Fast Five Quiz: Skin Cancer

William James, MD

Disclosures

January 04, 2019

People who burn easily, such as those with fair or red hair, blue eyes, and light-colored skin, are most prone to develop skin cancer. The presence of freckling and benign nevi also indicates an increased risk for melanoma development. The number of nevi appears to be more important than the size. The presence of more than 100 benign-appearing nevi in adults or greater than 50 clinically normal nevi in children increases risk.

Many risk factors for melanoma have been identified. The most important risk factor is exposure to sunlight, particularly UV-B radiation. Cutaneous melanomas of the head and neck are significantly more likely to occur in people with high levels of total sun exposure. Genetics also plays a role in melanoma development. Patients having at least one affected first-degree relative possess a higher likelihood of developing malignant melanoma.

Immunosuppression is also increasingly recognized as a risk factor for the development of skin cancer; this is true of iatrogenic and noniatrogenic immunosuppression (eg, in organ transplant recipients and persons with the human immunodeficiency virus, respectively). Regardless of the reason for immunosuppression, cSCC that arises in the setting of immunosuppression exhibits a more aggressive course, with a higher rate of local recurrence, metastasis, and death.

Both short-wavelength UV-B radiation (290-320 nm, sunburn rays) and longer-wavelength UV-A radiation (320-400 nm, tanning rays) contribute to the formation of BCC. UV-B is believed to play a greater role in the development of BCC than does UV-A, however, and is the primary agent responsible for most skin cancers.

For more on melanoma risk factors, read here.

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