IMPORTANCE Indoor tanning is a known carcinogen, but the scope of exposure to this hazard is not known. OBJECTIVE To summarize the international prevalence of exposure to indoor tanning. DATA SOURCES Studies were identified through systematic searches of PubMed (1966 to present), Scopus (1823 to present), and Web of Science (1898 to present) databases, last performed on March 16, 2013. We also hand searched reference lists to identify records missed by database searches and publicly available data not yet published in the scientific literature. STUDY SELECTION Records reporting a prevalence of indoor tanning were eligible for inclusion. We excluded case-control studies, reports with insufficient study information, and reports of groups recruited using factors related to indoor tanning. Two independent investigators performed searches and study selection. Our search yielded 1976 unique records. After exclusions, 161 records were assessed for eligibility in full text, and 88 were included. DATA EXTRACTION AND SYNTHESIS Two independent investigators extracted data on characteristics of study participants, inclusion/exclusion criteria, data collection format, outcomes, and statistical methods. Random-effects meta-analyses were used to summarize the prevalence of indoor tanning in different age categories. We calculated the population proportional attributable risk of indoor tanning in the United States, Europe, and Australia for nonmelanoma skin cancer (NMSC) and melanoma. MAIN OUTCOMES AND MEASURES Ever and past-year exposure to indoor tanning. RESULTS The summary prevalence of ever exposure was 35.7% (95% CI, 27.5%-44.0%) for adults, 55.0% (33.0%-77.1%) for university students, and 19.3% (14.7%-24.0%) for adolescents. The summary prevalence of past-year exposure was 14.0% (95% CI, 11.5%-16.5%) for adults, 43.1% (21.7%-64.5%) for university students, and 18.3% (12.6%-24.0%) for adolescents. These results included data from 406 696 participants. The population proportional attributable risk were 3.0% to 21.8% for NMSC and 2.6% to 9.4% for melanoma, corresponding to more than 450 000 NMSC cases and more than 10 000 melanoma cases each year attributable to indoor tanning in the United States, Europe, and Australia. CONCLUSIONS AND RELEVANCE Exposure to indoor tanning is common in Western countries, especially among young persons. Given the large number of skin cancer cases attributable to indoor tanning, these findings highlight a major public health issue.

Acute promyelocytic leukemia (APL) has evolved from being a deadly to a highly curable disease, due totargeted molecular therapy with all‐trans retinoic acid (ATRA). As a result, the incidence of early hemorrhagic deaths for which APL is notorious has reduced to 5–10% as reported in clinical trials. These results are not replicated outside of clinical trials as is evident from recent population‐based registries. High incidence of early hemorrhagic deaths remains the greatest contributor to treatment failure in this otherwise curable leukemia. Additionally, thrombosis is now being increasingly recognized in APL patients and may be associated with ATRA usage. Am. J. Hematol. 87:596–603, 2012. © 2012 Wiley Periodicals, Inc.

Background BRAF and MEK inhibitors frequently cause cutaneous adverse events. Objective To investigate the cutaneous safety profile of BRAF inhibitors versus BRAF- and MEK-inhibitor combination regimens. Methods We performed a retrospective cohort study, collecting data from 44 melanoma patients treated either with BRAF inhibitors (vemurafenib or dabrafenib) or BRAF- and MEK- inhibitor combination regimens (vemurafenib+cobimetinib or dabrafenib+trametinib). Patient characteristics, as well as the occurrence and severity of cutaneous adverse events are described. Results The development of cutaneous adverse events was significantly less frequent (p=0.012) and occurred after longer treatment time (p=0.025) in patients treated with BRAF- and MEK-inhibitor combination regimen compared to patients treated with BRAF inhibitor monotherapy. Among patients who received both BRAF inhibitor treatment and the combination of BRAF- and MEK-inhibitor at different time points during their treatment course, the development of squamous cell carcinoma or keratoacanthoma was significantly less frequent when they received the combination regimen (p=0.008). Patients receiving vemurafenib developed more cutaneous adverse events (p=0.001) and in particular more photosensitivity (p=0.010) than patients who did not. Limitations Limited number of patients. Conclusion Combination regimen with BRAF- and MEK-inhibitors shows fewer cutaneous adverse events and longer cutaneous adverse event-free interval compared to BRAF inhibitor monotherapy.