The Skin Cancer Foundation Journal

MAY 2014

The 2012 edition of The Skin Cancer Foundation Journal features medically reviewed, reader-friendly articles such as tanning, the increasing incidence of skin cancer diagnoses among young women, & the prevalence of melanoma among white males over 50.

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Beauty & Anti-Aging melanomas and other ALMs at an earlier stage. For this pur- pose, I like to add an "F" to these guidelines, so that you have: A=Asymmetry of the lesion, B=uneven Border, C=Color variations, D=Diameter greater than 6mm, E=Evolution or change in size, shape, color, elevation, or another trait, or any new symptom such as bleeding, itching or crusting, and f nally, F=Family history or past occurrence of the condition. After examining the growth with the naked eye, a der- matologist will often conduct a dermoscopy – a simple, painless imaging procedure using a hand-held device that emits polarized light, which provides an enlarged, more detailed view of the lesion. Although subungual melano- mas (in cases of longitudinal melanonychia) often start as a dark stripe under the nail, not all of these streaks represent melanoma. Dermoscopy can help diff erentiate melanomas from benign pigmented streaks. Signs of melanoma that show up under dermoscopy include brown or black background discoloration and a pig- mentation of the cuticle known as a micro-Hutchinson's sign, as well as ir- regularly spaced pigmented bands on the nail and irregular thickness, color, or ridge patterns. Some dermatologists will also take an X-ray of the area in question, which can be another very help- ful step in diagnosis. If a serious condition is suspected, a biopsy of the suspicious lesion will ultimately determine whether or not it is a melanoma. Beating the odds The thickness of the tumor (the depth of invasion) plays a major role in determining one's odds of overcom- ing melanoma. Someone with a melanoma less than 1 mm thick has an average f ve-year survival rate of 95 percent, but the rate falls to 50 percent for a patient with a lesion greater than 4 mm thick. That is why early detec- tion is so critical. Because of the frequent delay in diagnosis, nail bed melanomas and other ALMs tend to be thicker when diagnosed than the average melanoma, resulting in more serious consequences. 8 For the best chance of early detection, The Skin Cancer Foundation advises every- one, regardless of skin color, to examine their skin head to toe, front and back, once a month. As part of this, carefully check your bare nails, palms, and the soles of your feet. Remember to remove any nail polish before you look (as well as before any professional skin exam). If you see any new growth or a change that meets the ABCDEF or CUBE criteria, consult with a dermatologist as soon as possible. The Foundation also recommends annual full- body professional skin exams, which should always include a thorough check of your hands, feet, and nails. "Due to frequent delays in diagnosis , nail bed melanomas tend to be thicker when diagnosed than other melanomas, resulting in more serious consequences." Melanomas of the nail can be mistaken for a recent injury. 32 S K I N C A N C E R F O U N D A T I O N J O U R N A L T he ultraviolet (UV) radiation produced by nail-drying lamps has long been a con- cern, but recent research published in JAMA Dermatology found that it requires multiple visits to a manicurist to increase your risk of skin cancer. The study, by researchers in the Division of Dermatology at Georgia Regents University, tested 17 nail - drying lamps in 16 different nail salons, fi nding that the wattage of these devices varies signifi cantly, with higher-wattage lamps producing the most UV. As few as eight sessions using a high-wattage lamp may produce enough UV exposure to cause skin DNA damage; for low-wattage lamps, it may take as many as 208 drying sessions. Even with numerous visits, however, the increased risk of skin cancer or skin aging is small. Nonetheless, all UV exposures add up over your lifetime, and the authors agree with previous researchers' recommenda- tions to apply broad-spectrum (UVA/UVB) sunscreen with an SPF of 15 or higher to hands before exposing them to nail-drying devices that emit UV light. Other safe options are wearing UVA-protective gloves with the fi ngertips cut out, letting nails dry naturally, or using the nail dryer's fan only. Does Nail-Drying Cause UV Damage? Photo provided by Maral K.Skelsey, MD References available on p.95

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