Systematic review of factors influencing sunburn from population-based studies / 环境与职业医学

Sunburn is an acute phototoxic reaction caused by excessive exposure of skin to solar ultravilet (UV) or artificial UV light sources. Studies show that sunburn is common in the general population, so that associated financial burden cannot be ignored. Meanwhile, sunburn at any age increases the risk of melanoma. Only by clarifying the influencing factors of sunburn can precise preventive measures be formulated. Although many studies have been conducted on the influencing factors of sunburn worldwide, there are great heterogeneity in reported influencing factors. In this paper, by means of systematic review, factors affecting sunburn were sorted out and summarized from four aspects, including demographic and socioeconomic characteristics, photosensitive phenotypes, UV-related environmental factors, and sun protection knowledge, attitude & behavior. Combined with population characteristics and data availability in China, our review provided reference for subsequent research and development of precise prevention and control strategies.

Association of high-risk human papillomavirus with ocular surface squamous neoplasia: a case-control study in Mexico / Asociación del virus del papiloma humano de alto riesgo con la neoplasia escamosa de la superficie ocular: estudio de casos y controles en México

Abstract: Objective: To investigate the association of high-risk human papilloma virus (HR-HPV) and other risk factors with ocular surface squamous cell neoplasia (OSSN). Materials and methods: We obtained DNA from 22 fresh frozen OSSN tissues and 22 pterygia as controls, we used a broad-spectrum HPV DNA amplification short PCR fragment to identify HPV infection in all specimens and then genotyped HPV by a reverse hybridization line probe assay. We also obtained demographic, sun exposure, and tobacco consumption information. Results: HR-HPV frequency was 40.9% in the OSSN group and 4.5% in the pterygia group (p=0.009). After covariate adjustment, OSSN was associated with HR-HPV (OR=16.3, 95%CI=1.2,218.1, p=0.03) and sunburn (OR=10.8, 95%CI=1.8,86.0, p=0.02). Conclusions: Ocular surface squamous cell neoplasia is a multifactorial disease. The strong association between HR-HPV and OSSN, suggests that HR-HPV could play an etiological role in OSSN development.

Resumen: Objetivo: Investigar la asociación del virus del papiloma humano de alto riesgo (VPH-AR), así como de otros factores, con neoplasia escamosa de la superficie ocular (NESO). Material y métodos: Se obtuvieron 22 especímenes de tejido fresco de NESO y 22 de pterigión como controles; se utilizó una técnica molecular altamente sensible para identificar la infección por VPH en todos los especímenes, así como la genotipificación del VPH. También se obtuvo información demográfica sobre exposición a la luz solar y tabaquismo. Resultados: La frecuencia de infección por VPH-AR fue de 40.9% en el grupo de NESO y de 4.5% en el grupo control (p=0.009). Después de ajustar por covariables, NESO se asoció con el VPH-AR (OR=16.3, IC95%=1.2,218.1, p=0.03) y el eritema solar (OR=10.8, IC95%=1.8,86.0, p=0.02). Conclusiones: La neoplasia escamosa de superficie ocular en una neoplasia multifactorial. Los presentes resultados sugieren que el VPH-AR podría tener un papel etiológico en el desarrollo de NESO.

Características da aplicação de filtro solar na face por brasileiros previamente diagnosticados com câncer da pele / Characteristics of sunscreen application on the face of Brazilian skin cancer patients

