Prevalence of premalignant and malignant skin lesions in oculocutaneous albinism patients

SUMMARY OBJECTIVE: Oculocutaneous albinism describes a group of pigmentary disorders that lead to skin sensitivity and predisposition to skin malignances. Aims: To analyze clinical and epidemiological data in oculocutaneous albinism patients and to determine the prevalence of malignant skin lesions, assessing possible risk factors for skin cancer. METHODS: Cross-sectional study evaluating epidemiological data, habits of sun exposure and sun protection, and clinical examination of albino patients followed in a reference dermatology outpatient clinic in Brasil. Our primary outcome was the occurrence of malignant skin lesions in biopsied tissues. RESULTS: Of 74 patients analyzed, 11 (15%) had one or more suspicious lesions and were biopsied, of which 8 (72.7%) patients presented with basal cell carcinomas, 7 (63.3%) presented with squamous cell carcinoma, and 1 (9%) presented with melanoma. Moreover, 32(43%) patients presented with actinic keratosis. Age, female gender, previous history of sunburn, history of malignant lesions and history of sun exposure without photoprotection were associated with the presence of malignant lesions. Limitations: Unicentric, non-aleatory sample. CONCLUSIONS: There was a high prevalence of malignant and pre-malignant lesions in this population. Some potentially modifiable risk factors were associated with the occurrence of malignant skin lesions.

Knowledge and habits of sun exposure in university students: a cross-sectional study in Southern Brazil

Abstract BACKGROUND: Excessive sun exposure is the major risk factor for skin cancer. Thus, sun exposure behavior is the major focus for prevention of this disease, since it is potentially modifiable. Increasing the knowledge on sun related habits and other skin cancer risk factors is fundamental in the development of preventive programs, especially when directed to young people. OBJECTIVES: To assess the photoprotection habits and the knowledge about skin cancer in college students. METHODS: We conducted a cross-sectional study from Oct. 16 to Feb. 17, including 371 students from the Federal University of Santa Maria, RS, Brazil, through a self-administered questionnaire. RESULTS: The level of knowledge about skin cancer and photoprotection was unsatisfactory in more than 10% of the students. The occurrence of sunburn was extremely high among students, and 25% reported at least one episode of second degree sunburn. Proper use of sunscreen was referred by only 34% of individuals. Students who reported having received photo education in college were associated with a more consistent use of sunscreen. STUDY LIMITATIONS: health area represented a large part of the sample; instrument validated outside Brazil. CONCLUSIONS: Young people are unaware of basic information about sun protection and exposure. Even among those with proper knowledge, the use of photoprotective measures is very low. The sun exposure has shown to be excessive in most of the students, which makes this population an important target for photo-educational measures.

Recent advances in layered double hydroxides applied to photoprotection / Recentes avanços dos hidróxidos duplos lamelares aplicados à fotoproteção

ABSTRACT Layered double hydroxides have received more attention from researchers due to their range of applications, ease of synthesis and low cost of production. With broader knowledge about solar radiation effects on the body, the use of sunscreens has become even more important. The ability of some nanostructures, such as layered double hydroxides, to act as matrices has made it possible to obtain improvements in photoprotective formulations, with solutions to problems caused by radiation and sunscreens. This review article brings together the most recent advances of these clays, the layered double hydroxides, applied to photoprotection.

RESUMO Os hidróxidos duplos lamelares vêm ganhando maior atenção de pesquisadores, em decorrência da gama de aplicações, da facilidade de síntese e do baixo custo de produção. Com o crescente conhecimento sobre diversos efeitos da radiação solar sobre o organismo, a utilização de fotoprotetores tem se tornado indispensável. A capacidade de nanoestruturas, como os hidróxidos duplos lamelares, atuarem como matrizes possibilitou melhorias nas formulações fotoprotetoras, tendo em vista os problemas provocados pela radiação, bem como por alguns filtros solares. Este artigo de revisão reúne os avanços mais recentes destas argilas, os hidróxidos duplos lamelares, aplicados à fotoproteção.

