and trigger mechanisms can lead to acquired pigmentation of the neck.
Nonhereditary variants of reticulate and mottled pigmentation can affect the neck as
a typical site and therefore may give a diagnostic clue or it can occur sporadically
on the neck as well as on other sites. A well-known and important factor in the
pathogenesis is exposure to sunlight. Sun-induced pigmentation often presents on
the neck and may result from phototoxic, photoallergic and cumulative actinic
damage. Frequent forms comprise berloque dermatitis, Riehl‘s melanosis,
poikiloderma of Civatte and tanning bed lentigines. Different infections may also
lead to this distinct skin alteration as pediculosis capitis, pityriasis versicolor and
syphilis II. Treatment-induced irregular pigmentations may occur after applications
of topical agents (e.g. diphenylcyclopropenone), systemic medication (e.g. 5-
fluorouracil, chlorpromazine), as a complication of laser resurfacing or as a chronic
graft-versus-host reaction. Different neoplasms may also involve the neck.
Widespread pigmented basal cell carcinoma, cutaneous T-cell lymphoma,
syringolymphoid hyperplasia and histiocytic diseases may lead to reticulated
pigmentation. Various other infrequent conditions as connective tissue diseases,
malnutrition, lichen planus pigmentosus and others are summarized. The neck, a
readily accessible site to medical inspection, may have an underestimated value for
the diagnosis of different skin diseases.
Schlagwörter Humans; review; Neck; Skin; Pigmentation Disorders

Lever, L. R.; Lawrence, C. M. (1995): N Engl J Med. UNITED STATES (332), Nr. 21.
Schlagwörter case reports; Neoplasms, Radiation-Induced; Humans; Skin Neoplasms;
Cosmetics; Ultraviolet Rays; Female; letter; Adult; Bowen‘s Disease

Lim, H. W.; Cooper, K. (1999): The health impact of solar radiation and prevention strategies: Report of the
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Environment Council, American Academy of Dermatology. In: J Am Acad Dermatol, Jg. 41, H. 1, S. 81–99.
Abstract It is well recognized that exposure to solar radiation is a major risk factor for the
development of skin cancer, photoaged skin, and immune system alterations.
However, major questions remain regarding the specific wavelengths and type of
exposure that incur risk. The purpose of this article is to critically examine, on the
basis of current knowledge, the impact of stratospheric ozone depletions, tanning
bed skin cancer risk, the safety of sunscreens as an important element of our solar
protection strategies, the wavelengths of solar radiation responsible for melanoma,
and the incidence of melanoma. Recommendations are made on prevention
strategies and public health messages.
Schlagwörter Neoplasms, Radiation-Induced; guideline; Humans; Skin Neoplasms; Risk Factors;
Radiation Protection; Melanoma; practice guideline; Sunlight; Sunscreening Agents

Lucci, A.; Citro, H. W.; Wilson, L. (2001): Assessment of knowledge of melanoma risk factors, prevention, and
detection principles in Texas teenagers. In: J Surg Res, Jg. 97, H. 2, S. 179–183.
Abstract INTRODUCTION: The incidence of melanoma has increased in the past 10 years
more rapidly than any other cancer. Exposure to intense solar radiation in youth
significantly increases the lifetime risk of developing melanoma. We postulate that
teenagers have little awareness of melanoma prevention or detection principles.
The purpose of this study was to assess the knowledge of teenagers about
melanoma and to identify which age groups are most receptive to altering their sun
exposure behaviors. METHODS: Two hundred and ten examinations testing
general knowledge of sun exposure and melanoma were completed and returned
by junior high and high school students ages 12 to 18 in Dallas and Houston,
Texas. All students completing and returning the examination were provided with
the correct answers to the test and a detailed explanation of each of the test items
as part of an educational exercise. A second questionnaire was then administered
to determine the effect of the educational exercise on future sun exposure
practices. Students were divided into two age groups (12 to 15 and >or=16 years
old) for comparison of scores on the knowledge examination and responses to
behavioral items. Comparison of response rates between age groups was
performed using chi(2) analysis. RESULTS: The return rate was 100%, with 109
students age 12-15 years, and 101 students >or=16 years. Seventy-six percent of
all respondents sunbathed outdoors, and 18% had used a tanning bed in the past 6
months. Thirty-three percent of students admitted to at least three blistering
sunburns in the past. The average score on the knowledge assessment
examination was 65% correct for students >or=16 years old and 54% correct for
those 12-15 years old. Students 12 to 15 years old were significantly more likely to
indicate they planned to change future behaviors regarding performance of skin
self-examinations and limiting sun exposure as compared to the older students.
CONCLUSION: A significant number of teenagers have already enhanced their risk
for future melanoma by suffering severe sunburns. Students younger than 16 years
of age were significantly more likely to indicate they planned to change future
behaviors after receiving information about melanoma. The data from this pilot
study support education aimed at younger age groups to most effectively achieve
risk reduction and prevent future melanomas.
Schlagwörter Incidence; Genetic Predisposition to Disease; Patient Education as Topic; Humans;
Skin Neoplasms; Risk Factors; Child; Texas; Skin Pigmentation; Female; Needs
Assessment; Male; Melanoma; Sunlight; Adolescent Behavior; Adolescent