Introdução: Fotoproteção é indicada para reduzir a exposição ao dano actínico cutâneo, sendo relevante para a prevenção ao câncer da pele. A face é a área mais irradiada do corpo e é o local mais comum de ocorrência de tumores. Objetivo: Avaliar a quantidade aplicada de fotoprotetor tópico e a cobertura facial obtida por pacientes em seguimento por câncer da pele em uma instituição pública brasileira. Métodos: Estudo quasi-experimental envolvendo 40 pacientes oncológicos cutâneos. Foi solicitado que aplicassem filtro solar em suas faces (da forma como faziam habitualmente), e a quantidade (massa) utilizada foi aferida. Após, os participantes foram fotografados sob a luz de Wood para avaliar a homogeneidade da cobertura e as áreas faciais nas quais a cobertura falhou. Resultados: Quatorze participantes (35%) aplicaram uma quantidade menor do que a recomendada (2mg/cm2). As regiões com as menores coberturas foram as orelhas e a zona "H" da face. Conclusões: A aplicação insuficiente ou heterogênea de filtro solar em face, pescoço e orelhas promove falsa percepção de proteção, podendo acarretar uma exposição irresponsável. Conforme a idade da população e a incidência do câncer da pele aumentam, é essencial estimular a fotoproteção, por meio de informações apropriadas, especialmente entre indivíduos de alto risco.

Introduction: Photoprotection is indicated to reduce the exposure to cutaneous actinic damage and it is important to prevent skin cancer. The face is the most irradiated area of the body and is also where skin cancers most commonly occur. Objective: To evaluate the amount of sunscreen applied and its facial coverage in patients previously diagnosed with skin cancer, treated at a Brazilian public institution. Methods: Quasi-experimental study involving 40 patients undergoing skin cancer follow-up. Participants were asked to apply sunscreen on their face, as usual, and the mass used was measured. After, participants were photographed under Wood's light to evaluate the homogeneity of the sunscreen´s coverage, and facial sunscreen coverage failure. Results: Fourteen (35%) participants applied an estimated amount lower than recommended (2mg/cm2). The regions with smallest coverage were the ears and the "H" area of the face. Conclusions: The insufficient or heterogeneous sunscreen application on face, neck and ears may promote a false perception of protection, leading to irresponsible exposure. As the population ages and the incidence of skin cancers increases, it is essential to stimulate photoprotection, with appropriate information, especially among high-risk individuals

Dermatosis provocadas por la luz solar en pacientes menores de 18 años / Dermatosis caused by sunlight in patients under 18 years / Dermatose causada pela luz solar em pacientes com menos de 18 anos

RESUMEN Introducción: en la población pediátrica se han incrementado las dermatosis provocadas por la luz solar a una velocidad sin precedentes, que son más comunes en otro grupo de pacientes. Objetivo: caracterizar las afecciones cutáneas provocadas por la luz solar en pacientes menores de 18 años. Método: se realizó un estudio de tipo descriptivo, prospectivo longitudinal, para determinar las afecciones cutáneas provocadas por la luz solar en pacientes menores de 18 años, atendidos en las consultas de dermatología de las diferentes áreas de salud del municipio Bayamo, en el período de Enero del 2012 a Diciembre del 2013. El universo estuvo integrado por todos los pacientes atendidos en las consultas de Dermatología de la Atención Primaria de Salud de Bayamo, quedando constituida la muestra por 159 pacientes que cumplieron con los criterios de inclusión. Resultados: se puedo observar que el sexo masculino representó un 64,8%, con 103 pacientes. El lugar de procedencia con mayor número fue el rural con 91 pacientes para 57,2%. El fototipo II representó el grupo de pacientes más afectados con 128 pacientes para un 80.5%. El fototipo I y III se presentan de forma análoga, con un 10.7% y un 8.8% respectivamente. El grupo de edad con mayor número de casos fue el de 15 a 18 años con 101 casos para 63,5 %, las afecciones cutáneas provocadas por la luz solarque aparecieron en áreas expuesta de la piel predominando las pecas, los antecedentes personales de cáncer cutáneo se presentó en un caso, representando el 0.6 % del total de los pacientes estudiados. No se presentaron antecedentes familiares de cáncer cutáneo en ninguno de los pacientes. Conclusiones: las afecciones cutáneas provocadas por la luz solar que predominaron en pacientes de procedencia rural, en la adolescencia tardía, fototipo de piel II, sexo masculino y en zonas de piel foto expuesta. Las lesiones de mayor prevalencia fueron las efélides y la mayoría de los pacientes con foto dermatosis no presentaron antecedentes personales ni familiares de cáncer cutáneo.

