Skin carcinogenesis: the pathogenetic and therapeutic role of zinc

1. Introduction The increasing incidence of non-melanoma skin cancers (NMSC) and cutaneous malignant melanoma (CMM) is a significant burden on the health care system. The incidence of NMSC is approximately 100 per 100000 individuals in Europe [1]. Basal cell carcinoma (BCC) is a semi-malignant tumour that usually develops on sun-exposed skin areas. Both cumulative and intermittent high-dose ultraviolet irradiation (UVR) play a role in the formation of BCC [1]. Cutaneous squamous cell cancer (CSCC) appears to be associated with the cumulative UVR because it develops on the chronically sun damaged skin of elderly people at the site of precancerous skin lesions [1]. CSCCs rarely metastasise to regional lymph nodes, but they do so in a manner that depends on tumour depth and immune status. Cutaneous malignant melanoma (CMM) has a heterogeneous aetiology and pathogenesis, e.g., lentigo maligna melanoma is associated with chronic cumulative sun exposure, whereas other forms of CMM are associated with high-dose intermittent UVR, and there are even types of CMM that are not related to sunlight [2]. The incidence of CMM is 4-19 per 100000 individuals in Europe [3], and many patients are younger than 40 years old. Hereditary factors that affect skin pigmentation, DNA repair efficacy, and immune response play a very important role in the pathogenesis of CMM. CMM is characterised by a high propensity to metastasise and a low healing rate in metastatic cases. Surgery is the mainstay of skin cancer therapies. Topical and systemic medications are used to treat very early or advanced stages of the disease.

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