Ma, Fangchao; Collado-Mesa, Fernando; Hu, Shasa; Kirsner, Robert S. (2007): Skin cancer awareness and sun
protection behaviors in white Hispanic and white non-Hispanic high school students in Miami, Florida. In: Arch
Dermatol, Jg. 143, H. 8, S. 983–988.
Abstract OBJECTIVE: To examine skin cancer awareness and behavior in white Hispanic
(WH) and white non-Hispanic (WNH) high school students because increasing
incidence and delayed diagnosis of skin cancer in the growing Hispanic population
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in the United States represent an emerging health issue. DESIGN: Pilot survey
study. SETTING: A high school in Miami, Florida. PARTICIPANTS: A total of 369
high school students (221 WHs and 148 WNHs) were surveyed in the study. MAIN
OUTCOME MEASURES: Survey data were collected regarding skin cancer
knowledge, perceived risk, and sun protection behaviors. Differences between the 2
groups were compared with chi(2) tests. RESULTS: White Hispanic students were
more likely to tan deeply (P = .04) but less likely to have heard of (P < .01) or been
told how to perform (P < .01) skin self-examination. White Hispanics were less likely
to wear sun-protective clothing or to use sunscreen with a sun protection factor of
15 or higher and reported a greater use of tanning beds. White Hispanic students
also thought their chance of developing skin cancer was less than that of WNH
students (P < .01), which remained significant after adjustment for age, sex, family
history, and skin sensitivity to sun. After adjustment, WHs were 2.5 times more
likely than WNHs to have used a tanning bed in the past year. White Hispanics
were also 60% less likely to have heard of skin self-examination (P < .01) and 70%
less likely than WNHs to have ever been told to perform the examination (P = .03).
White Hispanics are about 1.8 and 2 times more likely to never or rarely wear
protective clothing (P < .01) and to use sunscreen (P = .01), respectively.
CONCLUSION: There are disparities in knowledge, perceived risk of skin cancer,
and sun-protective behaviors among WH and WNH high school students.
Schlagwörter Humans; comparative study; Skin Neoplasms; Pilot Projects; Health Behavior;
Female; European Continental Ancestry Group; Male; Florida; Health Surveys;
research support, n.i.h., extramural; Health Knowledge, Attitudes, Practice;
Adolescent Behavior; Hispanic Americans; Adolescent

MacFarlane, Deborah F.; Alonso, Carol A. (2009): Occurrence of nonmelanoma skin cancers on the hands after
UV nail light exposure. In: Arch Dermatol, Jg. 145, H. 4, S. 447–449.
Abstract BACKGROUND: Exposure to tanning beds, which contain mostly high-dose UV-A
emitters, is a known cause of photoaging. Evidence is also accumulating for an
association between tanning bed use and the development of skin cancer. Another
source of high-dose UV-A is UV nail lights, available for use in the home and in
beauty salons. OBSERVATIONS: Two healthy middle-aged women with no
personal or family history of skin cancer developed nonmelanoma skin cancers on
the dorsum of their hands. Both women report previous exposure to UV nail lights.
CONCLUSIONS: It appears that exposure to UV nail lights is a risk factor for the
development of skin cancer; however, this observation warrants further
investigation. In addition, awareness of this possible association may help
physicians identify more skin cancers and better educate their patients.
Schlagwörter case reports; Neoplasms, Radiation-Induced; Humans; Middle Aged; Skin
Neoplasms; Ultraviolet Rays; Female; Carcinoma, Squamous Cell; Beauty Culture;
Nails; Hand

Marks, P. V.; Belchetz, P. E.; Saxena, A.; Igbaseimokumo, U.; Thomson, S.; Nelson, M. et al. (2000): Effect of
photodynamic therapy on recurrent pituitary adenomas: clinical phase I/II trial‐an early report. In: Br J
Neurosurg, Jg. 14, H. 4, S. 317–325.
Abstract Pituitary adenomas, although histologically benign, are not always curable by
surgery alone, principally because of dural infiltration, as well as their peculiar
anatomical location. Radiotherapy has been employed as an adjuvant therapy to
address residual disease with favourable results. This approach is, however, not
without side effects, and it cannot be repeated. We are therefore investigating the
effectiveness of photodynamic therapy (PDT) on recurrent pituitary adenomas in
humans. This study details the protocol applied to 12 patients with recurrent
pituitary adenomas, which involved systemic administration of photosensitizer
(Photofrin) followed, after a period of 24-48 h, by intraoperative illumination of the
tumour bed using 630 nm laser light. The primary end points were visual, endocrine
and radiological improvement. The incidence of side effects was also monitored.
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The longest follow-up is 2 years. Most patients suffering from visual acuity or field
defects have shown improvement when followed for 12 months or more. Three
patients showed complete recovery of their visual fields. All those who presented
with functional adenomas have shown reduction in their hormone levels. Tumour
volume, relative to the preoperative size, was 122, 87, 66, 60 and 46% at 4 days,
and 3, 6, 18 and 24 months, respectively. One patient developed severe skin
photosensitization due to early exposure to direct sunlight and three others
displayed minor skin reactions. There was no treatment-related mortality or
morbidity. One patient (operated transcranially) developed hemiparesis
postoperatively, which recovered completely. We think this is unrelated to the
treatment. This prospective study demonstrates that PDT may be safely applied to
the pituitary fossa by the trans-sphenoidal route and indicates the need for a
randomized, controlled trial in order to establish its therapeutic potential.
Schlagwörter research support, non-u.s. gov‘t; clinical trial, phase i; Neoplasm Recurrence, Local;
Follow-Up Studies; Humans; Middle Aged; Adenoma; Chemotherapy, Adjuvant;
Pilot Projects; Female; clinical trial; Male; Aged; Magnetic Resonance Imaging;
clinical trial, phase ii; Photochemotherapy; Adult; Pituitary Neoplasms