ABSTRACT Introduction: in the pediatric population, dermatoses caused by sunlight have increased at an unprecedented rate, which are more common in another group of patients. Objective: to characterize skin conditions caused by sunlight in patients under 18 years of age. Method: a descriptive, prospective, longitudinal study was carried out to determine the cutaneous affections caused by sunlight in patients under 18 years of age, attended in the dermatology consultations of the different health areas of the municipality of Bayamo, during the period of January 2017 to December 2018. The universe consisted of all the patients seen in the Dermatology offices of the Primary Health Care of Bayamo, and the sample was constituted by 159 patients who met the inclusion criteria. Results: we can observe that the male sex represented 64.8%, with 103 patients. The place of origin with the greatest number was rural with 91 patients for 57.2%. Phototype II represented the group of patients most affected with 128 patients for 80.5%. Phototype I and III are presented analogously, with 10.7% and 8.8% respectively. The age group with the highest number of cases was 15 to 18 years with 101 cases for 63.5%, skin conditions caused by sunlight that appeared in exposed areas of the skin, freckles predominating, personal history of skin cancer it was presented in one case, representing 0.6% of the total of the patients studied. No family history of skin cancer was present in any of the patients. Conclusions: skin conditions caused by sunlight that prevailed in patients of rural origin, late adolescence, skin phototype II, male sex and skin photo exposed areas. The most prevalent lesions were freckles and the majority of patients with photodermatitis had no personal or family history of skin cancer.

RESUMO Introdução: na população pediátrica, as dermatoses causadas pela luz solar aumentaram a uma taxa sem precedentes, que são mais comuns em outro grupo de pacientes. Objetivo: caracterizar as condições de pele causadas pela luz solar em pacientes com menos de 18 anos de idade. Método: estudo descritivo, prospectivo, longitudinal, realizado para determinar as alterações cutâneas causadas pela luz solar em pacientes com idade inferior a 18 anos, atendidas nas consultas de dermatologia das diferentes áreas da saúde do município de Bayamo, durante o período de Janeiro de 2012 a dezembro de 2013. O universo constou de todos os pacientes atendidos nos consultórios de Dermatologia da Atenção Primária à Saúde de Bayamo, sendo a amostra constituída por 159 pacientes que atenderam aos critérios de inclusão. Resultados: podemos observar que o sexo masculino representou 64,8%, com 103 pacientes. O local de origem com maior número foi rural com 91 pacientes para 57,2%. O fototipo II representou o grupo de pacientes mais acometidos, com 128 pacientes, por 80,5%. Os fototipos I e III são apresentados de forma análoga, com 10,7% e 8,8%, respectivamente. A faixa etária com maior número de casos foi de 15 a 18 anos, sendo 101 casos com 63,5%, condições de pele causadas por luz solar que apareceu em áreas expostas da pele, predominando sardas, histórico pessoal de câncer de pele foi apresentado em um caso, representando 0,6% do total de pacientes estudados. Nenhuma história familiar de câncer de pele estava presente em nenhum dos pacientes. Conclusões: condições de pele causadas pela luz solar que predominaram em pacientes de origem rural, adolescência tardia, fototipo II, sexo masculino e áreas expostas à foto da pele. As lesões mais prevalentes foram as sardas e a maioria dos pacientes com fotodermatite não apresentava história pessoal ou familiar de câncer de pele.

A survey on sun protection behavior among middle-aged and elderly women in two districts in Beijing / 中华皮肤科杂志

