Thomas E. Rohrer

Guest Editor for the following articles:

Vol. 29. No. 4

Epidemiology of Melanoma

Darrell S. Rigel, MD

Malignant melanoma represents a significant and growing public health burden in the US and worldwide. It is estimated that 68, 130 cases of invasive malignant melanoma and at least 48,000 cases of melanoma in-situ will be diagnosed in the US this year. Melanoma is also one of the few remaining cancers with increasing US incidence. In the 1930s, the lifetime risk of an American developing invasive malignant melanoma was 1 in 1,500. Currently, that risk is 1 in 59. Deaths from malignant melanoma are also increasing. The mortality rate from malignant melanoma has risen about 2% annually since 1960. This year, it is estimated that 8,700 Americans will die from this cancer. The identification of individuals at high risk for malignant melanoma is important for the development of focused and efficient prevention efforts. Acute sun exposure resulting in sunburn remains a significant risk factor for the development of melanoma, but numerous other potential risk factors have been cited. Included among these are atypical mole syndrome/dysplastic nevus syndrome, blistering sunburns, immunosuppression, prior therapy with psoralen with ultraviolet A light (UVA) light, UV exposure at tanning salons, elevated socioeconomic status, and history of melanoma in a first-degree relative. With a better understanding of the reasons for the increasing rate of this cancer, and with enhanced early detection approaches, we may be able to decrease the incidence and mortality of malignant melanoma.
Semin Cutan Med Surg 29:204-209 © 2010 Published by Elsevier Inc.

Vol. 30. No. 1

New Agents for Prevention of Ultraviolet-Induced Nonmelanoma Skin Cancer

Craig A. Elmets, MD | Jennifer W. Turnham, BS | Mohammad Athar, PhD | William L. Camp, MD, MPH

With the incidence of nonmelanoma skin cancer on the rise, current prevention methods,
such as the use of sunscreens, have yet to prove adequate to reverse this trend. There has
been considerable interest in identifying compounds that will inhibit or reverse the biochemical
changes required for skin cancers to develop, either by pharmacologic intervention
or by dietary manipulation. By targeting different pathways identified as important in
the pathogenesis of nonmelanoma skin cancers, a combination approach with multiple
agents or the addition of chemopreventative agents to topical sunscreens may offer the
potential for novel and synergistic therapies in treating nonmelanoma skin cancer.
Semin Cutan Med Surg 30:6-13 © 2011 Elsevier Inc. All rights reserved.

Vol. 30. No. 1

No End in Sight: The Skin Cancer Epidemic Continues

Brett M. Coldiron, MD | Matthew R. Donaldson, MD

The incidence of nonmelanoma skin cancer (NMSC) continues to increase. Multiple reports
from the United States and Europe suggest we are in the midst of an epidemic. European
studies show substantial NMSC incidence increases during the last 2 decades. In the
United States, a recent analysis of Medicare Claims data showed that procedures performed
for NMSC nearly doubled from 1994 to 2006. From these data, the total number of
new NMSC in 2006 was estimated to be 3,507,693. Procedure data for 2006-2008 from the
5% Medicare Claims sample dataset corroborate the reported trajectory of incidence
increase. Destructions, excisions, and Mohs procedures for NMSC have increased by
2.6% per year during the last 2 years. On the basis of this current rate of increase, the
annual incidence of NMSC in the United States in 2008 would be nearly 3.69 million.
Recognizing the NMSC epidemic is critical as the incidence—and cost—will continue to
Semin Cutan Med Surg 30:3-5 © 2011 Elsevier Inc. All rights reserved.

Vol. 22. No. 4

Reconstruction after Surgery, Introduction

Thomas Roher, MD

Although it frequently goes unvoiced by the patient, there is almost always some underlying concern with how they will appear following a surgical procedure. This is true for all patients, not just the young attractive ones.