Lasers in skin cancer prophylaxis

Halachmi, Shlomit; Lapidoth, Moshe

doi:10.1586/14737140.8.11.1713

Cited by 10 publications

(7 citation statements)

References 39 publications

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“…Though effective, therapeutic options such as topical 5‐fluorouracil cream or topical photodynamic therapy are designed to remove pre‐cancerous lesions, but not generate long‐term changes in the aged skin, which could result in sustained protection from actinic neoplasia. In contrast, there is a volume of literature suggesting that wounding therapies used for cosmetic purposes appear to protect the recipient from AK and NMSC . The concept that wounding therapies could protect against NMSC fits with the hypothesis that dermal fibroblast senescence with a lack of IGF‐1 mediates the increased incidence of actinic neoplasia .…”

Section: Discussionmentioning

confidence: 90%

Single Ablative Fractional Resurfacing Laser Treatment For Forearm Actinic Keratoses: 6‐Month Follow‐Up Data From An Intrapatient Comparison Between Treated and Untreated Sites

et al. 2019

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Background and Objectives: Actinic keratoses (AK) are common pre-cancerous lesions, which are associated with ultraviolet light exposure and aging. Wounding therapies such as fractionated laser resurfacing (FLR) have been previously demonstrated to effectively treat facial AK. However, the effectiveness of FLR on other sites commonly afflicted with AK has not been studied in detail. Previously, our group has reported that treatment of aged skin with wounding therapies including dermabrasion and ablative fractionated resurfacing results in the removal of senescent fibroblasts and normalizing the procarcinogenic acute ultraviolet B radiation responses associated with aged skin. The current studies were designed to test the effectiveness of FLR of the forearm skin of subjects aged 60 and older to remove AKs. subjects were enrolled in a study, in which they underwent a single FLR treatment of one extremity including the dorsal forearm, wrist, and dorsal hand. The number of AKs was recorded on both extremities at baseline, 3 and 6 months in a blinded fashion. Side effects of the FLR were documented. Results: A single FLR treatment resulted in a 62% reduction in the absolute number of AK in the treated arm at 6 months post-treatment. The laser treatment was well-tolerated without major complications. Conclusions: These studies demonstrate that FLR using settings, which have demonstrated to remove senescent fibroblasts and normalize the pro-carcinogenic UVB-response of aged skin is a potentially effective and safe field therapy treatment that should be studied for long-term efficacy for use in treating upper extremity AKs. Lasers Surg. Med.

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Section: Discussionmentioning

confidence: 90%

Single Ablative Fractional Resurfacing Laser Treatment For Forearm Actinic Keratoses: 6‐Month Follow‐Up Data From An Intrapatient Comparison Between Treated and Untreated Sites

et al. 2019

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“…The development of a prophylactic therapy which could be used on at-risk actinically damaged skin could substantially reduce the overall treatment costs of NMSC. Interestingly, there have been isolated reports and small studies which indicate that cosmetic wounding techniques, including FLR and dermabrasion, have been used to treat existing NMSC [ Halachmi & Lapidoth, 2008 ; Choudhary et al, 2011 ]. In fact, dermabrasion has also been reported to successfully prevent the recurrence of actinic keratosis and NMSC [ Field, 2007 ]; however, the extensive cutaneous damage inherent with dermabrasion therapy is often unacceptable [ Field, 2007 ].…”

Section: Discussionmentioning

confidence: 99%

Fractionated Laser Resurfacing Corrects the Inappropriate UVB Response in Geriatric Skin

Spandau

Lewis

Somani

et al. 2012

Journal of Investigative Dermatology

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Non-melanoma skin cancer is a disease primarily afflicting geriatric patients as evidenced by the fact that 80% of all non-melanoma skin cancers are diagnosed in patients over the age of 60 years. As such, geriatric skin responds to cancer-inducing UVB irradiation in a manner that allows the establishment of tumor cells. Currently, the only effective treatment for non-melanoma skin cancer is the removal of the tumors after they appear, indicating the need for a more cost-effective prophylactic therapy. Geriatric volunteers were treated with fractionated laser resurfacing therapy on either sun-protected (upper buttocks) or chronically sun-exposed (dorsal forearm) skin. Fractionated laser resurfacing therapy was demonstrated to decrease the occurrence of senescent fibroblasts in geriatric dermis, increase the dermal expression of insulin-like growth factor-1, and correct the inappropriate UVB response observed in untreated geriatric skin. These responses to fractionated laser resurfacing were equal to the effects seen previously using the more aggressive wounding following dermabrasion. Furthermore, fractionated laser resurfacing was equally effective in both sun-protected and sun-exposed skin. The ability of fractionated laser resurfacing treatment to protect against the occurrence of UVB-damaged proliferating keratinocytes indicates the potential of fractionated laser resurfacing to reduce or prevent aging-associated non-melanoma skin cancer.

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“…Future avenues of investigation, including following our cohort of laser-treated subjects longer, as well as examination of wounding effects in immunosuppressed populations who are at high-risk for developing SCCs. The combination of chemopreventative 36,37 and prophylactic wounding therapies [38][39][40][41][42] could prove to be effective at controlling the incidence of SCC in high-risk older adults. These studies will provide well-characterized patient samples that will be useful for further indepth studies evaluating the effects of dermal wounding in this population.…”

Section: Discussionmentioning

confidence: 99%

Fibroblast Senescence and Squamous Cell Carcinoma: How Wounding Therapies Could Be Protective

Travers

Spandau

Lewis

et al. 2013

Dermatologic Surgery

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Background Squamous cell carcinoma (SCC), which has one of the highest incidences of all cancers in the United States, is an age-dependent disease as the majority of these cancers are diagnosed in people over 70 years of age. Recent findings have led to a new hypothesis on the pathogenesis of SCC. Objectives To evaluate the potential of preventive therapies to reduce the incidence of SCC in at-risk geriatric patients. Materials and Methods Survey of current literature on wounding therapies to prevent SCCs. Results This new hypothesis of SCC photocarcinogenesis states that senescent fibroblasts accumulate in geriatric dermis resulting in a reduction in dermal insulin-like growth factor-1 (IGF-1) expression. This lack of IGF-1 expression sensitizes epidermal keratinocytes to fail to suppress UVB-induced mutations leading to increased proclivity to photocarcinogenesis. Recent evidence suggests that dermal wounding therapies, specifically dermabrasion and fractionated laser resurfacing, can decrease the proportion of senescent dermal fibroblasts, increase dermal IGF-1 expression, and correct the inappropriate UVB response found in geriatric skin, thus protecting geriatric keratinocytes from UVB-induced SCC initiation. Conclusions In this review, we will discuss the translation of pioneering basic science results implicating commonly used dermal fibroblast rejuvenation procedures as preventative treatments for SCC.

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Lasers in skin cancer prophylaxis

Cited by 10 publications

References 39 publications

Single Ablative Fractional Resurfacing Laser Treatment For Forearm Actinic Keratoses: 6‐Month Follow‐Up Data From An Intrapatient Comparison Between Treated and Untreated Sites

Single Ablative Fractional Resurfacing Laser Treatment For Forearm Actinic Keratoses: 6‐Month Follow‐Up Data From An Intrapatient Comparison Between Treated and Untreated Sites

Fractionated Laser Resurfacing Corrects the Inappropriate UVB Response in Geriatric Skin

Fibroblast Senescence and Squamous Cell Carcinoma: How Wounding Therapies Could Be Protective

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