SKIN CANCER - A YEAR ROUND CONCERN
Written by Frank J. DeMento, MD, Chief, Division of Dermatology, Winthrop-University Hospital


April, 1999

  • Daniel P. Walsh Named President and Chief Executive Officer of Winthrop-University Hospital

  • Winthrop Receives "Accreditation with Commendation" from the Joint Commission on the Accreditation of Healthcare Organizations

  • Osteoporosis Study Underway: Participants Sought

  • Urogynecology: Female Incontinence is a Quality of Life Issue

  • New Chief of Pediatric Orthopaedics is Appointed

  • For Long Islanders Whose Children Don't Have Health Insurance

  • April Courses at Winthrop-University Hospital's Community Training Center

  • Nassau County's First ApligrafTM Skin Graft is Performed at Winthrop

  • Winthrop's Dr. Ibrahim Implants the "Reveal" Device

  • Pulmonary Rehabilitation Program at Winthrop: Dedicated to an Improved Quality of Life for Patients

  • Research: A Critical Element in Winthrop's Approach to Care for the Pulmonary Patient

  • New Medication for Rheumatoid Arthritis

  • Asthma Study - Phase IV Trial of the Serevent "Diskus"®

  • Pediatric Pulmonary Specialists at Winthrop Focus on Patients' Individual Needs ...Including Education of Parents and Caregivers

  • Winthrop's Sleep Disorders Center... The Only Accredited Sleep Disorders Facility in Nassau County

  • Skin Cancer - A Year Round Concern

  • Women's Cancer Specialist Joins Winthrop's Department of Obstetrics/Gynecology as Director of Gynecologic Oncology

  • SECOND ANNUAL CANCER SURVIVORS DAY

  • Looking for someone who understands a woman's special needs?

  • The 14th Annual Winthrop-University Hospital Golf Tournament

  • Copyright

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  • Skin not only serves as the outer covering of the body, but is a complex system of specialized tissues. Dermatologists remind us to take care of our skin by moderating the hazards of the sun - and above all, avoiding tannig studios.

    The Sun's Rays
    id you know that sun protection is just as nessary in the winter as in the summer? Snow reflects up to 80% of the sun's rays, causing sunburn and damage to unprotected skin. Trips to the mountains increase the risk of sunburn, as there is less atmosphere to block the sun's rays.

    Both visible and invisible rays are produced by the sun. The invisible rays, known as ultraviolet A (UVA) and ultraviolet B (UVB) cause most of the problems - suntan, sunburn, and sun damage. There is no "safe" UV light. Harmful effects are also incurred by exposure to wind, and from the sun's reflection from water, sand, and snow. Even on cloudy days, ultraviolet radiation reaches the earth. Other potential sources of ultraviolet rays are tanning salons, unshielded fluorescent bulbs, and reflected light - for example, in automobile windows. The amount of ultraviolet radiation reaching the earth's surface varies with the time of day, season, latitude, altitude, ozone thickness, solar angle, reflective surface, air pollution, and the amount of cloud cover. Numerous medications may heighten your susceptibility to ultraviolet rays - for example, oral antibiotics, diuretics, and antihypertensives, among others.

    SKIN TYPES
        Type 1 Always burns, never tans
        Type 2 Always burns, sometimes tans
        Type 3 Sometimes burns, sometimes tans
        Type 4 Never burns, always tans
        Type 5 Moderately pigmented (Hispanic and Asian)
        Type 6 African Americans

    Basal Cell Carcinoma

    Basal Cell Carcinoma is the most common skin cancer. Approximately 90% of these tumors are found in areas consistently exposed to the sun - head, ears, and face. Basal cell carcinomas typically have pearly, translucent rolled borders and lesions formed by a dilated capillary or terminal artery in the skin.
    Squamous Cell Carcinoma

    Squamous cell carcinoma, the second most common skin cancer, has a strong statistical correlation with chronic sun damage or photo aging. Squamous cell carcinoma usually appears as a scaly patch or raised, warty growth. The cure rate is high when found and treated early.
    Malignant Melanoma

    MMalignant Melanoma accounts for only 1% of all skin cancers, but is responsible for the majority of deaths attributable to skin cancer. The clinical hallmarks of melanoma are Asymmetry, Border irregularity, Color variegation (multiple or dark colors within a pigmented lesion), and Diameter enlargement. These can easily be remembered through the "A B C D's" memory device. Any pigmented lesion suspected to be melanoma should be evaluated by a dermatologist.
    ABCDs of Malignant Melanoma Recognition Asymmetry
    Border Irregularity
    Color Variegation
    Diameter Enlargement
     
    Tanning studios
    Currently, more than one million people are using commercial tanning facilities each day. Most are adolescents and young adults, especially women. While many people mistakenly view a tan as a "sign of good health," dermatologists know better. A suntan is actually a result of skin injury. Tanning occurs when ultraviolet rays penetrate the skin and the skin protects itself by producing more pigment, or melanin. Indoor tanning is just as injurious to the skin as the sun, because most tanning salons use ultraviolet A (UVA) bulbs. Studies have shown that ultraviolet A rays penetrate deeper in the skin, causing premature wrinkling and skin cancer. Ultraviolet A appears to potentiate natural ultraviolet B damage. Therefore, the more exposure the skin has to tanning beds and ultraviolet A, the more damage that occurs, in the form of basal cell carcinoma, squamous cell carcinoma, and melanoma.

    Eye Injuries
    We also need to be concerned about eye injury during tanning - acute burning, visual impairment, and pain. Although eye damage usually resolves itself within days, 8-10% results in permanent retinal damage.

    Skin Cancer
    Approximately one million people in the United States develop non-melanoma skin cancers per year. Calculations reveal that the lifetime risk of developing basal cell carcinomas in Caucasians (Skin Types 1-3) is 28-33%, and squamous cell carcinomas is 7-11%. Melanoma, the most dangerous form of skin cancer, is becoming more prevalent than non-skin cancers. Melanoma has become the number one cancer in women ages 25-29, and is second only to breast cancer in women ages 30-34 years of age.

    Detection
    Everyone should perform periodic self-examination and see a dermatologist on a regular basis. Make a commitment to have your skin examined on your birthday!
    The Risk Factors
  • Large number of nevi (mole)
  • Skin Types 1-3
  • Freckling
  • Light eyes and hair color
  • 9 or more atypical nevi ("beauty marks")
  • Race and ethnicity (White; Northern European)
  • History of severe childhood sunburns
  • Psoriatics undergoing PUVA
  • Immunocompromised patients (patients on cyclosporines)
  •  

    Prevention
    • Limit sun exposure to before 10 AM and after 4 PM during peak seasons.
    • Use appropriate broad spectrum (UVA and UVB) water-resistant sunscreens, re-applying every two hours. Use an SPF of 30 or higher.
    • Wear protective clothing and hats.
    • Remember to use umbrellas at the beach and pool.
    • Safeguard patients on the road from 99% of the sun's UVA and UVB with ultraviolet shields for your windows. (Lunar 1-888-2UVASHIELD or 1-888-228-7443).
    • Protect children. Minimize sun exposure and apply sunscreen to children age 6 months or older.
    • Wear protective UVA/UVB polarized sunglasses.
    • Avoid sun tanning parlors.



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