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Austin, A. S.; Spiller, R. C. (2001): Inflammatory bowel disease, azathioprine and skin cancer: case report andliterature 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 maintaina tan. Although the increased risk of non-melanoma skin cancer inimmunosuppressed transplant recipients is well recognized, patients with Crohn‘sdisease are not currently warned of the risk of exposure to ultraviolet light.Individuals with inflammatory bowel disease who take azathioprine, especially thosewith a fair complexion, should be informed of the potential dangers of sun bathingand 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 Swedishadults 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 changesun-related behaviors among young adults without a cancer diagnosis inmelanoma-prone families. Ten patients were interviewed, and questionnaires weresent on 3 occasions during a 15-month period to the total population (n = 87)meeting the inclusion criteria. Data from interviews and questionnaires showedextensive ultraviolet-exposure behaviors in this high-risk group for melanoma,although not always expressed in terms of sunbathing. When asked aboutsunbathing, 1/3 reported sunbathing "Often" or "Very often," despite a decrease insunbathing during the study period. In addition, 35% reported current sun bed use.The most important reason for sunbathing was attractiveness. The risk of gettingskin cancer was the most important reason to refrain from sunbathing. The majorityestimated their own risk for melanoma as equal or lower compared with the generalpopulation. The planned intervention failed due to low attendance. Ultravioletexposure is extensive. The individual perception of personal risk and the motivationto change behaviors are important factors to consider when designing a preventiveprogram. Interest for group information was low in this age group.

Schlagwörter research support, non-u.s. gov‘t; Genetic Predisposition to Disease; Humans; SkinNeoplasms; 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 theassociation 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 patientsyounger 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 todetermine potential risk factors for this population. Tanning bed visits, pack-years ofcigarette smoking, recreational sun exposure, number of blistering sunburns, anduse of sunscreens were determined for both groups. Among patients with a BCC,the histologic type of tumor, site of involvement, method of treatment, follow-upperiod, incidence of recurrence, and presence of actinic keratoses were alsoevaluated. Patients with a BCC had a statistically greater number of pack years ofsmoking (P =.045), and a greater percentage of these women had experiencedblistering sunburns (P =.028). Although women with a BCC had, on average, almosttwice as many tanning salon visits (152.2 vs 83.1), this was not statisticallysignificant. Sunscreen use and amount of recreational ultraviolet light exposurewere essentially equal between the two groups. Young women with a BCC aremore likely to have a past or current history of cigarette smoking and blisteringsunburns. Repeated exposure to tanning beds may also be a contributory factor.

Sunbeds - CitaviSunbeds - CitaviSunbeds - CitaviSunbeds - CitaviSchlagwörter Incidence; Attitude to Health; Biopsy, Needle; Humans; Middle Aged; Skin

Neoplasms; Risk Factors; Ultraviolet Rays; Female; Reference Values; CohortStudies; 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): Recenttanning 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 CDKN2Amutation who developed 3 primary melanomas within a few years of initiatingtanning bed use. CONCLUSION: Intense UV exposure as an adult likely contributedto 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 inclinical 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 increasingincidence. In most cases, BCC develops on chronically sun-exposed skin in elderlypeople, 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 ofskin cancer, skin type 1 and 2, a tendency to freckle in childhood,immunosuppression, previous radiotherapy, and chronic exposure to certain toxicsubstances such as inorganic arsenic. There are numerous variations in clinicalpresentation of BCC, such as nodular BCC, ulcerating BCC, pigmented BCC,sclerosing BCC, superficial BCC, and fibroepithelioma of Pinkus. Each varies interms of clinical presentation, histopathology and aggressive behavior. Treatmentmodalities for BCC include surgical excision, cryosurgery, curettage,electrodessication, radiotherapy, photodynamic therapy, topical cytostatics, andimmunomodulators. If left untreated or inadequately treated, BCC may becomeinvasive and locally destructive, although it very rarely metastasizes. Due to theextremely high incidence of BCC, medical professionals should be familiar with itsmanifold 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. AndersonCancer 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 theeffects on p16 and PCNA expression of repeated treatment with high-energy laser and intense pulsed lightexposure. 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 gainedmuch popularity in recent years due to the lack of down time that is associated withthem. One important but neglected issue is long-term safety. Does the repeated use

Sunbeds - CitaviSunbeds - CitaviSunbeds - CitaviSunbeds - Citaviof 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 ofsub-lethal QS 755 nm lasers on the expression of p16INK4a on melanoma celllines, and found that sub-lethal laser damage could increase DNA damage, whichled to an increase in p16 expression. Our objective was to assess the cutaneouseffect of repeated exposure to high-energy lasers and intense pulsed light sourceson male Institute of Cancer Research (ICR) mice. STUDY DESIGN/MATERIALSAND METHODS: Twenty-eight male ICR mice were divided into four groups. Otherthan the control group, all groups received either laser (585 nm pulsed dye laser or1,320 nm Nd:YAG laser) or intense pulsed light (IPL) treatment. All four groupswere anesthetized with a mixture of Hypnorm/Dormicum before treatment. Theanimals were irradiated twice a week for 6 months. Signs of toxicity such asmortality and weight loss were checked once a week. Skin tumor formation wasevidenced 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 immunohistochemicalstaining and immunoblotting using specific monoclonal antibodies for mouse PCNAand p16. The results were expressed as mean +/- standard error of the mean(SEM). Statistical difference was assessed by multiple ANOVA. A P-value of <0.05was considered to be significant. RESULTS: At the end of the 6 months, none ofthe 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 p16and 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 nmNd:YAG laser. CONCLUSION: The repeated use of high-energy laser and intensepulsed light source did not cause any toxicity in mice. The changes in p16 andPCNA imply that further studies are necessary to consider the implications ofrepeated exposure to longer wavelength radiation in human skin.

