Abstract
Sunscreens are ultraviolet radiation (UVR)-absorbing chemicals that attenuate the amount and nature of UVR reaching viable cells in the skin. They are selected and tested for their ability to prevent erythema. No sunscreen prevents photodamage, as it has been demonstrated that suberythemal doses of UVR cause a variety of molecular changes (including DNA damage) in these cells. Furthermore, the spectrum of UVR reaching viable cells is altered by topically applied sunscreen. In this review, the basic aspects of sunscreens and skin photobiology are reviewed briefly. Although there can be no question concerning the efficacy of sunscreens for the prevention of erythema, questions remain because of the possible cumulative effects of chronic suberythemal doses and the increased exposure of skin cells to longer UVR wavelengths. The current major issue surrounding sunscreens involves their ability to protect skin cells against the effects of UVA radiation. These UVA effects may be direct damage (base oxidations) or effects on the skin immune system, yet there is no uniformly accepted method for the evaluation of UVA protection. This review is focused primarily on the latter topic covering action spectra that implicate the need for UVA protection. In addition, in vivo and in vitro methods proposed for the evaluation of candidate sunscreen formulations of UVA protective ability are reviewed. Finally, revisions in the terminology used to describe the protection afforded by sunscreens are suggested. It is proposed that SPF ("sun" protection factor) be renamed "sunburn" protection factor and that "critical wavelength" be designated "long wave index."
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Selected References
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- Ainsleigh H. G. Beneficial effects of sun exposure on cancer mortality. Prev Med. 1993 Jan;22(1):132–140. doi: 10.1006/pmed.1993.1010. [DOI] [PubMed] [Google Scholar]
- Ananthaswamy H. N., Loughlin S. M., Cox P., Evans R. L., Ullrich S. E., Kripke M. L. Sunlight and skin cancer: inhibition of p53 mutations in UV-irradiated mouse skin by sunscreens. Nat Med. 1997 May;3(5):510–514. doi: 10.1038/nm0597-510. [DOI] [PubMed] [Google Scholar]
- Ananthaswamy H. N., Ullrich S. E., Mascotto R. E., Fourtanier A., Loughlin S. M., Khaskina P., Bucana C. D., Kripke M. L. Inhibition of solar simulator-induced p53 mutations and protection against skin cancer development in mice by sunscreens. J Invest Dermatol. 1999 May;112(5):763–768. doi: 10.1046/j.1523-1747.1999.00564.x. [DOI] [PubMed] [Google Scholar]
- Armstrong B. K., Kricker A. Epidemiology of sun exposure and skin cancer. Cancer Surv. 1996;26:133–153. [PubMed] [Google Scholar]
- Armstrong B. K., Kricker A. Epidemiology of sun exposure and skin cancer. Cancer Surv. 1996;26:133–153. [PubMed] [Google Scholar]
- Atillasoy E. S., Seykora J. T., Soballe P. W., Elenitsas R., Nesbit M., Elder D. E., Montone K. T., Sauter E., Herlyn M. UVB induces atypical melanocytic lesions and melanoma in human skin. Am J Pathol. 1998 May;152(5):1179–1186. [PMC free article] [PubMed] [Google Scholar]
- Autier P., Doré J. F., Négrier S., Liénard D., Panizzon R., Lejeune F. J., Guggisberg D., Eggermont A. M. Sunscreen use and duration of sun exposure: a double-blind, randomized trial. J Natl Cancer Inst. 1999 Aug 4;91(15):1304–1309. doi: 10.1093/jnci/91.15.1304. [DOI] [PubMed] [Google Scholar]
- BEUKERS R., BERENDS W. Isolation and identification of the irradiation product of thymine. Biochim Biophys Acta. 1960 Jul 15;41:550–551. doi: 10.1016/0006-3002(60)90063-9. [DOI] [PubMed] [Google Scholar]
