SKIN CANCER OVERVIEW Edited by Yaguang Xi Skin Cancer Overview Edited by Yaguang Xi Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2011 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Tajana Jevtic Technical Editor Teodora Smiljanic Cover Designer InTech Design Team Image Copyright prudkov, 2011. DepositPhotos First published December, 2011 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Skin Cancer Overview, Edited by Yaguang Xi p. cm. ISBN 978-953-307-746-8 free online editions of InTech Books and Journals can be found at www.intechopen.com Contents Preface IX Part 1 Etiology 1 Chapter 1 Photodermatoses and Skin Cancer 3 Serena Lembo, Nicola Balato, Annunziata Raimondo, Martina Mattii, Anna Balato and Giuseppe Monfrecola Chapter 2 Desmosomal Cadherins in Basal Cell Carcinomas 31 Justyna Gornowicz-Porowska, Monika Bowszyc-Dmochowska and Marian Dmochowski Chapter 3 Basal Cell Carcinoma 51 Yalçın Tüzün, Zekayi Kutlubay, Burhan Engin and Server Serdaroğlu Chapter 4 An Overview on Basal Cell Carcinoma 87 Gulden Avci Part 2 Diagnosis and Treatment 107 Chapter 5 Determination of Melanoma Lateral and Depth Margins: Potential for Treatment Planning and Five-Year Survival Rate 109 Tianyi Wang, Jinze Qiu and Thomas E. Milner Chapter 6 Differential Scanning Calorimetry, as a New Method to Monitor Human Plasma in Melanoma Patients with Regional Lymph Node or Distal Metastases 141 Andrea Ferencz, Tamás Fekecs and Dénes Lőrinczy Chapter 7 New Technology in High-Dose-Rate Brachytherapy with Surface Applicators for Non-Melanoma Skin Cancer Treatment: Electronic Miniature X-Ray Brachytherapy 153 Yi Rong and James S. Welsh VI Contents Part 3 Prevention 171 Chapter 8 Chemoprevention of Skin Cancer with Dietary Phytochemicals 173 BuHyun Youn and Hee Jung Yang Chapter 9 Bioactive Food Components for Melanoma: An Overview 191 Imtiaz A. Siddiqui, Rohinton S. Tarapore, Jean Christopher Chamcheu and Hasan Mukhtar Preface Skin cancer is one of the most common types of tumors in Western countries. In the United States only, more than one million people are diagnosed with skin cancer each year. Although the absolute number of skin cancer patients is increasing, the death is inversely decreasing, due to the early detection and treatment. Basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma are three major types of skin cancer. BCC and SCC rarely have metastasis; over 95 percent BCC and SCC patients can be cured. Melanoma only accounts for a small percentage of skin cancer, but it causes 75 percent death of this disease. In this book, we invited a number of experts to present their latest accomplishments on skin cancer research. Although the topics are varied, the authors did great work to help readers better understand skin cancer and learn the knowledge to prevent this disease. There are three sections in this book, starting with etiology. Ultraviolet (UV) light exposure is overwhelmingly believed to be the most frequent cause of skin cancer. In this section, the association between UV and photodermatoses, as well as skin cancer is discussed. Desmosomal cadherins are important molecules in tumor cell adhesion and invasion, and their important roles in BCC are also presented in details. In the diagnosis and treatment section, a few new methodologies are described. As known, the outcome of malignant melanoma greatly depends on the thickness of the tumor at the time of treatment. Accurate determination of melanoma lateral and depth of margins using non-invasive imaging technologies is of importance when making sound decisions for treatment and evaluating a five year survival rate. A novel method named differential scanning calorimetry is capable of predicting metastasis of melanoma patients by monitoring the temperature changes of plasma. Electronic miniature X-ray brachytherapy is introduced as a new technology to treat non- melanoms skin cancer. Although its potential has not yet been fully realized, chemoprevention, in terms of using chemical agents that naturally occur in foods, or are administered as pharmaceuticals to retard or reverse the process of carcinogenesis and progression of cancer, has been recognized to benefit individuals with precancerous lesions or genetic susceptibilities to cancer. In the prevention section, two chapters summarized the most recognized dietary phytochemicals and their potential application in skin cancer. X Preface This book would not have been possible without the contributions of all authors and the support from the publisher. Especially, I will convey my sincere appreciation to Ms. Tajana Jevtic, who has always been available and supportive of me to accomplish this project. Yaguang Xi, M.D., Ph.D. Assistant Professor of Oncologic Sciences, University of South Alabama, USA [...]