Conocimientos, hábitos y actitudes de fotoprotección en adolescentes / Knowledge, habits, and attitudes of photoprotection in teenagers

Introducción: el cáncer de piel es una neoplasia frecuente en el ser humano a nivel mundial, su incidencia se ha incrementado durante las últimas décadas, considerado como una expresión de hábitos de mayor exposición a radiaciones ultravioletas. Entre el 60% y 80 % de la exposición solar a lo largo de la vida tiene lugar antes de la edad de 18 años. Los niños y adolescentes son los más vulnerables a la radiación, debido a que el daño solar es máximo y acumulativo. Objetivo: describir los conocimientos, hábitos y actitudes de fotoprotección en escolares del nivel secundario. Material y métodos: se realizó un estudio descriptivo, transversal en adolescentes de la Escuela Secundaria Básica Cándido González, ubicada en la localidad ¨La Playa¨, municipio Matanzas, en el periodo de febrero a marzo del 2017. El universo quedó constituido por la totalidad de los estudiantes que cursan el séptimo y octavo grado (259). Resultados: se encontró un predominio del fototipo cutáneo III en la población de estudio. En cuanto a los conocimientos sobre fotoprotección y fotodaño, 195 estudiantes (75,3%) fueron evaluados de mal. El 65,6% de los adolescentes refirieron usar cremas de protección solar. En relación con la actitud ante el bronceado, se observó que fue adecuada en 240 alumnos (92,7%). Conclusiones: los malos conocimientos sobre fotoprotección y fotodaño de los alumnos encuestados pueden estar relacionados a hábitos inadecuados e historias de quemadura solar encontrados (AU).

Introduction: skin cancer is a frequent neoplasia in the human being all around the world; its incidence has increased during the last decades, fact that is considered as an expression of habits of more exposition to ultraviolet radiations. Between 60 % and 80 % of the exposition to sunlight throughout the live occurs before the age of 18 years. Children and teenagers are the most vulnerable to radiation due to the fact that sun damage is maximal and accumulative. Objective: to describe knowledge, habits and attitudes of photoprotection in students of the secondary level. Materials and methods: a descriptive, cro0ss-sectional study was carried out in teenagers of the Secondary School ¨Candido González¨, located in La Playa, municipality of Matanzas, in the period from January to March 2017. The universe was formed by all the students attending the 7th and 8th grade (259). Results: the skin phototype III predominated in the studied population. According to knowledge on photoprotection and photodamage, 195 students (75.3 %) were evaluated as bad. 65.6 % of teenagers referred the usage of sun protective creams. In relation with the attitude toward sun tanning, it was adequate in 240 students (92.7 %). Conclusions: the erroneous knowledge on photoprotection and photodamage of the questioned students could be related to inadequate habits and histories of sunburn they listened (AU).

Photoprotection in adolescents: what they know and how they behave

Abstract: Background: The greatest sun exposure occurs until adolescence and this is the only factor involved in photocarcinogenesis subject to modification with photoprotection. Objective: The objective of this study was to evaluate the habits and knowledge of adolescents regarding photoprotection. Method: Cross-sectional study that included 512 students from primary and high school. Data were collected by questionnaires with questions about habits and knowledge on sun protection. For data analysis, Pearson's Chi-square test and Yates test were applied, with 5% level of significance. Results: We evaluated 512 students, with a mean age of 14 years old. The teenagers agreed that ultraviolet rays cause skin cancer and aging (96% and 70%, respectively). Knowledge about the occurrence of burns even on cloudy days was recorded in 68% of cases, as well as the need for photoprotection for sports in 72%. The source of information about sun protection were by parents in 55%. In 70% was observed previous occurrence of sunburn, the daily use of sunscreens was found in 15% and 67% used only at the beach. of sunscreens with SPF higher than 30 was reported by 70% of students and 57% reported going to the beach between 10h and 16h. In 68% of cases it was registered insufficient sun protection, attributed, in 57% of the time to forgetfulness. Study limitations: The sample refers to two schools of Curitiba (PR), Brazil. Conclusion: Teenagers know the risks of sun exposure, but they do not adopt the practices for adequate protection.

Queilite actínica: relato de caso / Actinic cheilitis: case report

A Queilite Actínica (QA) é uma condição clínica que acomete o vermelhão do lábio inferior intimamente relacionada com com exposição excessiva à luz solar. Geralmente acomete o sexo masculino acima de 45 anos. O caso apresenta um paciente gênero masculino, leucoderma, 59 anos, com lesão de atrofia da borda do vermelhão do lábio inferior, superfícies lisas, manchas eritroleucoplásicas, limites nítidos e formato irregular. O diagnóstico clínico foi de Queilite Actínica. A biópsia incisional foi conduzida e apresentou microscopicamente um epitélio estratificado pavimentoso hiperqueratinizado com áreas de acantose, a lâmina própria era fibrosa, exibia infiltrado inflamatório crônico e uma faixa basofílica amorfa e acelular consistente com elastose solar proeminente e um quadro de Displasia Moderada. O tratamento proposto foi a vermelhectomia, mas houve recusa do paciente em realizar esse procedimento. Diante das alterações, percebe-se a importância do cirurgião- dentista na precisão do diagnóstico precoce e tratamento, impedindo a transformação maligna da lesão. (AU)

