Systemic Oxidative Stress Parameters in Skin Cancer Patients and Patients with Benign Lesions

Round 1

Reviewer 1 Report

Here the authors nicely summarize the published literature on oxidative stress in both benign and malignant skin cancers and conclude that these skin lesions have higher oxidative stress levels, and skin cancer therapies also affect the levels of oxidative stress. Although the information is not typically novel, this review is comprehensive and may serve as a good reference for the field. This Reviewer suggests the authors include a diagram summarizing the changes in the levels and the sources of oxidative stress between benign and malignant stages of skin cancer.

Author Response

Thank you for your effort and time dedicated to our manuscript. We have incorporated changes that reflect your suggestions and we present them point-by-point according to your concerns and comments.

Reviewer 1

Here the authors nicely summarize the published literature on oxidative stress in both benign and malignant skin cancers and conclude that these skin lesions have higher oxidative stress levels, and skin cancer therapies also affect the levels of oxidative stress. Although the information is not typically novel, this review is comprehensive and may serve as a good reference for the field. This Reviewer suggests the authors include a diagram summarizing the changes in the levels and the sources of oxidative stress between benign and malignant stages of skin cancer.

Thank you for your comments. We added a summarizing table and a bar charts figure concerning antioxidant enzyme levels, non-enzymatic antioxidants and  oxidative-damage molecules ( percentage of statistically significant disease vs control comparisons).This additions would make the message easier for the reader.

Reviewer 2 Report

The paper is very interesting, but it lacks in the organization. Namely, for a review paper, the Authors need some schemes to depict their most valuable ideas on a graphs (at least 3 for this paper). This would encourage the readers to cite the paper. 

Also some of the tables show data with "no significant difference detected" which could be moved to supplementary not to make the text look too crowdy. 

Otherwise a very nice work and valuable contribution to the field. 

Author Response

Thank you for your effort and time dedicated to our manuscript. We have incorporated changes that reflect your suggestions and we present them point-by-point according to your concerns and comments.

Reviewer 2

The paper is very interesting, but it lacks in the organization. Namely, for a review paper, the Authors need some schemes to depict their most valuable ideas on a graphs (at least 3 for this paper). This would encourage the readers to cite the paper. 

Thank you for your comments. We added a summarizing table and a bar charts figure ( with 3 graphs) concerning antioxidant enzyme levels, non-enzymatic antioxidants and oxidative-damage molecules (percentage of statistically significant disease vs control comparisons). This additions would make the message more clear for the reader.

Also some of the tables show data with "no significant difference detected" which could be moved to supplementary not to make the text look too crowdy. 

We preserved the no significance results as we think that they are important as by excluding non-significant results can introduce publication bias and create a distorted view of the field.  Also, we added a table that collects all the significant proved differences concerning the comparison between disease and control.

Otherwise a very nice work and valuable contribution to the field.

Reviewer 3 Report

The reviewed article is an extensive compilation of literature data on systemic oxidative stress parameters in patients with skin cancer or benign lesions. The authors presented the foundations of oxidative stress with a particular focus on dermatological aspects and skin tumors. The most important experimental data from individual publications were presented in tables in a clear and concise manner. However, it is worth additionally mentioning oxidative stress in skin cells induced by drugs and cosmetic products (e.g., doi: 10.3390/antiox10071008, doi: 10.3390/ph14080723). In my opinion, this issue is significant because there is an increasing discussion about the link between the use of certain drugs and the occurrence of skin tumors nowadays (e.g., doi: 10.2340/actadv.v103.3933). Moreover, in the abstract, the authors used the term "antioxidant enzyme capacities." I suggest replacing it with a more precise phrase, such as "levels" or "activity."

Minor editing of English language required.

Author Response

Thank you for your effort and time dedicated to our manuscript. We have incorporated changes that reflect your suggestions and we present them point-by-point according to your concerns and comments.

The reviewed article is an extensive compilation of literature data on systemic oxidative stress parameters in patients with skin cancer or benign lesions. The authors presented the foundations of oxidative stress with a particular focus on dermatological aspects and skin tumors. The most important experimental data from individual publications were presented in tables in a clear and concise manner.

However, it is worth additionally mentioning oxidative stress in skin cells induced by drugs and cosmetic products (e.g., doi: 10.3390/antiox10071008, doi: 10.3390/ph14080723). In my opinion, this issue is significant because there is an increasing discussion about the link between the use of certain drugs and the occurrence of skin tumors nowadays (e.g., doi: 10.2340/actadv.v103.3933).

You raised an important issue. We added a text from line 524 to 529 using the references you proposed and indicating the oxidative-stress-mediated cytotoxicity by cosmetics and certain drugs

Moreover, in the abstract, the authors used the term "antioxidant enzyme capacities." I suggest replacing it with a more precise phrase, such as "levels" or "activity."

We corrected the term, and we used the phrase you proposed