... the most common cancer worldwide: skin cancer The steady increases in melanoma and nonmelanoma skin cancer cases, contrast with the recent downward incidence for all other cancers (excluding lung cancer in women) The increases in skin cancer are largely attributed to recreational sun exposure (including tanning beds) practiced by the population Concern that further increases in skin cancer incidence... radiation is an ongoing cause of skin cancer, but overall ultraviolet radiation accounts for more than 90% of skin cancers Ultraviolet radiation is a complete carcinogen which means that, on its own, it has the ability to cause skin cancer without the need for other factors, although other co-carcinogens may have an expediting 22 Skin Cancer Overview effect on skin cancers leading to earlier onset... human skin; further studies measured the time for apoptosis induction after 3 repeated MED exposures Later, in the time course of the sunburn response the protein Bax is induced which leads to apoptosis and safe elimination of damaged cells Skin cancer is the most common type of cancer in light skinned populations around the world Skin cancers are mainly divided into melanoma, and non-melanoma skin cancers... UV-induced immunosuppression 12 Skin Cancer Overview 3 Photosensitive disorders Photosensitive disorders occur when human skin reacts abnormally to UVR or visible light (Murphy et al., 2001) Normal human skin produces a range of responses designed to protect man from adverse effects of UVR The normal response is determined by skin colour, which is in part genetically determined, and skin thickness, which is... setting of UV exposure, PLE occurs This ability to resist UV-induced depletion appears to be protective against skin cancer development This hypothesis is supported by an epidemiological study of the prevalence of polymorphic light eruption in those who have Photodermatoses and Skin Cancer 9 skin cancer, despite apparently equivalent UVR exposure, the prevalence of PLE appeared reduced (Lembo et al., 2008)... occur in transitional areas: keratinised skin- mucosal epithelium or keratinised skin- nail HPV favours anogenital areas, Photodermatoses and Skin Cancer 11 lips nose and also UV-irradiated skin Plane warts are almost inevitably found on the dorsum of the hands and the face, sites of maximal UV dose Immunosuppression caused by UVR in irradiated areas leads to skin exquisitely suited to the proliferation... role of the large number of these cells found infiltrating developed skin tumours, remains unclear Our aim was to provide an overview of UVR effects, photodermatoses and skin cancer, their epidemiology, incidence and the relationship of UVR-induced imbalance between immunosuppression or immunoactivation in PLE with relative skin cancer risk 2 Ultraviolet radiation Sunlight is a continuous spectrum... 21% in Sweden, 15% in the United Kingdom, and 5% in Australia All racial skin types have been documented as being affected in the medical literature, however, it most commonly occurs in fair-skinned individuals of Fitzpatrick skin types I–IV PLE has been widely reported, but it occurs most frequently in temperate 16 Skin Cancer Overview climates and is least prevalent in subtropical and tropical areas... UV-induced skin cancers Lifestyle changes during the past five decades, with increased sunlight exposure because of outdoor activities and worsening sunbathing habits, often result in skin cancers (SCs) Among Caucasians, intense early sunburns and blistering sunburns are closely associated with the development of melanoma As a result of chronic UV exposure: skin aging, wrinkles, uneven skin pigmentation,... the increase of tumour necrosis factor-α (TNF-α), IL-6, IL-10 and IL-15, resulting 4 Skin Cancer Overview in the immunosuppressed skin milieu that permits and maintains the proliferation of mutated cellular clones (Kamiya, 2003) It would seem that the skin performs a ‘balancing act’ between adequate elimination of early cancerous cells and suppression of abnormal reactions against UV-exposed cells that . common cancer worldwide: skin cancer. The steady increases in melanoma and non- melanoma skin cancer cases, contrast with the recent downward incidence for all other cancers (excluding lung cancer. SKIN CANCER OVERVIEW Edited by Yaguang Xi Skin Cancer Overview Edited by Yaguang Xi Published by InTech Janeza. resulting Skin Cancer Overview 4 in the immunosuppressed skin milieu that permits and maintains the proliferation of mutated cellular clones (Kamiya, 2003). It would seem that the skin performs