Fotoprotección y fotodaño en la niñez y la adolescencia / Photoprotection and photodamage in the childhood and adolescence

Durante las últimas décadas se ha incrementado la incidencia del cáncer de piel, debido fundamentalmente a la exposición a las radiaciones solares, por lo cual es importante la protección desde las edades tempranas. Teniendo en cuenta lo anterior, se realizó una revisión bibliográfica con el objetivo de describir los efectos que estas ocasionan en los seres humanos y las formas de protección adecuadas. Se concluyó que el conocimiento y la implementación de las recomendaciones para la fotoprotección, son necesarias para prevenir los efectos causados por dichas radiaciones.

During the last decades the incidence of the skin cancer has been increased, due fundamentally to the exposure to the sun radiations, reason why it is important the protection since early ages. Keeping this in mind, a literature review was carried out with the objective of describing the effects that they cause in the human beings and the appropriate protection forms. It was concluded that the knowledge and the implementation of the recommendations for photoprotection, are necessary to prevent the effects caused by these radiations.

Queilitis actínica: aspectos histológicos, clínicos y epidemiológicos / Actinic cheilitis: histological, clinical and epidemiological characteristics

Introducción: la destrucción de la capa de ozono ha provocado un aumento en la incidencia de lesiones de la piel, a la que se suma la queilitis actínica. Objetivo: describir los aspectos histológicos, clínicos y epidemiológicos de la queilitis actínica a partir de la literatura reciente. Métodos: se revisaron las bases electrónicas PubMed, SciELO y Google Scholar con los términos claves en inglés y español: queilitis, queratosis, actínica, solar. Se incluyeron artículos originales, de revisión, reportes de casos, tesis y libros de la especialidad publicados preferentemente en el período 2005-2014. Resultados: La queilitis actínica es un trastorno potencialmente maligno inducido por la exposición solar y caracterizado por alteraciones micro y macroestructurales del labio. Factores de riesgo que interaccionan con la exposición solar son el fototipo (piel clara), hábito tabáquico, sexo (hombres), edad y ocupación (aire libre). Entre las alteraciones histológicas se encuentran la displasia epitelial y la elastosis solar; sin embargo, la severidad de estas no correlacionan con la gravedad clínica. Los pacientes con queilitis actínica presentan alteraciones de color, descamación, ulceraciones, difuminación del bermellón, entre otras. En muchas ocasiones la consulta y el diagnóstico son tardíos; se realizan cuando el cuadro ha evolucionado a cáncer. El diagnóstico es principalmente clínico, sumado a la biopsia de las lesiones con presentaciones moderadas y severas. Actualmente la terapia incluye métodos quirúrgicos y farmacológicos, y métodos innovadores como la fototerapia. Sin duda, la estrategia de prevención más importante es aumentar el uso de protectores solares, especialmente en la población de alto riesgo ocupacional. Conclusiones: la queilitis actínica es una patología relevante para los países sudamericanos, debido a que los factores de riesgo están presentes diariamente en las actividades de millones de trabajadores de nuestra región, por eso es necesario potenciar la investigación que permita mejorar la prevención, tratamiento y rehabilitación de esta patología(AU)

Introduction: depletion of the ozone layer has brought about an increase in the incidence of skin lesions, including actinic cheilitis. Objective: describe the histological, clinical and epidemiological characteristics of actinic cheilitis based on a review of recent literature. Methods: a search was conducted in the databases PubMed, SciELO and Google Scholar using the descriptors cheilitis, keratosis, actinic, solar, and their counterparts in Spanish. The search included original papers, review papers, case reports, theses and books about the specialty preferably published from 2005 to 2014. Results: actinic cheilitis is a potentially malignant condition induced by sun exposure and characterized by micro- and macrostructural alterations of the lip. The risk factors interacting with sun exposure are the skin phototype (light skin), smoking, gender (male), age and occupation (outdoor jobs). Histological alterations include epithelial dysplasia and solar elastosis, though their severity does not correlate with the degree of clinical seriousness. Patients with actinic cheilitis present color alterations, desquamation, ulceration and blurring of the vermillion border, among other signs and symptoms. On many occasions patients do not seek care during the early stages of the disease. As a result, diagnosis is made when the condition has already evolved into cancer. The diagnosis is basically clinic, with the support of the biopsy of lesions with moderate to severe characteristics. Current therapy includes surgery and medication, as well as innovative techniques like phototherapy. The most important strategy is no doubt the use of sunscreens, especially by the population at high occupational risk. Conclusions: actinic cheilitis is a condition relevant to South American countries, since its risk factors are present in the daily activities of millions of workers from our region. It is therefore necessary to foster research aimed at improving its prevention, treatment and rehabilitation(AU)

Association of sunlight exposure and photoprotection measures with clinical outcome in Systemic Lupus Erythematosus

This study was designed to explore the relationship of sunlight exposure and ultraviolet (UV) light protection measures with clinical outcome in systemic lupus erythematosus (SLE). A structured questionnaire was administered to sixty Puerto Rican SLE patients, to assess their attitudes and behavior regarding sunlight exposure and photoprotection measures. Medical records were reviewed to evaluate the clinical outcome measures that included: clinical manifestations, number of SLE-related hospitalizations, number of exacerbations and pharmacologic treatment. Almost all (98.3 percent) patients were well acquainted of sunlight effects on disease activity. Two thirds were exposed to direct sunlight for an average of less than one hour per day and 33.3 percent for one hour or more. Thirty patients (50 percent) reported use of sunscreen, with sun protective factor of 15 or greater, when exposed to sunlight. Less than 40 percent of patients regularly wore hat or long-sleeves clothes to protect from sunlight. Although there were some clinical differences between the groups with different sunlight exposure times, none reached statistical significance. Also, no significant differences were found between the groups in regards to sunlight protective clothes. However, patients that regularly used sunscreen had significantly lower renal involvement (13.3 vs 43.3 percent), thrombocytopenia (13.3 vs 40 percent), hospitalizations (26.7 vs. 76.7 percent), and requirement of cyclophosphamide treatment (6.7 vs. 30 percent) than patients that did not used it (P < 0.05). We conclude that use of sunscreen photoprotection was associated with a better clinical outcome in our SLE patients. These findings further support the importance and benefits of photoprotective measures in patients with SLE

El factor de protección solar: consideraciones sobre su interpretación / Sun protection factors: considerations on their correct interpretation

El uso correcto de fotoprotectores tópicos incluye una interpreteación coherente del F.P.S. Se presenta información destinada a clarificar algunos conceptos vinculados al F.P.S. y alas técnicas diferentes que se utilizan para determinarlo. Se propone evitar las adjetivaciones engañosas en los preparados antisolares y utilizar una graduación comprensible para definir su acción fotoprotectora: Máxima-Alta-Mediana y Baja