- Bech-Thomsen N., Wulf H. C. Sunbathers' application of sunscreen is probably inadequate to obtain the sun protection factor assigned to the preparation. Photodermatol Photoimmunol Photomed. 1992;9(6):242–244. [PubMed] [Google Scholar]
- Berg R. J., de Laat A., Roza L., van der Leun J. C., de Gruijl F. R. Substitution of equally carcinogenic UV-A for UV-B irradiations lowers epidermal thymine dimer levels during skin cancer induction in hairless mice. Carcinogenesis. 1995 Oct;16(10):2455–2459. doi: 10.1093/carcin/16.10.2455. [DOI] [PubMed] [Google Scholar]
- Bhawan J., Andersen W., Lee J., Labadie R., Solares G. Photoaging versus intrinsic aging: a morphologic assessment of facial skin. J Cutan Pathol. 1995 Apr;22(2):154–159. doi: 10.1111/j.1600-0560.1995.tb01399.x. [DOI] [PubMed] [Google Scholar]
- Black G., Matzinger E., Gange R. W. Lack of photoprotection against UVB-induced erythema by immediate pigmentation induced by 382 nm radiation. J Invest Dermatol. 1985 Nov;85(5):448–449. doi: 10.1111/1523-1747.ep12277170. [DOI] [PubMed] [Google Scholar]
- Bouwes Bavinck J. N., Robertson I., Wainwright R. W., Green A. Excessive numbers of skin cancers and pre-malignant skin lesions in an Australian heart transplant recipient. Br Heart J. 1995 Oct;74(4):468–470. doi: 10.1136/hrt.74.4.468. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brash D. E., Ziegler A., Jonason A. S., Simon J. A., Kunala S., Leffell D. J. Sunlight and sunburn in human skin cancer: p53, apoptosis, and tumor promotion. J Investig Dermatol Symp Proc. 1996 Apr;1(2):136–142. [PubMed] [Google Scholar]
- Brown D. A., Ren W. Y., Khorlin A., Lesiak K., Conklin D., Watanabe K. A., Seidman M. M., George J. Aliphatic and alicyclic diols induce melanogenesis in cultured cells and guinea pig skin. J Invest Dermatol. 1998 Apr;110(4):428–437. doi: 10.1046/j.1523-1747.1998.00160.x. [DOI] [PubMed] [Google Scholar]
- Chung J. H., Youn J. I. Effect of ultraviolet A on IL-1 production by ultraviolet B in cultured human keratinocytes. J Dermatol Sci. 1995 Mar;9(2):87–93. doi: 10.1016/0923-1811(94)00352-f. [DOI] [PubMed] [Google Scholar]
- Coblentz W. W., Stair R., Hogue J. M. The Spectral Erythemic Reaction of the Human Skin to Ultra-Violet Radiation. Proc Natl Acad Sci U S A. 1931 Jun;17(6):401–405. doi: 10.1073/pnas.17.6.401. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cole C. A., Davies R. E., Forbes P. D., D'Aloisio L. C. Comparison of action spectra for acute cutaneous responses to ultraviolet radiation: man and albino hairless mouse. Photochem Photobiol. 1983 Jun;37(6):623–631. doi: 10.1111/j.1751-1097.1983.tb04531.x. [DOI] [PubMed] [Google Scholar]
- Colombo M. P., Modesti A., Parmiani G., Forni G. Local cytokine availability elicits tumor rejection and systemic immunity through granulocyte-T-lymphocyte cross-talk. Cancer Res. 1992 Sep 15;52(18):4853–4857. [PubMed] [Google Scholar]
- D'Errico M., Calcagnile A. S., Corona R., Fucci M., Annessi G., Baliva G., Tosti M. E., Pasquini P., Dogliotti E. p53 mutations and chromosome instability in basal cell carcinomas developed at an early or late age. Cancer Res. 1997 Feb 15;57(4):747–752. [PubMed] [Google Scholar]
- D'Errico M., Calcagnile A., Iavarone I., Sera F., Baliva G., Chinni L. M., Corona R., Pasquini P., Dogliotti E. Factors that influence the DNA repair capacity of normal and skin cancer-affected individuals. Cancer Epidemiol Biomarkers Prev. 1999 Jun;8(6):553–559. [PubMed] [Google Scholar]
