DOI QR코드

DOI QR Code

Pathogenesis and prevention of skin cancer

피부암의 병인과 예방

  • Oh, Byung-Ho (Department of Dermatology & Cutaneous Biology Research Institute, Yonsei University College of Medicine)
  • 오병호 (연세대학교 의과대학 피부과학교실 및 피부생물학연구소)
  • Received : 2018.10.15
  • Accepted : 2018.10.17
  • Published : 2018.11.20

Abstract

The incidence of skin cancer has continuously increased in Korea, probably due to sun exposure and increases in the aging population. Ultraviolet light, a well-known risk factor for skin cancer, can cause DNA damage, mutation, and immune suppression, followed by abnormal proliferation. To prevent photocarcinogenesis, the appropriate use of sunscreen should be emphasized. Using broad-spectrum sunscreens with sun protection factor values of 15 or higher and frequent reapplication are recommended. Controversy exists about whether vitamin D synthesis is inhibited by the use of sunscreen. However, considering that skin cancer most commonly develops on the head and neck area, applying it to the face and neck is reasonable in terms of balancing the risk-benefit ratio.

References

  1. Korean Statistical Information Service. Cancer Statistics in Korea [Internet]. Dajeon: Statistics Korea; 2018 [cited 2018 Oct 15]. Available from: http://kosis.kr/statHtml/statHtml.do?orgId=117&tblId=DT_117N_A00025&conn_path=I2.
  2. Ha SM, Ko DY, Jeon SY, Kim KH, Song KH. A clinical and statistical study of cutaneous malignant tumors in Busan city and the eastern Gyeongnam province over 15 years (1996-2010). Korean J Dermatol 2013;51:167-172.
  3. Gordon R. Skin cancer: an overview of epidemiology and risk factors. Semin Oncol Nurs 2013;29:160-169. https://doi.org/10.1016/j.soncn.2013.06.002
  4. Goldsmith LA, Fitzpatrick TB. Fitzpatrick's dermatology in general medicine. 8th ed. New York: McGraw-Hill Medical; 2012.
  5. Gandhi SA, Kampp J. Skin cancer epidemiology, detection, and management. Med Clin North Am 2015;99:1323-1335. https://doi.org/10.1016/j.mcna.2015.06.002
  6. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin 2018;68:7-30. https://doi.org/10.3322/caac.21442
  7. Hussein MR. Ultraviolet radiation and skin cancer: molecular mechanisms. J Cutan Pathol 2005;32:191-205. https://doi.org/10.1111/j.0303-6987.2005.00281.x
  8. Kozma B, Eide MJ. Photocarcinogenesis: an epidemiologic perspective on ultraviolet light and skin cancer. Dermatol Clin 2014;32:301-313. https://doi.org/10.1016/j.det.2014.03.004
  9. DʼErrico M, Calcagnile A, Canzona F, Didona B, Posteraro P, Cavalieri R, Corona R, Vorechovsky I, Nardo T, Stefanini M, Dogliotti E. UV mutation signature in tumor suppressor genes involved in skin carcinogenesis in xeroderma pigmentosum patients. Oncogene 2000;19:463-467. https://doi.org/10.1038/sj.onc.1203313
  10. Lesiak A, Sysa-Jedrzejowska A, Narbutt J. The role of sonic hedgehog pathway in skin carcinogenesis. Pol Merkur Lekar-ski 2010;29:141-143.
  11. Korean Dermatological Association. Textbook of dermato-logy. 6th ed. Seoul: Medbook; 2014.
  12. Goldenberg G, Perl M. Actinic keratosis: update on field therapy. J Clin Aesthet Dermatol 2014;7:28-31.
  13. Green A, Battistutta D. Incidence and determinants of skin cancer in a high-risk Australian population. Int J Cancer 1990;46:356-361. https://doi.org/10.1002/ijc.2910460303
  14. Feldman SR, Fleischer AB Jr. Progression of actinic keratosis to squamous cell carcinoma revisited: clinical and treatment implications. Cutis 2011;87:201-207.
  15. Fernandez-Figueras MT, Carrato C, Saenz X, Puig L, Musulen E, Ferrandiz C, Ariza A. Actinic keratosis with atypical basal cells (AK I) is the most common lesion associated with invasive squamous cell carcinoma of the skin. J Eur Acad Der-matol Venereol 2015;29:991-997. https://doi.org/10.1111/jdv.12848
  16. Stockfleth E, Ferrandiz C, Grob JJ, Leigh I, Pehamberger H, Kerl H; European Skin Academy. Development of a treatment algorithm for actinic keratoses: a European Consensus. Eur J Dermatol 2008;18:651-659.
  17. Wong SS, Tan KC, Goh CL. Cutaneous manifestations of chronic arsenicism: review of seventeen cases. J Am Acad Dermatol 1998;38:179-185. https://doi.org/10.1016/S0190-9622(98)70596-1
  18. Kim BJ, Kim SY, Kim GM. A case of multiple SCCs in situ and BCC induced probably by chronic exposure to arsenic-containing pills (Hwan-Yak). Korean J Dermatol 2009;47:1071-1073.
  19. Kim SY, Yun SJ. Cutaneous melanoma in Asians. Chonnam Med J 2016;52:185-193. https://doi.org/10.4068/cmj.2016.52.3.185
