Question

Nguyen comes to your clinic with a mole that has recently changed in appearance. You examine the mole and note that its borders are irregular, it has a deep blue-black color, and the color is unevenly distributed throughout the mole.
Nguyen tells you that she has used a tanning booth once per week for the past several years and that the tanning salon advertises it as safe. What do you tell her about the tanning salon's claim? How does any UV exposure affect keratinocytes and melanocytes? Explain.

Accepted Answer

Explain to Nguyen that the tanning salon's claim of being 'safe' is misleading. UV radiation, whether from the sun or tanning booths, is a known carcinogen and can damage skin cells, increasing the risk of skin cancer, including melanoma. Discuss how UV radiation affects keratinocytes, the primary cells in the epidermis. UV exposure can cause DNA damage in keratinocytes, leading to mutations. If these mutations are not repaired, they can result in uncontrolled cell growth and potentially skin cancer. Explain the role of melanocytes, which are responsible for producing melanin, the pigment that gives skin its color. UV exposure stimulates melanocytes to produce more melanin as a protective response, leading to tanning. However, excessive UV exposure can damage melanocytes, causing mutations that may lead to melanoma. Describe the warning signs of melanoma using the ABCDE rule: Asymmetry, Border irregularity, Color variation, Diameter greater than 6 mm, and Evolving size, shape, or color. Nguyen's mole exhibits several of these signs, such as irregular borders and uneven color distribution, which are concerning. Advise Nguyen to avoid further UV exposure, including tanning booths, and to consult a dermatologist for a thorough evaluation of the mole. Early detection and treatment are critical for managing potential skin cancers like melanoma.

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Key Concepts

Tanning Booths and UV Exposure

Keratinocytes

Melanocytes and Melanin Production