Mawn, V. B.; Fleischer, A. B. (1993): A survey of attitudes, beliefs, and behavior regarding tanning bed use,
sunbathing, and sunscreen use. In: J Am Acad Dermatol, Jg. 29, H. 6, S. 959–962.
Abstract BACKGROUND: Although cosmetic tanning and unprotected solar exposure are
common, little is known about general attitudes, beliefs, and behavior regarding
sunbathing, sunscreen use, and tanning salon use. OBJECTIVE: We sought to
determine the frequency of UV exposure in a select sample and to assess the
knowledge and beliefs of the effects of UV irradiation. METHODS: A written,
anonymous questionnaire was distributed to a sample of 477 persons in a shopping
mall, at a social gathering, and on a vacation cruise ship. The instrument explored
demographic information, sunscreen use, sunbathing habits, tanning bed use, and
cutaneous solar effects. RESULTS: Forty-two percent of respondents seldom or
never used sunscreen, and 33% sunbathed at least once a week. Although the
three sample populations differed in education, sunbathing habits, sunscreen use,
and tanning bed use, they were equally informed about UV light hazards.
Compared with those who had not used tanning beds, tanning bed users were more
likely to be female and more knowledgeable about the long-term effects of UV.
Tanning beds were most commonly used in tanning or hair salons, (mean 23 +/- 7
minutes at 2.3 +/- 1.1 times per week). Reported positive psychologic sequelae
from tanning bed use were more common than negative physical sequelae. At least
10% would continue to use tanning beds if these were proved to cause skin cancer.
CONCLUSION: In this select sample, sunbathing and tanning bed use were
common. No group surveyed universally practiced sun protection and avoidance.
Clientele of tanning beds may be aware of the damaging effects of the sun, but may
not be aware that tanning bed use is associated with skin damage.
Schlagwörter Humans; Middle Aged; Ultraviolet Rays; Female; Sex Factors; Male; Skin; Aged;
Time Factors; Beauty Culture; Aged, 80 and over; Public Opinion; Adult; Age
Factors; Occupational Exposure; Questionnaires; Sunscreening Agents; Health
Knowledge, Attitudes, Practice; Adolescent

McMullen, E. A.; Dolan, O. M.; McCarron, P.; Kee, F. (2007): Reliability testing of a sun exposure questionnaire
for the Northern Ireland population. In: J Eur Acad Dermatol Venereol, Jg. 21, H. 8, S. 1071–1073.
Abstract BACKGROUND: Sunbathing and other types of exposure to ultraviolet radiation are
the major preventable risk factors for skin cancer. Due to the continued increase in
incidence of melanoma in Northern Ireland, we have conducted a questionnaire
survey in an attempt to gather information about sunbathing habits and other forms
of ultraviolet light exposure amongst the Northern Ireland population. AIM: The aim
of this study was to examine the test-retest reliability of a questionnaire used in a
large-scale cross-sectional population survey pertaining to sunbathing habits, use of
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sun screen, skin types, and frequencies of sunburn and to assess the responses
given by the subjects to determine the nature of their sun-related behaviour.
METHODS: Thirty control subjects were randomly selected from a population
control sample participating in a large case-control study investigating melanoma in
the Northern Ireland population. All participants completed the interview
questionnaire on two occasions, with a median of 15 days (range, 12-42 days)
between interviews. We randomly chose control subjects who had been visited by
the same research nurse, thus ruling out interobserver bias in the analyses. We
used the test-retest method. Kappa statistics were used to calculate the association
between test and retest scores of all the individual items. If the items contained
within the questionnaire are reliable, then repeated measurement after a fairly short
period of time should result in high within-subject repeatability. RESULTS:
Questions pertaining to hours spent in the sun and sun bed usage showed high
reliability (kappa > 0.7). Questions about sunscreen usage showed moderately high
reliability (kappa > 0.6) in all but one of the 10-year age bands and complete
agreement (kappa = 1) in one age category (>50 years). CONCLUSION: This
questionnaire is a reliable method of assessing sun-associated behaviour
identifying high-risk sun-related behaviour and misconceptions about tanning, which
can be targeted for improvement in public health.
Schlagwörter Reproducibility of Results; Humans; Female; Health Behavior; Male; Case-Control
Studies; Sunlight; Adult; Ireland; Questionnaires

