The Molecular Basis of Nonmelanoma Skin Cancer: New Understanding

doi:10.1001/archderm.1997.03890460087010

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Vol. 133 No. 10, October 1997

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The Molecular Basis of Nonmelanoma Skin Cancer

New Understanding

Douglas Grossman, MD, PhD; David J. Leffell, MD

Arch Dermatol. 1997;133(10):1263-1270.

Abstract

Nonmelanoma skin cancers, including basal cell carcinomas andsquamous cell carcinomas, represent the most common malignantneoplasms in humans. Although many environmental and geneticfactors contribute to the development of skin cancers, the mostimportant is chronic exposure to UV radiation in sunlight. Wenow appreciate that the role of UV in the development of nonmelanomaskin cancers is 2-fold. First, UV radiation causes mutationsin cellular DNA. Failure to repair these genetic alterationsultimately leads to unrestrained growth and tumor formation.Second, UV radiation has profound effects on the cutaneous immunesystem, inducing a state of relative immunosuppression thatprevents tumor rejection. The purpose of this review is to educateclinical dermatologists about the recent developments in molecularbiology and immunology that have greatly enhanced our understandingof how skin cancers arise. The clinical implications of thisnew knowledge are farreaching and likely to soon impact thediagnosis, treatment, and prevention of a variety of benignand malignant skin conditions. It will be important for theclinician to understand the biological mechanisms underlyingthese new therapeutic developments to implement them effectively.

Arch Dermatol. 1997;133:1263-1270

Author Affiliations

From the Departments of Dermatology (Drs Grossman and Leffell) and Surgery (Dr Leffell), Yale University School of Medicine, New Haven, Conn.

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