Schlagwörter Lasers; Animals; Genes, p16; Male; Skin; Mice, Inbred ICR; Time; Proliferating CellNuclear Antigen; Laser Therapy, Low-Level; Mice; Biological Markers

Chen, Weiliang; Li, Jingsong; Yang, Zhaohui; Yongjie, Wang; Zhiquan, Wang; Wang, Youyuan (2008): SMASfold flap and ADM repair of the parotid bed following removal of parotid haemangiomas via pre- andretroauricular incisions to improve cosmetic outcome and prevent Frey‘s syndrome. In: J Plast Reconstr AesthetSurg, 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 psychologicalsequelae to the child. Although conservative management is usually proposed forparotid haemangiomas occurring in infancy, this may not be particularly helpful andthe haemangioma difficult to conceal. The purpose of this study was to evaluate thereliable and aesthetic benefit of using a superficial musculoaponeurotic system(SMAS) fold flap and allograft dermal matrix (ADM) repair of the parotid bedfollowing parotid haemangiomas via pre- and retroauricular incision. Forty-threepaediatric patients (33 boys and 10 girls) with haemangiomas involving the parotidgland underwent total parotidectomy using a pre- and retroauricular approach withintraoperative placement of ADM within the parotid bed. They further underwentrepair of the parotid bed with SMAS fold flaps. A panel of three plastic surgeonsassessed the cosmetic outcomes. All of the patients were evaluated using a shortquestionnaire; postoperative gustatory sweating was assessed using a modificationof 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; ReconstructiveSurgical Procedures; Parotid Neoplasms

Chernoff, Karen A.; Bordone, Lindsey; Horst, Basil; Simon, Katherine; Twadell, William; Lee, Keagan et al.

Sunbeds - CitaviSunbeds - CitaviSunbeds - CitaviSunbeds - Citavi(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 changesfrequently observed among melanomas arising from sun-protected sites, such asacral skin (palms, soles, and nail bed) and mucous membranes. GAB2 has recentlybeen implicated in melanoma pathogenesis, and increased copy numbers are foundin a subset of melanomas. We sought to determine the association of increasedcopy numbers of GAB2 among melanoma subtypes in the context of geneticalterations in BRAF, NRAS, and KIT. EXPERIMENTAL DESIGN: A total of 85melanomas arising from sun-protected (n = 23) and sun-exposed sites (n = 62)were analyzed for copy number changes using array-based comparative genomichybridization and for gain-of-function mutations in BRAF, NRAS, and KIT.RESULTS: GAB2 amplifications were found in 9% of the cases and wereassociated 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. Theoverall mutation frequencies for BRAF and NRAS were 43.5% and 14%,respectively, and were mutually exclusive. Among the acral and mucosalmelanomas studied, the genetic alteration frequency was 26% for GAB2, 13% forKIT, 30% for BRAF, and 4% for NRAS. Importantly, the majority of GAB2amplifications 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 molecularclassification of melanomas.

Schlagwörter Proto-Oncogene Proteins B-raf; Gene Dosage; Humans; Middle Aged; SkinNeoplasms; Neoplasm Staging; Adaptor Proteins, Signal Transducing; UltravioletRays; Proto-Oncogene Proteins c-kit; Female; Genes, ras; Male; Melanoma; GeneFrequency; DNA Mutational Analysis; research support, n.i.h., extramural; GeneAmplification

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 Daccompanied by its beneficial effects. The dilemma lies in that increased sunexposure could lead to an increase in skin cancers and yet is necessary for thebetter prognosis of internal cancers. Solar radiation varies in intensity and spectralcomposition with geographic location and time. Of central interest in the presentcontext is that the UVA/UVB ratio can vary. Thus, the UVA/UVB ratio increases withdecreasing solar elevation. The ratio is also larger for most sun beds than that inthe midday sun, but similar to that in the afternoon sun. This may have large healthimplications, since vitamin D is exclusively generated by UVB, while UVA and UVBlikely play a role in the onset of CMM. Sun and sun beds act similarly: one quantumof radiation at a given wavelength has the same biological effect, irrespective of thesource from which it comes. The winter levels of vitamin D are 10 to 100% lowerthan the summer levels in most populations, but can be brought up to summerlevels by moderate sun bed exposure. Doses of 200 IU of vitamin D per day are notsufficiently 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 epidemiologicalstudies, interventional studies, animal studies and cell experiments show thatvitamin D reduces the risk and/or prognosis of internal cancers. Populations living athigh latitudes would probably benefit from moderately increasing their exposure toUVB 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

Sunbeds - CitaviSunbeds - CitaviSunbeds - CitaviSunbeds - Citavi

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 423cases of melanoma and 678 controls in the state of New Hampshire. Exposuredata, including sunlamp and tanning bed use, were collected by telephoneinterview. 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 asunlamp, 1.23 (95% CI 0.81-1.88) for those starting sunlamp use <20 years, and1.71 (95% CI 1.00-2.92) for those starting >/=20 years. Data suggested increasingrisk 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%) occurredafter 1980. The OR was 1.14 (95% CI 0.80-1.61) for ever using a tanning bed; therewas no evidence that risk increased with frequency or duration of use. The OR was1.96 (95% CI 1.06-3.61) for having used both devices. CONCLUSION: Resultssuggest a modest association between sunlamp use and melanoma risk, andincreasing risk with greater frequency and duration of use. No association withtanning bed use was found, but sufficient lag time may not have elapsed to assessa potential effect.

Schlagwörter Neoplasms, Radiation-Induced; Humans; Middle Aged; Skin Neoplasms; UltravioletRays; 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 distinctsubtypes 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 inBRAF and NRAS, genes within the mitogen-activated protein (MAP) kinasepathway commonly mutated in melanomas on intermittently sun-exposed skin. Thisraises the question of whether other aberrations are occurring in the MAP kinasecascade in the melanoma types with infrequent mutations of BRAF and NRAS.PATIENTS AND METHODS: We analyzed array comparative genomic hybridizationdata from 102 primary melanomas (38 from mucosa, 28 from acral skin, and 18from skin with and 18 from skin without chronic sun-induced damage) for DNA copynumber aberrations specific to melanoma subtypes where mutations in BRAF andNRAS are infrequent. A narrow amplification on 4q12 was found, and candidategenes within it were analyzed. RESULTS: Oncogenic mutations in KIT were foundin three of seven tumors with amplifications. Examination of all 102 primarymelanomas found mutations and/or copy number increases of KIT in 39% ofmucosal, 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-ninepercent of tumors with mutations and 53% of tumors with multiple copies of KITdemonstrated increased KIT protein levels. CONCLUSION: KIT is an importantoncogene in melanoma. Because the majority of the KIT mutations we found inmelanoma also occur in imatinib-responsive cancers of other types, imatinib mayoffer an immediate therapeutic benefit for a significant proportion of the globalmelanoma burden.

