More than 5% of melanomas are caused by tanning bed use…

The International Agency for Research on Cancer, a unit of the World Health Organization, concluded in 2009 that sun beds, like radiation and cigarette smoke, are carcinogenic to humans. Since the meta-analysis that led to this conclusion, another eight epidemiologic studies have been performed. These investigators conducted a larger meta-analysis to explore this relationship in greater detail. They included 27 case-control, cohort, and cross-sectional studies involving 11,428 patients, performed in the U.S., Canada, Europe, and Australia between 1981 and 2012.

They found a statistically significant 20% increase in melanoma risk among ever users of tanning beds and a 42% increase among heavy users. Tanning bed use before age 35 increased melanoma risk by 87% compared with never use — a 12% increase even from the elevated risk reported in 2009. The risk for developing melanoma appears to increase with time. The authors estimate that 5.4% of melanomas and nearly 800 melanoma deaths annually in Europe can be attributed to artificial tanning.

Comment: This study provides new information about the relationship between tanning bed use and melanoma, and the numbers are rising rather than leveling off. A worrisome finding of this study is that the risk for developing melanoma increases over time from the first tanning bed exposure, which suggests that we will see greater numbers and percentages of past and present sun bed users developing melanoma. We must vigilantly monitor current and past tanning bed users for melanoma as well as continue our ongoing efforts to counsel patients and lobby for restrictions on tanning bed use.

by Craig A. Elmets, MD, Published in Journal Watch Dermatology August 10, 2012

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The ultimate cause of weight problem identified…

The discovery of the Higgs boson particle puts our understanding of nature on a new firm footing.

By |Posted Wednesday, July 4, 2012, at 5:56 AM ET

Now here is a REAL scientific breakthrough ! Everyone should read this over and over again until some degree of understanding is achieved.

It would not be long before a naturopath invents a potion to rid you of your Higgs boson for weight (mass) reduction !

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Getting enough Vitamin D ?

Ever wondered if you are getting enough Vitamin D from the sun; here’s a brief guide:

September to April; a few minutes to face, arms, hands outside peak UV times most days of the week.

May to August; 2 to 3 hours a week on your face, arms and hands.

Posted in BCC (basal cell carcinoma), cancer, melanoma, SCC (squamous cell carcinoma), sunscreen, Uncategorized | Leave a comment

Smoking increases risk for adult-onset atopic dermatitis (eczema)…

People who have ever smoked or who currently smoke are at increased risk for developing adult-onset atopic dermatitis (AD) (aka. eczema), say researchers.

Furthermore, non-smokers with AD are significantly more likely to have been exposed to environmental tobacco smoke (ETS) as children than those without the condition.

Writing in the British Journal of Dermatology, Hsin-Su Yu (Kaohsiung Medical University, Taiwan) and colleagues assessed tobacco smoking and ETS exposure in 83 AD patients, aged 58.1 years on average, who were diagnosed by physicians in adulthood (age 22 to 64 years) and 142 age- and gender-matched controls.

Overall, 53% of the AD patients smoked (current and ever) compared with only 18.3% of the controls.

Compared with never smoking, the team found that current and ever smoking increased the relative risk for adult-onset AD 4.99- and 3.62-fold, respectively. They suggest that there is likely to be a lifelong cumulative risk for AD in current smokers as each pack year increased the relative risk for adult-onset AD by 6%.

Of note, a significantly higher number of nonsmoking adult-onset AD patients had past exposure to ETS than controls, at 33% versus 12%.

“Although there are many potential risk factors contributing to development of adult-onset AD, this study provides convincing evidence of the association between both current smoking and exposure to ETS and the development of adult-onset AD,” write Yu et al.

“Further study is needed to understand the mechanisms underlying these observations and also to increase our understanding of other risk factors for adult-onset AD,” they conclude.

