Efficacy of oral lycopene supplementation for photoprotection in Filipino patients in a Tertiary Hospital in Makati: A single-blind randomized controlled trial

Background@#Ultraviolet radiation has been proven to result in unwarranted effects on the skin through reactive oxygen species (ROS) and direct DNA damage. Lycopene, a naturally occurring substance, acts as an antioxidant by neutralizing ROS.@*Objective@#The objective of the study was to determine the efficacy of oral lycopene supplementation for photoprotection in adult Filipino patients seen in a tertiary hospital in Makati City.@*Design@#The study design involves single-blind, parallel, randomized controlled trial.@*Methods@#Thirty-six Filipino patients aged 18 years old and above with Fitzpatrick Skin Phototype (FSP) III–V were divided into two groups using a computer-generated randomization. Group A received lycopene 500 mg/ soft gel capsule two capsules per orem once daily for 12 weeks, while Group B received no intervention during the entire observation period. Minimal erythema dose (MED) of patients from both groups was assessed by a single treatment-blinded reader at baseline, week 6, and week 12.@*Results@#Group A showed a significant increase in MED across periods, with a 20.83% increase from baseline at week 6 and a 43.06% increase at week 12. Group B MED remained constant from baseline to week 6 and to week 12. These results show that there is a significant effect in the increase in MED as compared to the control group.@*Conclusion@#Oral lycopene is effective in increasing the MED of patients and may be used for photoprotection among patients with FSP III–V.

Caracterización clínico-epidemiológica de pacientes con daño actínico crónico. Cochabamba, Bolivia / Clinical-epidemiological characterization of patients with chronic actinic damage. Cochabamba, Bolivia

RESUMEN Introducción: el daño actínico crónico es un grupo de alteraciones en la estructura, función y apariencia de la piel como resultado de la exposición no controlada a las radiaciones ultravioletas. Puede provocar el cáncer de piel. Objetivo: caracterizar a los pacientes con daño actínico crónico, atendidos en la consulta de Dermatología del Hospital Comunitario Valle Hermoso, en el departamento de Cochabamba, Bolivia. Materiales y métodos: se realizó un estudio clínico descriptivo, prospectivo, en un universo de 1 833 pacientes diagnosticados con daño actínico crónico, atendidos en la consulta de Dermatología del Hospital Comunitario Valle Hermoso, en Cochabamba, entre septiembre de 2017 y septiembre de 2018. Se evaluaron las variables edad, sexo, color y fototipo de piel, ocupación, uso de medios de protección solar, exposición a otro tipo de radiaciones, manifestaciones clínicas de fotodaño y altitud del lugar de residencia. Resultados: predominaron el grupo de edad de 25 a 59 años, el sexo femenino, el color de piel mestizo (77,08 %), el fototipo de piel IV (76,98 %) y la ocupación comerciante (72,56 %). La mayoría de los pacientes (82,7 %) no utilizaron medios de protección solar, y el 99,8 % no tuvieron exposición a otro tipo de radiaciones. Las lesiones por fotodaño que prevalecieron fueron melasma (83,03 %) y lentigos (12,22 %). El 99,29 % vivían en zonas de gran altitud. Conclusiones: se caracterizaron los pacientes con daño actínico crónico, obteniendo en algunas variables estudiadas resultados similares a los mencionados por otros investigadores (AU).

