Indoor tanning is associated with a significantly increased risk of both basal and squamous cell skin cancer. The risk is higher with use in early life (<25 years). This modifiable risk factor may account for hundreds of thousands of cases of non-melanoma skin cancer each year in the United States alone and many more worldwide. These findings contribute to the growing body of evidence on the harms of indoor tanning and support public health campaigns and regulation to reduce exposure to this carcinogen.

The Patient's StoryMr A is 85 years old and has multiple skin abnormalities with intractable pruritus of the trunk, groin, perianal area, face, and scalp. He cannot sleep for more than 4 to 5 hours per night because of his pruritus. Mr A was diagnosed as having seborrheic dermatitis, lichen simplex chronicus, seborrheic keratoses, tinea pedis, intertrigo, and xerosis (dry skin) in 2000. Treatments included numerous topical steroids and antifungals. None were effective, leaving Mr A significantly stressed.Mr A lives with his wife in an assisted-living facility. He requires help with dressing, transferring, using the telephone, shopping, and managing medications. His medical history includes type 2 diabetes mellitus, obesity, chronic kidney disease, and significant cardiovascular, cerebrovascular, and peripheral vascular disease. He has had 2 coronary artery bypass graft operations, 2 left carotid endarterectomies, and a left femoral-popliteal bypass operation. He also underwent multilevel lumbar laminectomy for spinal stenosis.His list of 28 oral and inhaled medications includes rosuvastatin and amlodipine. At one visit to Dr I, his geriatrician, Mr A produced 14 different tubes of topical medications, including multiple steroids and antifungals. He and his wife did not understand when and where to apply these medications. Mr A's skin was dry, with erythematous patches, seborrheic keratoses, and areas of excoriation on his trunk. He had bilateral inguinal fold and perianal erythema with a few white perianal plaques and several fissures. On monofilament testing, cutaneous sensation in his feet was absent. Screening for depression was unrevealing. His laboratory test results were notable for mild anemia, elevated creatinine, and normal liver function and routine chemistries.Mr A had several UV-B light treatments, which were minimally helpful. Mr A used over-the-counter diphenhydramine to help him sleep even though Dr I had advised against it because of potential anticholinergic adverse effects. Ultimately, Dr I, in collaboration with IMPORTANCE Pruritus is a common problem among elderly people and, when severe, causes as much discomfort as chronic pain. Little evidence supports pruritus treatment, limiting therapeutic possibilities and resulting in challenging management problems.OBJECTIVES To present the evidence on the etiology, diagnosis, and treatment of pruritus in the elderly and, using the best available evidence, provide an approach for generalist physicians caring for older patients with pruritus.EVIDENCE REVIEW PubMed and EMBASE databases were searched (1946( -August 2013.The Cochrane Database of Systematic Reviews and the Agency for Healthcare Research and Quality Systematic Review Data Repository were also searched from their inception to August 2013. References from retrieved articles were evaluated.FINDINGS More than 50% of elderly patients have xerosis (dry skin). Xerosis treatment should be included in the initial therapy for pruritus in all elderly patients. Calcium channel blockers and hydrochlorot...

Our meta-analysis suggests a potentially beneficial effect of statins on prostate cancer patients treated with RT but not among radical prostatectomy patients. Although limited by the lack of randomized data, these results suggest that primary treatment modality should be considered in future studies examining associations between statins and oncologic outcomes.

Background European studies have shown that itch is a widespread symptom, yet little is known about its frequency in the U.S. Objective To describe ambulatory care visits to clinicians in the U.S. for which itch was coded as a patient symptom. Methods This study uses retrospective data from the National Ambulatory Medical Care Survey from 1999–2009. Results Itch was coded as a symptom for an average of 7 million visits per year or approximately 1% of all outpatient visits, which was nearly 40% of the number of visits for the symptom of low back pain. Patients seen in visits for itch were more likely to be black or Asian than other patients (20% vs. 14%). They were also more likely than other patients to receive a new medication (68% vs. 36%) and were over twice as likely to receive two or more new medications (31% vs. 14%). Limitations Secondary datasets may not optimally capture patient reports and some of the procedures or medications may have been ordered for reasons other than itch. Conclusion Visits to clinicians for itch represent a sizeable proportion of ambulatory care visits in the US, and research on the epidemiology, treatments, and causes of itch should be a priority.