Tissue Stress and Tumor Promotion

• Cutaneous carcinomas often arise in patients with severe epidermolysis bullosa (or other cutaneous ulcers) at multiple primary sites. Chronic tissue stress thus appears to promote carcinogenesis in preexisting somatic mutants in a stem cell population. Altered contractile properties of fibroblasts cultured from skin with epidermolysis bullosa may result from an altered interaction of these cells with their surrounding, chronically stressed, connective tissue matrix. (Arch Dermatol1988;124:737-741)