UV-induced cancerogenesis in skin tumors

Rak kože je jedna od najzastupljenijih vrsta raka te se njegova učestalost sve više povećava u svijetu. Glavni uzrok njegova nastanka je preveliko izlaganje UV zračenju, zbog neinformiranosti o njegovoj štetnosti. Stanjivanjem ozonskog omotača više UV zračenja dopire na Zemljinu površinu, a posebice su štetne komponente UVA i UVB zračenje koje induciraju oštećenja kože formiranjem prekancerogenih lezija poput ciklobutanskih pirimidinskih dimera i 6,4-fotoprodukta te supresiju imunološkog odgovora i oksidativna oštećenja DNA molekule. Ukoliko se ova oštećenja ne poprave prije replikacije DNA, mogu rezultirati rastom i nekontroliranom diobom stanica u kojima je oštećenje nastalo a time i nastankom tumora. Tumor je uglavnom lako uočljiv, budući da nastaje u vanjskom sloju kože, pa ga je moguće dijagnosticirati u ranom stadiju, a time i liječiti. Postoji više vrsta raka kože te nisu svi jednako opasni. Najopasniji tip raka je melanom, zbog svoje sposobnosti da se širi i prodire u susjedna tkiva. Veći rizik od nastanka raka kože imaju ljudi svjetlije pigmentacije zbog manje količine melanina koji štiti od UV zračenja, ali i ljudi koji imaju genetičke predispozicije za razvoj ove bolesti. Postoji više načina prevencije razvoja ove bolesti, a uglavnom uključuje smanjeno izlaganje UV zračenju izbjegavanjem izlaska na sunce između 10 i 16 sati, nošenje pokrivala za glavu i sunčanih naočala, boravak u sjeni te nanošenje krema za sunčanje s visokim zaštitnim faktorom. Stoga je najvažnije ljude pravovremeno educirati o rizicima i štetnosti UV zračenja kako bi se povećala svijest o njegovoj opasnosti, a time i spriječio nastanak raka kože. Osim direktnog izlaganja suncu, velik rizik od nastanka raka kože predstavljaju i fototerapije i saloni za sunčanje, stoga bi njihovo korištenje također trebalo izbjegavati.Skin cancer is one of the cancer types with the highest prevalence and its incidence is increasing in the world. The main cause of its occurrence is overexposure to UV radiation, due to lack of information about its harmfulness. Thinning of the ozone layer is the cause of more UV radiation reaching the Earth's surface, especially its harmful components UVA and UVB. Those two components induce skin damage by forming the pre-cancerous lesions such as cyclobutane pyrimidine dimers and 6,4-fotoproduct, by suppressing immune responses and causing oxidative damage to DNA molecules. If this damage is not repaired before DNA replication, it can result in uncontrolled growth and cell division of the cells in which the damage occurred, thus causing tumors. The tumor is usually easily noticeable, since it occurs in the outer layer of skin, so it can be diagnosed at an early stage and therefore be treated. There are several types of skin tumors, and not all are equally dangerous. The most dangerous type of skin cancer is melanoma, because of its ability to spread and invade the surrounding tissues. People with lighter pigmentation have higher risk of skin cancer due to lower amounts of melanin, which protects against UV radiation, as do people who have a genetic predisposition for developing this disease. There are several ways of preventing the development of this disease and they generally include reduced exposure to UV radiation by avoiding the sun between 10 am and 16 pm, wearing hats and sunglasses, staying in the shade and applying sunscreen with high sun protecting factor. Therefore, it is very important to educate people about the risks and hazards of the UV radiation in order to increase awareness of its dangers, and thus prevent the formation of skin cancer. Besides direct sun exposure, photo therapies and tanning salons increase risk of developing skin cancer, so their use should also be avoided