Br J Dermatol, MedWire

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Women who exercise vigorously may reduce their psoriasis risk…

HealthDay (by Reinberg) reports, “Women who exercise vigorously may be reducing their risk of psoriasis,” according to a study published online May 21 in the Archives of Dermatology. After examining “data on nearly 867,000 women who took part in the US Nurses’ Health Study II,” researchers found that the “most physically active women had a significantly lower risk of psoriasis, compared to women who exercised the least.”

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Vitamin D supplements may help reduce high blood pressure…

 

The UK’s Telegraph (by Smith) reports, “Vitamin D supplements could be as effective as prescription medicine at reducing high blood pressure,” according to research to be presented at a medical conference. Among “112 participants, 92” of which “were found to have low levels of vitamin D at the start of the study,” investigators “found that those patients taking the vitamin D supplement showed a significant reduction in central systolic blood pressure, measured at the aorta, near the heart, when compared to the placebo group.”

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Risk factors for severe acne flare on Roaccutane identified…

Male gender, severe acne, macrocomedones (obvious “black/whiteheads”, presence of truncal comedones ( “black/whiteheads” on the trunk), a higher number of facial comedones, and the presence of more than two facial nodules (large / deep lumps) are risk factors for severe acne flare during isotretinoin (Roaccutane) treatment, say researchers in Turkey.

“Flare of acne is an expected event at the beginning of isotretinoin (Roaccutane) treatment,” explain Sadiye Kus (Acibadem Hospital, Istanbul) and colleagues.

“However, severe flare, which necessitates treatment with systemic steroids or discontinuation of the drug, is rare.”

Multiple comedones (“black/whiteheads”), male gender, and young age have previously been reported as promoting factors for severe acne flare during Roaccutane treatment; however, detailed information is currently limited.

Therefore, Kus and team conducted a prospective study to investigate the incidence, types and course of acne flare and the predictive factors for its occurrence during Roaccutane treatment in patients with moderate to very severe acne. Patients received an initial dose of 0.5 mg/kg, which was increased to 1 mg/kg at the end of the first month.

Of 244 patients enrolled, 161 completed the study. Of these, 79 patients (32%) experienced a facial and/or truncal flare which was classified as mild (18%), moderate (10%), or severe (4.5%).

The predictive factors for severe flare were male gender, severe acne, a global acne grading system cutoff score of >28, the presence of more than 44 facial comedones (“black/whiteheads”) or two facial nodules (large/deep lumps), and the presence of truncal nodules.

“Recognizing these predictive factors for severe flare may help us to take early precautions such as the mechanical extraction of comedones before starting isotretinoin, pretreatment or concomitant treatment with oral antibiotics or steroids and introduction of Roaccutane in low doses,” write Kus and team in the European Journal of Dermatology.

“These measures would not only increase our treatment success but also improve patient satisfaction in those suffering from acne.”

MedWire News

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Indoor tanning may be more strongly associated with melanoma than sunburns…

 

Medscape (by Johnson) reports, “Indoor tanning might be a more reliable predictor of invasive cutaneous melanoma than outdoor sunburns, according to a study presented…at the American Academy of Dermatology 70th Annual Meeting.” The new findings are based on the Minnesota Skin Health Study, and “involved 1167 cases diagnosed from 2004 to 2007 and 1101 control subjects.” The study identified “4 UV risk factors…significantly associated with melanoma: outdoor lifetime sunburns, indoor tanning, frequency of indoor tanning, and burns from indoor tanning (P < .0001 for all).” Yet after controlling for “personal risk factors (age, sex, family history, and phenotypic factors), outdoor lifetime sunburns became much less significant (P = .8) than indoor tanning frequency (P = .026).”

Survey Finds Young Women Know Risks Of Indoor Tanning, But Still Do It.

