Sun exposure practices, attitudes and knowledge among students and teachers at a University School of Health Sciences in Ecuador.

Skin cancer incidence is increasing worldwide. Late adolescence and young adulthood are fundamental stages of life to acquire good sun exposure practices, regarding both personal involvement in skin cancer prevention and being a role model for others, especially in a health education environment. This descriptive cross-sectional study is based on the validated CHACES questionnaire to study sun exposure and photoprotection behavior among students and teachers at the School of Health Sciences in the National University of Chimborazo, Riobamba (Ecuador). University members (814 students (89.8 %) and 93 teachers (10.2 %)) were studied, with a predominance of females and light-skin phototypes in both groups. Similar results were obtained regarding sun exposure, with higher recreative exposure in the teachers' group and higher occupational exposure in students. However, students significantly showed lower avoiding midday sun (41.9 % vs 60.9 %), and lower use of sunglasses (10.1 % vs. 41.6 %). Attitudes towards the sun and photoprotection knowledge issues were also equivalent between students and teachers (6.1/10 vs 6.2/10). Students' sunburn rate last year reaches 88.4 % and 52.7 % in teachers (p < 0.001). Using a multivariable logistic regression model, we identified risk factors associated with a greater risk of sunburn in our population. This study highlights areas to be improved regarding knowledge, attitudes and, especially, practices of photoprotection, among students and teachers at the University of Chimborazo. These results point out that awareness-raising campaigns should be implemented to reduce sunburns, morbidity and mortality of skin cancer in this environment.

Aspirin-Triggered Resolvin D1 (AT-RvD1) Protects Mouse Skin against UVB-Induced Inflammation and Oxidative Stress.

Intense exposure to UVB radiation incites excessive production of reactive oxygen species (ROS) and inflammation. The resolution of inflammation is an active process orchestrated by a family of lipid molecules that includes AT-RvD1, a specialized proresolving lipid mediator (SPM). AT-RvD1 is derived from omega-3, which presents anti-inflammatory activity and reduces oxidative stress markers. The present work aims to investigate the protective effect of AT-RvD1 on UVB-induced inflammation and oxidative stress in hairless mice. Animals were first treated with 30, 100, and 300 pg/animal AT-RvD1 (i.v.) and then exposed to UVB (4.14 J/cm2). The results showed that 300 pg/animal of AT-RvD1 could restrict skin edema, neutrophil and mast cell infiltration, COX-2 mRNA expression, cytokine release, and MMP-9 activity and restore skin antioxidant capacity as per FRAP and ABTS assays and control O2•- production, lipoperoxidation, epidermal thickening, and sunburn cells development. AT-RvD1 could reverse the UVB-induced downregulation of Nrf2 and its downstream targets GSH, catalase, and NOQ-1. Our results suggest that by upregulating the Nrf2 pathway, AT-RvD1 promotes the expression of ARE genes, restoring the skin's natural antioxidant defense against UVB exposition to avoid oxidative stress, inflammation, and tissue damage.

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.

Are TRPA1 and TRPV1 channel-mediated signalling cascades involved in UVB radiation-induced sunburn?

Burn injuries are underappreciated injuries associated with substantial morbidity and mortality. Overexposure to ultraviolet (UV) radiation has dramatic clinical effects in humans and is a significant public health concern. Although the mechanisms underlying UVB exposure are not fully understood, many studies have made substantial progress in the pathophysiology of sunburn in terms of its molecular aspects in the last few years. It is well established that the transient receptor potential ankyrin 1 (TRPA1), and vanilloid 1 (TRPV1) channels modulate the inflammatory, oxidative, and proliferative processes underlying UVB radiation exposure. However, it is still unknown which mechanisms underlying TRPV1/A1 channel activation are elicited in sunburn induced by UVB radiation. Therefore, in this review, we give an overview of the TRPV1/A1 channel-mediated signalling cascades that may be involved in the pathophysiology of sunburn induced by UVB radiation. These data will undoubtedly help to explain the various features of sunburn and contribute to the development of novel therapeutic approaches to better treat it.