Molekulare Heterogenität maligner Melanome

Zusammenfassung: Maligne Melanome bilden eine heterogene Gruppe von Tumoren, die in Abhängigkeit von ihrer anatomischen Lokalisation und der UV-Exposition charakteristische genetische Aberrationen aufweisen. Eine Aktivierung des Mitogen-aktivierte-Proteinkinase- (MAPK-)Signaltransduktionsweges findet sich bei einem Großteil aller Melanome, wobei entweder eine somatische Missense-Mutation von BRAF oder deutlich seltener eine Mutation von N-RAS vorliegt. Der Verlust der beiden Produkte des CDKN2A-Gens, p16ARF und p14INK4a, oder die Amplifikation von Microphthalmia-assoziiertem Transkriptionsfaktor (MITF) prädisponieren ebenfalls zur Melanomentwicklung. BRAF-Mutationen werden vor allem in Melanomen von intermittierend UV-exponierter Haut beobachtet. Akrale und mukosale Melanome sowie solche von chronisch UV-geschädigter Haut sind durch distinkte Muster chromosomaler Aberrationen mit häufigen Amplifikationen sowie Alterationen des KIT-Gens gekennzeichnet, während BRAF-Mutationen in diesen Lokalisationen selten nachweisbar sind. Uveamelanome zeigen wiederkehrende Chromosomenverluste (1p, 3, 6q) und Zugewinne (6p, 8q), aber kaum BRAF-Mutationen. Bis heute haben molekulare Untersuchungen noch keinen festen Platz in der Routinediagnostik des malignen Melanoms. Die Entwicklung gezielter molekularer Therapeutika wird es aber zukünftig notwendig machen, mittels molekularpathologischer Methoden diejenigen Melanompatienten zu identifizieren, die von einer bestimmten Therapie am ehesten profitiere

Early and Late Side Effects Associated with Photo(chemo)therapy

Phototherapy (PUVA ve UVB) is a widely used and effective treatment method for a variety of dermatological diseases. Adverse effects associated with phototherapy can be classified as acute and chronic side effects. Acute side effects are mostly related with UV doses and drug intolerance, and include itching, nausea, erythema, edema and phototoxic reactions that sometimes blister formation is seen. Acute side effects are usually moderate and transient. Chronic side effects of phototherapy are early aging of skin, pigmentary changes and increased risk of skin carcinogenesis. The major concern is development of skin cancer. This risk is especially related to long-term exposure and high cumulative doses of PUVA, increase in time and is persistent. Therefore, risk/advantage ratio of phototherapy should be carefully evaluated in each patient, and treatment protocols with minimal UV exposure should be chosen according to the phototherapy guides. Follow-up of the patients for long terms is important in prevention or in reduction of this risk by detecting and treating any premalignant or malignant lesion early. In this article, acute and chronic side effects of phototherapy are reviewed with recent literature findings

Malignant melanoma : awareness of malignant melanoma, risk factors and related behavior towards them among adolescents in Slovenia

Incidenca malignega melanoma v Sloveniji v zadnjih desetletjih strmo narašča, poznavanje malignega melanoma in dejavnikov tveganja pa je med populacijo še vedno vprašljivo in malo raziskano. Najpomembnejši dejavnik tveganja za nastanek bolezni je delovanje ultravijoličnih žarkov, pred katerimi se je treba fizično zaščititi in uporabljati sredstva za zaščito pred soncem, predvsem v mladosti. Namen raziskave je bil pridobiti podatke o poznavanju malignega melanoma, dejavnikov tveganja in odnosu do njih ter primerjava odgovorov med študenti Medicinske fakultete in študenti treh ostalih fakultet. V presečno in anketno raziskavo so bili vključeni študentje štirih fakultet Univerze v Ljubljani: Medicinske fakultete, Fakultete za elektrotehniko, Fakultete za farmacijo ter Fakultete za matematiko in fiziko, ki so prek spletne povezave odgovarjali na anonimni vprašalnik. Odgovori 66,3 odstotka študentov Medicinske fakultete in 33,7 odstotka študentov ostalih fakultet kažejo, da je poznavanje malignega melanoma boljše med študenti Medicinske fakultete, razlika je statistično značilna (p = 0,0001). Študenti se v poznavanju dejavnikov tveganja statistično značilno razlikujejo le v pogostnosti uporabe zaščite pred soncem (p = 0,0001) in uporabljenem zaščitnem faktorju (p = 0,015). Študenti medicine s svetlimi tipi kože se pred soncem zaščitijo pogosteje, obstaja statistično značilna razlika (p = 0,001). Študenti Medicinske fakultete statistično značilno bolje prepoznavajo maligni melanom kot nevarno obliko kožnega raka. Pogosteje se tudi zaščitijo pred ultravijoličnimi žarki in uporabljajo višje zaščitne faktorje kot študenti ostalih fakultet. Kljub zelo visokem vedenju o škodljivosti izpostavljanja UV-žarkom med mlado slovensko populacijo je ukrepanje bistveno slabše.Malignant melanoma in Slovenia continues to increase rapidly in incidence over the last decades. Knowledge and risk factors amongst the population is still questionable and poorly investigated. Exposure to ultraviolet radiation is the leading risk factor for melanoma development, therefore physical protection and use of sunscreens with sun protection factors is crucial. The study aimed to investigate awareness of melanoma, risk factors and related behavior towards them among students of four faculties of University of Ljubljana: Faculty of Medicine, Faculty of Electrical Engineering, Faculty of Pharmacy and Faculty of Mathematics and Physics and to compare the answers between medical students and students of the other three faculties. The study was cross-sectional and survey-based. Students answered an anonymous questionnaire, which was sent to them through a website link. Answers obtained by 66.3% medical students and 33.7% students of other three faculties showed that medical students have statistically significant better knowledge about melanoma, (p=0.0001). It has also been found that there was statistical difference in frequency of protecting themselves from the sun (p=0.0001) and in used sun protection factor (p=0.015). Medical students with fair skin types more frequently used some means of protection from ultraviolet radiation, the measured difference was statistically significant (p=0.001). Medical students significantly better recognize malignant melanoma as the most threatening type of skin cancer. They also protect themselves from the sun more often and use higher sun protection factors. Slovenian adolescent population has high knowledge about harmful effects of exposure to ultraviolet radiation, but responds poorly to it

