Zusammenfassung
Die zunehmende Anerkennung UV-Licht-induzierter Hautkarzinome als Berufsdermatose in entsprechend exponierten beruflichen Tätigkeiten stellt auch neue Herausforderungen für die Prävention dar. Seit nahezu 100 Jahren wird ein aktiver Sonnenschutz durch Verwendung von UV-Licht-filternden topischen Präparaten entwickelt. Darüber hinaus wird angestrebt, durch Anwendung verschiedener antioxidativer Prinzipien wie Vitamin E, Vitamin C und pflanzlichen Antioxidantien eine zusätzliche Schutzwirkung zu erzielen. Die Evidenz für diese Präparate in ihrer zur Anwendung kommenden Formulierung ist aber sehr unterschiedlich wie auch die Verwendung von Tabletten zum Sonnenschutz. Die aktuellen Änderungen der berufsdermatologischen Einordnung von UV-Licht-bedingten Hauttumoren werden verstärkt auch derartige präventive Strategien fordern und in angemessenen klinischen Studien zu belegen sein.
Abstract
UV-light induced skin cancer is being more and more accepted in Germany as an occupational disease for several jobs with increased UV-light exposure. Over the past 100 years sunscreens with filters against UVB- and UVA-light have been developed. Another development is the use of antioxidants such as vitamin E, vitamin C and herbal agents for additional photoprotection. The evidence supporting these products in their topical and systemic formulation is very variable. The recent changes in the recognition of UV-induced skin cancers as occupational diseases increases the need for preventive strategies which are supported by appropriate clinical studies.
Literatur
Afaq F, Abu Zaid M, Khan N et al (2009) Protective effect of pomegranate-derived products on UVB-mediated damage in human reconstituted skin. Exp Dermatol 18:553–561
Afaq F, Katiyar SK (2011) Polyphenols: skin photoprotection and inhibition of photocarcinogenesis. Mini Rev Med Chem 11(14):1200–1215
Ananthaswamy HN, Loughlin SM, Cox P et al (1997) Sunlight and skin cancer: Inhibition of p53 mutations in UV-irradiated mouse skin by sunscreens. Nat Med 3(5):510–514
Baur JA, Sinclair DA (2006) Therapeutic potential of resveratrol: the in vivo evidence. Nat Rev 5:493–506
Bickers DR, Merk H (1986) The treatment of porphyria. Seminars Dermatol 5:186–197
Bimczok R, Gers-Barlag H, Mundt C et al (2007) Influence of applied quantity of sunscreen products on the sun protection factor—a multicenter study organized by the DGK task force sun protection. Skin Pharmacol Physiol 20:57–64
Bowden GT (2004) Prevention of non-melanoma skin cancer by targeting ultraviolet-B-light signalling. Nat Rev 4:23–35
Chen L, Hu JY, Wang SQ (im Druck) The role of antioxidants in photoprotection: a critical review. J Am Acad Dermatol
Dennis LK, Beane Freeman LE, Van Beek MJ (2003) Sunscreen use and the risk for melanoma: a quantitative review. Ann Intern Med 139:966–978
Einspahr JG, Bowden GT, Alberts DS (2003) Skin cancer chemoprevention: strategies to save our skin. Recent Results Cancer Res 163:151–164
Elmets CA, Singh D, Tubesing K et al (2001) Cutaneous photoprotection from ultraviolet injury by green tea polyphenols. J Am Acad Dermtol 44:425–432
Fischer TW, Slominski A, Zmijewski MA et al (2008) Melatonin as a major skin protectant: from free radical scavenging to DNA damage repair. Exp Dermatol 17(9):713–730