ABSTRACT Introduction: chronic actinic damage is a group of alterations in the structure, function, and appearance of the skin as a result of uncontrolled exposure to ultraviolet radiation. It can cause skin cancer. Objective: to characterize the patients with chronic actinic damage, treated at the Dermatology consultation of Valle Hermoso Community Hospital, in the department of Cochabamba, Bolivia. Materials and methods: a descriptive, prospective clinical study was conducted in a universe of 1,833 patients diagnosed with chronic actinic damage, treated at the Dermatology clinic of the Valle Hermoso Community Hospital, Cochabamba, between September 2017 and September 2018. The variables age, sex, skin color, skin phototype, occupation, use of sun protectors, exposure to other types of radiation, clinical manifestations of photodamage and altitude of the place of residence were evaluated. Results: the age group from 25 to 59 years, the female sex, mestizo skin color (77.08 %), the IV skin phototype (76.98 %) and merchant occupation (72.56 %) predominated. Most patients (82.7 %) did not use sun protection means, and 99.8 % had no other radiation exposure. The prevailing photodamage lesions were melasma (83.03 %) and lentigo (12.22 %). 99.29 % lived in high altitude areas. Conclusions: the patients with chronic actinic damage were characterized, obtaining in some variables studied results similar to those mentioned by other researchers (AU).

Dermatosis en pacientes geriátricos / Dermatoses in geriatric patients

Introducción: El envejecimiento cutáneo es parte de un proceso de deterioro endógeno y exógeno en las células. Los cambios degenerativos y metabólicos que ocurren, hacen a esta población vulnerable a afecciones dermatológicas. Objetivo: Definir las enfermedades cutáneas frecuentes en pacientes geriátricos, atendidos en consulta de dermatología. Métodos: Se realizó una investigación observacional descriptiva transversal, en pacientes geriátricos atendidos en la consulta de Dermatología en la Policlínica de Combatientes de Ciego de Ávila, en el periodo comprendido de enero a diciembre del 2019. La serie de estudio se conformó con 144 adultos mayores. Las variables estudiadas fueron: edad, sexo, color de piel, fototipos cutáneos, afecciones dermatológicas, localización y morbilidades asociadas. Resultados: Predominaron los adultos mayores entre 70 y 79 años (53,5 por ciento), del sexo masculino (50,7 por ciento). El 63,9 por ciento de los pacientes tenía fototipo cutáneo III. Las dermatosis más frecuentes fueron la púrpura senil (34 por ciento) y queratosis seborreica (25 por ciento), fueron más afectados los adultos mayores de piel blanca (69,4 por ciento). Las dermatosis en la cara y extremidades fueron las más frecuentes (53,5 por ciento y 17,4 por ciento). El 46,6 por ciento de los pacientes padecían de afecciones del sistema osteomioarticular, seguido por la hipertensión arterial (18,5 por ciento) y diabetes mellitus (12,6 por ciento). Conclusiones: Predominaron los adultos mayores del sexo masculino de 70 a 79 años, con fototipo cutáneo III. La púrpura senil, la queratosis seborreica y la xerosis fueron afecciones frecuentes en ancianos de piel blanca. Se destacaron las lesiones limitadas a la cara(AU)

Introduction: Skin aging is part of an endogenous and exogenous deterioration process in cells. The degenerative and metabolic changes that occur make this population vulnerable to dermatological conditions. Objective: To define frequent skin diseases in geriatric patients, seen in a dermatology office. Methods: A cross-sectional descriptive observational investigation was carried out in geriatric patients treated in the Dermatology consultation at the Policlínica de los Combatientes, Ciego de Ávila, in the period from January to December 2019. The study series consisted of 144 older adults. The variables studied were: age, sex, skin color, skin phototypes, dermatological conditions, location and associated morbidities. Results: Older adults between 70 and 79 years old (53,5 percent), male (50,7 percent) predominated. 63,9 percent of the patients had skin phototype III. The most frequent dermatoses were senile purpura (34 percent) and seborrheic keratosis (25 percent), older adults with white skin were more affected (69,4 percent). Dermatoses on the face and extremities were the most frequent (53,5 percent and 17,4 percent). 46,6 percent of the patients suffered from disorders of the osteomyoarticular system, followed by arterial hypertension (18,5 percent) and diabetes mellitus (12,6 percent). Conclusions: Older male adults from 70 to 79 years old, with skin phototype III predominated. Senile purpura, seborrheic keratosis, and xerosis were common conditions in white-skinned elderly. Lesions limited to the face were highlighted(AU)