Protection against UVB deleterious skin effects in a mouse model: effect of a topical emulsion containing Cordia verbenacea extract.

Cordia verbenacea DC (Boraginaceae) is a flowering shrub found along the Brazilian Atlantic Forest, Brazilian coast, and low areas of the Amazon. The crude extract of its leaves is widely used in Brazilian folk medicine as an anti-inflammatory, both topically and orally. The aim of this study is to evaluate the activity of C. verbenacea ethanolic leaves extract (CVE) against UVB-triggered cutaneous inflammation and oxidative damage in hairless mice. CVE treatment recovered cutaneous antioxidant capacity demonstrated by scavenging ABTS+ free radical and iron-reducing antioxidant potential evaluated by FRAP. CVE also controlled the following UV-triggered events in the skin: reduced glutathione (GSH) depletion, catalase activity decrease, and superoxide anion (O⋅-) build-up. Furthermore, mice treated with CVE exhibited less inflammation, shown by the reduction in COX-2 expression, TNF-α, IL-1ß, IL-6, edema, and neutrophil infiltration. CVE also regulated epidermal thickening and sunburn cells, reduced dermal mast cells, and preserved collagen integrity. The best results were obtained using 5% CVE-added emulsion. The present data demonstrate that topical administration of CVE presents photochemoprotective activity in a mouse model of UVB inflammation and oxidative stress. Because of the intricate network linking inflammation, oxidative stress, and skin cancer, these results also indicate the importance of further studies elucidating a possible role of C. verbenacea in the prevention of UVB-induced skin cancer and evaluating a potential synergy between CVE and sunscreens in topical products against UVB damaging effects to the skin.

Sunburns among beachgoers in the northern coast of Peru: frequency and factors associated.

BACKGROUND: Overexposure to ultraviolet (UV) radiation has increased skin cancer incidence and the risk of sunburns, especially during the summer months. OBJECTIVE: Identify the frequency and factors associated with sunburns in a sample of beachgoers in the northern coast of Peru. METHODS: We conducted a secondary data analysis of a previous study that assessed the awareness, behavior and attitudes concerning sun exposure among beachgoers. We included adults between 18 and 59 years who went to a beach in northern Peru during summer (March 2018). Three generalized linear models of the Poisson family were constructed to evaluate the factors associated with having had at least one sunburn last summer. All regression models reported the adjusted prevalence ratio (aPR) with their respective 95% confidence interval (95% CI). RESULTS: Of a total of 402 participants, 225 (56.0%) had one to five sunburns and 25 (6.2%) had six or more. Beachgoers who were 1-15 days (aPR: 1.16, 95% CI [1.05-1.27]) or more than 15 days (aPR: 1.22, 95% CI [1.09-1.36]) exposed to the sun on the beach had a higher frequency of at least one sunburn. The non-regular wearing of a hat or cap also increased the frequency of sunburns (aPR: 1.06, 95% CI [1.01-1.12]). In contrast, those who had Skin Phototype III (aPR: 0.94, 95% CI [0.88-0.99]) or IV (aPR: 0.69, 95% CI [0.63-0.75]) had a lower frequency of sunburns. CONCLUSION: Three out of five beachgoers had one or more sunburns in the last summer. The factors associated with a higher frequency were the time of sun exposure at the beach and the non-regular use of a hat or cap. Type III-IV skin phototypes were associated with a lower sunburn frequency.

Diosmetin, a novel transient receptor potential vanilloid 1 antagonist, alleviates the UVB radiation-induced skin inflammation in mice.

