A new surgical approach for the treatment of severe epithelial skin sun-induced damage.
BACKGROUND
Cutaneous photoageing is a complex biological process affecting all layers of the skin. Skin damage resulting from intrinsic ageing and extrinsic photoageing may trigger skin cancer. In patients with advanced photoageing and/or diffuse actinic damage, local therapy is often inadequate and the possibility of combined therapy needs to be assessed.


METHODS
Here we report three cases of patients over 75 years of age with advanced diffuse epithelial skin damage of photoexposed areas consisting of several superficial actinic keratoses, ipermelanotic lesions and multiple skin cancers.


METHODS
Neoplastic lesions and damaged skin were removed by superficial erbium laser ablation and the epidermis reconstructed with autologous epidermal sheets expanded in vitro from healthy cells obtained from unexposed areas of the body.


RESULTS
Our initial studies show that this procedure is very effective in the short term for treating and preventing the UV-induced skin cancer and precancerous lesions, and also suggest good long-term control of the disease with very interesting aesthetic results.
Pianigiani
E
E
Department of Dermatology and Skin Bank of Siena, Policlinico Le Scotte, Viale Bracci, 53100 Siena, Italy. pianigianie@unisi.it
Di Simplicio
F Cherubini
FC
Ierardi
F
F
Taddeucci
P
P
Andreassi
A
A
Fimiani
M
M
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D004848:Epithelium / Q000473:pathology / Q000528:radiation effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D015595:Skin Aging / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology / Q000517:prevention & control / Q000601:surgery; D016038:Skin Transplantation / Q000379:methods*; D013472:Sunlight / Q000009:adverse effects*; D014466:Ultraviolet Rays / Q000009:adverse effects*