Skin Cancers — Causes and Treatment

The JID Milestone Series allows both experts and non-experts to delve into the broader context of diseases and their biology in a comprehensive fashion. Now, the Milestones series has a new posting on the biology and etiology of skin cancers.

There are wonderful time lines for understanding the effects of the immune response, viruses, DNA repair, and external agents in causing and modifying skin cancers. Copy the time lines with proper attribution for lectures to both scientists and the general public and for your grant applications. In addition to UV and papilloma viruses as causes, I especially appreciated considering coal tar-induced cancers under a larger rubric, fossil fuel products and skin cancer. A new wording for the disease that Percival Potts found affects the skin and especially the scrotal sac of chimney sweeps. While there are far fewer chimney sweeps today, large parts of the population have fossil fuel fragments in their daily ambient atmosphere. Signaling pathways are important in the etiology of some skin cancer and as importantly have led to new therapeutic modalities now in the clinic.

Dr Stuart Yuspa organized this milestone and is to be congratulated as are all the authors of each milestone. Please see his introduction to this series, reproduced below, and be sure to read the articles.

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INTRODUCTION TO THE MILESTONES IN CUTANEOUS MALIGNANCY

Every review of the modern history of cancer research that doesn’t involve black humors begins with skin. Much of the current cancer lexicon used casually when discussing human cancer pathogenesis is derived from studies of human or rodent skin. Furthermore, the three major cancer-causing environmental agents, ultraviolet light, fossil fuel combustion products, and papilloma viruses, were recognized by astute clinicians and experimental biologists because they produced skin tumors. In fact, were it not for clinical observations and experimental studies of skin, whole fields now considered intimately involved in cancer development and progression would have been delayed or unrecognized. Such is the case, for example, of inflammation and the importance of immune function. It is because these vital contributions of skin research advance cancer research that the Journal of Investigative Dermatology chose to make this a subject of its Milestones feature. The following sections will outline some of the pioneering skin research that led to our current understanding of cancer pathogenesis and the pathogenesis of other human diseases. Here we discuss the basic biology of chemically induced tumors on mouse skin that revealed the sequential multistage nature of cancer development now recognized for virtually all human epithelial cancers. The importance of DNA repair for cancer risk, the incredible story of sonic hedgehog signaling in basal cell carcinoma, the most common human cancer, now recognized more broadly in many other target organs, the widespread influence of inflammation with specific positive and negative contributions by each component of the immune system, and the expanding recognition of the viral etiology of multiple cancer types are presented. This feature is not designed to be a comprehensive review of each topic but rather to give the historical context in which key observations were made that opened doors and illuminated the path to enormous insights.

Stuart H. Yuspa, MD, Lead Author, Milestones in Cutaneous Malignancy

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