Patel, Gopal A.; Ragi, Gangaram; Krysicki, Jan; Schwartz, Robert A. (2008): Subungual melanoma: a deceptive
disorder. In: Acta Dermatovenerol Croat, Jg. 16, H. 4, S. 236–242.
Abstract Subungual melanoma is an uncommon form of acral melanoma that arises within
the nail bed. The incidence for acral melanomas is similar worldwide, but the
proportion is higher in dark-skinned individuals. The subungual form represents
about 2% of cutaneous non-sun induced melanomas in the western world, and up
to 75% in Africans, 10% in Japanese, and 25% in the Chinese of Hong Kong. Up to
33% of subungual melanomas are amelanotic. Black pigmentation of the adjacent
nail fold, termed Hutchinson‘s sign, may be a diagnostic clue. Non-specific features
and symptoms along with a high incidence of amelanosis often lead to delayed
diagnosis, disease progression, and a poor prognosis with challenging treatment
options.
Schlagwörter Humans; Skin Neoplasms; review; Melanoma; Nail Diseases

Rafnsson, Vilhjalmur; Hrafnkelsson, Jon; Tulinius, Hrafn; Sigurgeirsson, Bardur; Olafsson, Jon H. (2004): Risk
factors for malignant melanoma in an Icelandic population sample. In: Prev Med, Jg. 39, H. 2, S. 247–252.
Abstract OBJECTIVES: To describe the constitutional risk factors for malignant melanoma
and exposure to sunlight in a population sample in Iceland. METHODS: Information
on various risk factors for malignant melanoma was collected through mailed
questionnaires sent to a random sample of the Icelandic population. The
information collected was the first phase of a prospective study on malignant
melanoma among aircrew members as compared to a population sample.
RESULTS: The overall participation rate was about 50%. Seven percent of women
and six percent of men had red hair color. Blue or green eye color was reported
among 89% of women and 87% of men. Sixteen percent of women aged 20 to 39
had used sun beds more than 100 times during their lifetime, while the
corresponding figure was 12% for men of the same age. Younger age groups had
more sunny vacations than the older age groups. The frequency of sunburn differed
in the groups with reported different skin types according to Fitzpatrick
classification. CONCLUSION: The high prevalence of sun bed usage among young
women is concurrent with the increased incidence of malignant melanoma among
young women registered in the nationwide cancer registry. Young people have
more often used sun beds and taken sunny vacation than the older, indicating a
changed behavior in the population.
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Schlagwörter Iceland; Incidence; Prospective Studies; Humans; Skin Neoplasms; Risk Factors;
Prevalence; Female; Male; Time Factors; Melanoma; Sunlight; Adult;
Environmental Exposure; Questionnaires

Rhainds, M.; Guire, L. de; Claveau, J. (1999): A population-based survey on the use of artificial tanning devices
in the Province of Québec, Canada. In: J Am Acad Dermatol, Jg. 40, H. 4, S. 572–576.
Abstract BACKGROUND: The suntanning industry has grown up over the last decade in
North America, mainly because tanned skin is socially desirable and artificial
tanning is perceived as a "safe tan." However, exposure to UV radiation is known to
cause adverse health effects. OBJECTIVE: The purpose of this study was to
estimate the prevalence of use of tanning equipment in the Province of Québec and
to characterize people who reported using these devices. METHODS: In 1996, a
telephone survey was carried out among adults from the two most densely
populated regions (Montréal, Québec) of the Province of Québec. The final sample
included 1003 white persons 18 to 60 years old. Interviewers used a standardized
questionnaire to document the characteristics of the participant, skin phototype, and
exposure habits to artificial UV radiation sources. RESULTS: During the last 5 years
before the survey, 20.2% of the respondents reported they had used, at least once,
a tanning device in a commercial tanning salon. The rate of use during the last 12
months before the study was 11.1%. A significantly higher proportion of female,
young people (18 to 34 years old) and single persons was found among tanning
bed users. Twenty-six percent of users experienced one or more acute adverse
health effects from the artificial UV irradiation. Most of these were cases of skin
burns. A high proportion (77.5%) of those who used tanning equipment during the
last year before the study said they would return to tanning salons. The intention of
returning to a tanning salon was not influenced by the occurrence of the acute
adverse health effects. The most prevalent reason given for using tanning
equipment was "to improve their appearance by a tan." Most people (60.4%) who
used a tanning bed during the last 5 years before the study believe that tanning
salons are not dangerous. CONCLUSION: This survey indicates that tanning bed
use is very prevalent in the Province of Québec, mainly among young women. The
high rate of acute adverse health effects related to artificial tanning, particularly skin
burns, is of concern. Finally, our results underline the importance of changing
attitudes and beliefs in the population regarding artificial tanning.
Schlagwörter research support, non-u.s. gov‘t; Cross-Sectional Studies; Population Surveillance;
Neoplasms, Radiation-Induced; Humans; Middle Aged; Skin Neoplasms; Risk
Factors; Ultraviolet Therapy; Ultraviolet Rays; Female; Sunburn; Male;
Heliotherapy; Quebec; Adult; Health Knowledge, Attitudes, Practice; Adolescent