Objective To investigate sun protection behavior among middle-aged and elderly women in Beijing.Methods The central (Xuanwumen district) and peripheral areas (Yanqing district) of Beijing city were selected for investigation from May to June in 2016.By random sampling and field investigation,interviewees completed questionnaires with the help of dermatologists.Results A total of 400 females aged 40-90 years were investigated,including 190 in the Xuanwumen district and 210 in the Yanqing district.Among all the subjects,the average duration of outdoor activities was 2 hours.Moreover,117 (29.2％) of the 400 interviewees had the active sun exposure habit,including 38 (18.1％) in the Yanqing district and 79 (41.6％) in the Xuanwumen district,and the proportion of subjects with the active sun exposure habit significantly differed between the two districts (x2 =26.582,P ＜ 0.001).In addition,67 (16.8％) interviewees had a sunburn history,and 130 (32.5％) were used to applying sunscreen.The proportion of sunscreen users was significantly higher in moderately or highly educated women (103 [45.2％]) than in lowly educated women (28/172 [16.3％],P ＜ 0.001).The proportion of sunscreen users in women with skin type Ⅲ (41.2％ [70/170]) was significantly higher than that in those with skin type Ⅳ (26.5％ [61/230],P =0.002).The scores for facial skin aging and dorsal hand skin aging were both significantly lower in sunscreen users than in non-users (Z =18.536,10.731,P =0.002,0.026,respectively).Conclusion The active sun exposure habit in the middle-aged and elderly women differs between the central and peripheral areas of Beijing,and the use of sunscreen is associated with education level.

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)

Protective effect of essential oils from Blumea balsamifera on sunburn induced by UVB in mouse skin / 中成药

AIM To study the protective effect of essential oils from Blumea balsamifera (L.) DC.(BBO) on UVB-induced sunburn in mouse skin and its mechanism of action.METHODS The model for sunburned mouse skin was established by acute UVB irradiation.Essential oils from B.balsamifera were applied to the surface of wound for external use.The pathological changes of sunburned skin tissue were observed by hematoxylin-eosin HE) staining.The activity of superoxide dismutase (SOD),and the contents of malondialdehyde (MDA) and glutathione (GSH) were measured.The levels of 8-hydroxy-desoxyguanosine (8-OHdG),interleukin-6 (IL-6) and nuclear factor kappa-B (NF-κB) in epidermis were detected by ELISA.Additionally,the expressions of tumor necrosis factor-alpha (TNF-α),P53 tumor suppressor protein and proliferation cell nuclear antigen (PCNA) were evaluated by immunohistochemistry (IHC).RESULTS Compared with the model group,treatment with essential oils from B.balsamifera significantly reduced the thickness of epidermis,and the activity of SOD and the contents of MDA,GSH in mouse skin were restored.In addition,the essential oils from B.balsamifera resulted in a significant decrease in levels of 8-OHdG,IL-6 and NF-κB,and an inhibition in expressions of P53 and PCNA.CONCLUSION The essential oils from B.balsamifera can alleviate UVB-induced sunburn.Its mechanism is related to enhanced antioxidant power,inhibited NF-κB signal passway,down-regulated release of IL-6 and reduced levels of 8-OHdG,PCNA.

Effects of Different Honey Sunburn Methods on Calycosin and Formononetin in Hedysari Radix / 中国中医药信息杂志

Objective To compare the effects of different methods of honey sunburn on the contents of calycosin and formononetin in Hedysari Radix; To provide the basis for the establishment of the optimum processing technology. Methods By frying (traditional method), baking, and microwave methods put Hedysari Radix under honey sunburn. Agilent HC-C18 column (4.6 mm × 250 mm, 5 μm) was used; the mobile phase was acetonitrile-0.01% phosphoric acid solution, gradient elution (0–12 min, 30%–33% acetonitrile; 12–13 min, 31%–40% acetonitrile; 13–25 min, 40% acetonitrile) with velocity of 1.0 mL/min; detection wavelength was 248 nm;the column temperature was 30 ℃; sample volume was 10 μL. Results There was statistical significance in the contents of calycosin and formononetin of different methods of honey sunburn for Hedysari Radix. Among them, the contents of calycosin and formononetin in Hedysari Radix processed by honey roast were the highest, 7.9116 and 49.6996 μg/g, respectively; the contents of calycosin and formononetin in Hedysari Radix processed by traditional method were the lowest, 4.7767 and 37.2910 μg/g, respectively; the contents of calycosin and formononetin in raw Hedysari Radix and Hedysari Radix by honey microwave method were the same, 5.0802, 42.7989 μg/g, and 3.9839, 42.3145 μg/g, respectively. Conclusion Different honey sunburn methods for the contents of calycosin and formononetin in Hedysari Radix have certain effects, and honey roast method is the optimum method.