Schlagwörter Nucleic Acid Hybridization; Humans; Middle Aged; Skin Neoplasms; AntineoplasticAgents; 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 ExpressionRegulation, Neoplastic

Del Bino, S.; Sok, J.; Bessac, E.; Bernerd, F. (2006): Relationship between skin response to ultraviolet exposure

Sunbeds - CitaviSunbeds - CitaviSunbeds - CitaviSunbeds - Citaviand 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 constitutivepigmentation. The relationship between ultraviolet (UV) sensitivity and skin colortype was analyzed on 42 ex vivo skin samples objectively classified from light todark skin, based on their values of individual typology angle (ITA) determined bycolorimetric parameters. The biologically efficient dose (BED) was determined foreach sample by quantifying sunburn cells after exposure to increasing doses of UVsolar-simulated radiation. Typical UV-induced biologic markers, other thanerythema, such as DNA damage, apoptosis and p53 accumulation, were analyzed.A statistically significant correlation was found between ITA and BED and, ITA andDNA damage. Interestingly, DNA lesions were distributed throughout the wholeepidermal layers and the uppermost dermal cells in light, intermediate and tannedskin 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 andskin color type. They emphasize the impact of DNA damage accumulation in basallayer in relation to the prevalence of skin cancer.

Schlagwörter Humans; Epidermis; Epithelial Cells; Ultraviolet Rays; Female; Apoptosis; SkinPigmentation; Organ Culture Techniques; Skin; Dermis; DNA Damage; BiologicalMarkers; Tumor Suppressor Protein p53

Geller, Alan C.; Brooks, Daniel R.; Colditz, Graham A.; Koh, Howard K.; Frazier, A. Lindsay (2006): Sunprotection 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 historyof skin cancer on the sun protection behaviors of the offspring has been published.METHODS: A retrospective study was conducted of the sun protection behaviors ofthe adolescent participants in the Growing Up Today Study (GUTS), who wereoffspring of mothers from the Nurses Health Study II. Adolescents‘ surveys werematched with their mothers‘ reports of a personal or family history of skin cancerand compared with adolescents whose mothers did not report a personal or familyhistory of skin cancer. The outcome measures were (1) occurrence of frequentsunburns 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 reportedhaving used a tanning bed in the past year at least once with those who reported notanning bed use in the past year. Routine use of sunscreen was defined as arespondent who replied that he or she "always" or "often" used sunscreen with sunprotection factor of 15 or more when he or she was outside for > 15 minutes on asunny day during the past summer. General estimating equations were used tocalculate odds ratios and 95% confidence intervals adjusted for gender, age, colorof untanned skin, and number of friends who were tanned. We also conducted anadditional analysis restricted to children whose mothers had received a diagnosis ofskin cancer in which we assessed sun protection behaviors according to the child‘sage and mother‘s age at the time of the mother‘s diagnosis and the number of yearsthat had passed since the diagnosis of the mother‘s skin cancer. RESULTS: In1999, 9943 children reported their sun protection behaviors; 8697 of their mothershad not received a diagnosis of skin cancer or reported a family history ofmelanoma, 463 participants‘ mothers had received a diagnosis of skin cancer, and783 participants‘ mothers reported a family history of melanoma. Between 1989 and1999, 371 mothers of GUTS participants received a diagnosis of skin cancer:melanoma (n = 44), squamous cell (n = 39), and basal cell cancer (n = 311); 23mothers received a diagnosis of > 1 type of skin cancer. Because GUTS includessiblings from the same family, the 371 mothers with skin cancer had 463 offspring inGUTS. Offspring of mothers with skin cancer were slightly more likely to report

Sunbeds - CitaviSunbeds - CitaviSunbeds - CitaviSunbeds - Citavifrequent sunburns in the past year compared with those with neither maternaldiagnosis nor family history (39% vs 36%). Tanning bed use was not significantlydifferent among those with either a maternal diagnosis of skin cancer or familyhistory of melanoma as compared with nonaffected adolescents (8% vs 9% vs10%). Sunscreen use among offspring of mothers with skin cancer was higher thanamong those whose mothers had a family history of melanoma or mothers with nopersonal history of skin cancer (42% vs 33% vs 34%). Tan-promoting attitudes werealso similar across all groups. Only 25% thought that a natural skin color was mostattractive, and on average, 25% in each group agreed that it was worth burning toget a tan. Children of mothers who had received a diagnosis > 2 years in the pastwere less likely to use sunscreen, more likely to sunburn, and more likely to usetanning beds than children of mothers with a more recent diagnosis, although theresults did not reach statistical significance. CONCLUSION: Frequent sunburns,suboptimal sunscreen use, and high rates of tanning bed use are commonplaceeven among the children of health professionals who are at risk for developing skincancer themselves as a result of personal or family history. With new information onfamily risk, pediatricians can use the potential of a teachable moment to ensureoptimal 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 000US 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 withtan-seeking behaviors, and to compare these findings with sun protectionrecommendations from federal agencies and cancer organizations. METHODS: Across-sectional study, from all 50 states, of 10 079 boys and girls 12 to 18 years ofage in 1999. Data were collected from self-report questionnaires with the children ofthe participants from the Nurses Health Study (Growing Up Today Study).RESULTS: The prevalence of sunscreen use was 34.4% with girls more likely touse 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 theprevious summer, and 36% had 3 or more sunburns. Nearly 10% of respondentsused a tanning bed during the previous year. Girls were far more likely than boys toreport tanning bed use (14.4 vs 2.4), and older girls (ages 15-18) were far morelikely 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, andmore than doubled again by age 17 (35%; N = 244). Multivariate analysisdemonstrated that attitudes associated with tanning, such as the preference fortanned skin, having many friends who were tanned, and belief in the worth ofburning to get a tan, were generally associated with sporadic sunscreen use, morefrequent sunburns, and increased use of tanning beds. CONCLUSIONS: Ourfindings suggest that many children are at subsequent risk of skin cancer becauseof suboptimal sunscreen use, high rates of sunburning, and tanning bed use.Recommendations in the United States for improved sun protection and avoidanceof tanning beds and sunburning, which began in the early 1990s, have beenprimarily unheeded. Nationally coordinated campaigns with strong policycomponents must be developed and sustained to prevent skin cancer in a newgeneration of children and adolescents.