- Davenport V., Morris J. F., Chu A. C. Immunologic protection afforded by sunscreens in vitro. J Invest Dermatol. 1997 Jun;108(6):859–863. doi: 10.1111/1523-1747.ep12292582. [DOI] [PubMed] [Google Scholar]
- De Fabo E. C., Noonan F. P. Mechanism of immune suppression by ultraviolet irradiation in vivo. I. Evidence for the existence of a unique photoreceptor in skin and its role in photoimmunology. J Exp Med. 1983 Jul 1;158(1):84–98. doi: 10.1084/jem.158.1.84. [DOI] [PMC free article] [PubMed] [Google Scholar]
- DiGiovanna J. J. Posttransplantation skin cancer: scope of the problem, management, and role for systemic retinoid chemoprevention. Transplant Proc. 1998 Sep;30(6):2771–2778. doi: 10.1016/s0041-1345(98)00806-9. [DOI] [PubMed] [Google Scholar]
- Diffey B. L. Ultraviolet radiation and human health. Clin Dermatol. 1998 Jan-Feb;16(1):83–89. doi: 10.1016/s0738-081x(97)00172-7. [DOI] [PubMed] [Google Scholar]
- Elmets C. A., LeVine M. J., Bickers D. R. Action spectrum studies for induction of immunologic unresponsiveness to dinitrofluorobenzene following in vivo low dose ultraviolet radiation. Photochem Photobiol. 1985 Oct;42(4):391–397. doi: 10.1111/j.1751-1097.1985.tb01586.x. [DOI] [PubMed] [Google Scholar]
- Garty M., Stull R., Kopin I. J., Goldstein D. S. Skin color, aging, and plasma L-dopa levels. J Auton Nerv Syst. 1989 Apr;26(3):261–263. doi: 10.1016/0165-1838(89)90175-6. [DOI] [PubMed] [Google Scholar]
- Gasparro F. P. Photobiology 101. J Invest Dermatol. 1998 Feb;110(2):183–183. doi: 10.1046/j.1523-1747.1998.00135.x. [DOI] [PubMed] [Google Scholar]
- Gilchrest B. A., Park H. Y., Eller M. S., Yaar M. Mechanisms of ultraviolet light-induced pigmentation. Photochem Photobiol. 1996 Jan;63(1):1–10. doi: 10.1111/j.1751-1097.1996.tb02988.x. [DOI] [PubMed] [Google Scholar]
- Halliday G. M., Bestak R., Yuen K. S., Cavanagh L. L., Barnetson R. S. UVA-induced immunosuppression. Mutat Res. 1998 Nov 9;422(1):139–145. doi: 10.1016/s0027-5107(98)00185-7. [DOI] [PubMed] [Google Scholar]
- Halliday G. M., Ho K. K., Barnetson R. S. Regulation of the skin immune system by retinoids during carcinogenesis. J Invest Dermatol. 1992 Nov;99(5):83S–86S. doi: 10.1111/1523-1747.ep12669926. [DOI] [PubMed] [Google Scholar]
- Holick M. F., MacLaughlin J. A., Doppelt S. H. Regulation of cutaneous previtamin D3 photosynthesis in man: skin pigment is not an essential regulator. Science. 1981 Feb 6;211(4482):590–593. doi: 10.1126/science.6256855. [DOI] [PubMed] [Google Scholar]
- Holly E. A., Aston D. A., Cress R. D., Ahn D. K., Kristiansen J. J. Cutaneous melanoma in women. I. Exposure to sunlight, ability to tan, and other risk factors related to ultraviolet light. Am J Epidemiol. 1995 May 15;141(10):923–933. doi: 10.1093/oxfordjournals.aje.a117359. [DOI] [PubMed] [Google Scholar]
- Kaidbey K. H., Agin P. P., Sayre R. M., Kligman A. M. Photoprotection by melanin--a comparison of black and Caucasian skin. J Am Acad Dermatol. 1979 Sep;1(3):249–260. doi: 10.1016/s0190-9622(79)70018-1. [DOI] [PubMed] [Google Scholar]
- Kaidbey K. H., Kligman A. M. Cumulative effects from repeated exposures to ultraviolet radiation. J Invest Dermatol. 1981 May;76(5):352–355. doi: 10.1111/1523-1747.ep12520007. [DOI] [PubMed] [Google Scholar]
- Kawada A., Hiruma M., Nakada R., Kukita A. An evaluation of broad-spectrum sunscreens against topical PUVA-induced erythema. Acta Derm Venereol. 1989;69(4):335–337. [PubMed] [Google Scholar]
- Kelsall S. R., Mintz B. Metastatic cutaneous melanoma promoted by ultraviolet radiation in mice with transgene-initiated low melanoma susceptibility. Cancer Res. 1998 Sep 15;58(18):4061–4065. [PubMed] [Google Scholar]