UVB radiation-mediated inflammation and the oxidative process involve the transient receptor potential vanilloid 1 (TRPV1) channel activation in neuronal and non-neuronal cells. Once diosmetin has been identified as a novel TRPV1 antagonist, we evaluated the action of diosmetin from the inflammatory [ear oedema, myeloperoxidase (MPO) activity, histological changes, and cytokines levels] and oxidative [nicotinamide adenine dinucleotide phosphate (NADPH) oxidase and SOD activities] parameters in mice exposed to UVB radiation (0.5 j/cm2). We also verified the action of diosmetin on UVB radiation-induced inflammatory parameters after cutaneous nerve fibers denervation by RTX (50 µg/kg s.c.). The topical treatment with the novel TRPV1 antagonist, diosmetin (1%; 15 mg/ear), reduced ear oedema, MPO activity, and MIP-2 and IL-1ß cytokines levels by 82 ± 8%, 59 ± 10%, 40 ± 12%, and 85 ± 9%, respectively. The action of diosmetin on ear oedema and inflammatory cell infiltration was histologically confirmed. Topical diosmetin (1%) also reduced NADPH oxidase activity by 67 ± 10% and reverted SOD activity by 81 ± 13%. After cutaneous nerve fibers denervation using RTX, diosmetin reduced ear oedema, but not the inflammatory cell infiltration in mice exposed to UVB radiation. Diosmetin can be a promising molecule against skin inflammatory disorders as a result of sunburn induced by UVB radiation exposure.

Neuronal and non-neuronal transient receptor potential ankyrin 1 mediates UVB radiation-induced skin inflammation in mice.

AIMS: Neuronal and non-neuronal TRPA1 channel plays an active role in the pathogenesis of several skin inflammatory diseases. Although a recent study identified the TRPA1 channel activation upon UVB exposure, its role in inflammatory, oxidative, and proliferative processes underlying UVB radiation-induced sunburn was not yet fully understood. We evaluated the TRPA1 channel contribution in inflammatory, oxidative, and proliferative states on skin inflammation induced by UVB radiation in mice. MAIN METHODS: TRPA1 role was evaluated from inflammatory (ear edema, myeloperoxidase, and N-acetyl-ß-D-glycosaminidase activities, histological changes, and cytokines levels), proliferative (epidermal hyperplasia, PCNA, and TRPA1 levels), and oxidative (reactive oxygen intermediates measure, H2O2 quantification, and NADPH oxidase activity) parameters caused by UVB radiation single (0.5 J/cm2) or repeated (0.1 J/cm2) exposure. We verified the contribution of non-neuronal and neuronal TRPA1 on UVB radiation-induced inflammatory parameters using RTX-denervation (50 µg/kg s.c.). KEY FINDINGS: TRPA1 blockade by the selective antagonist Lanette® N HC-030031 reduced all parameters induced by UVB radiation single (at concentration of 1%) or repeated (at concentration of 0.1%) exposure. We evidenced an up-regulation of the TRPA1 protein after UVB radiation repeated exposure, which was blocked by topical Lanette® N HC-030031 (0.1%). By RTX-denervation, we verified that non-neuronal TRPA1 also interferes in some inflammatory parameters induction. However, cutaneous nerve fibers seem to be most needed in the development of UVB radiation-induced inflammatory processes. SIGNIFICANCE: We propose the TRPA1 channel participates in the UVB radiation-induced sunburn in mice, and it could be a promising therapeutic target to treat skin inflammatory disorders.

Topical transient receptor potential ankyrin 1 antagonist treatment attenuates nociception and inflammation in an ultraviolet B radiation-induced burn model in mice.