Schlagwörter research support, non-u.s. gov‘t; Cross-Sectional Studies; Humans; SkinNeoplasms; Prevalence; Child; Ultraviolet Rays; Female; United States; SexFactors; Sunburn; Male; Melanoma; Health Education; research support, u.s. gov‘t,

Sunbeds - CitaviSunbeds - CitaviSunbeds - CitaviSunbeds - Citavip.h.s.; Beauty Culture; Age Factors; Sunscreening Agents; Adolescent

Gorell, Emily; Lee, Carolyn; Muñoz, Claudia; Chang, Anne Lynn S. (2009): Adoption of Western culture byCalifornian 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. MAINOUTCOME MEASURES: Results based on 546 questionnaires returned.RESULTS: The overall response rate was 74.4%. Multivariate regression analysiscontrolling for age and skin type showed that westernization (as determined bygeneration in the United States, location raised, or self-rated acculturation) wasassociated with attitudes and behaviors promoting sun exposure (including thebelief that having a tan is attractive, negative attitudes toward use of sunscreen andsun protective clothing, and increased weekend sun exposure, lying out to get atan, and tanning bed use) at a level of P < .05. CONCLUSIONS: Our data suggestthat adoption of Western culture may be associated with attitudes and behaviorspromoting sun exposure among Asian Americans. This group should be targeted bydermatologists for increased education regarding sun protection, solar damage, andskin cancer prevention and detection.

Schlagwörter California; Attitude to Health; Humans; comparative study; Skin Neoplasms;Prevalence; Acculturation; Female; Sex Distribution; Sunburn; Male; HealthEducation; Sunlight; Asian Americans; Adult; Questionnaires

Greene, Kathryn; Brinn, Laura S. (2003): Messages influencing college women‘s tanning bed use: statisticalversus narrative evidence format and a self-assessment to increase perceived susceptibility. In: J HealthCommun, 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. Thisstudy explores the effect of type of evidence, self-assessments of risk for skincancer, and personality factors on intention to use and use of tanning beds amongCaucasian female college students. Specifically, it targeted the perceivedsusceptibility component of the Health Belief Model and its impact on intention totan as well as changes in actual tanning behavior. College students (N=141) in thesoutheast United States read randomly assigned messages and self-assessments,filled out surveys, and were later contacted for a follow-up telephone survey. Thestatistical message was rated higher on information value and also resulted indecreased intention to tan, decreased tanning behavior, and increased perceivedsusceptibility to skin cancer. The narrative message, in contrast, increasedperceptions of realism and also worked to decrease intentions to tan. Additionally,the self-assessment manipulation resulted in increased susceptibility anddecreased intention to tan and post tanning behavior. Personality factors explainedsmall portions of variance. Key limitations and directions for future research are alsoaddressed.

Schlagwörter research support, non-u.s. gov‘t; Risk Assessment; Humans; comparative study;Skin Neoplasms; Risk Factors; Ultraviolet Rays; Southeastern United States; HealthBehavior; Intention; Female; European Continental Ancestry Group; randomizedcontrolled trial; clinical trial; Students; Communication; Beauty Culture; Adult;Universities; Questionnaires; Health Knowledge, Attitudes, Practice; SocialMarketing

Hussein, Mahmoud R.; Elsers, Dalia A.; Fadel, Sabah A.; Omar, Abd-Elhady M. E. (2006): Clinicopathologicalfeatures 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

Sunbeds - CitaviSunbeds - CitaviSunbeds - CitaviSunbeds - Citaviliterature was limited to Caucasians. To date, the clinicopathologic features of theselesions in Egyptians are still unknown. To define these features, diagnostic recordsof the melanocytic skin lesions received at the Pathology Department, AssuitUniversity Hospitals (1989-2004) were reviewed. The lesions examined included 12benign naevi (BN), 10 dysplastic naevi (DN), and 21 cutaneous malignantmelanomas (CMMs). The DN and CMMs were more common in men than inwomen (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, DNand 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 meantumour thickness (Breslow) was 6+/-0.5 mm. CMMs included two of 21(9%), threeof 21(14%), six of 21(38%), and 10 of 21(38%) with Clark level II, III, IV and V. InEgypt, CMM is the third most common cutaneous neoplasm following squamousand basal cell carcinomas. Compared with Western societies, melanoma has amale sex predilection, similar histological features but different topographicaldistribution and rare incidence. The striking difference from Western series is theincidence of nodular melanoma - in the West this represents 15-30% ofmelanomas, with superficial spreading being the majority. Another key differencefrom 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 skinlesions 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 melanomaawareness 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 305questionnaires, distributed among university students (medical school and economyprogramme) were analysed (157 men, 139 women, mean age 24 years). Thepercentage of students sunbathing with the intention of getting a tan was 75%.Thirteen per cent reported having experienced at least one painful sunburn everyyear and 93% stated at least one burn during the last ten years. The majority of thestudents 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 andsunburns. Significantly more women (70%) than men (51%) used sunscreen. Theoverall knowledge of melanoma was high. No difference in knowledge was foundbetween the high- and low-exposure group. Medical students scored higher onknowledge than economy students, but did not differ in exposure score. Ourfindings reveal an excessive sun exposure among university students. A high levelof knowledge of risk does not lead to a sun-protective behaviour. Futurepreventative campaigns targeting young people must focus on strategies to changeattitudes towards tanning as being healthy and attractive.

Schlagwörter research support, non-u.s. gov‘t; Attitude to Health; Humans; Skin Neoplasms; RiskFactors; 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 indoortanning facilities and services in New Zealand, 1992‐2006. In: Aust N Z J Public Health, Jg. 32, H. 4, S.372–377.