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)

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.

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.

Exposição e proteção solar dos estudantes de medicina de Curitiba (PR) / Sun exposure and protection among medical students in curitiba (PR)

Trata-se de estudo observacional de corte transversal que teve como objetivo analisar a exposição e proteção solar de estudantes de Medicina de Curitiba (PR), através de questionário autoaplicado, comparando os resultados entre alunos de ambos os sexos que tiveram ou não intervenção da disciplina de Dermatologia. Análise estatística pelo Teste Exato de Fisher e Qui-Quadrado. Amostra composta de 398 estudantes com perfil sociodemográfico caracterizado principalmente por mulheres (54,9%), brancas, predominando a média de 23,8 anos. A maioria cursou a disciplina de Dermatologia (72,1%) e possui conhecimentos básicos sobre fotoproteção (65,3%). Quanto às práticas de exposição solar, os horários preferidos foram após 16 horas (55%) e entre 10-16 horas (23,3%), com uso diário de protetor solar (36,5%) e fator de proteção 30 ou superior (65,5%). Em relação aos riscos individuais para carcinomas cutâneos, 61,2% se enquadraram nos fototipos II e III de Fitzpatrick. Histórico familiar de câncer de pele ocorreu em 24,6% nos avós e/ou pais. Entre as mulheres que cursaram a disciplina de Dermatologia, verificou-se aplicação diária de fotoprotetor mais vezes ao dia e com fator de proteção solar mais alto.

This observational cross-sectional study aims to analyze exposure to the sun and solar protection measures among medical students in Curitiba (PR), by means of a self-administered questionnaire, comparing the outcomes among students of both sexes, with or without the benefit of studying Dermatology. Statistical analysis was conducted using Fisher’s exact and Chi-square tests. The sample consisted of 398 students, characterized mainly by women (54.9%), a white socio-demographic profile, with a predominant average age of 23.8 years. Most of them studied at the Department of Dermatology (72.1%) and had basic knowledge of sun protection (65.3%). For their reported practices of sun exposure, the preferred times were after 4:00 p.m. (55%) and between 10:00 a.m. and 4:00 p.m. (23.3%), with daily use of sunscreen (36.5%) and one with a protection factor of 30 or more (65.5%). Regarding individual risk to cutaneous carcinomas, 61.2% fell within skin types II and III Fitzpatrick. A family history of skin cancer was reported in 24.6% of cases among grandparents and/or parents. Female Dermatology students reported the twice daily application of sunscreen of higher sun protection factor.

Butyl flufenamate ointment in the treatment of solar dermatitis: a clinical observation / 中华皮肤科杂志

Objective To evaluate the efficacy and safety of butyl flufenamate ointment for the treatment of solar dermatitis.Methods Sixty-four patients with solar dermatitis were randomly divided into the observation group (n =32) and control group (n =32) to topically apply butyl flufenamate ointment and diclofenac sodium cream,respectively,for 3 weeks.The efficacy was evaluated by lesion scores and a visual analog scale for pruritus.Results At the end of the treatment,4 patients in the observation group were clinically cured,19 markedly improved,17 improved,and 2 showed no improvement; meanwhile,2 patients in the control group were clinically cured,11 markedly improved,14 improved,and 5 showed no improvement.The total response rate was significantly higher (93.8％ vs.84.4％,P ＜ 0.05),while the pruritus score was significantly lower (P ＜ 0.05) in the observation group than in the control group.Conclusion Butyl flufenamate ointment is superior to dicofenac sodium cream in terms of both efficacy and anti-pruritic effect.

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.