BACKGROUND: Ultraviolet B (UVB) radiation exposure promotes sunburn and thereby acute and chronic inflammatory processes, contributing to pain development and maintenance. New therapeutic alternatives are necessary because typical treatments can cause adverse effects. An attractive alternative would be to target the transient receptor potential ankyrin 1 (TRPA1), a calcium-permeable, non-selective cation channel, which is involved in a variety of inflammatory pain models. OBJECTIVE: Evaluate the peripheral participation of TRPA1 using a topical treatment (HC030031 gel formulation; a selective TRPA1 antagonist) in nociception and inflammation caused by a UVB radiation-induced burn model in male mice (25-30 g). METHODS: The mice were anaesthetised, and just the right hind paw was exposed to UVB radiation (0.75 J/cm2). Topical treatments were applied immediately after irradiation and once a day for 8 days. RESULTS: HC030031 gel presented suitable pH and spreadability factor, ensuring its quality and the therapeutic effect. HC030031 0.05 % reversed UVB-induced mechanical and cold allodynia, with maximum inhibition (Imax) of 69 ± 13 % and 100 % (on day 4), respectively. HC030031 0.05 % also reduced the paw edema and MPO activity, with Imax of 77 ± 6 % (on day 5) and 69 ± 28 %, respectively. Likewise, UVB radiation increased the H2O2 levels (a TRPA1 agonist) and the Ca2+ influx in mice spinal cord synaptosomes. UVB radiation-induced Ca2+ influx was reduced by HC030031. CONCLUSION: These findings confirm the activation of the TRPA1 channel by UVB radiation, suggesting that topical TRPA1 antagonists can be a new strategy for the adjuvant treatment of sunburn-associated pain and inflammation.

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

Oleic acid-containing semisolid dosage forms exhibit in vivo anti-inflammatory effect via glucocorticoid receptor in a UVB radiation-induced skin inflammation model.

The treatment of cutaneous inflammation with topical corticosteroids may cause adverse effects reinforcing the need for therapeutic alternatives to treat inflammatory skin disorders. We investigated the anti-inflammatory effect of oleic acid (OA), a fatty acid of the omega-9 (ω-9) family, and we point out it as an alternative to treat inflammatory skin disorders. OA was incorporated into Lanette®- or Pemulen® TR2-based semisolid preparations and the pH, spreadability, rheological behavior and in vivo anti-inflammatory performance in a UVB radiation-induced skin inflammation model in mice were assessed. The anti-inflammatory activity was verified after single or repeated treatment of the mouse ear following the UVB. The OA action on glucocorticoid receptors was investigated. Both semisolids presented pH values compatible with the deeper skin layers, appropriate spreadability factors, and non-Newtonian pseudoplastic rheological behavior. Pemulen® 3% OA inhibited ear edema with superior efficacy than Lanette® 3% OA and dexamethasone after a single treatment. Pemulen® 3% OA and dexamethasone also reduced inflammatory cell infiltration. After repeated treatments, all formulations decreased the ear edema at 24 h, 48 h and 72 h after UVB. OA in semisolids, especially Pemulen® TR2-based ones, presented suitable characteristics for cutaneous administration and its anti-inflammatory activity seems to occur via glucocorticoid receptors. OA was also capable to reduce croton oil-induced skin inflammation. Besides, the ex vivo skin permeation study indicated that OA reaches the receptor medium, which correlates with a systemic absorption in vivo. The natural compound OA could represent a promising alternative to those available to treat inflammatory skin disorders.

Dermatological and Epidemiological Profiles of Patients with Albinism in São Paulo, Brazil, between 2010 and 2017: A Cross-Sectional Study.

