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 Germicidal UVB Sunburn UVA 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