Actinic cheilitis (AC) is a common clinical condiction which affects the lower lip vermilion closely related to excessive exposure to sunlight. Usually affects males above 45 years. The case features a male patient, leucoderma, 59, edge of atrophic lesion of the lower lip vermilion, smooth surfaces, eritroleucoplásicas spots, clear limits and irregular shape. The clinical diagnosis was Actinic cheilitis. The incisional biopsy was conducted and microscopically presented a stratified epithelium hiperqueratinizado with areas of acanthosis, the lamina propria was fibrous, showed chronic inflammatory infiltrate and basophilic amorphous band and acellular consistent with prominent solar elastosis and Dysplasia Moderate frame. The proposed treatment was vermilionectomy but was patient refusal to perform this procedure. Faced with the changes, we see the importance of dental surgeon on the accuracy of early diagnosis and treatment, preventing malignant transformation of the lesion. (AU)

Estudo retrospectivo dos pacientes portadores de melanoma cutâneo atendidos na Universidade Federal de São Paulo / Retrospective study of patients with cutaneous melanoma treated at the Federal University of São Paulo

RESUMO Objetivo: avaliar as características dos pacientes portadores de melanoma cutâneo atendidos no Hospital São Paulo - UNIFESP. Métodos: estudo retrospectivo de 184 casos de melanoma cutâneo. Foram analisadas as informações sobre sexo, idade, características do tumor, características histológicas e estadiamento. Resultados: a média de idade ao diagnóstico foi de 58,7 anos, com distribuição etária homogênea entre os sexos e predominância em indivíduos brancos (70,6%). Observou-se acometimento predominante de tronco, em homens (36,7%), e de membros inferiores, em mulheres (42%). A exposição solar, com queimaduras, foi mais comum entre homens (31,2%) do que entre mulheres (23,5%). Houve aumento de aproximadamente três vezes no acometimento linfonodal quando o índice mitótico subia de zero (11,9%) para uma ou mais mitoses por campo (36,2%), e aumento progressivo do acometimento linfonodal e de desfechos ruins quanto maior a espessura de Breslow: 10,2% quando menor do que 1mm e 59,2% quando maior do que 4mm. Conclusão: as características dos pacientes portadores de melanoma cutâneo atendidos no Hospital São Paulo são semelhantes às encontradas na literatura.

ABSTRACT Objective: to evaluate the characteristics of the patients with cutaneous melanoma treated at the São Paulo Hospital - UNIFESP. Methods: we conducted a retrospective study of 184 cases of cutaneous melanoma. We analyzed information on gender, age, tumor characteristics, histological characteristics and staging. Results: mean age at diagnosis was 58.7 years, with homogeneous age distribution between genders and predominance in white individuals (70.6%). There was a predominance of trunk involvement in men (36.7%) and lower limbs in women (42%). Sun exposure, with sunburns, was more common among males (31.2%) than among females (23.5%). There was an approximately three-fold increase in lymph node involvement when the mitotic index rose from zero (11.9%) to one or more mitosis per field (36.2%). In addition, the greater the Breslow thickness, the greater the lymph node involvement and poor the outcomes: 10.2% when less than 1mm and 59.2% when greater than 4mm. Conclusion: the characteristics of patients with cutaneous melanoma treated at Hospital São Paulo are similar to those found in the literature.

Skin cancer risk perception and sun protection behavior at work, at leisure, and on sun holidays: a survey for Danish outdoor and indoor workers

BACKGROUND@#To prevent occupational skin cancer, it is essential that the sun-protective behavior of outdoor workers is adequate. The aim is to study the sun-protective behavior of Danish outdoor workers at work, at leisure, and on sun holiday and compare it to that of indoor workers.@*METHODS@#This is a cross-sectional study, based on a 53-item survey completed by Danish outdoor (n = 380) and indoor workers (n = 119) in 2016-2017. Status as outdoor or indoor worker was decided based on self-report and behavioral differences were tested using (paired) t tests and multiple regression adjusted for age, sex, educational level, history of smoking, and skin type.@*RESULTS@#Danish outdoor workers at work use sun protection less than they do at leisure and on sun holiday (α  80.0% agree that risk of skin cancer is reduced by the use of sun protection, and only 4.0% dismiss the possibility of sun protection use at work.@*CONCLUSIONS@#Skin cancer risk and use of sun protection at work are largely neglected in Danish outdoor workers, more so than at leisure and on sun holiday where their risk behavior resembles that of indoor workers. This indicates an untapped workplace preventive potential.

