SkinCancerNet Article
Can We Inherit Skin Cancers Other Than Melanoma?

While anyone can develop skin cancer, some people have an increased risk. The reason lies in our genes. The risk of developing skin cancer after exposure to UV rays (from the sun, tanning beds, etc.) increases dramatically when a person also inherits the genes that cause:

• Light skin, especially when the person has light-colored hair and/or eyes
   

• Basal cell nevus syndrome
  (This inherited medical condition, also known as Gorlin’s syndrome, can affect the skin, nervous system, eyes, bones, and some glands. A person may develop numerous basal cell skin cancers, often before age 30.)
   

• Xeroderma pigmentosum
  (Pronounced zeer-oh-der-ma pig-men-toe-sum, this inherited medical condition impairs the body’s ability to repair damage caused by exposure to UV rays.)

Why This Increased Risk
Light skin. Having light-colored skin makes a person more susceptible to UV damage. The paler the skin, the more readily it absorbs UV light. The more UV light that the skin absorbs, the more damage to the skin. While the body can repair this damage, with repeat UV exposure, the body becomes less capable of repairing the damage. Eventually, skin cancer develops.

People with light skin who have had years of unprotected sun exposure or used tanning devices, such as tanning beds, should learn how to examine their skin for signs of skin cancer. They also should be screened regularly by a dermatologist. With early detection and treatment, even melanoma has a 95% cure rate.

Basal cell nevus syndrome. Regular skin examinations can be lifesaving for people who inherit the genes that cause basal cell nevus syndrome. Usually before 30 years of age, a person with basal cell nevus syndrome will develop basal cell carcinoma, the most common type of skin cancer. Some people develop only a few basal cell carcinomas; others have hundreds. Most of these cancers develop on sun-exposed skin.

Along with regular skin examinations, sun avoidance is essential for anyone diagnosed with this medical condition. Sun avoidance decreases the risk of developing basal cell cancers. When the sun cannot be avoided, the person should practice comprehensive sun protection. This includes wearing protective clothing, a broad-spectrum (offers protection from UVA and UVB rays) sunscreen recommended by a dermatologist, and sunglasses that protect the eyes from harmful UVA and UVB rays.

Xeroderma pigmentosum. Sun avoidance is necessary for everyone who inherits the genes for xeroderma pigmentosum. This medical condition causes the person to be extremely sensitive to the effects of UV light because the body’s ability to repair the damage caused by UV light is absent or severely diminished. While it may seem that this condition would only affect people with very light skin, xeroderma pigmentosum develops in all races.

Inability to repair the damage caused by exposure to UV light gives people with xeroderma pigmentosum a 1000-fold increased risk of developing skin cancer. As the damage accumulates in the skin, even brief exposure to UV light can cause skin cancer. By age 8, most patients with xeroderma pigmentosum have skin cancer. Tumors also frequently develop in their eyes. Without complete UV protection, multiple skin cancers can develop. As many as 100 tumors have been reported in a single patient.

Xeroderma pigmentosum can significantly decrease life expectancy. Many with this condition die when a skin cancer, such as melanoma or squamous cell carcinoma, spreads. To protect a child from UV exposure, some families reverse their day/night cycles.

How a Dermatologist Can Help
Anyone diagnosed with basal cell nevus syndrome or xeroderma pigmentosum should be under the care of a dermatologist. This medical doctor receives years of medical training that focuses on treating skin conditions.

Research shows that dermatologists more accurately detect skin cancer than any other doctor. Treating skin cancer in its earliest stage can prevent the tumor from growing. Delaying treatment may require the doctor to remove a large amount of skin and tissue. This can be disfiguring. Early treatment also has the highest cure rate.

By seeing a dermatologist, the patient and family can learn how to perform regular self-examinations, which should be performed frequently between office visits.

In addition to treating skin cancers, a dermatologist will work with the patient to help prevent new skin cancers. A dermatologist can recommend a sun-protection plan that is appropriate for the patient as well as recommend suitable sun-protective clothing and other products to help shield the skin and eyes from UV exposure. If a patient has a high risk of developing numerous skin cancers, a dermatologist may prescribe medication to help prevent new skin cancers.

Those who have spent years in the sun or regularly used tanning beds also should see a dermatologist regularly. Years of unprotected sun exposure or frequent tanning-bed use significantly increase the risk of developing skin cancer. This is especially true if you inherited the genes for light-colored skin, hair, or eyes.

Note: An upcoming article will cover what is known about the genes that cause melanoma.

References:
Berg D. “Nevoid Basal Cell Carcinoma Syndrome.” eMedicine. Last update: January 25, 2007. Last accessed: February 15, 2007.

Hornstein MC et al. “Xeroderma Pigmentosum.” eMedicine. Last update: June 8, 2005. Last accessed: February 15, 2007.

Taylor, SC. “Skin of color: Biology, structure, function, and implications for dermatologic disease.” Journal of the American Academy of Dermatology. 2002 February;46(2)suppl. 2:S41-S62.

Yimaz B et al. “Basal cell nevus syndrome concurrent with adenoid cystic carcinoma of salivary gland.” Journal of the American Academy of Dermatology. 2003 May;48(5)suppl:S64-S66.

All content solely developed by the American Academy of Dermatology