Knowledge, Attitudes, and Behaviors of Mostar University Students on the Harmful Effects of Ultraviolet Radiation Exposure - A KAB Study.

Various reports suggest that adolescents seem to be obsessed with tanning. Existing evidence on attitudes demonstrate that young adults focus on improving appearance through a tan, with protective behaviors often being absent. The popularity of tanning, primarily among the young adult population, further promotes unsafe sun-related behaviors. The aim of this study was to determine the knowledge level of Mostar University students on the harmful effects of ultraviolet radiation (UVR), their attitudes and sun-related behaviors, and whether medical students are more likely to apply preventive measures against UVR in comparison with students from other faculties. The survey included a total of 140 undergraduate Mostar University students: 70 medical students and 70 non-healthcare-related faculty students. The data were collected by completing the personal design questionnaire created for this study. This study shows that Mostar University students have a high level of knowledge about UVR and skin cancer, but their behavior is not sufficiently preventive and appropriate to their knowledge. Medical students often use UV protection measures and employ more preventive behavior than that of other faculty students, but it is still at a low level of prevention. Findings concurred with existing evidence that the knowledge of associated risks from UVR was not sufficient to motivate safer sun-related practices.

Comportamientos, actitudes y conocimientos relacionados con la exposición solar en estudiantes de medicina de la Universidad de Las Palmas de Gran Canaria / Behaviors, Attitudes, and Knowledge Related to Sun Exposure Among Medical Students at the Universidad de Las Palmas de Gran Canaria

Introducción: En las últimas décadas se ha producido un aumento en la incidencia de cáncer de piel a nivel mundial, siendo la exposición a la radiación ultravioleta el principal factor de riesgo. La quemadura solar es uno de los parámetros más sencillos para valorar los hábitos de exposición solar. Actualmente existen pocos trabajos que evalúen la fotoexposición en la población universitaria. Objetivos: Determinar los comportamientos, actitudes y conocimientos sobre fotoexposición y fotoprotección en estudiantes de medicina de la Universidad de Las Palmas de Gran Canaria y su relación con la quemadura solar. Material y métodos: Se realizó un estudio trasversal mediante participación voluntaria de alumnos de 1.°, 3.° y 6.° matriculados en el curso 2016-2017. Se utilizó un cuestionario validado sobre hábitos, actitudes y conocimientos en exposición solar. Se agruparon según el número de quemaduras solares en el último verano. Resultados: Participaron 286 alumnos. Si bien los estudiantes mostraron un elevado nivel de conocimiento, se observó un alto porcentaje de quemaduras (70,6%). Tras el análisis multivariante las variables que mostraron una asociación independiente con las quemaduras fueron la edad, el sexo masculino, el curso matriculado, el fototipo y las actitudes negativas con respecto al empleo de fotoprotectores. Conclusiones: En nuestro ámbito el nivel de conocimientos que presentan los estudiantes de medicina sobre fotoexposición y fotoprotección apenas varía durante la carrera y, a pesar de ser alto, no se refleja en su comportamiento, actitudes ni en la frecuencia de quemaduras solares

Introduction: The incidence of skin cancer, for which the main risk factor is exposure to ultraviolet radiation, has risen worldwide. Sunburn is one of the simplest ways to assess sun exposure habits. To date, few studies have evaluated sun exposure in university students. Objectives: To determine behaviors, attitudes, and knowledge related to sun exposure and sun protection measures among medical students at the Universidad de Las Palmas de Gran Canaria; and to assess their relation to sunburn frequency. Material and methods: The voluntary participants in this cross-sectional survey were first-, second- and sixth-year university students enrolled during the 2016-2017 academic year. The students responded to a validated questionnaire about their habits, attitudes, and knowledge in relation to sun exposure. Respondents were grouped according to the number of sunburns they had experienced during the previous summer. Results: A total of 286 students responded. The students demonstrated a high level of knowledge, but the percentage who experienced a sunburn was high. Multivariate analysis showed independent correlations between experiencing a sunburn and age, male sex, academic year of enrollment at the time of the survey, phototype, and negative attitudes toward the use of sun protection measures. Conclusions: Our medical students’ level of knowledge about sun exposure and sun protection is high and scarcely varies with time spent at the university. However, their knowledge is not reflected in their behavior and attitudes or in the frequency of sunburns

Basal Cell Carcinoma Arising in a Breast Augmentation Scar.

We report a case of a 46-year-old female who presented with a persistent lesion on the inferior right breast. The lesion was located within the scar from a breast augmentation procedure 12 years ago. The lesion had been treated as several conditions with no improvement. Biopsy revealed a superficial and nodular basal cell carcinoma, and the lesion was successfully removed with Mohs micrographic surgery. Basal cell carcinoma arising in a surgical scar is exceedingly rare with only 13 reported cases to date. This is the first reported case of basal cell carcinoma arising in a breast augmentation scar. We emphasize the importance of biopsy for suspicious lesions or those refractory to treatment, particularly those lesions that form within a scar. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

One week's holiday sun exposure induces expression of photoaging biomarkers.