Reticulohistiocitosis multicéntrica de inicio súbito por quemadura solar / Multicentric reticulohistiocytosis, sudden onset after sunburn

Las reticulohistiocitosis son un grupo de enfermedades muy poco frecuentes que se caracterizan por la acumulación de histiocitos en piel y articulaciones principalmente. Se suelen asociar a condiciones y patologías muy variadas, predominantemente neoplasias. Presentamos un caso de inicio súbito luego de quemadura solar (AU)

Reticulohisticytosis is a group of diseases characterized by the accumulation of cells of histiocytic lineage primarily in the skin and joints. They have been associated with many conditions and diseases, mainly malignant neoplasms. A case of multicentric reticulohitiocytosis of sudden onset after sunburn is reported (AU)

Photoprotective effect of verbascoside from Buddleja cordata in SKH-1 mice exposed to acute and chronic UV-B radiation / Efecto fotoprotector del verbascósido de Buddleja cordata en ratones SKH-1 expuestos de forma aguda y crónica a laradiación UV-B

Ultraviolet radiation (UVR) is involved in both sunburn and the development of skin cancer, which has a high incidence worldwide. Strategies to reduce these effects include the use of photoprotective substances. The aim of this work was to investigate the photoprotective effect of verbascoside isolated from the methanolic extract of Buddleja cordata (BCME) in SKH-1 mice exposed to acute and chronic UV-B radiation. The mouse dorsal area was evaluated macroscopically and microscopically for diagnosis; verbascoside penetration into mouse skin was investigated in vivo by the tape stripping method. After acute UV-B exposure, 100 percent of irradiated mice that had been protected with verbascoside showed no signs of sunburn or of inflammatory processes. After chronic exposure, 100 percent of unprotected mice showed skin carcinomas; in contrast, in mice topically treated with either BCME or verbascoside, the presence of lesions was decreased by 90 percent. These results prove that verbascoside penetrates through the skin of mice and suggest that verbascoside and BCME may potentially prevent photodamage on mice’s skin after acute and chronic UVR exposure.

La radiación ultravioleta (RUV) provoca quemaduras solares y el desarrollo de cáncer de piel. El objetivo de este trabajo fue investigar el efecto fotoprotector del verbascósido obtenido del extracto metanólico de Buddleja cordata (EMBC) en ratones SKH-1 expuestos a RUV-B de manera aguda y crónica. El diagnóstico histológico se llevó a cabo en la piel de la zona dorsal de los ratones. La penetración del verbascósido fue cuantificada mediante la técnica de la cinta adhesiva. En el experimento agudo, el 100 por ciento de los ratones protegidos con verbascósido no evidenciaron signos de quemadura ni procesos inflamatorios. En el experimento crónico los ratones sin protección e irradiados presentaron carcinomas cutáneos. En contraste en los ratones protegidos con EMBC o verbascósido las lesiones disminuyeron un 90 por ciento en ambos grupos. El verbascósido penetró en la piel del ratón. Los resultados sugieren que el EMBC y el verbascósido previenen el fotodaño en la piel de ratones expuestos de forma aguda o crónica a la RUV.

Hábitos de fotoprotección en los niños que concurren a Dermatología Pediátrica del Centro Hospitalario Pereira Rosell: Photoprotective habits in children seen at the Pediatric Dermatology Unit of CHPR / Photoprotective habits in children seen at the Pediatric Dermatology Unit of CHPR

Introducción: la exposición a la radiación ultravioleta durante la infancia y la adolescencia juega un papel trascendente en el desarrollo futuro del cáncer de piel. Los niños se exponen al sol tres veces más que los adultos y antes de los 21 años se ha recibido entre el 50 y el 80 % de la radiación solar total. Objetivo: conocer qué saben los padres de la población objetivo sobre los efectos del sol en la piel y los ojos, y cuáles son sus hábitos de fotoprotección, los de sus hijos y los factores relacionados con ello. Métodos: estudio transversal a padres de niños que concurrieron a la policlínica de Dermatología Pediátrica del Centro Hospitalario Pereira Rossell durante los meses de octubre 2013 a enero 2014. Resultados: se entrevistó a un total de 100 padres, la media de edad de los hijos fue de 7,85 años, el 62% de los niños eran provenientes de familias de bajo nivel socioeconómico y educacional. El 43% de los encuestados respondió que le gusta estar bronceados, en comparación con un 28% que no le gusta. La medida de fotoprotección más utilizada tanto por padres (73%) como por hijos (86%) fue el protector solar, seguida de los lentes de sol en los adultos y del uso rutinario de sombrero en los niños. Conclusiones: los métodos utilizados se basan en gran medida en el uso de protectores solares con un uso inadecuado de los mismos en gran parte de los encuestados.

