Psoriasis, PUVA, and skin cancer-molecular epidemiology: The curious question of T -> A transversions

Citation
Ae. Peritz et Fp. Gasparro, Psoriasis, PUVA, and skin cancer-molecular epidemiology: The curious question of T -> A transversions, J INV D SYM, 4(1), 1999, pp. 11-16
Citations number
62
Categorie Soggetti
Dermatology
Journal title
JOURNAL OF INVESTIGATIVE DERMATOLOGY SYMPOSIUM PROCEEDINGS
ISSN journal
10870024 → ACNP
Volume
4
Issue
1
Year of publication
1999
Pages
11 - 16
Database
ISI
SICI code
1087-0024(199909)4:1<11:PPASCE>2.0.ZU;2-X
Abstract
Photochemotherapy with 8-methoxypsoralen and long wavelength ultraviolet ra diation (PUVA) is commonly used to treat psoriasis and vitiligo, These vast ly different diseases respond to the therapy by different mechanisms even t hough the immediate effects of the therapy photoadduct formation - is the s ame for both. Because psoriasis is not cured by PUVA, patients receive many treatments over their lifetime and develop a significant risk for the deve lopment of skin cancers (primarily squamous cell carcinomas). In this revie w the basic aspects of psoralen photobiology are reviewed briefly. In addit ion the impact of the analysis of mutations in the tumor suppressor gene, p 53, are summarized. An unexpected mutation spectrum (very few T --> A trans versions and frequent UVB signature C --> T transitions) suggest that effec ts other than direct DNA photoadduct formation may be at play. The roles of reactive oxygen species-induced base changes as well as other clastogenic factors are discussed. This analysis suggests that it may be possible to im prove the therapeutic efficacy of PUVA by a careful evaluation of the mode of delivery.