Sunbeds - CitaviSunbeds - CitaviSunbeds - CitaviSunbeds - CitaviAbstract 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 Zealandregions for 1992, 1996, 2001 and 2006 were examined. Entries under solaria andsun bed headings were supplemented with entries where sun bed/indoor tanningservices were explicitly advertised under hairdressing, beauty therapy/supplies, andhealth and fitness centre categories. Duplicate listings were eliminated. RESULTS:From 1992 to 2006, inclusive, there was a 241% increase in the number ofbusinesses that advertised some form of indoor tanning service in the NZ YellowPages telephone directories. There was a 525% increase in the number ofwholesale trade providers, indicative of expansion in the industry, overall. Hireservices also increased. The reported findings are likely to represent anunderestimate of the total numbers of facilities and providers. CONCLUSION:Substantial growth in indoor tanning facilities and services in New Zealand hasoccurred since 1992. IMPLICATIONS: The evidence of potential serious healthrisks from sunbed use, in conjunction with evidence of irresponsibility among someproviders, suggests a need for regulatory controls to strengthen existing voluntaryguidelines. With legislation recently introduced for the states of Victoria and SouthAustralia, and proposed in Queensland and Western Australia before the end of2008; it would be timely for New Zealand authorities to collaborate with thosedrafting 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; NewZealand; Sunscreening Agents; Advertising as Topic; Beauty; PopulationSurveillance

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 asa typical site and therefore may give a diagnostic clue or it can occur sporadicallyon the neck as well as on other sites. A well-known and important factor in thepathogenesis is exposure to sunlight. Sun-induced pigmentation often presents onthe neck and may result from phototoxic, photoallergic and cumulative actinicdamage. Frequent forms comprise berloque dermatitis, Riehl‘s melanosis,poikiloderma of Civatte and tanning bed lentigines. Different infections may alsolead to this distinct skin alteration as pediculosis capitis, pityriasis versicolor andsyphilis II. Treatment-induced irregular pigmentations may occur after applicationsof topical agents (e.g. diphenylcyclopropenone), systemic medication (e.g. 5-fluorouracil, chlorpromazine), as a complication of laser resurfacing or as a chronicgraft-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 reticulatedpigmentation. Various other infrequent conditions as connective tissue diseases,malnutrition, lichen planus pigmentosus and others are summarized. The neck, areadily accessible site to medical inspection, may have an underestimated value forthe 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

Sunbeds - CitaviSunbeds - CitaviSunbeds - CitaviSunbeds - CitaviEnvironment 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 ofexposure that incur risk. The purpose of this article is to critically examine, on thebasis of current knowledge, the impact of stratospheric ozone depletions, tanningbed skin cancer risk, the safety of sunscreens as an important element of our solarprotection strategies, the wavelengths of solar radiation responsible for melanoma,and the incidence of melanoma. Recommendations are made on preventionstrategies 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, anddetection 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 youthsignificantly increases the lifetime risk of developing melanoma. We postulate thatteenagers have little awareness of melanoma prevention or detection principles.The purpose of this study was to assess the knowledge of teenagers aboutmelanoma and to identify which age groups are most receptive to altering their sunexposure behaviors. METHODS: Two hundred and ten examinations testinggeneral knowledge of sun exposure and melanoma were completed and returnedby junior high and high school students ages 12 to 18 in Dallas and Houston,Texas. All students completing and returning the examination were provided withthe correct answers to the test and a detailed explanation of each of the test itemsas part of an educational exercise. A second questionnaire was then administeredto determine the effect of the educational exercise on future sun exposurepractices. Students were divided into two age groups (12 to 15 and >or=16 yearsold) for comparison of scores on the knowledge examination and responses tobehavioral items. Comparison of response rates between age groups wasperformed using chi(2) analysis. RESULTS: The return rate was 100%, with 109students age 12-15 years, and 101 students >or=16 years. Seventy-six percent ofall respondents sunbathed outdoors, and 18% had used a tanning bed in the past 6months. Thirty-three percent of students admitted to at least three blisteringsunburns in the past. The average score on the knowledge assessmentexamination was 65% correct for students >or=16 years old and 54% correct forthose 12-15 years old. Students 12 to 15 years old were significantly more likely toindicate they planned to change future behaviors regarding performance of skinself-examinations and limiting sun exposure as compared to the older students.CONCLUSION: A significant number of teenagers have already enhanced their riskfor future melanoma by suffering severe sunburns. Students younger than 16 yearsof age were significantly more likely to indicate they planned to change futurebehaviors after receiving information about melanoma. The data from this pilotstudy support education aimed at younger age groups to most effectively achieverisk 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; NeedsAssessment; Male; Melanoma; Sunlight; Adolescent Behavior; Adolescent

Ma, Fangchao; Collado-Mesa, Fernando; Hu, Shasa; Kirsner, Robert S. (2007): Skin cancer awareness and sunprotection behaviors in white Hispanic and white non-Hispanic high school students in Miami, Florida. In: ArchDermatol, 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 increasingincidence and delayed diagnosis of skin cancer in the growing Hispanic population

Sunbeds - CitaviSunbeds - CitaviSunbeds - CitaviSunbeds - Citaviin the United States represent an emerging health issue. DESIGN: Pilot surveystudy. SETTING: A high school in Miami, Florida. PARTICIPANTS: A total of 369high school students (221 WHs and 148 WNHs) were surveyed in the study. MAINOUTCOME MEASURES: Survey data were collected regarding skin cancerknowledge, perceived risk, and sun protection behaviors. Differences between the 2groups were compared with chi(2) tests. RESULTS: White Hispanic students weremore likely to tan deeply (P = .04) but less likely to have heard of (P < .01) or beentold how to perform (P < .01) skin self-examination. White Hispanics were less likelyto wear sun-protective clothing or to use sunscreen with a sun protection factor of15 or higher and reported a greater use of tanning beds. White Hispanic studentsalso thought their chance of developing skin cancer was less than that of WNHstudents (P < .01), which remained significant after adjustment for age, sex, familyhistory, and skin sensitivity to sun. After adjustment, WHs were 2.5 times morelikely than WNHs to have used a tanning bed in the past year. White Hispanicswere 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 wearprotective 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 afterUV 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 anassociation between tanning bed use and the development of skin cancer. Anothersource of high-dose UV-A is UV nail lights, available for use in the home and inbeauty salons. OBSERVATIONS: Two healthy middle-aged women with nopersonal or family history of skin cancer developed nonmelanoma skin cancers onthe 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 thedevelopment of skin cancer; however, this observation warrants furtherinvestigation. In addition, awareness of this possible association may helpphysicians identify more skin cancers and better educate their patients.

Schlagwörter case reports; Neoplasms, Radiation-Induced; Humans; Middle Aged; SkinNeoplasms; 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 ofphotodynamic therapy on recurrent pituitary adenomas: clinical phase I/II trial‐an early report. In: Br JNeurosurg, 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 peculiaranatomical location. Radiotherapy has been employed as an adjuvant therapy toaddress residual disease with favourable results. This approach is, however, notwithout side effects, and it cannot be repeated. We are therefore investigating theeffectiveness of photodynamic therapy (PDT) on recurrent pituitary adenomas inhumans. This study details the protocol applied to 12 patients with recurrentpituitary adenomas, which involved systemic administration of photosensitizer(Photofrin) followed, after a period of 24-48 h, by intraoperative illumination of thetumour bed using 630 nm laser light. The primary end points were visual, endocrineand radiological improvement. The incidence of side effects was also monitored.