Introduction: exposure to ultraviolet radiation during childhood and adolescence plays an important role in the future development of skin cancer. Children are three times more sun exposed than adults. Before age 21, people receive between 50 and 80% of the total solar radiation throughout their lives. Objective: to determine what parents know about the impact of the sun on the skin and eyes, and to learn about their photoprotective habits for them and their children and some associated factors. Methods: a cross-sectional study to parents of children who were seen at the Pediatric Dermatology Unit of CHPR during the months of October 2013 to January 2014. Results: a total of 100 surveys were conducted, the average age of the children was 7.85 years old, 62% of the children came from families of low socioeconomic status. 43% of respondents declared who like to be tan, compared to 28% who did not like it. The most widely used photoprotective measure by both parents (73%) and children (86%) was sunscreen, followed by sunglasses in adults and the routine use of a cap by children. Conclusions: the photoprotection method used is based largely, on sunscreen but with an improper use in most of the respondents.

Práticas de exposição e proteção solar de jovens universitários / Prácticas de exposición y protección solar de jóvenes universitários / Exposure and sun protection practices of university students

RESUMO Objetivo: conhecer práticas de exposição e proteção solar de jovens universitários. Método: estudo descritivo, transversal, realizado em uma universidade de São Paulo. Resultados: a amostra foi composta por 385 jovens e a coleta de dados realizada por meio de formulário. Do total, 239 (62%) jovens classificaram-se como fototipo III e IV e 69 (17,9%) afirmaram ter histórico de câncer de pele na família. A maioria afirmou exposição ao sol entre as 10 e 16 horas e por mais de uma hora de duração; 112 (29,1%) informaram não empregar meios de proteção. Dentre os que utilizam protetor solar, a minoria o faz regularmente. Conclusão: embora a amostra tenha sido constituída por pessoas com maior acesso a informações, constatou-se exposição e proteção solar de modo impróprio. Ações educativas, individuais e coletivas devem ser fortalecidas e priorizadas tendo em vista a incidência de câncer de pele no país.

RESUMEN Objetivo: conocer las prácticas de exposición y de protección solar de jóvenes universitarios. Método: estudio descriptivo, transversal, realizado en una universidad de São Paulo. Resultados: la muestra estuvo constituida por 385 jóvenes y la colecta de datos realizada a través de formulario. Del total, 239 (62%) jóvenes fueron clasificados como tipo de piel III y IV y 69 (17,9%) afirmaron tener cáncer de piel en la historia familia. La mayoría afirma exposición al sol entre las 10 y 16 horas y durante más de una hora; 112 (29,1%) reportaron no emplear métodos de protección. Entre los que usan protector solar, la minoría lo hace regularmente. Conclusión: a pesar de que la muestra haya sido constituída por personas con mayor acceso a informaciones, se constató exposición y protección solar de manera impropia. Acciones educativas, individuales y colectivas deben fortalecerse y priorizarse teniendo en cuenta la incidencia de cáncer de piel en el país.

ABSTRACT Objective: to learn exposure and sun protection practices for university students. Method: a descriptive, cross-sectional study performed at a university in São Paulo. Results: the sample consisted of 385 young and data collection conducted through a form. Of the total, 239 (62%) young people were classified as skin type III and IV and 69 (17.9%) affirmed to have a history of skin cancer in the family. Most affirmed exposure to the sun between 10 a.m and 04 p.m and for more than one hour; 112 (29.1%) informed not employ safeguards. Among those who use sunscreen, the minority does so regularly. Conclusion: although the sample was made up of people with greater access to information, it was found exposure and sunscreen improperly. Education, individual and collective actions should be strengthened and prioritized given the incidence of skin cancer in the country.

