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Arm yourself with TOTAL BLOCK, against UVA but also UVB, making you a balanced dose of daily hours with the skin exposed to the sun, without exaggerating with whole weekends in the mountains, or stopping in the central hours of the day, especially dangerous in May and June. But without exaggerating even the other way around, hiding from the rays that allow us to produce the precious vitamin D.
Paolo Amerio, head of the Department of Dermatology and Venereology of the University of Chieti-Pescara, talks well in advance about the risks and remedies for UV radiation while preparing a dedicated website with his students.
1) Are ultraviolet radiation among the main risk factors for the onset of skin cancers?
THE skin tumors they represent more than 50% of all human cancers. What the ultraviolet (UV) radiation represent the main agent capable of inducing these tumors has been recognized for more than 50 years. UV radiation must be associated with other conditions to represent a real risk of cancer. The most important concomitant factors are: light skin, light colored eyes, blond or red hair, phototype, familiarity with skin cancers, frequent burns in pre-adolescent age. Ultraviolet radiation directly induces DNA damage and increases the amount of free radicals which in turn cause even more damage by interacting with proteins and cell membranes. The risk of developing skin cancers (melanoma and epithelioma) is given both by natural ultraviolet radiation (sun) and by exposure to artificial ultraviolet radiation sources such as sun beds whose use, especially under the age of 35, doubles the risk of developing melanoma.
The mode of sun exposure is also important. Acute and intermittent sun exposure is more closely linked to the development of melanomas, while continuous exposure is more closely linked to the development of epitheliomas.
The changed conditions of exposure to ultraviolet radiation by the population have made melanoma much more frequent than a few years ago: for fair-skinned subjects the risk today is 1/65, in the middle of the last century it was 1/5000.
In Italy, the AIRTUM (Italian Network of Cancer Registries) calculated an incidence of 12.5 cases of skin melanoma per 100,000 in men and 13.1 per 100,000 in women. The frequency of melanoma decreases as it moves to the southern regions. There are, however, southern regions such as Abruzzo where the incidence of melanoma is very high (14 out of 100,000) (as reported by the International Journal of Dermatology).
2) What degree of awareness is there in citizens?
Sensitizing the population to the knowledge of the risk associated with solar radiation and artificial UV sources, especially in children and adolescents, is essential to reduce the development of these tumors. The degree of awareness is directly proportional to the development of awareness campaigns that have yielded excellent results in countries with a high incidence of epithelial and melanoma tumors such as Australia or Canada. The gravity of the situation in these countries has also led to the legislative limitation of the development of tanning centers. In Australia there even seems to be some bills to completely abolish tanning salons starting from 2014!
In Italy, awareness is certainly less organized. Several associations of dermatologists such as SIDEMAST, ADOI and AIDA have organized various awareness-raising initiatives since 2000, (Melanoma Day, Euromelanoma Day and cancer prevention day) but unfortunately these are single days annually. Other initiatives are on a regional or local basis and therefore very little uniformly distributed on the national territory.
A recent study of ours has shown that although melanoma is a fairly well-known health problem (over 80% of respondents have heard of it) but less than 1/3 of people know exactly what the risk factors are for its development. Most people get information from television (40%) while only 15% have read some news in magazines or newspapers. Hence the need to offer more complete information to the population also with the use of modern information media such as websites.
3) What did you create and why?
The need to offer information to patients and the general population has prompted us to create a site, called "Previde", which can be a reference point for medical information on dermatology with special attention to issues related to sun exposure in gender and UV radiation.
The site will contain information that can be easily used by users on the main mechanisms of solar damage and UV radiation. On the site it will be possible to calculate your phototype, and view, thanks to the collaboration with “Virgilio Meteo”, the quantity of solar radiation present in the geographical area of interest at any given time. This information will allow users to choose the sunscreen or clothing that is most appropriate for the day, and the maximum exposure time before incurring rashes and burns. Furthermore, on the site, registered doctors will be able to access an online teledermatology service carried out by the staff of the Chieti Dermatological Clinic to access specialist services such as dermatoscopies, mole maps, removal of precancerous or tumor lesions.
4) How does ultraviolet radiation harm us? How to keep them at bay?
They induce skin damage both directly through DNA mutations and indirectly through the development of free radicals. Both of these mechanisms induce a state of less activity of the immune system in the skin favoring the development of skin tumors. The direct action of UV radiation on DNA occurs with the formation of pyrimidine rings that distort its structure - the exclusive prerogative of ultraviolet radiation - such mutations do not allow the normal replication of cells that become cancerous. The second mechanism of action involves the development of free radicals that interact with cellular proteins and membranes, altering the normal physiological life of skin cells.
You should avoid exposing yourself too much, especially in June-July and in the central hours of the day, or in an occasional and intense way such as entire weekends, in the mountains. In addition, the use of sunscreens, TOTAL BLOCK, for both UVA and UVB, can reduce the risk of developing skin cancers by 70%, but they should be applied every 2 hours as they degrade quickly enough and lose their protective capacity.
However, ultraviolet radiations are not to be completely avoided: they allow the production of vitamin D in the skin, a very important vitamin for the correct development of the immune system and bones in our body.
5) Which areas of the country are most affected and when?
In Italy, the highest incidence of skin cancers is to be recorded in the northern regions. The variability could be justified, in addition to the type of skin and the amount of irradiation, to a genetic difference of the different regional populations. The most irradiated areas are mountainous (the amount of UV radiation increases with altitude). The greater irradiation present in the regions of southern Italy is counterbalanced by the skin type of the populations residing there with generally darker skin and therefore in a certain sense more protected from the deleterious effects of solar radiation.
6) What consequences on health?
UV radiation has been closely related to the development of skin cancers, both melanoma and epithelial cancers. Although the latter represent 90% of skin cancers, they are generally less aggressive. Melanoma, on the other hand, represents only 5% of skin cancers, but is responsible for over 90% of skin cancer deaths.
This is the reason why primary and secondary prevention, together with early diagnosis, represent the objectives to be pursued for the dermatologist and the general practitioner.
7) Who to contact if you notice suspicious lesions?
The general practitioner is the protagonist of the management of citizens' health and therefore is at the forefront of implementing primary and secondary prevention of the deleterious effects of UV radiation. The dermatologist represents the main point of reference for the diagnosis and therapy of skin cancer lesions and is the most suitable professional for establishing the nature of skin lesions induced by UV radiation.
Interview byMarta Abbà
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