The Effect of Narrowband Ultraviolet B Phototherapy on Vitamin D Status in Psoriasis Patients with Skin Phototype III, IV and V

Background@#Narrowband ultraviolet-B (NBUVB) is an effective treatment option for psoriasis. Vitamin D insufficiency is common in psoriasis patients. We assessed the effect of NBUVB on vitamin D levels amongst psoriasis patients with skin phototype III, IV and V.@*Methods@#Psoriasis patients planned for NBUVB phototherapy were enrolled in a prospective cohort study in Hospital Putrajaya and Hospital Kuala Lumpur from May 2020-December 2020. NBUVB phototherapy was given twice weekly for 12 weeks. Serum 25 (OH)D level was measured at baseline and at week 12.@*Results@#A total of 21(63.6%) male and 12(36.4%) female patients aged 18-66 years participated. Majority were Fitzpatrick skin phototype (FSP) IV (66.7%) followed by FSP V (21.2%) and FSP III (12.1%). Serum 25(OH)D increased significantly (p<0.001) from 52.09±21.43 nmol/L at baseline to 72.80±19.56 nmol/L at week 12 with the most increment seen in skin type V. There was also a significant improvement seen in Body Surface Area (BSA) involvement after 12 weeks of phototherapy (p<0.001). There was no correlation seen between BSA at week 12 with serum 25(OH)D and percentage of serum 25(OH) D increment.@*Conclusion@#NBUVB phototherapy increases the level of serum 25(OH)D in psoriasis patients with darker skin types while simultaneously clearing psoriasis.

Sun Exposure Among Healthy Adults in a Health Facility

@#Introduction: Sun exposure is a risk for skin cancer but is beneficial for multiple other diseases. Recommendations for photoprotection are well defined, guidelines for optimal sun exposure is not clear. We determined sun exposure in healthy adults, considering their skin phototype and amount of skin exposed. Methods: A cross sectional study was performed involving healthy adults working in a tertiary health facility. Fitzpatrick skin phototype quiz was used to determine skin phototype. Sun exposure was quantified as an index (SEI); body surface area exposed times duration of exposure. Results: We recruited 167 volunteers, 110(66%) women and 56(34%) men. Mean age was 29.77±6.58 years, 124(74.7%) were Malay, 27(16.3%) Chinese, 14(8.4%) Indians and 1(0.6%) of other ethnicity. Fitzpatrick skin phototypes were 30(18.1%) type III, 109(65.7%) type IV and 27(16.3%) type V. Exposed body surface area was 13.96±8.33% in males and 14.55±9.58% in females. The duration of sun exposure per week in males was 11.52±6.11hours and 10.71±5.75 hours in females. Mean SEI was 160 ±144. The SEI in females was 158 ±151, 164 ±130 in males, p value =0.81. There were no significant differences in SEI between gender and skin phototypes. Conclusion: SEI was very low in our study population due to limited body surface area exposed and duration of sun exposure. SEI was higher in darker skin and males, however these were not statistically significant.

Ethnic aspects of vitamin D deficiency / Aspectos étnicos da deficiência de vitamina D

Vitamin D deficiency has been linked to bone fragility in children and adults, and to an increased risk of chronic diseases. The main sources of vitamin D are the diet and cutaneous synthesis, the latter being the most important one, since foods are relatively poor in vitamin D. The main factors influencing this endogenous production are the seasons, the time of day, latitude and skin phototype. Due to the contribution of sun exposure in maintaining vitamin D levels, it would be expected that this deficiency would be more prevalent in countries at a high latitude; it has been shown, however, that hypovitaminosis D is commonly found in tropical regions such as Brazil. In high latitude regions in which extreme skin phototypes have been compared, the prevalence of vitamin D deficiency is more common in people with originally darker skin who have a natural barrier to the already lower UV irradiation penetrating the skin. In Brazil, particularly in the areas where sun rays are more abundant, the difference in sunlight exposure between subjects showed no significant variation in serum 25-hydroxyvitamin D (25OHD). .