Conocimiento y actitud frente a exposición solar del personal de salud en Atención Primaria, comuna Recoleta, Santiago, Chile / Knowledge and attitude regardings sun exposure in the workers from primary health care, district of Recoleta, Santiago, Chile

Skin cancer rates have increased worldwide despite the current prevention measures. It’s crucial to evaluate people’s knowledge, attitudes, and behaviour regarding sun exposure. Objective: To assess the knowledge and attitudes regarding sun exposure in the workers from primary health care. Method: 223 workers from three Family Care Centres(CESFAM) and from one Primary Emergency Service (SAPU) in the district of Recoleta were surveyed between the months of October and November 2015. Fisher’s exact test and Chi square test were used for statistic analysis. The survey included questions about demographic variables, knowledge of the association between sun radiation/skin cancer and attitudes towards sun protection. Results: the sample consists of 74 men and 149 women, with a mean age of 37 years ±SD 7.9. Phototype III was the most common (41.3percent). The majority of the surveyed declared to be aware of the association between sun exposure and skin cancer (93.3percent). As photoprotecting measures, sunscreens (87.4percent) and seeking shade (71.3percent) were the most frequently measures used. Regarding sunburns, 91.9percent declared to have at least one during their lifetime, 21.5percent occurring during the previous summer. As to the use of sunscreen, 42.1percent referred only using while at the pool / beach and 12.6percent declared not to use it at all. As for health promotion, 29.1percent declared they never recommend the use of sun protection measures in their working practice. Discussion: Although there is adequate knowledge regarding the effects of sun exposure, it doesn’t always reflect on favourable attitudes and photoprotecting measures. There was a significantly greater amount of females with adequate knowledge and use of sun protection measures. This study is one of the first to assess photoprotection behaviour in health care workers.

Knowledge, attitudes and practices concerning sun exposure and sun protection among adult triathletes in Metro Manila, Cebu and Davao City, Philippines: A cross-sectional study

BACKGROUND: Ultraviolet radiation is a major modifiable risk factor for aging and skin cancer. Studies assessing knowledge, attitudes and practices towards sun exposure and protection should be conducted on high-risk groups like the triathlete community. OBJECTIVES: To assess the knowledge, attitudes, and practices regarding sun exposure and protection among triathletes in Manila, Cebu and Davao City. To determine if these are associated with demographic characteristics, and if knowledge and attitudes are correlated with protective practices. METHODS: This was a cross-sectional study conducted among adult triathletes evaluating their knowledge, attitudes and practices concerning sun exposure and protection, using a self-administered e-questionnaire. RESULTS: There were 120 respondents. Almost half of the respondents had inadequate knowledge scores, while majority (83%) had desirable attitudes. Having at least a college degree significantly increased the odds ratio of having a desirable attitude (OR 6.0, 95% CI 1.36-26.45). Only 37.5% of the participants practiced good sun protection. Triathletes with Fitzpatrick III phototype had significantly increased odds ratio of having adequate sun protection practices (OR 2.22; 95% CI 1.04-4.72), while higher socioeconomic status was associated with poor protection practices (OR 0.42, 95% CI 0.19-0.90). Only 32.5% of the participants had adequate KAP scores combined. CONCLUSION: Even though more than half of the respondents had limited knowledge scores, most of them had desirable attitudes towards sun protection. Athletes with adequate knowledge and desirable attitude were more likely to exhibit adequate practice. These findings indicate the pressing need for public health strategies on sun protection for the triathlete community.

Ações extensionistas voltadas para a prevenção de queimaduras solares: relato de experiência / Acciones de extensión dirigidas a prevenir las quemaduras solares: relato de experiencia / Extension actions towards the prevention of sunburn: experience report

Objetivou-se relatar a experiência de ações educativas visando à prevenção de queimaduras, principalmente as queimaduras solares. A atividade ocorreu em uma praia no interior do Estado de Rio Grande do Sul e atingiu, aproximadamente, 550 pessoas que foram abordadas face-a-face, sendo orientadas quanto aos riscos de queimaduras solares, horários seguros de exposição ao sol e acessórios que contribuem para a proteção. Também foram mencionadas formas de agir frente aos danos causados pela intensa exposição aos raios solares, e queimaduras eventuais por meio de toxinas das lagartas e cnidários. Conclui-se que atividades como estas, além de auxiliar na assistência integral à população, contribuem com o desempenho do papel social e aprendizado dos acadêmicos de enfermagem, futuros profissionais integrantes da equipe multiprofissional de saúde.

This study was aimed to experience the educational actions focusing on the prevention of burnings, mainly sunburn. The activity was carried out in a beach at the countryside of the State of Rio Grande do Sul, and attained approximately 550 persons, which were personally approached, and oriented about the sunburn risks, safe time to sun exposure, and accessories that contribute to protection. Moreover, forms to act towards the damage caused by the intense exposure to sun, and eventual burnings throughout toxins of caterpillars and cnidarians were mentioned. It is possible to conclude that activities such as these contribute to the performance of the nursing students’ social role and learning, who are the future professionals that will compose the multidimensional health team.

