BACKGROUND: \ud \ud During recent years numerous studies have suggested that personal and environmental factors might influence cancer development.\ud \ud OBJECTIVES: \ud \ud To investigate environmental and personal characteristics associated with skin cancer risk.\ud \ud METHODS: \ud \ud A multicentre hospital-based case-control study was performed in Finland, Germany, Greece, Italy, Malta, Poland, Scotland and Spain, including 409 patients with squamous cell carcinoma (SCC), 602 with basal cell carcinoma (BCC) and 360 with cutaneous malignant melanoma (CMM) and 1550 control persons. Exposures were assessed by questionnaires that were partly self-administered, partly completed by dermatologists. Unconditional logistic regression modelling was used to assess associations including the influence of certain drugs and food items on skin cancer risk.\ud \ud RESULTS: \ud \ud The usual associations were observed for sun exposure and pigmentation characteristics, with chronic sun exposure being most strongly associated with SCC risk, and naevi and atypical naevi with CMM risk. Use of ciprofloxacin was associated with a decreased risk of BCC [odds ratio (OR) 0·33] and use of thiazide diuretics was associated with an increased risk of SCC (OR 1·66). Ciprofloxacin was also associated with SCC (OR 0·34) and thiazines with BCC (OR 2·04), but these associations lost significance after correction for multiple testing. Consumption of pomegranate, rich in antioxidants, was associated with decreased BCC and SCC risk, also after correcting for multiple testing. Recent experience of stressful events was associated with increased risk, particularly of CMM.\ud \ud CONCLUSIONS: \ud \ud In this large case-control study from across Europe the expected associations were observed for known risk factors. Some new potential protective factors and potential risk factors were identified for consumption of certain food items, medication use and stress, which deserve further investigation in future studies

SummaryBackground There are limited data regarding the association of actinic keratosis (AK) and other types of nonmelanoma skin cancer (NMSC); studies investigating possible correlation of AK with melanocytic naevi are even scarcer. To our knowledge, there are no data examining the risk of AK in people using specific medications. Objective To investigate constitutional and exposure risk factors leading to AK and the coexistence of AK with NMSC and melanoma. Methods A multicentre hospital-based case-control study was performed in Finland, Germany, Greece, Italy, Malta, Poland, Scotland and Spain, including 343 patients with actinic keratosis (AK), 409 with squamous cell carcinoma (SCC), 602 with basal cell carcinoma (BCC), 360 with invasive melanoma and 119 with in situ melanoma, and 686 control subjects. Exposures were assessed by questionnaires that were partly self-administered and partly filled out by dermatologists. Unconditional logistic regression modelling was used to assess associations including the influence of phenotypic characteristics, presence of naevi, sunexposure habits and certain drugs on AK risk. Results Differences in hair and eye coloration variably influenced the risk for AK, with red hair signifying a seven times higher risk [odds ratio (OR) 6AE9, 95% confidence interval (CI) 4AE34-11AE00), and brown -compared with blue -eyes, about a 40% reduced risk (OR 0AE61, 95% CI 0AE13-0AE92). The darker the skin phototype, the lower the risk for AK, with phototype IV exhibiting nine times less risk of developing AK. Some and many freckles on the arms were associated with an OR of 1AE8 (95% CI 1AE08-2AE81) and 3AE0 (95% CI 1AE10-3AE54), respectively, while overall number of naevi and high educational level were inversely associated with AK. Sun exposure, thiazide diuretics and cardiac drugs had a higher risk for AK. SCC was the most frequent (58%) skin neoplasm coexisting with AKs, followed by BCC (30%), melanoma in situ (12%) and invasive melanoma (6%). Conclusion In this large case-control study from across Europe the expected associations were confirmed for known risk factors. Some possible new risk factors, including cardiac and diuretic drugs, were identified, creating a new field for further investigation in future studies.

A 27-year-old female, gravida 1, para 0, in week 22 of pregnancy, presented with an eruption consisting of annular erythematosquamous plaques with an active polycyclic elevated border comprised of superficial micropustules. Clinical and histological features were typical of impetigo herpetiformis (IH). Systemic steroids resulted in an unstable condition, with no resolution of lesions. Resistance to the above therapeutic scheme served as a stimulus to discuss the use of cyclosporine as a therapeutic option in this condition. Reviewing the limited literature, cyclosporine seems to serve not as a monotherapy in the management of IH but as an additional medication, in order to achieve a stable course of the disease and avoid high doses of systemic steroids.

Photodermatoses are a group of skin disorders induced by ultraviolet radiation (UVR) and, in some cases, visible light. To establish a diagnosis it is important to carefully take a history, physical examination and perform phototesting as well as other testing when appropriate (patch and photopatch tests, antinuclear antibodies, porphyrin profile). This article focuses on the photodermatoses that affect the elderly, which with the ageing of population, particularly in the industrialized societies, are becoming an increasingly important group for the healthcare systems. The most common photodermatoses with onset in the elderly are chronic actinic dermatitis and drug induced photosensitivity.

Compared to previous studies from Northern Greece, the epidemiology of superficial mycoses in the specific geographic region seems not to have been altered the last two to three decades.

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The potent systemic immunosuppression therapy necessary to sustain a life-saving solid organ transplant is associated with an increased incidence of various infections including human papillomavirus infection and skin cancers in organ transplant recipients. Imiquimod, a topical agent that functions through local induction of a specific anti-viral or anti-tumor immune response, appears to be a promising therapeutic option that could potentially counteract in situ the effects of systemic immunosupression in this vulnerable group. Up-to-date studies using this local immune-response modifier in transplanted patients have yielded reassuring and encouraging results regarding its safety and efficacy in this population. However, in order to establish the use of imiquimod as a standard treatment option for organ transplant recipients, additional research and clinical trials are required.The past decades have seen unprecedented progress in the development of solid organ transplantation as a therapeutic choice for endstage organ disease. Organ Transplant Recipients (OTR) live longer, have a good quality of life and represent a rapidly growing population of people with specific medical needs. As the number of solid organ transplants continues to rise, so too does the number of various infections including human papillomavirus (HPV) infections and skin cancers in OTR. Consequently, physicians will be called upon to manage these diseases in the sensitive OTR population and to develop novel therapeutic and preventive strategies to better deal with them.The clinical efficacy of imiquimod 5% cream (a topical therapy approved for genital warts, actinic keratoses and superficial basal cell carcinoma) stems from stimulation ofinnate and cell-mediated immune responses, resulting in antiviral, antiproliferative and antitumor activity. Because of these properties, imiquimod and other members of this family of immune response modifiers are potential agents for treatment of conditions where the immune system can affect the regression of the disease (1). In light of the role of systemic immunosupression in the development of cutaneous infections and neoplasms in OTR, the use of imiquimod to locally stimulate immune responses against cancerous, pre-cancerous

Ichthyoses are a heterogeneous group of cutaneous keratinization disorders that can be congenital or acquired. Apart from neoplastic disorders, the acquired form of ichthyosis (AI) has been associated with a variety of diseases including infections, autoimmune/inflammatory and endocrine/metabolic diseases as well as nutritional conditions, medications and others. However, malignancy accounts for half of the reported cases, most commonly including lymphoproliferative disorders. We present a case of AI as a paraneoplastic skin manifestation of a primary, osseous hemangiopericytoma (HP) accompanied by multiple liver metastases. We also review the literature and discuss the necessity of investigating underlying diseases, especially malignancy, when adult-onset ichthyosis arises.