Robb-Nicholson, Celeste (2009): By the way, doctor. Does tanning in a tanning bed cause less damage than
natural sunlight. In: Harv Womens Health Watch, Jg. 17, H. 1, S. 8.
Schlagwörter Humans; Skin Neoplasms; Ultraviolet Rays; Female; Women‘s Health; Skin
Pigmentation; Melanoma; Beauty Culture; Sunlight; Suntan; Health Knowledge,
Attitudes, Practice

Roberts, Daniel J.; Hornung, Carlton A.; Polk, Hiram C. (2009): Another duel in the sun: weighing the balances
between sun protection, tanning beds, and malignant melanoma. In: Clin Pediatr (Phila), Jg. 48, H. 6, S.
614–622.
Abstract OBJECTIVE: The purpose of this report is to put the dueling factors of risk and
prevention for melanoma in perspective for the thoughtful pediatric specialist to
facilitate preteen preventive health counseling. STUDY DESIGN: We examined the
rate of malignant melanoma among Kentucky residents and compared this rate with
indicators of tanning bed prevalence in a large metropolitan area and sunscreen
sales from a major distributor. We obtained malignant melanoma annual incidence
data from the Kentucky Cancer Registry, which recorded Kentucky population
incidence rates over the years 1995 to 2004. The rates reflected 2 malignant
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melanoma classifications: pre-invasive cancer only, or both invasive and
noninvasive cancers combined. RESULTS: The age-adjusted incidence rate per
hundred thousand for combined invasive and pre-invasive malignant melanoma
swelled from 21.9 in 1995 to 31.3 in 2004. The respective invasive-only malignant
melanoma incidence rates increased less dramatically, from 17.3 to 20.7, during
this same 10-year time period. Since 1983, the number of separate tanning bed
businesses increased from 1 in 1983 to 119 by the mid-1990s, and then declined to
about 74 separate businesses by 2003. Sunscreen sales data is uneven between
states and is currently inconclusive. CONCLUSIONS: Although current data cannot
draw a precise link between melanoma and the use of tanning beds, the associated
risk is implicit, as the ultraviolet A (UVA) and ultraviolet B (UVB) radiation in tanning
bed usage is a well-established melanoma risk factor. In advising patients, the
pediatric specialist should consider that melanoma rates are poised as a balance of
some known risk factors and a few potential preventive factors.
Schlagwörter research support, non-u.s. gov‘t; Incidence; Risk Reduction Behavior; Patient
Education as Topic; Humans; comparative study; Skin Neoplasms; Risk Factors;
Counseling; Prevalence; Ultraviolet Rays; Female; Skin Pigmentation; Male;
Melanoma; Kentucky; Beauty Culture; Sunlight; Retrospective Studies; Adult;
Sunscreening Agents; Registries

Roth, D. E.; Hodge, S. J.; Callen, J. P. (1989): Possible ultraviolet A-induced lentigines: a side effect of chronic
tanning salon usage. In: J Am Acad Dermatol, Jg. 20, H. 5 Pt 2, S. 950–954.
Abstract A patient who developed lentigines after prolonged ultraviolet A (UVA) exposure in
a tanning booth is described. The patient had no exposure to psoralens or
furocoumarins. Histologic examination of a representative lentigo revealed
melanocytic hyperplasia and cytologic atypia. Increased nevocytic activity with
histologic dysplasia was present in several junctional nevi excised during the period
of UVA exposure. Several studies have revealed significant effects of UVA on
melanocytes. Patients should be cautioned to avoid tanning bed use in view of
these potentially deleterious effects.
Schlagwörter case reports; Humans; Lentigo; Skin Neoplasms; Ultraviolet Rays; Female;
Phototherapy; Heliotherapy; Adult; Dysplastic Nevus Syndrome

Salvador Alonso, R.; Lahbabi, I.; Ben Hassel, M.; Boisselier, P.; Chaari, N.; Lesimple, T. et al. (2008): [Merkel
cell carcinoma: outcome and role of radiotherapy]. In: Cancer Radiother, Jg. 12, H. 5, S. 352–359.
Abstract Merkel cell carcinoma (MCC) are rare neuroendocrine malignant tumor of the skin,
occurring in elderly patients. It affects primarily the sun-exposed areas of the skin,
with approximately 50% of all tumors occurring in the face and neck and 40% in the
extremities. Immunohistochemical markers (CK20+, CK7- and TTF1-) are used to
distinguish between MCC and other tumors. MCC have a tendency to rapid local
progression, frequent spread to regional lymph nodes and distant metastases. Due
to the rarity of the disease, the optimal treatment has not been fully defined.
Localized stages (stages I and II) are treated by surgical excision of the primary
tumor (with 2 to 3 cm margin) and lymphadenectomy in case of node-positive
disease, followed by external beam radiotherapy (EBRT) to a total dose of 50 to
60Gy in the tumor bed. Adjuvant EBRT has been shown to decrease markedly
locoregional recurrences and to increase survival in recent studies. Treatment of
lymph nodes area is more controversial. Chemotherapy is recommended only for
metastatic disease.
Schlagwörter Humans; Middle Aged; Skin Neoplasms; Prognosis; Treatment Outcome; review;
Female; Male; english abstract; Carcinoma, Merkel Cell

