Sunlight-induced cancer: some new aspects and implications of the xeroderma pigmentosum model

Symptoms of xeroderma pigmentosum, a hereditary disease characterized by accelerated light-induced ageing of the skin, are due to deficiencies in the repair of damaged DNA. Following UV irradiation a high incidence of thioguanine-resistant mutations have been observed, which may be a model for the abnormally high incidence of freckling and benign and malignant transformation observed in these patients. Cells from patients with Cockayne's syndrome and trichothiodystrophy have also been shown to be hypermutable by UV radiation with a similar DNA repair defect, but unlike xeroderma pigmentosum patients they do not experience a higher incidence of skin cancer or freckling. An immunological defect may be a further crucial factor determining the dermatological symptoms of xeroderma pigmentosum patients. Much can be learned about the way normal individuals function from a study of aberrant functioning of individuals with defined genetic deficiencies. In the field of senescence of the skin, the disease xeroderma pigmentosum (XP) has been of particular value, as the exposed skin of these sun-sensitive individuals shows at an early age many of the features of aged sun-exposed skin of normal individuals. These features of XP skin include hyperkeratosis, freckling, benign lesions and malignant tumours, including melanomas. A full discussion of this syndrome has been given by Kraemer et al.