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Do Sunscreens Eliminate the Risk of Melanoma?
FR ¿El uso de fotoprotectores elimina el riesgo de desarrollar melanoma?
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"tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "837" "paginaFinal" => "838" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "I. Pastushenko, Y. Gilaberte-Calzada" "autores" => array:2 [ 0 => array:4 [ "nombre" => "I." "apellidos" => "Pastushenko" "email" => array:1 [ 0 => "jane.pastushenko@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Y." "apellidos" => "Gilaberte-Calzada" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Interdisciplinary Research Institute (IRIBHM), Université Libre de Bruxelles (ULB), Brussels, Belgium" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital San Jorge, Huesca, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "FR ¿El uso de fotoprotectores elimina el riesgo de desarrollar melanoma?" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1494 "Ancho" => 3307 "Tamanyo" => 458510 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Schematic representation of the experimental study design used by Viros et al. UVR indicates utraviolet radiation.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Exposure to ultraviolet radiation (UVR) is the leading risk factor for developing cutaneous melanoma and the only modifiable factor known to date. Multiple mutations linked to melanoma have also been reported, the most common somatic mutation being a V600E substitution in BRAF. The main sources of UVR exposure are sunlight and tanning booths. As early as the 1980s, numerous epidemiological studies had found a strong association between a history of sunburn and the risk of developing skin cancer. Surprisingly however, and contrary to what one might expect given the results of laboratory experiments, several population studies have linked the use of sunscreens with an increased risk of developing melanoma<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> and with a higher number of melanocytic nevi in children and adolescents.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> One explanation for these seemingly contradictory findings could be that, in people who intentionally expose themselves to sunlight, sunscreen use delays the onset of burns and, therefore, increases the duration of exposure to UVR.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> However, both the mechanism by which UVR induces melanoma and the role of sunscreen use in preventing the disease has, for decades, remained unclear.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The journal <span class="elsevierStyleItalic">Nature</span> recently published a fascinating study carried out by a group of British researchers who investigated the effect of UVR on melanomagenesis in a mouse model expressing BRAF (V600E) in melanocytes.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> They used conditional knockout mice (genetically engineered using the Cre-loxP system); the mice carried the mutated BRAF V600E gene but its expression was suppressed until activated. It is possible, using Cre-LoxP technology, to repress the normal gene and activate the expression of the mutated gene at a specific point in the study. The Cre protein is an enzyme, and its expression can be induced by several different substances, including tetracycline and tamoxifen. Topical application of tamoxifen to the shaved back of the animal induced the expression of the BRAF V600E mutation only in the area where the activating substance was applied. One month later, half of the area in which the mutated gene had been activated was covered with a fabric opaque to UVR and the unprotected half of the back was exposed weekly for 6 months to UV-A or UV-B radiation (160<span class="elsevierStyleHsp" style=""></span>mJ/cm<span class="elsevierStyleSup">−2</span>) from a broad spectrum lamp. To investigate the effect of sunscreen in preventing melanoma the investigators applied an FDA-recommended, broad-spectrum (UV-B or UV-A) sunscreen product with an SPF of 50 (2.2 mg/cm<span class="elsevierStyleSup">−2</span>), 30<span class="elsevierStyleHsp" style=""></span>min before exposure to UVR (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The authors of the study made several observations of great interest and clinical significance. First, these low doses of UVR (which induced mild erythema) induced an increase in the size and development of new nevi only in the areas of skin with the BRAF mutation; this phenomenon was not observed in the areas without mutation. Second, all the mice with the BRAF mutation exposed to UVR developed melanomas, while the same exposure of skin without the mutation produced no increase in melanoma incidence, indicating that UVR accelerates the BRAF-driven melanomagenesis process. Another finding of great significance was that the application of sunscreen blocks the short-term effects of UVR (induction of <span class="elsevierStyleItalic">Trp53</span>, apoptosis of epidermal keratinocytes, epidermal hypertrophy, and thickening of the dermis); however, in mice carrying the BRAF mutation, it delayed rather than completely prevented the development of melanoma. In addition, the authors demonstrated that topical application of the sunscreen reduces, but does not completely eliminate, the DNA damage induced by UVR.