Sunbeds - CitaviSunbeds - CitaviSunbeds - CitaviSunbeds - CitaviThe longest follow-up is 2 years. Most patients suffering from visual acuity or fielddefects have shown improvement when followed for 12 months or more. Threepatients showed complete recovery of their visual fields. All those who presentedwith functional adenomas have shown reduction in their hormone levels. Tumourvolume, 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 skinphotosensitization due to early exposure to direct sunlight and three othersdisplayed minor skin reactions. There was no treatment-related mortality ormorbidity. One patient (operated transcranially) developed hemiparesispostoperatively, which recovered completely. We think this is unrelated to thetreatment. This prospective study demonstrates that PDT may be safely applied tothe pituitary fossa by the trans-sphenoidal route and indicates the need for arandomized, 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 regardingsunbathing, sunscreen use, and tanning salon use. OBJECTIVE: We sought todetermine the frequency of UV exposure in a select sample and to assess theknowledge and beliefs of the effects of UV irradiation. METHODS: A written,anonymous questionnaire was distributed to a sample of 477 persons in a shoppingmall, at a social gathering, and on a vacation cruise ship. The instrument exploreddemographic information, sunscreen use, sunbathing habits, tanning bed use, andcutaneous solar effects. RESULTS: Forty-two percent of respondents seldom ornever used sunscreen, and 33% sunbathed at least once a week. Although thethree 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 morelikely 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 +/- 7minutes at 2.3 +/- 1.1 times per week). Reported positive psychologic sequelaefrom tanning bed use were more common than negative physical sequelae. At least10% would continue to use tanning beds if these were proved to cause skin cancer.CONCLUSION: In this select sample, sunbathing and tanning bed use werecommon. No group surveyed universally practiced sun protection and avoidance.Clientele of tanning beds may be aware of the damaging effects of the sun, but maynot 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; AgeFactors; Occupational Exposure; Questionnaires; Sunscreening Agents; HealthKnowledge, Attitudes, Practice; Adolescent

McMullen, E. A.; Dolan, O. M.; McCarron, P.; Kee, F. (2007): Reliability testing of a sun exposure questionnairefor 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 inincidence of melanoma in Northern Ireland, we have conducted a questionnairesurvey in an attempt to gather information about sunbathing habits and other formsof ultraviolet light exposure amongst the Northern Ireland population. AIM: The aimof this study was to examine the test-retest reliability of a questionnaire used in alarge-scale cross-sectional population survey pertaining to sunbathing habits, use of

Sunbeds - CitaviSunbeds - CitaviSunbeds - CitaviSunbeds - Citavisun screen, skin types, and frequencies of sunburn and to assess the responsesgiven by the subjects to determine the nature of their sun-related behaviour.METHODS: Thirty control subjects were randomly selected from a populationcontrol sample participating in a large case-control study investigating melanoma inthe Northern Ireland population. All participants completed the interviewquestionnaire on two occasions, with a median of 15 days (range, 12-42 days)between interviews. We randomly chose control subjects who had been visited bythe same research nurse, thus ruling out interobserver bias in the analyses. Weused the test-retest method. Kappa statistics were used to calculate the associationbetween test and retest scores of all the individual items. If the items containedwithin the questionnaire are reliable, then repeated measurement after a fairly shortperiod of time should result in high within-subject repeatability. RESULTS:Questions pertaining to hours spent in the sun and sun bed usage showed highreliability (kappa > 0.7). Questions about sunscreen usage showed moderately highreliability (kappa > 0.6) in all but one of the 10-year age bands and completeagreement (kappa = 1) in one age category (>50 years). CONCLUSION: Thisquestionnaire is a reliable method of assessing sun-associated behaviouridentifying high-risk sun-related behaviour and misconceptions about tanning, whichcan be targeted for improvement in public health.

Schlagwörter Reproducibility of Results; Humans; Female; Health Behavior; Male; Case-ControlStudies; Sunlight; Adult; Ireland; Questionnaires

Patel, Gopal A.; Ragi, Gangaram; Krysicki, Jan; Schwartz, Robert A. (2008): Subungual melanoma: a deceptivedisorder. 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 theproportion is higher in dark-skinned individuals. The subungual form representsabout 2% of cutaneous non-sun induced melanomas in the western world, and upto 75% in Africans, 10% in Japanese, and 25% in the Chinese of Hong Kong. Up to33% of subungual melanomas are amelanotic. Black pigmentation of the adjacentnail fold, termed Hutchinson‘s sign, may be a diagnostic clue. Non-specific featuresand symptoms along with a high incidence of amelanosis often lead to delayeddiagnosis, disease progression, and a poor prognosis with challenging treatmentoptions.

Schlagwörter Humans; Skin Neoplasms; review; Melanoma; Nail Diseases

Rafnsson, Vilhjalmur; Hrafnkelsson, Jon; Tulinius, Hrafn; Sigurgeirsson, Bardur; Olafsson, Jon H. (2004): Riskfactors 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: Informationon various risk factors for malignant melanoma was collected through mailedquestionnaires sent to a random sample of the Icelandic population. Theinformation collected was the first phase of a prospective study on malignantmelanoma among aircrew members as compared to a population sample.RESULTS: The overall participation rate was about 50%. Seven percent of womenand six percent of men had red hair color. Blue or green eye color was reportedamong 89% of women and 87% of men. Sixteen percent of women aged 20 to 39had used sun beds more than 100 times during their lifetime, while thecorresponding figure was 12% for men of the same age. Younger age groups hadmore sunny vacations than the older age groups. The frequency of sunburn differedin the groups with reported different skin types according to Fitzpatrickclassification. CONCLUSION: The high prevalence of sun bed usage among youngwomen is concurrent with the increased incidence of malignant melanoma amongyoung women registered in the nationwide cancer registry. Young people havemore often used sun beds and taken sunny vacation than the older, indicating achanged behavior in the population.

