Use your head and put a hat on it

doi:10.1136/bmj.a1131

Published 6 August 2008, doi:10.1136/bmj.a1131
Cite this as: BMJ 2008;337:a1131

Letters

Sun and melanoma

Use your head and put a hat on it

The first 150 words of the full text of this article appear below.

There is very good epidemiological evidence that melanoma isrelated to UV exposure that Shuster has not cited.¹ Marks hasshown that the public health campaign in Australia has shownnot only a decrease in the incidence of melanoma but also anincrease in the detection of early, treatable lesions.² Despitethis positive progress, Queensland, a tropical region, has thedubious honour of having the world’s highest incidenceof melanoma. Is it Shuster’s assertion that the whiteAnglo-Saxon and Celtic majority living in this area somehowhave inherited genetically unstable melanocytes? Alternatively,is it his assertion that Queensland has a particularly overzealousand poorly trained group of pathologists?

The role of intermittent, high intensity exposure has been suggestedas the mechanism by which UV light induces malignant changein melanocytes.³ Intermittent ionising radiation is a well recognisedand well documented model for inducing other cancers, most notablysarcomas.⁴ Shuster suggests . . . [Full text of this article]

Marc D Moncrieff, consultant plastic surgeon¹, Jennifer Garioch, chairperson and dermatologist²

¹ Norfolk and Norwich University Hospital, Norwich. NR4 7UY, ² Skin Cancer Multidisciplinary Team, Norfolk and Norwich University Hospital Foundation NHS Trust

marc@moncrieff.net