- Kim T. H., Ullrich S. E., Ananthaswamy H. N., Zimmerman S., Kripke M. L. Suppression of delayed and contact hypersensitivity responses in mice have different UV dose responses. Photochem Photobiol. 1998 Nov;68(5):738–744. [PubMed] [Google Scholar]
- Kligman L. H., Sayre R. M. An action spectrum for ultraviolet induced elastosis in hairless mice: quantification of elastosis by image analysis. Photochem Photobiol. 1991 Feb;53(2):237–242. doi: 10.1111/j.1751-1097.1991.tb03928.x. [DOI] [PubMed] [Google Scholar]
- Koh H. K. Preventive strategies and research for ultraviolet-associated cancer. Environ Health Perspect. 1995 Nov;103 (Suppl 8):255–257. doi: 10.1289/ehp.95103s8255. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kollias N., Malallah Y. H., al-Ajmi H., Baqer A., Johnson B. E., González S. Erythema and melanogenesis action spectra in heavily pigmented individuals as compared to fair-skinned Caucasians. Photodermatol Photoimmunol Photomed. 1996 Oct;12(5):183–188. doi: 10.1111/j.1600-0781.1996.tb00197.x. [DOI] [PubMed] [Google Scholar]
- Kraemer K. H., Lee M. M., Scotto J. Xeroderma pigmentosum. Cutaneous, ocular, and neurologic abnormalities in 830 published cases. Arch Dermatol. 1987 Feb;123(2):241–250. doi: 10.1001/archderm.123.2.241. [DOI] [PubMed] [Google Scholar]
- Kripke M. L., Cox P. A., Alas L. G., Yarosh D. B. Pyrimidine dimers in DNA initiate systemic immunosuppression in UV-irradiated mice. Proc Natl Acad Sci U S A. 1992 Aug 15;89(16):7516–7520. doi: 10.1073/pnas.89.16.7516. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kvam E., Tyrrell R. M. Induction of oxidative DNA base damage in human skin cells by UV and near visible radiation. Carcinogenesis. 1997 Dec;18(12):2379–2384. doi: 10.1093/carcin/18.12.2379. [DOI] [PubMed] [Google Scholar]
- Learn D. B., Beard J., Moloney S. J. The ultraviolet C energy emitted from FS lamps contributes significantly to the induction of human erythema and murine ear edema. Photodermatol Photoimmunol Photomed. 1993 Aug;9(4):147–153. [PubMed] [Google Scholar]
- Levins P. C., Carr D. B., Fisher J. E., Momtaz K., Parrish J. A. Plasma beta-endorphin and beta-lipoprotein response to ultraviolet radiation. Lancet. 1983 Jul 16;2(8342):166–166. doi: 10.1016/s0140-6736(83)90150-2. [DOI] [PubMed] [Google Scholar]
- Levy S. B. Dihydroxyacetone-containing sunless or self-tanning lotions. J Am Acad Dermatol. 1992 Dec;27(6 Pt 1):989–993. doi: 10.1016/0190-9622(92)70300-5. [DOI] [PubMed] [Google Scholar]
- Ley R. D. Ultraviolet radiation A-induced precursors of cutaneous melanoma in Monodelphis domestica. Cancer Res. 1997 Sep 1;57(17):3682–3684. [PubMed] [Google Scholar]
- Lock-Andersen J., Drzewiecki K. T., Wulf H. C. Eye and hair colour, skin type and constitutive skin pigmentation as risk factors for basal cell carcinoma and cutaneous malignant melanoma. A Danish case-control study. Acta Derm Venereol. 1999 Jan;79(1):74–80. doi: 10.1080/000155599750011778. [DOI] [PubMed] [Google Scholar]
- Marrot L., Belaidi J. P., Meunier J. R., Perez P., Agapakis-Causse C. The human melanocyte as a particular target for UVA radiation and an endpoint for photoprotection assessment. Photochem Photobiol. 1999 Jun;69(6):686–693. [PubMed] [Google Scholar]
- McCarthy E. M., Ethridge K. P., Wagner R. F., Jr Beach holiday sunburn: the sunscreen paradox and gender differences. Cutis. 1999 Jul;64(1):37–42. [PubMed] [Google Scholar]