  20. Yun SJ, Kwon OS, Han JH, Kweon SS, Lee MW, Lee DY, Kim MB, Kim YC, Yoon TY, Chung KY, Kim IH, Kim KH, Suh KS, Lee SJ, Seo YJ, Kim KH, Park HJ, Roh MR, Ahn KJ, Yoon TJ, Kim MH, Li KS, Park JS, Shin BS, Ko JY, Ahn HH, Kim HJ, Park SD, Jang SJ, Won YH. Clinical characteristics and risk of melanoma development from giant congenital melanocytic naevi in Korea: a nationwide retrospective study. Br J Dermatol 2012;166:115-123. https://doi.org/10.1111/j.1365-2133.2011.10636.x
  21. McArthur GA, Chapman PB, Robert C, Larkin J, Haanen JB, Dummer R, Ribas A, Hogg D, Hamid O, Ascierto PA, Garbe C, Testori A, Maio M, Lorigan P, Lebbe C, Jouary T, Schadendorf D, O'Day SJ, Kirkwood JM, Eggermont AM, Dreno B, Sosman JA, Flaherty KT, Yin M, Caro I, Cheng S, Trunzer K, Hauschild A. Safety and efficacy of vemurafenib in BRAF(V600E) and BRAF(V600K) mutation-positive melanoma (BRIM-3): extended follow-up of a phase 3, ran-domised, open-label study. Lancet Oncol 2014;15:323-332. https://doi.org/10.1016/S1470-2045(14)70012-9
  22. Gallagher RP, Spinelli JJ, Lee TK. Tanning beds, sunlamps, and risk of cutaneous malignant melanoma. Cancer Epidemiol Biomarkers Prev 2005;14:562-566. https://doi.org/10.1158/1055-9965.EPI-04-0564
  23. Jung HJ, Kweon SS, Lee JB, Lee SC, Yun SJ. A clinicopatho-logic analysis of 177 acral melanomas in Koreans: relevance of spreading pattern and physical stress. JAMA Dermatol 2013;149:1281-1288. https://doi.org/10.1001/jamadermatol.2013.5853
  24. US Food and Drug Administration. Sunscreen: how to help protect your skin from the sun [Internet]. Silver Spring: US Food and Drug Administration [cited 2018 Oct 15]. Available from: https://www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/understandingover-the-countermedicines/ucm239463.htm.
  25. Neale R, Williams G, Green A. Application patterns among participants randomized to daily sunscreen use in a skin cancer prevention trial. Arch Dermatol 2002;138:1319-1325.
  26. Autier P, Boniol M, Severi G, Dore JF; European Organizatin for Research and Treatment of Cancer Melanoma Co-opera-tive Group. Quantity of sunscreen used by European students. Br J Dermatol 2001;144:288-291. https://doi.org/10.1046/j.1365-2133.2001.04016.x
  27. Kim SM, Oh BH, Lee YW, Choe YB, Ahn KJ. The relation between the amount of sunscreen applied and the sun protec-tion factor in Asian skin. J Am Acad Dermatol 2010;62:218-222. https://doi.org/10.1016/j.jaad.2009.06.047
  28. Vanchinathan V, Lim HW. A dermatologistʼs perspective on vitamin D. Mayo Clin Proc 2012;87:372-380. https://doi.org/10.1016/j.mayocp.2011.12.010
  29. Mason RS, Reichrath J. Sunlight vitamin D and skin cancer. Anticancer Agents Med Chem 2013;13:83-97. https://doi.org/10.2174/187152013804487272
  30. Terushkin V, Bender A, Psaty EL, Engelsen O, Wang SQ, Halpern AC. Estimated equivalency of vitamin D production from natural sun exposure versus oral vitamin D supple-mentation across seasons at two US latitudes. J Am Acad Der-matol 2010;62:929.e1-929.e9.
  31. Bolland MJ, Grey A, Gamble GD, Reid IR. The effect of vitamin D supplementation on skeletal, vascular, or cancer outcomes: a trial sequential meta-analysis. Lancet Diabetes Endocrinol 2014;2:307-320. https://doi.org/10.1016/S2213-8587(13)70212-2
  32. Autier P, Boniol M, Pizot C, Mullie P. Vitamin D status and ill health: a systematic review. Lancet Diabetes Endocrinol 2014;2:76-89. https://doi.org/10.1016/S2213-8587(13)70165-7
  33. Vieth R. Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr 1999;69:842-856. https://doi.org/10.1093/ajcn/69.5.842
  34. Maxmen A. Nutrition advice: the vitamin D-lemma. Nature 2011;475:23-25. https://doi.org/10.1038/475023a
  35. Holick MF. Sunlight "D"ilemma: risk of skin cancer or bone disease and muscle weakness. Lancet 2001;357:4-6. https://doi.org/10.1016/S0140-6736(00)03560-1
  36. Reichrath J, Nürnberg B. Cutaneous vitamin D synthesis versus skin cancer development: the Janus faces of solar UV-radiation. Dermatoendocrinol 2009;1:253-261. https://doi.org/10.4161/derm.1.5.9707
  37. Rosso S, Zanetti R, Martinez C, Tormo MJ, Schraub S, Sancho-Garnier H, Franceschi S, Gafa L, Perea E, Navarro C, Laurent R, Schrameck C, Talamini R, Tumino R, Wechsler J. The multicentre south European study 'Heliosʼ. II: different sun exposure patterns in the aetiology of basal cell and squamous cell carcinomas of the skin. Br J Cancer 1996;73:1447-1454. https://doi.org/10.1038/bjc.1996.275
  38. Yu C, Yang S, Kim W, Jung J, Chung KY, Lee SW, Oh B. Acral melanoma detection using a convolutional neural network for dermoscopy images. PLoS One 2018;13:e0193321. https://doi.org/10.1371/journal.pone.0193321
  39. Esteva A, Kuprel B, Novoa RA, Ko J, Swetter SM, Blau HM, Thrun S. Dermatologist-level classification of skin cancer with deep neural networks. Nature 2017;542:115-118. https://doi.org/10.1038/nature21056