effects of ultraviolet radiation henry w. lim, md co-chair national council on skin cancer...
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EFFECTS OF ULTRAVIOLET RADIATION
Henry W. Lim, MD
Co-Chair
National Council on
Skin Cancer Prevention
PRESENTER
• Chairman, Department of Dermatology, Henry Ford Hospital, Detroit, MI
• Photodermatology
DISCLOSURE
• Consultant : La Roche-Posay/L’Oreal, Orfagen, Dow Pharmaceutical Sciences
• Investigator: Johnson & Johnson
ELECTROMAGNETIC RADIATION
ULTRAVIOLET RADIATION
UV λ (nm) Properties
UVC 200-290 Germicidal
UVB 290-320 Sunburn
UVA 320-400 Pigment darkening, tanning
EFFECTS OF UV
• DNA damage• Erythema• Tanning• Vitamin D synthesis• Immunosuppression• Skin cancer
EFFECTS OF UV
• DNA damage
UV AND DNA DAMAGE
UVB:
• Direct effect
• Cyclobutane-pyrimidine dimers
Bolognia, et al. Dermatology. 2008
UV AND DNA DAMAGE(Agar NS, PNAS 4/04; 101:4954; Budiyanto A, P&P10/02; 76:397)
UVA:• Indirect mechanism• Absorption by skin chromophores →
reactive oxygen species → reacts with guanine → oxidative products (8-oxoG, 8-oxo-dG)
• Mutagenic
EFFECTS OF UV
• DNA damage• Erythema
ERYTHEMA
• Primarily the effect of UVB
• Peaks at 24 hrs
EFFECTS OF UV
• DNA damage• Erythema• Tanning
MECHANISMS OF TANNING (Hönigsmann H, PPP 4/02; 18:75)
• UV: activation of tyrosinase• UV DNA damage
nucleotide fragments excised in repair stimulate melanogenesis
ERYTHEMA & TANNING
• UVB: Erythema > tanning
• UVA: Tanning > erythema
• Tanning is an indication that DNA damage has occurred
• There is no “safe tan”
EFFECTS OF UV
• DNA damage• Erythema• Tanning• Vitamin D synthesis– Action spectrum: UVB
EFFECTS OF UV
• DNA damage• Erythema• Tanning• Vitamin D synthesis• Immunosuppression• Skin cancer
UV: IMMUNOSUPPRESSION AND SKIN CANCER
(International Agency for Research on Cancer Working Group on artificial ultraviolet light and skin cancer. Green A, et al.
Int J Cancer 3/07; 120:1116)
• UV: immunosuppressive• Chronic UV exposure:– Photoaging changes– Squamous cell carcinoma– Basal cell carcinoma
• Tanning bed users:– Melanoma– Squamous cell carcinoma
NATURAL AND ARTIFICIAL UV
• DNA damage, immunosuppression, skin cancer
• WHO: UV is carcinogen• WHO: UV tanning beds:
“carcinogenic to humans.” (El Ghissassi F, Lancet Oncol 7/09; 10: 751)
NCSCP RECOMMENDATIONS• To reclassify sunlamps for tanning
as Class II devices
• To impose special controls: user labeling and user registry
• To prohibit use by consumers younger than 18 years
• To require license for facilities at which sunlamps may be used
• To have training and certification of operators
www.skincancerprevention.org