Photoprotective effect of butyl flufenamate ointment on SKH-1 hairless mice / 中华皮肤科杂志

Objective To investigate the protective effect of butyl flufenamate ointment against ultraviolet (UV)-induced skin damage,skin aging,and cutaneous squamous cell carcinoma (CSCC) in SKH-1 hairless mice.Methods A total of 128 mice were randomly and equally divided into four groups:UV group receiving UV irradiation only,butyl flufenamate ointment group and matrix cream group receiving UV irradiation after 30-minute pretreatment with topical butyl flufenamate ointment and matrix cream respectively,and blank control group receiving neither pretreatment nor irradiation.In the sunburn experiment (n =24),mice were exposed to single session of UV irradiation (1.5 minimal erythema doses (MEDs)),and 24 hours later,erythema and swelling response was observed,and skin tissue was obtained from the irradiated area on the back of mice followed by the determination of COX-2 expression using the streptavidin biotin peroxidase complex (SABC) method.To establish a photoaging (n =24) and CSCC (n =80) model,mice were exposed to four sessions of UV irradiation every week for 12 and 28 successive weeks respectively,with the irradiation dose starting at 0.9 MED and increasing gradually.After 12-week irradiation,skin tissue was resected from the back of photoaged mice and subjected to Masson staining for the evaluation of collagen changes as well as immunohistochemical analysis for the quantification of Bax,Bcl-2 and Caspase 3 expression.The initiation and progression of CSCC were observed in mice on a once-a-week basis from 12 to 28 weeks.SPSS 21.0 software was used for statistical analysis.One way analysis of variance was carried out for multiple-group comparisons of numerical data,Ridit analysis for the comparison of immunohistochemical staining intensity.Kaplan-Meier method and log-rank test were utilized for the comparison of tumor-free survival time.Results Both the degree of erythema and swelling response and expression level of COX-2 were significantly lower in the butyl flufenamate ointment group than in the other two UV-irradiated groups (all P ＜ 0.05).After 12-week irradiation,the butyl flufenamate ointment group showed milder degree of skin aging,together with higher density of collagen in dermis,weaker expression of Bcl-2 but stronger expression of Bax and Caspase 3,by comparison with the other two UV-irradiated groups (all P ＜ 0.05).During the 28 weeks of irradiation,the median tumor-free survival time was statistically longer in the butyl flufenamate ointment group than in the matrix cream group and UV group((25.0 ± 0.4) months vs.(24.0 ± 0.3) months and (23.0 ± 0.4) months,P ＜ 0.05 and 0.01 respectively).Conclusion Butyl flufenamate ointment has a certain photoprotective effect.

Low-dose ultraviolet B induces sunburn reaction in Nrf2 gene-deficient mice / 中华皮肤科杂志

[Objective] To investigate the roles of Nrf2-Keap1 system in the protection of skin from ultraviolet B (UVB)-induced damage.[Methods] The dorsal surface of ears of 8 wild-type and 8 nrf2-null mutant 8-week-old female mice was exposed to a single dose of UVB irradiation (200 mJ/cm2) by using a FL120SE UV lamp source.Then,the morphology of ears was observed with the measurement of thickness before,as well as on day 1,2,4,7,9,11 and 14 after,the irradiation.Biopsy specimens were taken from the ears 36hours after the irradiation and subjected to hematoxylin and eosin staining as well as terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay.The test Results were recorded and statistically analyzed by rank sum test and t test.[Results] A significant increase was observed in the thickness of mouse ears and number of sunburn cells per high-power field (400 ×) in nrf2-null mutant mice compared with wild-type mice ((0.49 ± 0.22) cm vs.(0.25 ± 0.03) cm,P＜ 0.01; 17.0 ± 3.9 vs.5.0 ± 1.7,t=13.8,P＜ 0.01).The number of TUNEL positive cells in the nrf2-null mutant mice was about 5 times that in the wild mice.The sunburn reaction appeared more intense and persistent in nrf2-null mutant mice than in the wild mice.[Conclusion] Nrf2-Keap1 pathway may protect skin against acute UVB damage,including cell apoptosis and oxidative damage.