INTRODUCTION: Oculocutaneous albinism is an autosomal recessive disease caused by complete absence of or decrease in melanin biosynthesis in melanocytes. Due to the reduction or absence of melanin, albinos are highly susceptible to the harmful effects of ultraviolet radiation and are at greater risk of actinic damage and skin cancer. There are no epidemiological data on the incidence of albinism in Brazil. OBJECTIVE: To analyze the clinical and epidemiological profile of patients with albinism treated by the Pró-Albino Program of the Dermatology Clinic of Santa Casa de Misericórdia from its beginning in 2010 until 2017. METHODS: In this cross-sectional study, the records of all consecutive albino patients admitted to the service in the study period were reviewed. Sociodemographic data, family history, and dermatological clinical data were collected. RESULTS: Between March 2010 and April 2017, 191 patients were admitted, of whom 109 were female (57.07%) and the age range was 0-92 years, with >30% under the age of 18 years. Consanguinity among the parents was confirmed by 26% of the patients. Unprotected sun exposure was reported by 109 (57.07%), and 138 (72.25%) had a history of sunburn. Of the 146 records with information, 38 had skin cancer (26%), with a mean age of 47.4 (p < 0.0001); the youngest patient diagnosed with a cutaneous tumor was 23 years old. The prevalence of actinic damage was high. There was information on solar elastosis and actinic keratosis in 148 medical records, of which 96 (64.8%) patients had elastosis and 75 (50.67%) keratoses. Elastosis, keratosis, and skin cancer were significantly associated with age, unprotected sun exposure, and sunburn (p < 0.05). Of the 37 (26% of the sample of 146) patients with a previous or current history of skin cancer, it was possible to identify the histological type in 29 (13 men and 16 women); of these, 18 (62%) were basal cell carcinomas (BCC), 15 (51%) were squamous cell carcinomas (SCC), and 2 (7%) were melanomas. Of these, 4 cases (14%) presented the 2 types of carcinoma (BCC and SCC), and the 2 that had a diagnosis of melanoma also had BCC. Some patients had multiple ulcerated tumors. The tumor site was preferentially in the head and neck (43%), trunk (37%) and limbs (20%). CONCLUSIONS: Albinos represent a risk group for skin cancer and other actinic lesions. These lesions were found to be prevalent in the albinos seen by the program and probably reflect the characteristics found in the Brazilian albino population. Access to health care, especially through multidisciplinary programs that enable the diagnosis and early treatment of these lesions, health education, and the use of photoprotective measures can reduce morbidity and mortality and improve the quality of life of patients with this rare genetic condition.

Are the Fitzpatrick Skin Phototypes Valid for Cancer Risk Assessment in a Racially and Ethnically Diverse Sample of Women?

The Fitzpatrick Skin Phototypes (FSP) were developed to classify skin color and response to ultraviolet radiation. FSP are used clinically to assess risk for sunburn and skin cancer. Our aim was to determine the criterion-related validity of self-reported FSP when compared with skin color and sunburn history, controlling for age, race/ethnicity, and seasonality/geography. We performed a secondary analysis of data (N=466) from an observational study. The racial/ethnic composition of the sample was 45% White/White Hispanic (WWH), 40% Black/Black Hispanic (BBH), and 15% Other Identities. Outcome measures were self-reported FSP and sunburn history, as well as physiological measures of skin color (L* lightness/darkness, a* redness/greenness, b* yellowness/blueness). Correlation between FSP and L* was -.77 (95% CI -.81, -.73; P<.001). Although 60% of the variance in FSP was accounted for by L* values for the entire sample, only 5% of the variance was accounted for among BBH participants (r=-.23), and up to 30% for WWH/Other Identity participants (r=-.48 and -.52). Multiple regression analysis indicated L* and b* values, sunburn history, and race/ethnicity, but not geography/seasonality or a* values significantly and collectively accounted for 72% of the variance in FSP. While the criterion validity of FSP was established by the strong relationship between L* values and FSP for the entire sample, when examined at the level of individual racial/ethnic subgroups, criterion validity of FSP was not demonstrated. When self-reported FSP are used for clinical skin assessment and sun cancer screening, they provide a restricted range of options for people with darker skin that does not capture variations in their skin color. Inaccuracy of clinical data may lead to unequal treatment or inadequate cancer risk assessment.

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.

Persea americana Mill. crude extract exhibits antinociceptive effect on UVB radiation-induced skin injury in mice.

