Chronic onycholysis dramatically responds to enhanced intake of carotene-rich food.

was the cause of their melanoma, seven (11%) blamed sunbed use and 10 more (16%) did not exclude the possibility that exposure to UV radiation was the cause of their melanoma (Table 1). Males attributed their melanoma directly to the sun or sunbeds more often (32%) than females (22%). Patients who were more susceptible to the sun (fairskinned, blue eyes, blond hair) and had been sunburned frequently during childhood and adulthood were more likely to hold UV radiation responsible for their melanoma. Of those with skin type 1 and 2, 42% attributed their melanoma directly to the sun or sunbeds, whereas 43% of those with skin type 3 and 4 assumed the opposite, with an odds ratio of 3Æ3 (0Æ9–12Æ1). Comparing patients with a high level of education and patients with a lower level of education, 60% vs. 40%, respectively, mentioned UV radiation as a possible cause of their melanoma. Only two of five patients with melanomas on the most exposed areas of the body (head and neck) blamed exposure to the sun for their melanomas. In the category other , one patient mentioned the Chernobyl incident and two patients mentioned swimming in polluted water as a cause. The latter received a lot of attention in the media after it was listed as a risk factor for melanoma in a 1994 Dutch study. Four people assumed that they had a greater risk of developing melanomas because a relative had had (skin) cancer: a father with non-melanoma skin cancer, a grandmother with melanoma, two relatives with cancer of unknown type. Patient perception of the cause of their melanoma did not correlate with the reported number of sessions on sunbeds, tanning habits, or wearing protective clothing when in the sun. Although most scientists, health educators and physicians assume that melanomas are usually caused by exposure to the sun, only one-third of patients say that such exposure could have caused their melanomas; only in the group with a higher level of education was this percentage higher (60%). Most patients who blamed exposure to the sun for their melanoma had a sun-sensitive skin (skin type 1 abd 2) and had suffered more sunburns, during both childhood and adulthood. In an earlier case–control study cancer patients held less firm convictions about causative factors in the aetiology of cancer than did non-cancer patients and cancer patients listed God s will’ and Inherited more often as one of the top four causes of cancer. How can this discrepancy between real risks and risk perception be explained? Patients may not like the idea that their behaviour could have caused the melanoma. By endorsing other explanations that are beyond their control, they avoid blaming themselves. However, patients who easily get sunburnt were more familiar with the harmful effects of the sun and more likely to mention the sun as a risk factor. People with a less sensitive skin type may be less familiar with the adverse effects of UV radiation and therefore assume that exposure to the sun is harmless, despite the fact that the dangers of exposure to the sun have been reported extensively in the media.