WebMD (by Laino) reports on a study presented at the annual meeting of the American Academy of Dermatology finding that “most young women know that indoor tanning raises the risk of skin cancer, but two-thirds of sorority members at a Midwestern university used tanning beds in the past year, and 6% used them every week, a new survey shows.” Also, “virtually all the young women (96%) planned to sunbathe the following year, but only 60% planned to use sunscreen or wear protective clothing.” This despite the fact that “one-third reported a family history of skin cancer.”

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Medication allergies are wrongly blamed for rashes in about 25% of the time…

MedWire reports, “Drug (as in medication) allergies are wrongly blamed for causing skin rashes in around one-quarter of cases,” according to a study published in the January issue of the British Journal of Dermatology. After evaluating “612 patients with suspected cutaneous drug reactions,” researchers found that only 75.9% “of the patients had suffered a bona fide drug reaction.” Of the remaining cases, 20.6% “were not drug related, and…3.5% were of indeterminate cause.” The study authors advocated “more thorough assessment of patients with suspected drug reactions, including full dermatologic and allergologic workup.”

Allergy is commonly wrongly blamed for a lot of skin diseases.  Of course, this problem is infinitely worse when it comes to pseudo-health practitioners with no scientific basis of practice. So be VERY SKEPTICAL when someone tells you your rash is due to an “allergy”.

An allergy refers to a SPECIFIC reaction against a SPECIFIC substance (allergen). An example would be hives (aka urticaria, a specific skin condition) induced by nut protein (a specific class of allergen). A negative example (and it is THE MYTH of all myths) is that eczema (atopic dermatitis) is due to specific allergies. Ignorance on the part of the practitioner is often disguised behind the label of “allergy”.

Admitting ignorance is a virtue and recognising ignorance is an inducement to learn. Hiding ignorance is fraud.

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Curettage (scrapping) and cryosurgery (liquid nitrogen cold spray) for superficial skin cancers…

For some thin cancers of the trunk and extremities, curettage followed by cryosurgery is effective.

Superficial basal and squamous cell carcinomas (BCCs and SCCs) usually occur on the trunk and extremities. As the name implies, these tumors grow sideways instead of down, so their area tends to be large while their tumor mass tends to be small. Surgical removal causes relatively large wounds. Especially on the legs, these heal slowly. These tumors do not invade vital tissues and are accessible to removal by curettage and destruction by cryosurgery. To determine the long-term cure rate associated with these methods in the treatment of superficial BCCs and SCCs, researchers prospectively followed 69 patients with 100 nonfacial, nonmelanoma skin cancers smaller than 2 mm in diameter that were treated in a dermatologist’s office. The primary endpoint was the number of patients who remained disease-free for 5 years.

All lesions were biopsied to confirm diagnosis; 83 were superficial BCCs, and 17 were superficial SCCs (including 11 SCCs in situ). Margin outlines of 4 mm were drawn around each tumor. All lesions were raked in multiple directions with a 2-mm curette until all friable tumor and epidermis were removed within the marked margins. After hemostasis was achieved with 20% aluminum chloride solution, each lesion was additionally treated with one freeze–thaw cycle of liquid nitrogen spray. Patients were evaluated at 1 and 5 years after treatment.

Treatments were well tolerated, and infections did not occur. Several mild-to-moderate hypertrophic scars developed over treatment sites on the chest, back, and shoulders. No tumors had recurred by 1 year. After 5 years, only one superficial BCC had recurred among 95 evaluable tumor sites. This occurred at the edge of the treated site, rather than at its depth.

Comment: This may be the first study to prospectively evaluate curettage followed by cryosurgery treatment of superficial nonfacial basal and squamous cell carcinomas. The results confirm the effectiveness of curettage followed by cryosurgery. The cryosurgical treatment was minimal, with a freeze time of only 10 to 20 seconds, creating a thin, palpable frozen disc at the skin surface. I like this form of treatment for selected thin cancers of the trunk and extremities. In my experience, it is effective, healing is faster than after curettage with electrodessication, and the scars seem less prominent. I am happy to see its success documented.

— Mark V. Dahl, MD

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