Filtros solares e fotoproteção / Sunscreens and skin

Filtro solar é uma loção, spray, gel ou outro produto tópico que absorve ou reflete a radiação solar na pele fotoexposta e ajuda na proteção contra a queimadura solar, o fotoenvelhecimento e o câncer de pele.

Influence of grape seed proanthocyanidin extract on sunburn cell formation and p53 protein expression induced by acute ultraviolet injury / 中华皮肤科杂志

Objective To evaluate the influence of grape seed proanthocyanidin extract (GSPE) on sunburn cell formation and p53 protein expression induced by acute ultraviolet injury. Methods Ten volunteers were enrolled in this study. The buttock region served as the exposed region. Four areas were randomized and delineated on the buttock: one area (control area) received no exposure or product, the other 3 areas were exposed to two minimal erythema doses (MED) of simulated solar radiation (SSR) for 3 days. Of the 3 exposed areas, one area (SSR) received no product before exposure, one area (SSR + Veh) was pretreated with vehicle, the third area (SSR + GSPE) with the samples of GSPE. GSPE or vehicle was applied 30 minutes before each exposure at 2 μL/cm2. Skin biopsy was performed 24 hours after the last exposure, and skin specimens were subjected to hematoxylin eosin (HE) staining and histochemical analysis for p53 protein. Results There was a statistical difference in the number of sunburn cells per high power field (×200) between SSR sites and SSR + GSPE sites (29.8±11.1 cells vs 2.2±0.2 cells, P<0.01). A significant decrease was noticed in the account of p53 protein-positive cells per high power field (×200) in SSR + GSPE sites com-pared with the SSR sites (4.6±0.7 cells vs 19.3±3.4 cells, P<0.05). Conclusion GSPE exerts a poten-tial protective effect against acute ultraviolet injury and can serve as a natural sunscreen.

Análisis de la densidad y distribución anatómica de nevos melanocíticos adquiridos, en adolescentes del estrato socioeconómico bajo de Santiago de Chile / Body distribution and density of acquired melanocytic nevi in adolescents of low socioeconomic stratus of Santiago, Chile

Background: There is an increase in the incidence of malignant melanoma in Chile. Previous studies have shown that the density and size of acquired melanocytic nevi (AMN) are a risk factor for developing malignant melanoma. Aim: To assess the number and anatomical distribution of acquired melanocytic nevi in Chilean adolescents. Material and methods: The number of AMN was counted in 30 anatomical sites in 201 Chilean school children (111 females), aged from 11 to 15 years. The number oí small AMN (2-4.9 mm) and large AMN (>5 mm ofdiameter) was determined. Results: Mean AMN number per person was 32.7 (95 percent confidence interval (CI) 30.7-42.3) in males and 29 (95 percent CI 271-38.6) in females (p =NS). Males had a higher number of AMN in the face, neck and trunk. Females had a higher number of AMN in the upper and lower limbs. Older children, adolescents with history of sunburns and with lighter skin had a higher number of total, small and large nevi. Conclusions: The average number ofAMNfound in this study is similar to that reported in the literature. The differences in site distribution between males and femalesmay be explainedby a differentsun exposurepattern.

Skin damage induced by ultraviolet radiation in high altitude: a survey in officers and soldiers / 中华皮肤科杂志

Objective To characterize the skin damage induced by ultraviolet radiation in officers was observed in 67.5% of the 1286 officers and soldiers:tanning in 62.05%(798/1286),photoaging in 18.66%(240/1286),polymorphous light eruption in 13.69%(176/1286)and sunbum in 13.30%(171/1286).Two hundred and thirteen subjects each had two kinds of skin amage,and 152 subjects each had three kinds of skin damage.With the time of being in the army and cumulative sun-exposure period,the prevalence of tanning,photoaging and polymorphous light eruption increased,while the prevalence of sunburn decreased.Sunburn mostly occurred in newly assigned soldiers.Conclusions The condition of skin damage nduced by ltraviolet radiation iS severe in officers and soldiers working in high altitude,and effective measures are warranted for the prevention and treatment of the skin damage.