Savona, M. R.; Jacobsen, M. D.; James, R.; Owen, M. D. (2005): Ultraviolet radiation and the risks of cutaneous
malignant melanoma and non-melanoma skin cancer: perceptions and behaviours of Danish and American
adolescents. In: Eur J Cancer Prev, Jg. 14, H. 1, S. 57–62.
Abstract The highest prevalence rates of skin malignancy in the northern hemisphere occur
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in Scandinavia and the United States (USA). Most Danes and Americans receive
50% of their lifetime ultraviolet (UV) radiation before the age of 21, making it
important to address sun exposure risks with adolescents. The project was
undertaken to determine differences between Danish and American adolescents in
knowledge of sun exposure and skin malignancy, activities accounting for sun
exposure, and means used for sun protection. Questionnaires regarding skin
cancer and sun exposure were distributed to 674 secondary school age students in
Hilleroed, Denmark, and to 483 similarly aged students in Winston-Salem, North
Carolina, USA. Differences in responses between and within groups were
compared. American adolescents had more knowledge of the characteristics and
malignant potential of melanoma than did Danish adolescents. Danish youth and
females from both countries were significantly more likely to engage in sunbathing
and tanning bed use. Black Danish students reported significantly more sunburn
and were more likely to sunbathe or use a tanning bed than were black American
students. Danish students were more likely than Americans to use sunscreen,
however, Americans were more likely to apply sun protective factor (SPF) 15 or
greater. In conclusion, given that sunbathing and tanning bed use are associated
with the development of precancerous lesions and skin malignancy, Danish teens
are at increased risk. The rates of skin malignancy are relatively high in
Scandinavia and efforts to improve understanding of exposure and cancer risks
should be undertaken in adolescents.
Schlagwörter research support, non-u.s. gov‘t; Humans; comparative study; Skin Neoplasms;
Risk Factors; Ultraviolet Rays; Health Behavior; Female; United States; Sex
Factors; Male; Melanoma; Health Surveys; Perception; Adult; Denmark;
Environmental Exposure; Adolescent Behavior; Adolescent

Schulman, Joshua M.; Fisher, David E. (2009): Indoor ultraviolet tanning and skin cancer: health risks and
opportunities. In: Curr Opin Oncol, Jg. 21, H. 2, S. 144–149.
Abstract PURPOSE OF REVIEW: Skin cancer incidence is higher than that of any other
human malignancy, and yet one of its root causes [ultraviolet (UV) radiation] is
perhaps better understood than any other human carcinogen. The roles of UV
radiation exposure and indoor tanning behaviors on skin cancer risk are explored
here. RECENT FINDINGS: Studies from the past several years have shown a
significant association between ever-use of an indoor tanning facility and an
increased risk of basal cell carcinoma, squamous cell carcinoma, and melanoma.
The association between indoor tanning and skin cancer is particularly strong
among those who first used a tanning facility in early adulthood. Elevated vitamin D
levels have been suggested to protect against various internal malignancies and
other disease states, but sources of vitamin D that do not require UV exposure are
easily available. SUMMARY: Although additional research is needed to understand
fully the relationship between UV and skin cancer, it is already clear that indoor
tanning bed use represents an avoidable risk factor for melanoma and
nonmelanoma skin cancer - both of which may be lethal. Acting upon this
information provides a unique opportunity for protecting the public health.
Schlagwörter Humans; Vitamin D; Skin Neoplasms; Risk Factors; review; Ultraviolet Rays;
Melanoma; Carcinoma, Squamous Cell; Beauty Culture; Carcinoma, Basal Cell

Sheehan, Daniel J.; Lesher, Jack L. (2005): The effect of sunless tanning on behavior in the sun: a pilot study.
In: South Med J, Jg. 98, H. 12, S. 1192–1195.
Abstract BACKGROUND: In the United States, indoor tanning is a booming industry and
contributes to the ultraviolet light (UVL) burden that ultimately leads to skin cancer.
"Sunless" tanning methods that avoid UVL exposure may represent a safe
alternative. However, the effects of sunless tanning methods on ultraviolet light-
related behaviors have never been investigated. METHODS: Anonymous survey of
121 individuals who underwent a spray-on sunless tanning treatment between
February and May 2004. RESULTS: Women completed 107 surveys. Men
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completed 14 surveys. The majority of individuals reported that they had not or
would not change their time spent outdoors or their sunscreen use as a result of
undergoing sunless tanning. However, 73% of individuals who had used UVL
tanning beds said they had decreased or would decrease their UVL tanning bed
use. CONCLUSION: Sunless tanning is associated with a self-reported decrease in
traditional UVL tanning bed use among tanning bed users. Physicians should
advocate the use of sunless tanning to their patients who use traditional UVL
tanning beds as a means of decreasing their UVL exposure and cancer risk.
Schlagwörter Humans; Dihydroxyacetone; Middle Aged; Skin Neoplasms; Pilot Projects; Health
Behavior; Female; Skin Pigmentation; Male; Health Surveys; Sunlight; Adult;
Sunscreening Agents; Adolescent