Sunbeds - CitaviSunbeds - CitaviSunbeds - CitaviSunbeds - CitaviSchlagwörter 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 devicesin 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 artificialtanning is perceived as a "safe tan." However, exposure to UV radiation is known tocause adverse health effects. OBJECTIVE: The purpose of this study was toestimate the prevalence of use of tanning equipment in the Province of Québec andto characterize people who reported using these devices. METHODS: In 1996, atelephone survey was carried out among adults from the two most denselypopulated regions (Montréal, Québec) of the Province of Québec. The final sampleincluded 1003 white persons 18 to 60 years old. Interviewers used a standardizedquestionnaire to document the characteristics of the participant, skin phototype, andexposure habits to artificial UV radiation sources. RESULTS: During the last 5 yearsbefore 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 12months 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 tanningbed users. Twenty-six percent of users experienced one or more acute adversehealth effects from the artificial UV irradiation. Most of these were cases of skinburns. A high proportion (77.5%) of those who used tanning equipment during thelast year before the study said they would return to tanning salons. The intention ofreturning to a tanning salon was not influenced by the occurrence of the acuteadverse health effects. The most prevalent reason given for using tanningequipment was "to improve their appearance by a tan." Most people (60.4%) whoused a tanning bed during the last 5 years before the study believe that tanningsalons are not dangerous. CONCLUSION: This survey indicates that tanning beduse is very prevalent in the Province of Québec, mainly among young women. Thehigh rate of acute adverse health effects related to artificial tanning, particularly skinburns, is of concern. Finally, our results underline the importance of changingattitudes 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; RiskFactors; 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 thannatural 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 balancesbetween 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 tofacilitate preteen preventive health counseling. STUDY DESIGN: We examined therate of malignant melanoma among Kentucky residents and compared this rate withindicators of tanning bed prevalence in a large metropolitan area and sunscreensales from a major distributor. We obtained malignant melanoma annual incidencedata from the Kentucky Cancer Registry, which recorded Kentucky populationincidence rates over the years 1995 to 2004. The rates reflected 2 malignant

Sunbeds - CitaviSunbeds - CitaviSunbeds - CitaviSunbeds - Citavimelanoma classifications: pre-invasive cancer only, or both invasive andnoninvasive cancers combined. RESULTS: The age-adjusted incidence rate perhundred thousand for combined invasive and pre-invasive malignant melanomaswelled from 21.9 in 1995 to 31.3 in 2004. The respective invasive-only malignantmelanoma incidence rates increased less dramatically, from 17.3 to 20.7, duringthis same 10-year time period. Since 1983, the number of separate tanning bedbusinesses increased from 1 in 1983 to 119 by the mid-1990s, and then declined toabout 74 separate businesses by 2003. Sunscreen sales data is uneven betweenstates and is currently inconclusive. CONCLUSIONS: Although current data cannotdraw a precise link between melanoma and the use of tanning beds, the associatedrisk is implicit, as the ultraviolet A (UVA) and ultraviolet B (UVB) radiation in tanningbed usage is a well-established melanoma risk factor. In advising patients, thepediatric specialist should consider that melanoma rates are poised as a balance ofsome known risk factors and a few potential preventive factors.

Schlagwörter research support, non-u.s. gov‘t; Incidence; Risk Reduction Behavior; PatientEducation 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 chronictanning 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 orfurocoumarins. Histologic examination of a representative lentigo revealedmelanocytic hyperplasia and cytologic atypia. Increased nevocytic activity withhistologic dysplasia was present in several junctional nevi excised during the periodof UVA exposure. Several studies have revealed significant effects of UVA onmelanocytes. Patients should be cautioned to avoid tanning bed use in view ofthese 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): [Merkelcell 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 theextremities. Immunohistochemical markers (CK20+, CK7- and TTF1-) are used todistinguish between MCC and other tumors. MCC have a tendency to rapid localprogression, frequent spread to regional lymph nodes and distant metastases. Dueto 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 primarytumor (with 2 to 3 cm margin) and lymphadenectomy in case of node-positivedisease, followed by external beam radiotherapy (EBRT) to a total dose of 50 to60Gy in the tumor bed. Adjuvant EBRT has been shown to decrease markedlylocoregional recurrences and to increase survival in recent studies. Treatment oflymph nodes area is more controversial. Chemotherapy is recommended only formetastatic 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 cutaneousmalignant melanoma and non-melanoma skin cancer: perceptions and behaviours of Danish and Americanadolescents. 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

Sunbeds - CitaviSunbeds - CitaviSunbeds - CitaviSunbeds - Citaviin Scandinavia and the United States (USA). Most Danes and Americans receive50% of their lifetime ultraviolet (UV) radiation before the age of 21, making itimportant to address sun exposure risks with adolescents. The project wasundertaken to determine differences between Danish and American adolescents inknowledge of sun exposure and skin malignancy, activities accounting for sunexposure, and means used for sun protection. Questionnaires regarding skincancer and sun exposure were distributed to 674 secondary school age students inHilleroed, Denmark, and to 483 similarly aged students in Winston-Salem, NorthCarolina, USA. Differences in responses between and within groups werecompared. American adolescents had more knowledge of the characteristics andmalignant potential of melanoma than did Danish adolescents. Danish youth andfemales from both countries were significantly more likely to engage in sunbathingand tanning bed use. Black Danish students reported significantly more sunburnand were more likely to sunbathe or use a tanning bed than were black Americanstudents. Danish students were more likely than Americans to use sunscreen,however, Americans were more likely to apply sun protective factor (SPF) 15 orgreater. In conclusion, given that sunbathing and tanning bed use are associatedwith the development of precancerous lesions and skin malignancy, Danish teensare at increased risk. The rates of skin malignancy are relatively high inScandinavia and efforts to improve understanding of exposure and cancer risksshould 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; SexFactors; 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 andopportunities. 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] isperhaps better understood than any other human carcinogen. The roles of UVradiation exposure and indoor tanning behaviors on skin cancer risk are exploredhere. RECENT FINDINGS: Studies from the past several years have shown asignificant association between ever-use of an indoor tanning facility and anincreased risk of basal cell carcinoma, squamous cell carcinoma, and melanoma.The association between indoor tanning and skin cancer is particularly strongamong those who first used a tanning facility in early adulthood. Elevated vitamin Dlevels have been suggested to protect against various internal malignancies andother disease states, but sources of vitamin D that do not require UV exposure areeasily available. SUMMARY: Although additional research is needed to understandfully the relationship between UV and skin cancer, it is already clear that indoortanning bed use represents an avoidable risk factor for melanoma andnonmelanoma skin cancer - both of which may be lethal. Acting upon thisinformation 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 safealternative. However, the effects of sunless tanning methods on ultraviolet light-related behaviors have never been investigated. METHODS: Anonymous survey of121 individuals who underwent a spray-on sunless tanning treatment betweenFebruary and May 2004. RESULTS: Women completed 107 surveys. Men

Sunbeds - CitaviSunbeds - CitaviSunbeds - CitaviSunbeds - Citavicompleted 14 surveys. The majority of individuals reported that they had not orwould not change their time spent outdoors or their sunscreen use as a result ofundergoing sunless tanning. However, 73% of individuals who had used UVLtanning beds said they had decreased or would decrease their UVL tanning beduse. CONCLUSION: Sunless tanning is associated with a self-reported decrease intraditional UVL tanning bed use among tanning bed users. Physicians shouldadvocate the use of sunless tanning to their patients who use traditional UVLtanning beds as a means of decreasing their UVL exposure and cancer risk.

