Organ of the
GD Society for Dermopharmacy
New Insights Regarding Light Skin Carcinoma:
Society for Dermopharmacy establishes Task Force "Light.Skin Carcinoma.Prevention"
Whereas the wide public is in the meantime to a great extent informed about the fact that excessive sunbathing may lead to the malignant melanoma, only little attention is in comparison paid to the light skin carcinoma types, i.e. the spinocellular carcinoma and the basalioma. And yet there is a much higher incidence of these carcinoma types than of the malignant melanoma. It is a special concern of this Task Force that has been recently established by the Gesellschaft für Dermopharmazie to direct the public's attention to this important subject.
In Germany several institutions have already brought the issue of prevention from skin cancer for discussion. In this context special importance is to be attached to the Kommission zur Früherkennung und Prävention von Hautkrebs (Committee for the Early Diagnosis and Prevention of Cutaneous Carcinoma) of the Arbeitsgemeinschaft Dermatologische Prävention (Study Pool Dermatological Prevention) der Deutschen Dermatologischen Gesellschaft (German Dermatological Society). However, a definite focus is here on the prevention of the malignant melanoma. Caused by the changed leisure-time activities and the corresponding massive sun exposure in our society there is not only an increased incidence of the malignant melanoma but also of the light skin carcinoma types.
Due to the fact that especially with these cancer types (non-melanoma skin cancer) there are still many open questions concerning therapy and prevention but also regarding their epidemiology and pathogenesis, the managing committee of the Gesellschaft für Dermopharmazie deems the establishing of a further institution necessary. In view of the practised approach of interdisciplinarity that has already been successful in other areas, the GD will take up the challenge by incorporating experts from the fields photo-biology, epidemiology, dermatology, pharmacy and cosmetology.
Actinic Keratosis as Preliminary
Stage of the Prickle-Cell Carcinoma
The spinocellular carcinoma which is also called prickle-cell carcinoma of skin is relatively unknown despite its high incidence because metastases are formed only seldom. Untreated, however, this carcinoma type may, as the malignant carcinoma lead to death. The prickle-cell carcinoma shows in most cases only at the age of 60 and above. Affected are mostly persons with a fair complexion who have exposed themselves excessively to sun during their entire lifespan.
The skin disease actinic keratosis is largely understood as a preliminary stage of the prickle-cell carcinoma, can however not be clearly separated from this dermatological disease. In the laymen communication the new GD Task Force will denominate the actinic keratosis as "rough light tyloma". In Australia it is proceeded from the assumption that already 40 percent of the over forty-year old are affected by one or more actinic keratoses. In the US and Europe, a frequency of the actinic keratosis of 10 to 15 percent is assumed. The risk of developing a spinocellular carcinoma at existing actinic keratosis is estimated differently; the figures reach from 0,25 to 16 percent.
A reddened skin area with a brownish, thickened horny layer clinically characterizes the actinic keratosis. In case the modified skin cells burst the limitation from the epidermis to the dermis, the cauliflower-like proliferating prickle-cell carcinoma is developed. The most frequently affected places are the ones which have been most exposed to the sun, for example face, ears, the back of the hands and lower arms as well as the bald head with men.
At an early diagnosis and timely therapy start both the prickle-cell carcinoma and the actinic keratosis can be successfully treated. Besides traditional physical treatment methods as the cryo-therapy there is a scientifically well-founded medicinal treatment approach today to which in particular the application of a gel with the active agent Diclofenac and the additive hyaluronic acid belongs. Moreover, the so-called photodynamic therapy is applied at present based on a light-sensitizing agent (aminolaevuline acid) in combination with light.
Basalioma - the Most Frequent
Skin Carcinoma Type in Central Europe
An even higher incidence than the spinocellular carcinoma has the basal cell carcinoma (basalioma) in Central Europe. This skin cancer type does not form metastases, however, enlarges continuously and destroys skin, as well as tissue lying underneath and possibly even bones in this process. The most frequently affected skin areas and the high-risk groups correspond to the ones of the prickle-cell carcinoma whereas there is an increasing number of young persons diseased with the basalioma.
In most cases basalioma show as small even node with a shiny surface. Subsequently they may turn reddish or brownish and can become crusty or scaly. A basalioma as well can be removed by different methods. After the removal a regular dermatological control is required; since once a basalioma has appeared such tumors may emerge at other places, which however are no metastases. In case of an incomplete removal of a basalioma, the remaining tumor may start to regrow.
Task Force Aims at
Sensitizing the Public
The GD intends to draw the public's attention in direction of the light skin cancer types by means of the Task Force "Licht.Hautkrebs.Prävention" (Light.Skin Carcinoma.Prevention). The consolidated experience in public relations as well as the established ways of communication of the society are means of realizing this intention. There are for example plans for an initiation of a dedicated Internet homepage with links to the GD-homepage (www.gd-online.de) in the meantime established as Dermopharmacy portal as well as the furnishing of a brochure, which will complete the advisory series of the GD for consumers, and patients. This planned brochure will be presented next year in the frame of an action week and distributed by physician practices, pharmacies, health insurances and other institutions.
The GD has initiated its public relation concerning the prevention from light skin cancer in the frame of its 7th Annual Meeting on 1 and 2 April of this year in Bonn. Under the slogan "also light skin cancer is dangerous" the subject has been incorporated into the widespread media campaign of the society on the occasion of the meeting. In this context the dermatologists professor Dr. med. Hans Christian Korting, Munich, as vice-president of the GD and professor Dr. med. Thomas Diepgen, Heidelberg, in his function as spokesmen of the newly founded Task Force emphasized that excessive sun exposure may not only lead to black but to an even larger extent to the light skin cancer. Both experts stress that the best form of prevention is effective sun protection by light protecting agents and appropriate clothing as well as regular dermatological control.
Besides more intensive public relations the Task Force "Licht.Hautkrebs.Prävention" (Light.Skin Carcinoma.Prevention) also aims at pushing forward the evidence-based research concerning the light skin cancer types by studies of their pathogenesis and epidemiology as well as a therapy and prophylaxis optimization. Moreover, they will establish diagnosis and therapy guidelines and give rise to an integration of these cancer types into the cancer registry. So far they are summarized under the WHO classification ICD 173 "Miscellaneous Skin Carcinoma". As the planned activities of the Task Force require a considerable employment of resources, the GD will make efforts to obtain support by the pharmaceutical and cosmetical industry as well as support from the public sector.
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