Evaluation de la stratégie de lutte contre le cancer en Suisse, Phase 2, 2002 : document de synthèse

[Table des matières] 1. Introduction. 2. Méthode. 3. Conclusions et recommandations générales. 3.1. Stratégie. 3.2. Conclusions et recommandations concernant la stratégie, les structures et le fonctionnement, la collaboration avec l'extérieur. 3.3. Les 4 programmes nationaux. 3.4. Conclusions et recommandations pour les 4 programmes nationaux. 3.5. Bilan de l'expérience de la mise en place du dépistage du sein. 3.6. Conclusions et recommandations pour la mise en place du dépistage du sein. 3.7. Les données à disposition pour le suivi et l'évaluation de la stratégie nationale de lutte contre le cancer. 3.8. Conclusions et recommandations pour le suivi et l'évaluation de la stratégie nationale de lutte contre le cancer. 4. Annexes: Résumés des études 1 à 7. Etude 1: Suivi du développement de la stratégie nationale. Studie 2: Prozessevaluation und Prozessdokumentation. Studie 3: Mammographie-Screening in der Schweiz : eine retrospektive Analyse zur Umsetzung. Studie 4: Sekundäre Analyse der verfügbaren Indikatoren zur Messung der Ergebnisse des nationalen Krebsbekämpfungsprogrammes. Etude 5: Quel ancrage local des actions de la Ligue suisse contre le cancer ? : l'exemple de la prévention du mélanome. Studie 6: Begleitevaluation der Pilotphase des Aktionsmonats Brustkrebs. Etude 7: Accompagnement psychosocial des personnes ayant un diagnostic de cancer : étude de deux cantons

Contact-allergy time

The most commonly used techniques for the in vivo evaluation of the cellular immune response include intracutaneous testing with microbial recall antigens or sensitization with neoantigens. The reliability of these tests for the individual patient usually is low due to the lack of standardization and quantification. Moreover only the efferent branch of the immune response can be judged. The dinitrochlorobenzene-contact allergy time (DNCB-CAT) is a quantitative approach for the assessment of the cellular immune response. 2% DNCBointment is applied on the upper arm in a 1 cm2 area. On the following days patch-testing with 0.05% DNCB-ointment is done on the homolateral forearm in alternating localizations till an allergic contact dermatitis reaction appears. As assessed in patients with malignant melanoma (MM, n=\\5) and with lymphoproliferative disorders (LD, η = 25), the DNCB-CAT correlates with the age of the patients and can be expressed by a formula given by the age (years) χ factor (MM = 0.16; LD = 0.17) + constant figure (MM = 5.5; LD = 4.3). There was no significant difference between the two groups or subgroups investigated. By DNCB-CAT quantitative analysis of the cellular immune response in vivo is possible. It is an appropriate model for further investigations of the cellular immunity under different clinical, histological, prognostic, and therapeutic aspects

R\uf6tliche L\ue4sion am Stamm

Anamnese 1 Ein 65-j\ue4hriger Patient, der im Gesichtsbereich bereits chronische Lichtsch\ue4den aufwies, wurde im Rahmen des Nierentransplantationsscreenings wegen einer neu aufgetretenen r\uf6tlichen L\ue4sion in unserer Ambulanz vorstellig. Der Patient selbst bemerkte die L\ue4sion nicht. Anamnese 2 Eine 59-j\ue4hrige Patientin kam wegen multipler N\ue4vi zur allj\ue4hrlichen Routinekontrolle. Die neu aufgetretene r\uf6tliche Papel am R\ufccken rechts war ihr nicht aufgefallen