Situm, Mirna; Buljan, Marija; Bulat, Vedrana; Lugović Mihić, Liborija; Bolanca, Zeljana; Simić, Dubravka (2008):
The role of UV radiation in the development of basal cell carcinoma. In: Coll Antropol, Jg. 32 Suppl 2, S.
167–170.
Abstract Basal cell carcinoma (basalioma, BCC) is undoubtedly the most common malignant
skin cancer and the most common human malignancy in general, with the
continuous increase in its incidence. BCC is generally a disorder of white
individuals, especially those with fair skin. UV radiation is the most important risk
factor in the development of BCC. Short-wavelength UVB radiation (290-320 nm,
sunburn rays) is believed to play a greater role in BCC formation than long-
wavelength UVA radiation (320-400 nm, tanning rays). A latency period of 20-50
years is typical between the time of UV damage and the clinical onset of BCC.
Therefore, in most cases BCC develops on chronically sun-exposed skin in elderly
people, most commonly in the area of head and neck. UVB radiation damages DNA
and its repair system and alters the immune system resulting in a progressive
genetic alterations and formation of neoplasm. UV-induced mutations in the TP53
tumor-suppressor gene have been found in about 50% of BCC cases. The
mutations that activate the Hedgehog intercellular signaling pathway genes,
including PTCH, Sonic hedgehog (Shh) and Smoothened (Smo) play a significant
role in cutaneous carcinogenesis. Epidemiologic studies demonstrate the higher
incidence of the BCC in more equatorial latitudes than in polar latitudes. Other risk
factors for the development of BCC include sun bed use, family history of skin
cancers, skin type 1 and 2, immunosuppression, previous radiotherapy, and chronic
exposure to toxic substances such as inorganic arsenic. Although rarely metastatic,
its malignant nature is sometimes emphasized by the local tissue destruction,
disfigurement, and even death if left untreated. Due to extremely high incidence of
BCC medical professionals should be aware of the importance of the public
education on the etiology of this tumor and the importance of the UV protection.
Schlagwörter Humans; Skin Neoplasms; Risk Factors; Receptors, Cell Surface; review;
Ultraviolet Rays; DNA Damage; Carcinoma, Basal Cell

Strickland, J.; Sun, Y.; Dong, Z.; Colburn, N. H. (1997): Grafting assay distinguishes promotion sensitive from
promotion resistant JB6 cells. In: Carcinogenesis, Jg. 18, H. 6, S. 1135–1138.
Abstract The JB6 mouse epidermal cell system has been used extensively as an in vitro
transformation model for the study of tumor promotion. The standard JB6 cell assay
for promotion of transformation is carried out in soft agar or other anchorage
independent conditions. The present study was directed to the development of an in
vivo model to distinguish the promotion resistant (P-) and promotion sensitive (P+)
progression phenotypes. Results indicate that the grafting assay distinguishes P-
and P+ cells in vivo with P+ but not P- cells forming tumors within 7-9 weeks.
Expression of dominant negative mutant jun TAM67 blocks both anchorage
independent transformation response and graft bed tumor formation by P+ cells,
suggesting that the requirement for AP-1 activation in transformation now applies in
vivo. Expression of mutated p53 produced a gain of P+ phenotype in P- cells in
vitro, but not in vivo. Histochemical and Northern blot analysis for expression of
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various keratinocyte markers revealed no evidence for expression, suggesting a
loss of keratinocyte markers following establishment in culture. In summary, the
skin-grafting assay described in this study appears to be a valid in vivo assay for
distinguishing the preneoplastic progression phenotypes represented by JB6 P- and
P+ cells.
Schlagwörter Mice, Inbred BALB C; Animals; comparative study; Skin Neoplasms; Neoplasm
Transplantation; Tetradecanoylphorbol Acetate; Cell Line, Transformed;
Fibroblasts; Phenotype; Mutation; Sensitivity and Specificity; Disease Models,
Animal; Male; Mice, Nude; Skin; Carcinogens; Cell Transformation, Neoplastic;
Mice, Inbred SENCAR; Transcription Factor AP-1; Skin Physiological Phenomena;
Mice