- McGregor J. M., Berkhout R. J., Rozycka M., ter Schegget J., Bouwes Bavinck J. N., Brooks L., Crook T. p53 mutations implicate sunlight in post-transplant skin cancer irrespective of human papillomavirus status. Oncogene. 1997 Oct 2;15(14):1737–1740. doi: 10.1038/sj.onc.1201339. [DOI] [PubMed] [Google Scholar]
- Mintz B., Silvers W. K. Transgenic mouse model of malignant skin melanoma. Proc Natl Acad Sci U S A. 1993 Oct 1;90(19):8817–8821. doi: 10.1073/pnas.90.19.8817. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Moan J., Dahlback A., Setlow R. B. Epidemiological support for an hypothesis for melanoma induction indicating a role for UVA radiation. Photochem Photobiol. 1999 Aug;70(2):243–247. [PubMed] [Google Scholar]
- Morliere P., Moysan A., Tirache I. Action spectrum for UV-induced lipid peroxidation in cultured human skin fibroblasts. Free Radic Biol Med. 1995 Sep;19(3):365–371. doi: 10.1016/0891-5849(95)00043-w. [DOI] [PubMed] [Google Scholar]
- Pontén F., Berne B., Ren Z. P., Nistér M., Pontén J. Ultraviolet light induces expression of p53 and p21 in human skin: effect of sunscreen and constitutive p21 expression in skin appendages. J Invest Dermatol. 1995 Sep;105(3):402–406. doi: 10.1111/1523-1747.ep12321071. [DOI] [PubMed] [Google Scholar]
- Roelandts R. Shedding light on sunscreens. Clin Exp Dermatol. 1998 Jul;23(4):147–157. doi: 10.1046/j.1365-2230.1998.00353.x. [DOI] [PubMed] [Google Scholar]
- Rosenstein B. S., Weinstock M. A., Habib R. Transmittance spectra and theoretical sun protection factors for a series of sunscreen-containing sun care products. Photodermatol Photoimmunol Photomed. 1999 Apr;15(2):75–80. doi: 10.1111/j.1600-0781.1999.tb00060.x. [DOI] [PubMed] [Google Scholar]
- Routaboul C., Denis A., Vinche A. Immediate pigment darkening: description, kinetic and biological function. Eur J Dermatol. 1999 Mar;9(2):95–99. [PubMed] [Google Scholar]
- Routaboul C., Marguery M. C., Garigue J., Bazex J. Influence of UVA pre-exposure on UVB-induced erythema. A chromometric study. Photodermatol Photoimmunol Photomed. 1999 Apr;15(2):52–58. doi: 10.1111/j.1600-0781.1999.tb00057.x. [DOI] [PubMed] [Google Scholar]
- Roy C. R., Gies H. P., Lugg D. J., Toomey S., Tomlinson D. W. The measurement of solar ultraviolet radiation. Mutat Res. 1998 Nov 9;422(1):7–14. doi: 10.1016/s0027-5107(98)00180-8. [DOI] [PubMed] [Google Scholar]
- Sterenborg H. J., van der Leun J. C. Change in epidermal transmission due to UV-induced hyperplasia in hairless mice: a first approximation of the action spectrum. Photodermatol. 1988 Apr;5(2):71–82. [PubMed] [Google Scholar]
- Sterenborg H. J., van der Leun J. C. Change in epidermal transmission due to UV-induced hyperplasia in hairless mice: a first approximation of the action spectrum. Photodermatol. 1988 Apr;5(2):71–82. [PubMed] [Google Scholar]
- Stokes R., Diffey B. How well are sunscreen users protected? Photodermatol Photoimmunol Photomed. 1997 Oct-Dec;13(5-6):186–188. doi: 10.1111/j.1600-0781.1997.tb00227.x. [DOI] [PubMed] [Google Scholar]
- Strickland F. M., Kripke M. L. Immune response associated with nonmelanoma skin cancer. Clin Plast Surg. 1997 Oct;24(4):637–647. [PubMed] [Google Scholar]
- Sutherland B. M., Harber L. C., Kochevar I. E. Pyrimidine dimer formation and repair in human skin. Cancer Res. 1980 Sep;40(9):3181–3185. [PubMed] [Google Scholar]
- Szepietowski J., Wasik F., Szepietowski T., Włodarczyk M., Sobczak-Radwan K., Czyz W. Excess benign melanocytic naevi in renal transplant recipients. Dermatology. 1997;194(1):17–19. doi: 10.1159/000246050. [DOI] [PubMed] [Google Scholar]