El objetivo fue relatar la experiencia de acciones educativas para la prevención de quemaduras, principalmente las quemaduras solares. La actividad fue desarrollada en una playa del interior del Estado de Rio Grande del Sur y atendió, aproximadamente, 550 personas que fueron abordadas directamente, siendo orientadas en relación a los riesgos de las quemaduras solares, horarios seguros de exposición al sol y accesorios que contribuyen con la protección. También fueron mencionadas formas de actuar frente a los daños causados por la intensa exposición a los rayos solares, y quemaduras eventuales por medio de toxinas de gusanos e cnidarios. Actividades como estas, además de contribuir con la asistencia integral de la populación, contribuyen con el desempeño del papel social y aprendizaje de los estudiantes de enfermería, futuros profesionales integrantes del staff multiprofesional de salud.

A Survey of Attitudes, Knowledge, and Behavior Regarding Sun Exposure and Sunscreen in Korea / 대한피부과학회지

BACKGROUND: Although sunscreen is used as a primary strategy for the prevention of sunburn, photoaging, and skin cancer, few people regularly use sunscreen. OBJECTIVE: To investigate awareness regarding the effects of sunlight, the extent of sun exposure, and sunscreen use behaviors in Korean subjects. METHODS: A questionnaire was administered to 467 adult patients who visited the Dermatology Department at Seoul National University Boramae Hospital. The questionnaire covered demographic characteristics, causes of wrinkles, sunspots, and skin cancer, awareness of the harmful effects of sun exposure, perceived and actual extent of sun exposure, and the use of sun-protective methods including sunscreen. RESULTS: Sun exposure was selected as the major cause of age spots (60.6%), skin cancer (60.9%), and wrinkles (25.9%). Respondents were likely to underestimate the extent of sun exposure. On average, quite a few respondents stated that they were exposed to sunlight for more than one hour per day (22.7% on weekdays, 52.4% on weekends). However, only 9.4% of respondents thought that their sun exposure was problematic and 62.7% of respondents considered moderate sunlight exposure healthy. Respondents' sun-protective behaviors were inadequate: only 29.8% used sunscreen regularly, and 16.5% have never used sunscreen. SPF was the most important factor in choosing sunscreen, and 83.3% used a sunscreen with a labeled SPF over 30. By contrast, only 34.6% of respondents used PA+++ sunscreen. CONCLUSION: Despite fairly good knowledge regarding the harmful effects of sunlight, subjects underestimated the risks of their sun exposure and sun-protective behaviors were suboptimal. Education on the risk of UV exposure and effects of sunscreen is still needed.

Brazilian Consensus on Photoprotection

Brazil is a country of continental dimensions with a large heterogeneity of climates and massive mixing of the population. Almost the entire national territory is located between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the south certainly makes Brazil one of the countries of the world with greater extent of land in proximity to the sun. The Brazilian coastline, where most of its population lives, is more than 8,500 km long. Due to geographic characteristics and cultural trends, Brazilians are among the peoples with the highest annual exposure to the sun. Epidemiological data show a continuing increase in the incidence of non-melanoma and melanoma skin cancers. Photoprotection can be understood as a set of measures aimed at reducing sun exposure and at preventing the development of acute and chronic actinic damage. Due to the peculiarities of Brazilian territory and culture, it would not be advisable to replicate the concepts of photoprotection from other developed countries, places with completely different climates and populations. Thus the Brazilian Society of Dermatology has developed the Brazilian Consensus on Photoprotection, the first official document on photoprotection developed in Brazil for Brazilians, with recommendations on matters involving photoprotection.

Frecuencia de insuficiencia de Vitamina D en adultos jóvenes sanos de Asunción / Frequency of Vitamin D insufficiency in healthy young adults of Asunción