Thomson, M. A.; Suggett, N. R.; Nightingale, P. G.; Milford, D. V.; Baumann, U.; Kelly, D. A. et al. (2007): Skin
surveillance of a U.K. paediatric transplant population. In: Br J Dermatol, Jg. 156, H. 1, S. 45–50.
Abstract BACKGROUND: Solid organ transplant recipients are at increased risk of skin
cancer. Melanoma is less common than nonmelanoma skin cancer (NMSC)
although the relative proportion of melanoma among skin cancers has been shown
to be higher in paediatric than adult recipients. Multiple melanocytic naevi and/or
atypical naevi may be a risk factor for the development of melanoma. The
relationship between naevus counts and phenotypic characteristics, disease-related
variables and sun exposure has not been explored in paediatric transplant patients.
OBJECTIVES: To determine the prevalence of premalignant and malignant skin
lesions and to identify known risk factors associated with benign and atypical
melanocytic naevi in a U.K. paediatric transplant population. METHODS: Paediatric
(< or = 19 years) renal and liver transplant patients, who were 5 or more years post-
transplantation, were reviewed over 12 months. Lifetime history of sun exposure,
episodes of sunburn, sunny holidays, sunscreen use, sun bed use, demographic
and transplantation details were collected using interview, questionnaire and case
note review. A skin examination was performed for regional counts of malignant
lesions, benign and atypical naevi. RESULTS: Ninety-eight patients (82 liver, 13
renal, three multiorgan) with a median follow up of 9 years (range 5-16) were
reviewed. Neither skin cancer nor premalignant lesions for NMSC were detected in
this group. Eighty-five patients had benign naevi (median 6, range 1-57). Clinical
risk factors for increased counts of benign naevi included increasing age (P = 0.03),
more episodes of sunburn (P = 0.003) and prolonged treatment with cyclosporin (P
= 0.009). The presence of atypical naevi in six patients was significantly associated
with more episodes of sunburn (P = 0.006) and more transplants (P = 0.04). Other
variables including phenotype, skin type, sun exposure, holidays abroad, residence
abroad and total duration of immunosuppression did not correlate with benign or
atypical naevus counts. CONCLUSIONS: Skin cancer was not observed in
paediatric solid organ transplant recipients who were 5-16 years post-
transplantation. Both benign and atypical naevus counts were higher in children
with frequent episodes of sunburn. As both naevi and sunburn are risk factors for
melanoma, we should target fair-skinned transplant recipients with naevi for
intensive sun avoidance education. A prospective, longitudinal follow-up study
should determine the onset of skin cancer post-transplantation and the significance
of benign and atypical naevus counts in this cohort.
Schlagwörter Immunosuppression; Humans; Skin Neoplasms; Risk Factors; Female; Sunburn;
Male; Melanoma; Nevus, Pigmented; Adult; Transplantation; Adolescent

Ting, William; Schultz, Kara; Cac, Natalie N.; Peterson, Michael; Walling, Hobart W. (2007): Tanning bed
exposure increases the risk of malignant melanoma. In: Int J Dermatol, Jg. 46, H. 12, S. 1253–1257.
Abstract BACKGROUND: Epidemiologic studies have associated tanning bed exposure and
cutaneous melanoma. The relationship between the extent of tanning bed exposure
and the risk of melanoma has not been elucidated in detail. METHODS: Surveys
assessing the extent of tanning bed exposure and the history of skin cancer,
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including malignant melanoma, were collected from academic dermatology clinic
patients (n = 1518). Of these, 551 (36.3%) completed all components of the survey.
The available medical records, including pathology reports (n = 501; 33%), were
reviewed to confirm cases of skin cancer. Data on potential confounding factors,
including indoor vs. outdoor occupation and leisure activities, Fitzpatrick skin type,
history of blistering sunburn, use of sunscreen and sun protective clothing, history
of phototherapy, and level of education, were assessed and compared. RESULTS:
Of the patients surveyed, 487 (32.1%) reported tanning bed exposure. Women
aged 45 years or younger accounted for about 60% of all tanning bed users.
Seventy-nine cases of malignant melanoma were reported, 22 in women aged 45
years or younger. In the entire cohort, the "ever-use" of tanning beds was found to
be a significant risk factor for the development of melanoma [P < 0.05; odds ratio
(OR), 1.64; 95% confidence interval (95% CI), 1.01-2.67]. The risk was greater in
women aged 45 years or younger (P < 0.05; OR, 3.22; 95% CI, 1.01-11.46).
Patients with a history of melanoma were significantly more likely to report tanning
bed sessions exceeding 20 min (P < 0.01; OR, 3.18; 95% CI, 1.48-6.82); this
association was even stronger for women aged 45 years or younger (OR, 4.12;
95% CI, 1.41-12.02). LIMITATIONS: The study was subject to recall bias, included
only patients at a midwestern academic practice, and had a relatively low response
rate. CONCLUSION: Exposure to tanning beds increases the risk of malignant
melanoma, especially in women aged 45 years or younger. These findings reinforce
the hazards of tanning bed exposure.
Schlagwörter Logistic Models; research support, non-u.s. gov‘t; Humans; Middle Aged; Skin
Neoplasms; Ultraviolet Rays; Female; Sex Factors; Male; Melanoma; Aged; Time
Factors; Beauty Culture; Adult; Age Factors; Adolescent

Zabawski, E. J.; Washak, R. V.; Cohen, J. B.; Cockerell, C. J.; Brown, S. M. (2001): Squamous cell carcinoma of
the nail bed: is finger predominance another clue to etiology? A report of 5 cases. In: Cutis, Jg. 67, H. 1, S.
59–64.
Abstract Although squamous cell carcinoma (SCC) is commonly found on sun-exposed skin,
the occurrence of this malignancy in the nail bed is rare. We report 5 cases of SCC
of the nail bed and suggest that the disproportionate number of neoplasms of this
type on the second, third, and fourth fingers, combined with the known relationship
of SCC and human papillomavirus (HPV), is evidence that most SCC of the nail bed
result from contact with HPV. Moreover, we suggest that patients who present with
new, verrucous lesions of the nail bed and have a history of cervical dysplasia,
cervical carcinoma, or condyloma acuminata undergo diagnostic biopsy as opposed
to traditional destructive therapy for a lesion presumed benign.
Schlagwörter case reports; Humans; Middle Aged; Fingers; Tumor Virus Infections;
Papillomavirus Infections; Female; Male; Aged; Carcinoma, Squamous Cell;
Papillomaviridae; Aged, 80 and over; Nail Diseases