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      Skin Cancer: Epidemiology, Disease Burden, Pathophysiology, Diagnosis, and Therapeutic Approaches

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          Abstract

          Skin cancer, including both melanoma and non-melanoma, is the most common type of malignancy in the Caucasian population. Firstly, we review the evidence for the observed increase in the incidence of skin cancer over recent decades, and investigate whether this is a true increase or an artefact of greater screening and over-diagnosis. Prevention strategies are also discussed. Secondly, we discuss the complexities and challenges encountered when diagnosing and developing treatment strategies for skin cancer. Key case studies are presented that highlight the practic challenges of choosing the most appropriate treatment for patients with skin cancer. Thirdly, we consider the potential risks and benefits of increased sun exposure. However, this is discussed in terms of the possibility that the avoidance of sun exposure in order to reduce the risk of skin cancer may be less important than the reduction in all-cause mortality as a result of the potential benefits of increased exposure to the sun. Finally, we consider common questions on human papillomavirus infection.

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          Most cited references57

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          A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

          The Lancet, 380(9859), 2224-2260
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            GBD 2010: design, definitions, and metrics.

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              Is Open Access

              Human papillomavirus molecular biology and disease association

              Summary Human papillomaviruses (HPVs) have evolved over millions of years to propagate themselves in a range of different animal species including humans. Viruses that have co‐evolved slowly in this way typically cause chronic inapparent infections, with virion production in the absence of apparent disease. This is the case for many Beta and Gamma HPV types. The Alpha papillomavirus types have however evolved immunoevasion strategies that allow them to cause persistent visible papillomas. These viruses activate the cell cycle as the infected epithelial cell differentiates in order to create a replication competent environment that allows viral genome amplification and packaging into infectious particles. This is mediated by the viral E6, E7, and E5 proteins. High‐risk E6 and E7 proteins differ from their low‐risk counterparts however in being able to drive cell cycle entry in the upper epithelial layers and also to stimulate cell proliferation in the basal and parabasal layers. Deregulated expression of these cell cycle regulators underlies neoplasia and the eventual progression to cancer in individuals who cannot resolve high‐risk HPV infection. Most work to date has focused on the study of high‐risk HPV types such as HPV 16 and 18, which has led to an understanding of the molecular pathways subverted by these viruses. Such approaches will lead to the development of better strategies for disease treatment, including targeted antivirals and immunotherapeutics. Priorities are now focused toward understanding HPV neoplasias at sites other than the cervix (e.g. tonsils, other transformation zones) and toward understanding the mechanisms by which low‐risk HPV types can sometimes give rise to papillomatosis and under certain situations even cancers. Copyright © 2015 John Wiley & Sons, Ltd.
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                Author and article information

                Contributors
                zoimd@yahoo.gr
                Journal
                Dermatol Ther (Heidelb)
                Dermatol Ther (Heidelb)
                Dermatology and Therapy
                Springer Healthcare (Cheshire )
                2193-8210
                2190-9172
                1 February 2017
                1 February 2017
                January 2017
                : 7
                : Suppl 1
                : 5-19
                Affiliations
                [1 ]ISNI 0000000109457005, GRID grid.4793.9, First Department of Dermatology, , Aristotle University of Thessaloniki, ; Thessaloniki, Greece
                [2 ]ISNI 0000 0004 0551 4246, GRID grid.16149.3b, , Teaching Hospital of the University of Münster, ; Münster, Germany
                [3 ]ISNI 0000 0004 1936 7988, GRID grid.4305.2, , University of Edinburgh, ; Edinburgh, UK
                [4 ]GRID grid.417656.7, Catalan Institute of Oncology (ICO), , L’Hospitalet de Llobregat, ; Catalonia, Spain
                Article
                165
                10.1007/s13555-016-0165-y
                5289116
                28150105
                dd805d0a-9c4e-45ab-9792-414703dec8f8
                © The Author(s) 2017
                History
                : 11 August 2016
                Funding
                Funded by: Almirall S.A
                Categories
                Review
                Custom metadata
                © Springer Healthcare 2017

                Dermatology
                dermatology,diagnosis,disease burden,epidemiology,skin cancer,therapy,treatment
                Dermatology
                dermatology, diagnosis, disease burden, epidemiology, skin cancer, therapy, treatment

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