It is well known that melanoma patients are at risk of suffering from other cancers, like pancreas and breast cancer. Moreover, a previous diagnosis of skin cancer, melanoma or nonmelanoma, increases the risk of acquiring cutaneous melanoma (CM). Dr. Geoffrey B. Yang and collaborators have just published a very interesting paper in the Archives of Dermatology analyzing the risk of CM following a previous cancer.

Risk and survival of cutaneous melanoma diagnosed subsequent to a previous cancer.

By means of the Surveillance, Epidemiology, and End Results database (1988-2007) the authors calculated the relative risk (RR) for development of primary CM in 70819 patients suffering from CM as first primary cancer, and in 6353 patients diagnosed CM subsequent to a previous cancer.

Probably, the most interesting results Dr. Geoffrey B. Yang et al report in their paper are the following:

• Patients with any initial cancer diagnosis and younger than 45 years were at an overall 192% increased risk for developing CM,  and those 45 years or older at an overall 36% increased risk .
• The risk for subsequent melanoma in melanoma survivors was significantly elevated throughout the study period. In fact, CM was the most common second primary cancer in patients with a first CM.

This is a large-scale study backed up by a high quality database and it deserves to be read in detail. Based on their findings the authors confirm the need to perform periodic skin evaluations in patients suffering from melanoma. Undoubtedly, this  is an important point in  the current times of limited resources. Moreover, the authors remind us that there is an increased risk of CM in cancer survivors, a group of patients in which primary and secondary prevention should also be stressed.

The fact that patients suffering from psoriasis are at an elevated risk to develop other chronic health conditions, also known as co-morbidities, has become lately a matter of intense debate. In this context, Dr. Jonas F. Ludvigsson and collaborators have just published a very interesting paper in the Journal of Investigative Dermatology.  The authors determine the prevalence of psoriasis in a nationwide population-based sample of patients with celiac disease (CD), confirmed by biopsy:

Psoriasis in a nationwide cohort study of patients with celiac disease.

Cutaneous lupus erythematosus (LE) encompasses a group of skin disorders that can present with several clinical presentations like chronic cutaneous lupus erythematosus (that includes localized and generalized discoid LE , hypertrophic LE, tumid LE, and lupus panniculitis), subacute cutaneous LE and acute LE. The etiology of LE is presently unknown, but it is thought both genetic and environmental factors play a role in its development. Among environmental factors involved in LE the most well known are sunlight and several drugs. Previous studies have suggested that smoking might be another factor involved in the pathogenesis of LE.

In a recent study published in the September issue of the Archives of Dermatology, a group of dermatologist from 3 different hospitals in France has studied prospectively the relationship of cigarette smoking and alcohol consumption as risk factors for developing cutaneous LE comparing a series of patients with a control group. 108 patients with LE and 216 controls were included in the study. Of the LE patients there were 48.1% of DLE or disseminated DLE, 24.1% of subacute LE, and 15.7% of acute LE, 6.5% of tumid LE, and 5.6% of SLE with no specific cutaneous lesions. 73.1% of the LE patients were smokers while only 49.5% of the controls smoked (P<.001). There was no difference in alcohol consumption between LE patients and controls. Patients who met ACR criteria for SLE smoked less than those who did not, and those with SLE smoked much less (average 5.5 pack-years), than those who did not met ACR criteria for SLE (average 16 pack-years). In addition, patients who had circulating anti-nDNA were less frequently smokers. Globally, patients with LE with only cutaneous involvement, who did not met ACR criteria for SLE, and had no anti-nDNA antibodies were those who smoked most. On the other hand, those patients who ACR criteria for SLE and had anti-nDNA antibodies were those who smoked the least (compared with other LE patients, and even with controls).

These data suggest that cigarette smoking is strongly associated with cutaneous manifestations of lupus erythematosus. The authors hypothesize that smoking can trigger lupus erythematosus through some of its toxic substances (some may also be contained in drugs known to be associated with lupus erythematosus), a possible phototoxic potential, and/or its effects on the immunologic system. (more…)

Two recent separate studies that have been published on-line in the journal Nature Genetics have identified new genetic risk factors for male-pattern baldness. Both studies have found similar results, and they found that there is a susceptibility locus for male-pattern baldness at chromosome 20p11. These studies add a new candidate gene for androgenetic alopecia. Previous studies had shown that variants in the androgen receptor gene on the X chromosome were associated with androgenetic alopecia. These investigators found that the combination of both gene variants (the one on chromosome X and the new one found in chromosome 20) were present in 1 out of 7 caucasian men, and that this increased seven-fold their risk of having androgenetic alopecia.

The gene on chromosome 20p11 has not been identified but it is probable that it harbors an androgen-independent pathway in androgenetic alopecia that may be the target of future therapies. (more…)

Atopic dermatitis (AD) or atopic eczema is a chronic inflammatory condition that usually begins in childhood. The prevalence of AD has been rising in all industrialized countries during the last decades and it currently affects 10 to 20% of children. Although there is a genetic basis for AD, the underlying causes remain unknown.

In a recent study published in the Archives of Disease in Childhood, a group of Swedish investigators have found that introducing fish in the diet of babies before they are nine months old may cut their risk of developing AD.

The investigators followed the children from a cohort of 8176 families, who were sent a questionnaire about diet and home environment when the children were six months of age. These families were then sent another questionnaire when the child was twelve months of age. 4941 families completed the two questionnaires. The prevalence of eczema was13% at six months, and 20% at twelve month.

Genetic factors were found to be the most important risk factor for developing eczema, as having either the mother or a sibling with eczema doubled the risk of a child to develop eczema. Breast feeding, the age at which dairy products were introduced, and the presence of a furry pet in the home had no detectable influence on eczema. Interestingly, the introduction of fish into the diet before nine months diminished the risk of developing eczema by 25 percent compared with children who never ate it. There was no link with the amount of fish or type of fish. Although one explanation might be that fish is rich in omega-3 fatty acids, the investigators found no differences between children who ate white fish, and those who ate other types of fish richer in omega-3. (more…)