Persea americana, popularly known as avocado, has been empirically used as analgesic and anti-inflammatory including in the skin disorder treatment. Species of the genus Persea also show a photoprotective effect against UVB radiation. We investigated the antinociceptive and anti-inflammatory effects from a topical formulation containing the P. americana leaf extract in a UVB irradiation-induced burn model in mice and performed a gel-formulation stability study. The antinociceptive and anti-inflammatory effect was evaluated through mechanical allodynia, paw oedema, and inflammatory cell infiltration. Phenolic compounds were quantified by UHPLC-MS/MS. The gel-formulation stability study was performed analyzing organoleptic characteristics, pH, and viscosity. P. americana (3%) gel was able to prevent the UVB irradiation-induced mechanical allodynia on the 2nd and 3rd day after irradiation with maximum inhibition of 60 ± 12% at 2nd day. Such effect may be attributed, at least in part, due the presence of (+)-catechin (302.2 ± 4.9 µg/g) followed by chlorogenic acid (130 ± 5.1 µg/g) and rutin (102.4 ± 0.9 µg/g) found in the extract. The gel was not able to prevent the inflammatory parameters such as edema and leukocyte infiltration induced by UVB irradiation. No changes important were detected in the stability study, mainly in low temperature. Our results suggest that P. americana gel-formulation, which presented stability, ensuring its quality and the therapeutic effect, could be an interesting strategy for the treatment of the pain associated with sunburn; this effect could be attributed to its biological constituents, especially catechin, chlorogenic acid, and rutin.

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)

Histological observation of hairless mice skin after exposure to Simulated Solar Light: Comparison between the histological findings with different methodologies and 3R principle correlations.

BACKGROUND: Albino hairless mouse (AHM) has been used as a biological model in photodermatology. However, the experimental landscape is diverse to follow and need particular attention. PURPOSE: Irradiation parameters were investigated for the development of a protocol to assess alterations in the AHM skin using Simulated Solar Light (SSL). The present study was compared with published articles (last 15 years) according to irradiation protocols, morphological findings to minimize animal suffering and UV exposure. MATERIALS AND METHODS: Three groups: Control (G1), experimental - sunburn (G2) and skin photodamage assay (G3). G2 were immobilized and exposed to SSL once for 15, 30 and 45min. G3 were exposed to SSL, without immobilization, for 15min once a day for one week. The dorsal skin was analyzed using hematoxylin and eosin technique. RESULTS: G2 displayed different sunburn degrees. Based on the profile of the observed morphological alterations, a 15min irradiation was chosen as the exposure time to expose G3, without immobilization, for 5 consecutive days. CONCLUSION: These conditions produced the same morphological changes in the AHM with a shorter solar exposure time, without immobilizing the animals but using environmental exposure fluences, conforming to 3R (reduction - refinement - replacement) recommendations.

Phytohormone Interaction Modulating Fruit Responses to Photooxidative and Heat Stress on Apple (Malus domestica Borkh.).

Sun-related physiological disorders such as sun damage on apples (Malus domestica Borkh) are caused by cumulative photooxidative and heat stress during their growing season triggering morphological, physiological, and biochemical changes in fruit tissues not only while it is on the tree but also after it has been harvested. The objective of the work was to establish the interaction of auxin (indole-3-acetic acid; IAA), abscisic acid (ABA), jasmonic acid (JA), salicylic acid (SA), and ethylene (ET) and its precursor ACC (free and conjugated, MACC) during development of sun-injury-related disorders pre- and post-harvest on apples. Peel tissue was extracted from fruit growing under different sun exposures (Non-exposed, NE; Exposed, EX) and with sun injury symptoms (Moderate, Mod). Sampling was carried out every 15 days from 75 days after full bloom (DAFB) until 120 days post-harvest in cold storage (1°C, > 90%RH). Concentrations of IAA, ABA, JA, SA, were determined using UHPLC mass spectrometry, and ET and ACC (free and conjugated MACC) using gas chromatography. IAA was found not to be related directly to sun injury development, but it decreased 60% in sun exposed tissue, and during fruit development. ABA, JA, SA, and ethylene concentrations were significantly higher (P ≤ 0.05) in Mod tissue, but their concentration, except for ethylene, were not affected by sun exposure. ACC and MACC concentrations increased until 105 DAFB in all sun exposure categories. During post-harvest, ethylene climacteric peak was delayed on EX compared to Mod. ABA and SA concentrations remained stable throughout storage in both tissue. JA dramatically increased post-harvest in both EX and Mod tissue, and orchards, confirming its role in low temperature tolerance. The results suggest that ABA, JA, and SA together with ethylene are modulating some of the abiotic stress defense responses on sun-exposed fruit during photooxidative and heat stress on the tree.

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.