Fritsche E, Schäfer C, Calles C et al (2007) Lightening up the UV response by identification of the arylhydrocarbon receptor as a cytoplasmatic target for ultraviolet B radiation. PNAS 104(21):8851–8856
Gasparini G, Longo R, Sarmiento R, Morabito A (2003) Inhibitors of cyclo-oxygenase 2: a new class of anticancer agents? Lancet Oncol 4(10):605–610
Gilchrest BA (1993) Sunscreens—a public health opportunity. N Engl J Med 329:1193–1194
Green A, Williams G, Neale R et al (1999) Daily sunscreen application and betacarotene supplementation in prevention of basal-cell and squamous-cell carcinomas of the skin: a randomised controlled trial. Lancet 354:723–729
Hayden CGJ, Roberts MS, Benson HAE (1997) Systemic absorption of sunscreen after topical application. Lancet 350:863–864
Hexsel CI, Bangert SD, Hebert AA, Lim HW (2008) Current sunscreen issues: 2007 food and drug administration sunscreen labelling recommendations and combination sunscreen/insect repellent products. J Am Acad Dermatol 59(2):316–323
Hill D (1999) Efficacy of sunscreens in protection against skin cancer. Lancet 354:699–700
Jang M, Cai L, Udeani GO et al (1997) Cancer chemopreventive activity of resveratrol, a natural product derived from grapes. Science 275:218–220
Junkins-Hopkins JM (2010) Antioxidants and their chemopreventive properties in dermatology. J Am Acad Dermatol 62(4):663–665
Kim KH, Back JH, Zhu Y et al (2011) Resveratrol targets transforming growth factor-β2 signaling to block UVB-induced tumor progression. J Invest Dermatol 131(1):195–202
Krutmann J, Schroeder P (2009) Role of mitochondria in photoaging of human skin: the defective powerhouse model. J Invest Dermatol Symp Proc 14(1):44–48
Krutmann J (2009) Actives – Zentraler Bestandteil des modernen Lichtschutzes. Hautarzt 60:294–300
Kullavanijaya P, Lim HW (2005) Photoprotection. J Am Acad Dermatol 52:937–958
Lademann J, Meinke M, Sterry W, Patzelt A (2009) Wie sicher sind Nanopartikel? Hautarzt 60:305–309
Lambert JD, Sang S, Yang CS (2007) Possible controversy over dietary polyphenols: benefits vs risks. Chem Res Toxicol 20:583–585
Lautenschlager S, Wulf HC, Pittelkow MR (2007) Photoprotection. Lancet 307:528–537
Liby KT, Yore MM, Sporn MB (2007) Triterpenoids and rexinoids as multifunctional agents for the prevention and treatment of cancer. Nat Rev 7:357–369
Lim HW, Hönigsmann H (2007) Photoprotection. In: Lim HW, Hönigsmann H, Hawk JLM (Hrsg) Photodermatology. Informa Healthcare, New York, S 267–278
Lin FH, Lin JY, Gupta RD et al (2005) Ferulic acid stabilizes a solution of vitamin C and E and doubles its photoprotection of skin. J Invest Dermatol 125:826–832
Lin JY, Selim MA, Shea CR et al (2003) UV photoprotection by combination topical antioxidants vitamin C and E. J Am Acad Dermatol 48:866–874
Lodén M, Beitner H, Gonzalez H et al (2011) Sunscreen use: controversies, challenges and regulatory aspects. BJD 165:255–262
Maier T, Korting HC (2005) Sunscreens—which and what for? Skin Pharmacol Physiol 18:253–262
Marks R, Rennie G (1988) Malignant transformation of solar keratoses to squamous cell carcinoma. Lancet 4:795–797
Merk HF, Baron JM, Heise R et al (2006) Concepts in molecular dermatotoxicology. Exp Dermatol 15:692–704
Merk HF (2007) Topical diclofenac in the treatment of actinic keratoses. Int J Dermatol 46(1):12–18
Moseley H (2006) Photoprotection. In: Ferguson J, Dover JS (Hrsg) Photodermatology. Manson Publishing, London, S 21–28