- Therrien J. P., Rouabhia M., Drobetsky E. A., Drouin R. The multilayered organization of engineered human skin does not influence the formation of sunlight-induced cyclobutane pyrimidine dimers in cellular DNA. Cancer Res. 1999 Jan 15;59(2):285–289. [PubMed] [Google Scholar]
- Thompson S. C., Jolley D., Marks R. Reduction of solar keratoses by regular sunscreen use. N Engl J Med. 1993 Oct 14;329(16):1147–1151. doi: 10.1056/NEJM199310143291602. [DOI] [PubMed] [Google Scholar]
- Tyrrell R. M., Pidoux M. Action spectra for human skin cells: estimates of the relative cytotoxicity of the middle ultraviolet, near ultraviolet, and violet regions of sunlight on epidermal keratinocytes. Cancer Res. 1987 Apr 1;47(7):1825–1829. [PubMed] [Google Scholar]
- Tyrrell R. M. Ultraviolet radiation and free radical damage to skin. Biochem Soc Symp. 1995;61:47–53. doi: 10.1042/bss0610047. [DOI] [PubMed] [Google Scholar]
- Wagner S. N., Schultewolter T., Wagner C., Briedigkeit L., Becker J. C., Kwasnicka H. M., Goos M. Immune response against human primary malignant melanoma: a distinct cytokine mRNA profile associated with spontaneous regression. Lab Invest. 1998 May;78(5):541–550. [PubMed] [Google Scholar]
- Willis I., Cylus L. UVA erythema in skin: is it a sunburn? J Invest Dermatol. 1977 Mar;68(3):128–129. doi: 10.1111/1523-1747.ep12492440. [DOI] [PubMed] [Google Scholar]
- Wolf P., Donawho C. K., Kripke M. L. Effect of sunscreens on UV radiation-induced enhancement of melanoma growth in mice. J Natl Cancer Inst. 1994 Jan 19;86(2):99–105. doi: 10.1093/jnci/86.2.99. [DOI] [PubMed] [Google Scholar]
- Wood J. M., Jimbow K., Boissy R. E., Slominski A., Plonka P. M., Slawinski J., Wortsman J., Tosk J. What's the use of generating melanin? Exp Dermatol. 1999 Apr;8(2):153–164. doi: 10.1111/j.1600-0625.1999.tb00365.x. [DOI] [PubMed] [Google Scholar]
- Woollons A., Kipp C., Young A. R., Petit-Frère C., Arlett C. F., Green M. H., Clingen P. H. The 0.8% ultraviolet B content of an ultraviolet A sunlamp induces 75% of cyclobutane pyrimidine dimers in human keratinocytes in vitro. Br J Dermatol. 1999 Jun;140(6):1023–1030. doi: 10.1046/j.1365-2133.1999.02899.x. [DOI] [PubMed] [Google Scholar]
- Yarosh D. B., Kibitel J., Ullrich S. E., Kim T. H., Ananthaswamy H. N., Krien P., Fourtanier A., Kripke M. L. Direct comparison of DNA damage, isomerization of urocanic acid and edema in the mouse produced by three commonly used artificial UV light sources. Photochem Photobiol. 1999 May;69(5):571–574. [PubMed] [Google Scholar]
- Young A. R., Chadwick C. A., Harrison G. I., Nikaido O., Ramsden J., Potten C. S. The similarity of action spectra for thymine dimers in human epidermis and erythema suggests that DNA is the chromophore for erythema. J Invest Dermatol. 1998 Dec;111(6):982–988. doi: 10.1046/j.1523-1747.1998.00436.x. [DOI] [PubMed] [Google Scholar]
- Zerp S. F., van Elsas A., Peltenburg L. T., Schrier P. I. p53 mutations in human cutaneous melanoma correlate with sun exposure but are not always involved in melanomagenesis. Br J Cancer. 1999 Feb;79(5-6):921–926. doi: 10.1038/sj.bjc.6690147. [DOI] [PMC free article] [PubMed] [Google Scholar]
- de Gruijl F. R., Forbes P. D. UV-induced skin cancer in a hairless mouse model. Bioessays. 1995 Jul;17(7):651–660. doi: 10.1002/bies.950170711. [DOI] [PubMed] [Google Scholar]
- de Gruijl F. R., Van der Leun J. C. Estimate of the wavelength dependency of ultraviolet carcinogenesis in humans and its relevance to the risk assessment of a stratospheric ozone depletion. Health Phys. 1994 Oct;67(4):319–325. doi: 10.1097/00004032-199410000-00001. [DOI] [PubMed] [Google Scholar]