</p><p id="par0020" class="elsevierStylePara elsevierViewall">In conclusion, the study cited has demonstrated that the <span class="elsevierStyleItalic">TP53/Trp53</span> mutations induced by UVR accelerate the process of BRAF-driven melanomagenesis. Furthermore, the results support the use of other photoprotection strategies in addition to sunscreen in at risk individuals who carry the BRAF mutation.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-11-13" "fechaAceptado" => "2014-12-22" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec602149" "palabras" => array:3 [ 0 => "Melanoma" 1 => "BRAF" 2 => "Ultraviolet radiation" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Pastushenko I, Gilaberte-Calzada Y. Do Sunscreens Eliminate the Risk of Melanoma?. Actas Dermosifiliogr. 2015;106:837–838.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1494 "Ancho" => 3307 "Tamanyo" => 458510 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Schematic representation of the experimental study design used by Viros et al. UVR indicates utraviolet radiation.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sunscreen abuse for intentional sun exposure" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P. Autier" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2133.2009.09448.x" "Revista" => array:7 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2009" "volumen" => "161" "numero" => "Suppl 3" "paginaInicial" => "40" "paginaFinal" => "45" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19775356" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of sunscreen and clothing on the number of melanocytic nevi in 1,812 German children attending day care" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. Bauer" 1 => "P. Buttner" 2 => "T.S. Wiecker" 3 => "H. Luther" 4 => "C. Garbe" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/aje/kwi086" "Revista" => array:6 [ "tituloSerie" => "Am J Epidemiol" "fecha" => "2009" "volumen" => "161" "paginaInicial" => "620" "paginaFinal" => "627" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15781951" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sunscreen use and increased duration of intentional sun exposure: Still a burning issue" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P. Autier" 1 => "M. Boniol" 2 => "J.F. Doré" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ijc.22745" "Revista" => array:6 [ "tituloSerie" => "Int J Cancer" "fecha" => "2007" "volumen" => "121" "paginaInicial" => "1" "paginaFinal" => "5" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17415716" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ultraviolet radiation accelerates BRAF-driven melanomagenesis by targeting TP53" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Viros" 1 => "B. Sanchez-Loarden" 2 => "M. Pedersen" 3 => "S.J. Furney" 4 => "J. Rae" 5 => "K. Hogan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/nature13298" "Revista" => array:6 [ "tituloSerie" => "Nature" "fecha" => "2014" "volumen" => "511" "paginaInicial" => "478" "paginaFinal" => "482" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24919155" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack197207" "titulo" => "Acknowledgments" "texto" => "<p id="par0025" class="elsevierStylePara elsevierViewall">The authors wish to acknowledge the invaluable help of K. Kokoriev in developing the figure.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010600000010/v1_201512060022/S1578219015002942/v1_201512060022/en/main.assets" "Apartado" => array:4 [ "identificador" => "34945" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Resident's Forum" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010600000010/v1_201512060022/S1578219015002942/v1_201512060022/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219015002942?idApp=UINPBA000044" ]
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| 2020 September | 38 | 10 | 48 |
| 2020 August | 17 | 16 | 33 |
| 2020 July | 22 | 16 | 38 |
| 2020 June | 34 | 35 | 69 |
| 2020 May | 28 | 13 | 41 |
| 2020 April | 32 | 21 | 53 |
| 2020 March | 34 | 17 | 51 |
| 2020 February | 2 | 0 | 2 |
| 2019 December | 4 | 1 | 5 |
| 2019 September | 5 | 0 | 5 |
| 2019 July | 0 | 2 | 2 |
| 2019 June | 0 | 3 | 3 |
| 2019 May | 3 | 14 | 17 |
| 2019 April | 0 | 1 | 1 |
| 2019 March | 2 | 2 | 4 |
| 2019 February | 1 | 0 | 1 |
| 2018 December | 7 | 0 | 7 |
| 2018 November | 4 | 0 | 4 |
| 2018 October | 7 | 0 | 7 |
| 2018 September | 5 | 0 | 5 |
| 2018 February | 58 | 2 | 60 |
| 2018 January | 27 | 8 | 35 |
| 2017 December | 54 | 9 | 63 |
| 2017 November | 19 | 6 | 25 |
| 2017 October | 22 | 10 | 32 |
| 2017 September | 32 | 7 | 39 |
| 2017 August | 48 | 11 | 59 |
| 2017 July | 26 | 7 | 33 |
| 2017 June | 16 | 14 | 30 |
| 2017 May | 21 | 3 | 24 |
| 2017 April | 31 | 4 | 35 |
| 2017 March | 12 | 16 | 28 |
| 2017 February | 14 | 8 | 22 |
| 2017 January | 10 | 5 | 15 |
| 2016 December | 31 | 2 | 33 |
| 2016 November | 31 | 8 | 39 |
| 2016 October | 27 | 12 | 39 |
| 2016 September | 0 | 5 | 5 |
| 2016 July | 1 | 0 | 1 |
| 2016 June | 1 | 1 | 2 |
| 2016 May | 0 | 4 | 4 |
| 2016 April | 0 | 1 | 1 |
| 2016 March | 0 | 2 | 2 |
| 2016 February | 0 | 1 | 1 |
| 2016 January | 0 | 1 | 1 |
Show all