A deficiência de vitamina D tem sido associada à fragilidade óssea em crianças e adultos e ao aumento do risco de doenças crônicas. As principais fontes de vitamina D são a dieta e a síntese cutânea, sendo esta última a mais importante, uma vez que os alimentos são relativamente pobres em vitamina D. Os principais fatores que influenciam essa produção endógena são as estações do ano, a hora do dia, a latitude e o fototipo de pele. Devido à contribuição da exposição solar em manter os níveis de vitamina D, seria de esperar que essa deficiência fosse mais prevalente nos países com alta latitude; no entanto, a hipovitaminose D é comumente encontrada em regiões tropicais como o Brasil. Em regiões de alta latitude em que os extremos de fototipos de pele foram comparados à prevalência de deficiência de vitamina D, é mais comum em pessoas com pele originalmente mais escura que têm uma barreira natural à já baixa penetração da irradiação UV na pele. No Brasil, particularmente nas áreas mais ensolaradas, a diferença de exposição solar entre os indivíduos não mostrou variação significativa nos níveis séricos de 25-hidroxivitamina D (25OHD).

Spectrophotometric Measurement of Minimal Erythema Dose Sites after Narrowband Ultraviolet B Phototesting: Clinical Implication of Spetrophotometric Values in Phototherapy

BACKGROUND: The spectrophotometer is well known to be a useful tool for estimating the objective minimal erythema dose (MED) during planning of phototherapy protocol. However, only a few spectrophotometric values are used to evaluate the erythema and pigmentation of the MED site during phototesting. OBJECTIVE: To determinea new meaning of the relationships among spectrophotometric values during phototesting. METHODS: Twenty-five patients with psoriasis and 23 patients with vitiligo were selected before undergoing narrowband ultraviolet B phototherapy. We interpreted the gross findings of erythema and measured the L*a*b* values using a spectrophotometer at each phototest spot. We compared MEDs, basic spectrophotometric values (L*a*b*), and b*/L* values separately according to skin type, and determined the correlation of each spectrophotometric value and the correlation between a* and b*/L* values. RESULTS: Among L*a*b* values, only b* values showed a statistically significant difference between the type III and IV groups (p=0.003). There was a positive correlation only between MEDs and b* values (p<0.05). The average b*/L*value in the type IV group was significantly higher than the type III group (p<0.05). CONCLUSION: The higher b* values in type IV skin indicates that skin tanning develops more prominently than type III. The correlation between MEDs and b* values may signify that the skin pigmentation status is deepened with the higher MEDs. The difference in b*/L*values between type III and IV skin reflects that the b*/L*value is thought to be an index of tanning. The a* value, known as an index of erythema, does not influence the degree of tanning.

Classification of the Skin Phototype According to UVB Induced Minimal Erythema Dose in Young Korean Adults / 대한피부과학회지

BACKGROUND: We predicted that the self-reporting questionnaire proposed by Fitzpatrick might not be appropriate for classifying the skin phototype in Korean people. OBJECTIVE: We classified the skin phototypes in Korean people by measuring the minimal erythema dose (MED) of UVB on the basis of MEDs of skin type proposed by Pathak and Fitzpatrick. METHODS: Two hundred and eighty-four male Korean medical students participated in this study. We irradiated UVB with Waldmann UV 800 and measured MEDs after 24 hours. RESULTS: The mean MED was 70.1+/-21.3 mJ/cm2. Most of the MEDs were 70, 60, 50 mJ/cm2 in the order of frequency. On the basis of the skin type proposed by Pathak and Fitzpatrick, the most frequent phototype was the skin type V(56.3%) by MED. 20.8% and 13.8% of the subjects corresponded to the skin types UV and III, respectively. 9.1% of the subjects fell into the UV sensitive group, skin type l and II. CONCLUSION: Using these results as groundwork, simple and precisely applicable classification of skin phototype in Korean people needs to be established.