Mukhtar H, Merk HF (1989) Skin chemocarcinogenesis. Clin Dermatol 7:1–10
Ong CS (1998) Percutaneous absorption of sunscreens. Lancet 351:139–140
Osterwalder U, Herzog B (2009) Sun protection factors: world wide confusion. Br J Dermatol 161(Suppl. 3):13–24
Osterwalder U, Lim HW (2007) Novel developments in photoprotection: part I. In: Lim HW, Hönigsmann H, Hawk JLM (Hrsg) Photodermatology. Informa Healthcare, New York, S 279–296
Pinell SR (2003) Cutaneous photodamage, oxidative stress, and topical antioxidant protection. J Am Acad Dermatol 48(1):1–19
Rohr M, Klette E, Ruppert S et al (2010) In vitro sun protection factor: still a challenge with no final answer. Skin Pharmacol Physiol 23:201–212
Rougier A, Seite S, Lim HW (2007) Novel developments in photoprotection: part II. In: Lim HW, Hönigsmann H, Hawk JLM (Hrsg) Photodermatology. Informa Healthcare, New York, S 298–309
Sambandan DR, Ratner D (2011) Sunscreens: an overview and update. J Am Acad Dermatol 64:748–758
Schauber J, Gallo RL (2008) The vitamin D pathway: a new target for control of the skin’s immune response? Exp Dermatol 17:633–639
Schroeder P, Krutmann J (2009) IRA-Schutz – Notwendigkeit und Möglichkeiten. Hautarzt 60:301–304
Schwarz A, Navid F, Sparwasser T et al (2012) 1,25-Dihydroxyvitamin D exerts similar immunosuppressive effects as UVR but is dispensable for local UVR-induced immunosuppression. J Invest Dermatol [Epub ahead of print]
Schwarz T (2010) The dark and the sunny sides of UVR-induced immunosuppression: photoimmunology revisited. J Invest Dermatol 130:49–54
Shapira N (2010) Nutritional approach to sun protection: a suggested complement to external strategies. Nutr Rev 68(2):75–86
Sorg O, Antille C, Saurat JH (2004) Retinoids, other topical vitamins, and antioxidants. In: Rigel DS, Weiss RA, Lim HW, Dover JS (Hrsg) Photoaging. Marcel Dekker, New York, S 89–113
Stahl W, Krutmann J (2006) Systemische Photoprotektion durch Karotinoide. Hautarzt 57:281–285
Stege H, Mang R (2006) Lichtschutz – Grundlagen der UV-Protektion. Hautarzt 57:459–470
Surh YJ (2003) Cancer chemoprevention with dietary phytochemicals. Nature 3:768–780
Thompson SC, Jolley D, Marks R (1993) Reduction of solar keratoses by regular sunscreen use. N Engl J Med 329:1147–1151
Trémezaygues L, Reichrath J (2010) Zur Bedeutung des Vitamin D-Stoffwechsels in der humanen Haut. Hautarzt 61:478–486
Von Felbert V, Schumann H, Mercer JB et al (2007) Therapy of chronic wounds with water-filtered infrared-A (wIRA). GMS Krankenhaushygiene Interdisziplinär 2(2):1–12
Wolf P (2009) UV-Filter, State of the Art. Hautarzt 60:285–293
Yang CS, Wang X, Lu G, Picinich SC (2009) Cancer prevention by tea: animal studies, molecular mechanisms and human relevance. Nat Rev 9 429–439
Young AR, Wikonkal NM (2007) The chronic effects of ultraviolet radiation on the skin: photocarcinogenesis. In: Lim HW, Hönigsmann H, Hawk JLM (Hrsg) Photodermatology. Informa Healthcare, New York, S 107–117
Zussman J, Ahdout J, Kim J (2010) Vitamins and photoaging: Do scientific data support their use? J Am Acad Dermatol 63(3):507–525
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Merk, H., Baratli, J. Moderner Lichtschutz aus berufsdermatologischer Sicht. Hautarzt 63, 796–800 (2012). https://doi.org/10.1007/s00105-012-2462-4
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DOI: https://doi.org/10.1007/s00105-012-2462-4