Sun exposure, onset of nonmelanoma skin cancers (NMSCS) and photoprotection: what's new?
Keywords:
Basal cell carcinoma, squamous cell carcinomas, actinik keratoses, nonmelanoma skin cancers, photoprotection, sun exposureAbstract
Introduction: NonMelanoma Skin Cancers (NMSCs) are the most common types of skin cancers and are the most frequently diagnosed worldwide. Sun exposure is considered the major risk factor for the onset of skin cancers, particularly for NMSCs. The head and neck area appears to be the one most affected by skin tumors related to sun exposure. There are two main subtypes of NMSCs: Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC). Among the most frequent lesions of the head and neck area, there are also Actinic Keratoses (AKs), considered precancerous lesions. Aims: The purpose of this article is to highlight what’s new in the field of photoprotection and reiterate the importance of protecting our skin from the potential risks of incorrect exposure to UV rays. Results: The frequency of AKs increases with age and with the cumulative dose of lifetime sunlight. Patients with multiple AKs are at higher risk of developing NonMelanoma Skin Cancers. Conclusion: The most effective tool in preventing the onset of these types of cancers persists being adequate photoprotection, both topical and systemic.
References
1. Gholizadeh N, Rokni GR, Zaresharifi S, Gheisari M, Tabari MAK, Zoghi G. Revolutioning non-melanoma skin cancer treatment: Receptor Tyrosin kinase inhibitors take the stage. J Cosmet Dermatol. 2024; 23(9):2793-2806.
2. Eisen DB, Asgari MM, Bennett DD, et al. Guidelines of care for the menagement of actinic keratosis. J Am Acad Dermatol. 2021; 85(4):e209-e233.
3. Ouyang YH. Skin cancer of the head and neck. Semin Plast Surg. 2010; 24(2):117-126.
4. Reinehr CPH, Bakos RM. Actinic keratoses: review of clinical, dermoscopic, and therapeutic aspects. An Bras Dermatol. 2019; 94(6):637-657.
5. Zalaudek I, Giacomel J, Schmid K, et al. Dermatoscopy of facial actinic keratosis, intraepidermal carcinoma, and invasive squamous cell carcinoma: a progression model. J Am Acad Dermatol. 2012; 66(4):589-597.
6. US Preventive Services Task Force; Mangione CM, Barry MJ, Nicholson WK, et al. Screening for Skin Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2023; 329(15):1290-1295.
7. Wysong A. Squamous –cell carcinoma of the skin. N Eng J Med. 2023; 388(24):2262-2273.
8. Sander Megan, Sander Micheal, Burbidge T, Beecker J. The efficacy and safety of sunscreen use for the prevention of skin cancer. CMAJ. 2020; 192(50):E1802-E1808.
9. Aguilera J, Gracia-Cazaña T, Gilaberte Y. New development in sunscreens. Photochem Photobiol Sci. 2023; 22(10):2473-2482.
10. Bacqueville D, Jacques-Jamin C, Dromigny H, et al. Phenylene Bis-Diphenyltriazine (TriAsorb), a new sunfilter protecting the skin against both UVB+UVA and blu radiations. Photochem Photobiol Sci. 2021; 20(11):1475-1486.
11. Cui B, Wang Y, Jin J, et al. Resveratrol Treats UVB-Induced Photoaging by AntiMMP Expression, through Anti-Inflammatory, Antioxidant, and Antiapoptotic Properties, and Treats Photoaging by Upregulating VEGF-B Expression. Oxid Med Cell Longev. 2022; 2022:6037303.
12. Park J, Halliday GM, Surjana D, Damian DL. Nicotinamide prevents ultaviolet radiation induced cellular energy loss. Photochem Photobiol. 2010; 86(4):942-948.
13. Stratigos AJ, Garbe C, Dessinioti C, et al. European consensus-based interdisciplinary guideline for invasive cutaneous squamous cell carcinoma. Part 1: Diagnostics and prevention-Update 2023. Eur J Cancer. 2023; 193:113251.
14. Ramchatesingh B, Martínez Villarreal A, Arcuri D, et al. The Use of Retinoids for the Prevention and Treatment of Skin Cancers: An Updated Review. Int J Mol Sci. 2022; 23(20):12622.
15. Johannesdottir SA, Chang ET, Mehnert F, Schmidt M, Olesen AB, Sørensen HT. Nonsteroidal anti-inflammatory drugs and the risk of skin cancer. Cancer. 2012; 118(19):4768-4776.
16. Nestor MS, Berman B, Swenson N. Safety and Efficacy of Oral Polypodium Leucotomos Extract in Healty Adult Subjects J Clin Aesthet Dermatol. 2015; 8(2): 19-23.
17. Pellacani G, Peris K, Ciardo S, et al. The combination of oral and topical photoprotection with a standardized Polypodium Leucotomos extract is beneficial against actinic keratosis. Photodermatol Photoimmunol Photomed. 2023; 39(4):384-391.
18. Cheng L, Liu J, Wang Q, Hu H, Zhou L. The Protective Effect of a Human Umbilical Cord Mesenchymal Stem Cell Supernatant on UVB-Induced Skin Photodamage. Cells. 2024; 13(2):156.
19. Katta R, Brown DN. Diet and Skin Cancer: The Potential Role of Dietary Antioxidants in Nonmelanoma Skin Cancer Prevention. J Skin Cancer. 2015: 2015:893149.
20. Evans JA, Johnson EJ. The Role of Phytonutrients in Skin Health. Nutrients. 2010; 2(8):903-928.
21. Lauer AC, Groth N, Haag SF, Darvin ME, Lademann J, Meinke MC. Dose dependent Vitamin C uptake an radical Scavenging Activity in human skin measured with in vivo electron paramagnetic resonance spectroscopy. Skin Pharmacol Physiol. 2013; 26(3):147-154.
22. Nusgens BV, Humbert P, Rougieret A, et al. Topically applied vitamin C enhances the mRna level of Collagenes I and III, their processing enzymes and tissue inhibitor of matrix metalloproteinase 1 in the human dermis. J Invest Dermatol. 2001; 116(6):853-859.
23. Fabbrocini G, Triassi M, Mauriello MC, et al. Epidemiology of skin cancer: role of some environmental factors Cancers (Basel) 2010; 2(4):1980-9.
24. Rubén D Piacentini, Lara Sofía Della Ceca, Adriana Ipiña. Climate change and its relationship with non-melanoma skin cancers. Photochem Photobiol Sci. 2018; 17(12):1913-1917.
25. Eva Rawlings Parker 1 The influence of climate change on skin cancer incidence – A review of the evidence. Int J Womens Dermatol. 2020; 7(1):17–27.
26. Jonathan R Raymond-Lezman, Suzanne I Riskin. Benefits and Risks of Sun Exposure to Mantain Adequate Vitamin D levels. Cureus. 2023; 15(5):e38578.
27. De La Garza H, Maymone MBC, Vashi NA. Impact of Social Media on Skin Cancer Prevention. Int J Environ Res Public Health. 2021; 18(9):5002.
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Copyright (c) 2025 Antonella Tammaro, Ilaria Demofonte, Pietro Pasquale Cozza, Ganiyat Adenike Adebanjo , Gabriella De Marco, Fabiola Luzi, Antonino Trischitta, Giovanni Pellacani

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