Schlagwörter Humans; Dihydroxyacetone; Middle Aged; Skin Neoplasms; Pilot Projects; HealthBehavior; 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 thecontinuous increase in its incidence. BCC is generally a disorder of whiteindividuals, especially those with fair skin. UV radiation is the most important riskfactor 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 20-50years 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 elderlypeople, most commonly in the area of head and neck. UVB radiation damages DNAand its repair system and alters the immune system resulting in a progressivegenetic alterations and formation of neoplasm. UV-induced mutations in the TP53tumor-suppressor gene have been found in about 50% of BCC cases. Themutations that activate the Hedgehog intercellular signaling pathway genes,including PTCH, Sonic hedgehog (Shh) and Smoothened (Smo) play a significantrole in cutaneous carcinogenesis. Epidemiologic studies demonstrate the higherincidence of the BCC in more equatorial latitudes than in polar latitudes. Other riskfactors for the development of BCC include sun bed use, family history of skincancers, skin type 1 and 2, immunosuppression, previous radiotherapy, and chronicexposure 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 ofBCC medical professionals should be aware of the importance of the publiceducation 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 frompromotion 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 assayfor promotion of transformation is carried out in soft agar or other anchorageindependent conditions. The present study was directed to the development of an invivo 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 anchorageindependent transformation response and graft bed tumor formation by P+ cells,suggesting that the requirement for AP-1 activation in transformation now applies invivo. Expression of mutated p53 produced a gain of P+ phenotype in P- cells invitro, but not in vivo. Histochemical and Northern blot analysis for expression of

Sunbeds - CitaviSunbeds - CitaviSunbeds - CitaviSunbeds - Citavivarious keratinocyte markers revealed no evidence for expression, suggesting aloss of keratinocyte markers following establishment in culture. In summary, theskin-grafting assay described in this study appears to be a valid in vivo assay fordistinguishing the preneoplastic progression phenotypes represented by JB6 P- andP+ cells.

Schlagwörter Mice, Inbred BALB C; Animals; comparative study; Skin Neoplasms; NeoplasmTransplantation; 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): Skinsurveillance 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 shownto be higher in paediatric than adult recipients. Multiple melanocytic naevi and/oratypical naevi may be a risk factor for the development of melanoma. Therelationship between naevus counts and phenotypic characteristics, disease-relatedvariables and sun exposure has not been explored in paediatric transplant patients.OBJECTIVES: To determine the prevalence of premalignant and malignant skinlesions and to identify known risk factors associated with benign and atypicalmelanocytic 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, demographicand transplantation details were collected using interview, questionnaire and casenote review. A skin examination was performed for regional counts of malignantlesions, benign and atypical naevi. RESULTS: Ninety-eight patients (82 liver, 13renal, three multiorgan) with a median follow up of 9 years (range 5-16) werereviewed. Neither skin cancer nor premalignant lesions for NMSC were detected inthis group. Eighty-five patients had benign naevi (median 6, range 1-57). Clinicalrisk 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 associatedwith more episodes of sunburn (P = 0.006) and more transplants (P = 0.04). Othervariables including phenotype, skin type, sun exposure, holidays abroad, residenceabroad and total duration of immunosuppression did not correlate with benign oratypical naevus counts. CONCLUSIONS: Skin cancer was not observed inpaediatric solid organ transplant recipients who were 5-16 years post-transplantation. Both benign and atypical naevus counts were higher in childrenwith frequent episodes of sunburn. As both naevi and sunburn are risk factors formelanoma, we should target fair-skinned transplant recipients with naevi forintensive sun avoidance education. A prospective, longitudinal follow-up studyshould determine the onset of skin cancer post-transplantation and the significanceof 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 bedexposure 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 exposureand the risk of melanoma has not been elucidated in detail. METHODS: Surveysassessing the extent of tanning bed exposure and the history of skin cancer,

Sunbeds - CitaviSunbeds - CitaviSunbeds - CitaviSunbeds - Citaviincluding malignant melanoma, were collected from academic dermatology clinicpatients (n = 1518). Of these, 551 (36.3%) completed all components of the survey.The available medical records, including pathology reports (n = 501; 33%), werereviewed 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, historyof phototherapy, and level of education, were assessed and compared. RESULTS:Of the patients surveyed, 487 (32.1%) reported tanning bed exposure. Womenaged 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 45years or younger. In the entire cohort, the "ever-use" of tanning beds was found tobe 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 inwomen 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 tanningbed sessions exceeding 20 min (P < 0.01; OR, 3.18; 95% CI, 1.48-6.82); thisassociation 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, includedonly patients at a midwestern academic practice, and had a relatively low responserate. CONCLUSION: Exposure to tanning beds increases the risk of malignantmelanoma, especially in women aged 45 years or younger. These findings reinforcethe hazards of tanning bed exposure.

Schlagwörter Logistic Models; research support, non-u.s. gov‘t; Humans; Middle Aged; SkinNeoplasms; Ultraviolet Rays; Female; Sex Factors; Male; Melanoma; Aged; TimeFactors; 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 ofthe 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 SCCof the nail bed and suggest that the disproportionate number of neoplasms of thistype on the second, third, and fourth fingers, combined with the known relationshipof SCC and human papillomavirus (HPV), is evidence that most SCC of the nail bedresult from contact with HPV. Moreover, we suggest that patients who present withnew, verrucous lesions of the nail bed and have a history of cervical dysplasia,cervical carcinoma, or condyloma acuminata undergo diagnostic biopsy as opposedto 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