La insuficiencia de vitamina D sérica se asocia a diversos trastornos, con alta prevalencia a nivel regional y mundial. En nuestro país no existen estudios publicados al respecto. En este estudio observacional, descriptivo, con componente analítico se determinaron niveles de vitamina D y prevalencia de su insuficiencia en jóvenes y se indagó posibles asociaciones con factores de riesgo conocidos como la falta de exposición solar, uso de protectores solares, y falta de consumo de alimentos ricos en vitamina D. Fueron incluidos 100 estudiantes y funcionarios del Hospital de Clínicas de la Universidad Nacional de Asunción, a quienes se les tomó una muestra de sangre y llenaron un cuestionario. Los niveles de vitamina D fueron determinados por el método ECLIA (inmunoensayo de electro quimioluminiscencia). Las edades estaban entre 20 y 30 años, el 69% era del sexo femenino. La concentración media ± desvío estándar de vitamina D fue de 17,6 ± 6,25 ng/dl (rango: 4-38). El 53% de los participantes presentaba insuficiencia (10 a 20 ng/dL) y 11% deficiencia (<10 ng/dL) de vitamina D. Aunque los participantes que reportaron consumir lácteos y no utilizar protectores solares tuvieron mayores niveles de vitamina D, la diferencia no fue estadísticamente significativa. Se encontró una frecuencia elevada de insuficiencia de vitamina D en esta población, en concordancia con los hallazgos de estudios similares a nivel mundial y regional. Se recomienda la suplementación con vitamina D en la población de manera a prevenir los trastornos asociados con la deficiencia de esta vitamina.

Insufficientserum vitamin D is associated with various disorderswith highprevalence at global and regional levels. In our country,there are notpublishedstudiesrelated to this matter.Inthisdescriptive,observational studywithanalytical component,thelevels ofvitamin Dand the prevalence of its insufficiencywere determined in young peopleand also thepossible associations with knownriskfactors likesun exposure, sunscreen useand lack ofconsumption ofvitamin D-enrichedfoodswere analyzed.One hundred medical students andmembers of thestaff of theHospital de Clinicas ofthe National University of Asuncion, Paraguaywere included.Participants wereaged 20to30 yearsand69%of them werewomen.The mean concentrationof vitamin Dwas 17.6 ± 6.25 ng/dl (range: 4-38);53% oftheparticipants had insufficientlevelsof vitamin D(10-20 ng/dL) and 11%had vitamin Ddeficiency (less than 10 ng/dL).Althoughtheindividuals whoreportedconsumption of dairyproductsand non-use of sunscreenhad higher levels ofvitamin D,thedifferencewas not statistically significant. A high frequency ofvitamin D insufficiency was foundin this population in agreementwith similarstudiescarried outatworldwideandregionallevels.Vitamin D supplementationisrecommendedin thepopulation to prevent disorders associated withthedeficiency.

Hábitos solares, queimaduras e fotoproteção em atletas de meia maratona / Solar exposition, burns and photoprotection in half marathon athletes

Meia maratona é competição desenvolvida ao ar livre, considerada como prática em expansão e de grande exposição solar. Verificar hábitos solares e frequência de queimaduras em atletas de meia maratona. Estudo transversal de 220 atletas, de ambos os sexos, de 18 a 68 anos, que participaram da meia maratona de setembro de 2012, na cidade de Curitiba-PR. Todos preencheram questionário sobre lesões cutâneas, bem como hábitos de exposição e proteção solar. Utilizou-se a análise de freqüência para descrever as prevalências, sendo que para as associações foram aplicados os testes de Qui-quadrado. Predominou atletas masculinos, adultos, praticantes de corrida de longa distância, procedentes do sul do Brasil (86,3%), e com pele branca (74%). Cerca de 13,2% dos atletas declararam alta sensibilidade da pele e facilidade de se queimar quando exposto ao sol. A maior adesão ao filtro solar foi verificada no sexo feminino, que apresenta frequência de aplicações diárias em maior proporção do que os homens. A prevalência de queimadura solar não se mostrou significativamente associada ao sexo (15% homens e 20,4% mulheres, p=0,359; x2=0,839). Neste grupo de atletas, identificou-se que os hábitos solares adotados são impróprios pela exposição que ocorre na prática esportiva. Há necessidade de ampliar medidas fotoprotetoras para adeptos de meia maratona e outros esportes ao ar livre.

Half marathon competition is developed outdoors, considered expanding practical and great sun exposure. To assess sun habits and frequency of burns in elite half marathon. Cross-sectional study of 220 athletes, of both sexes, 18-68 years old, who participated in the half marathon in September 2012 in the city of Curitiba - PR. All completed a questionnaire about skin lesions, as well as habits of exposure and sun protection. Statistical analysis was performed by chi-square. The predominant male athletes, adults, runners long distance, coming from southern Brazil (86.3%), and white (74%). Approximately 13.2% of the athletes reported high sensitivity and ease of skin burn when exposed to the sun. A greater adherence to sunscreen was observed in females, which features daily frequency applications in greater proportion than men. The prevalence of sunburn was not significantly associated with gender (15% men and 20.4% women, p = 0.359, x2 = 0.839). In this group of athletes, it was identified that the sun habits are inadequate sports practice. There is need to expand photoprotective measures for half marathon enthusiasts and other outdoor sports.