INTRODUCTION: Skin aging is accompanied by the upregulation of the expression of various matrix metalloproteinases (MMPs). It was shown that exposure to ultraviolet radiation (UVR) may induce skin expression of MMPs and dysregulation of the transforming growth factor beta (TGF-ß)/Smad pathway. The aim of our study was to compare the effects of short holiday UVR exposure and lifetime UVR exposure, on the expression of MMP-8, TGF-ß1, and Smad2 in human skin biopsies. MATERIAL AND METHODS: Skin biopsies were taken from the outer upper arm of 15 elderly people with significant photoaging (mean age 64.1 years) (Group 1) and from 15 healthy young adult volunteers (mean age 24.1 y) who participated in a six-day sun holiday. Biopsies were taken twice: 24 hours before leaving for holiday (Group 2a) and 24 hours after returning (Group 2b). The expression of TGF-ß1, Smad2, and MMP-8 was examined by immunochemistry and measured semiquantitatively by two independent pathologists. RESULTS: The mean expression of TGF-ß1 in dermal fibroblasts and keratinocytes in Group 1 and Group 2b was significantly lower than in Group 2a (0.54% ± 0.44% and 0.48% ± 0.51% vs. 1.48% ± 0.72%, respectively). The percentage of Smad2 (+) cells in Group 1 and Group 2b was lower than in Group 2a (2.13% ± 1.39% and 1.81% ± 1.16% vs. 4.13% ± 1.58%, respectively). The MMP-8 expression in Group 2b was 1.36% ± 0.68% and was significantly higher than in Group 1 (0.34% ± 0.42%) and Group 2a in which the protein was not detected (p < 0.001). CONCLUSIONS: We conclude that the decrease in the expression of TGF-ß1 and Smad2 is a persistent biomarker of skin photoaging, while the increased expression of MMP-8 in keratinocytes can be regarded as a marker of acute sun exposure.

[UV radiation, tanning and DNA damage]. / UV-säteily, ruskettuminen ja DNA-vaurio.

Excessive exposure to UV radiation is the most significant known risk factor for skin cancer. Solarium devices produce UVA radiation that is 5 to 10 times stronger than that produced by the sun. All wavelengths of UV radiation cause DNA damage to skin cells and cause tanning. Tanning protects skin cells from further damage. The DNA damages caused by UVA and UVB radiation, however, differ from each other. The protective capacity of tanning caused by UVA radiation seems to be lower than that caused by UVB radiation.

Knowledge, understanding, and use of preventive strategies against nonmelanoma skin cancer in healthy and immunosuppressed individuals undergoing Mohs surgery.

BACKGROUND: Despite various national recommendations advising individuals to reduce their exposure to ultraviolet radiation, many people still do not use these skin cancer prevention strategies. OBJECTIVES: To assess patient sources of medical information, knowledge of sun protection strategies, and barriers to implementing these strategies and to compare the overall rate of use of skin cancer prevention strategies of healthy and immunocompromised patients. MATERIALS AND METHODS: Survey-based study conducted on 140 individuals undergoing Mohs surgery. RESULTS: Seventy-three percent of healthy and 74% of immunosuppressed participants identified sunscreen use as a form of protective strategy, whereas 36% and 27%, respectively, used sunscreen daily. Participants cited physicians and the internet as equal sources of medical information. Knowing two or more strategies correlated to a higher self-rating of daily use of any protective strategy. CONCLUSION: General knowledge regarding sun protection strategies is limited, but awareness of multiple strategies correlated with greater sun protective behavior. Despite having a much higher incidence of skin cancers, the immunosuppressed group did not show more awareness of prevention strategies or higher use than healthy participants.

Severe burn on 81% of body surface after sun tanning.

We report herein the case of a 42-year-old woman who presented to the Burns Unit with 81% of her body surface severely burned following sun bathing, after applying fig leaf tea as a tanning agent. The patient was hospitalized for 13 days in a Burns Intensive Care Unit, and was discharged for an ambulatory follow-up. The treatment of such burns does not differ from any conventional treatment for heat- induced second-degree burns. The physiopathology of the phytophotodermatitis induced by such homemade tanning solutions rich in psoralen is discussed in detail.

UVA tanning is involved in the increased incidence of skin cancers in fair-skinned young women.

Melanomas are the most prevalent cancers in 25-29 yr old females and compose roughly 12% of cancers in 20-40 yr old women; under the age of 40, women have a higher incidence of melanomas than do men. Within the past few decades, the alarming trend to use commercial sunlamps for cosmetic pigmentation is of particular concern, especially since 71% of those patrons are women with 50% of patrons under the age of 29. A major problem may be the use of UVA-rich sunlamps which produce a visible tan but afford little to no protection from subsequent UV exposure. We hypothesize that the additional exposure of adolescents to unnaturally large amounts of UVA from artificial UV sources is implicated in the increasing incidence of malignant melanomas disproportionately in young women.

Solaria compliance with the Australia/New Zealand Standard in Adelaide.

ISSUE ADDRESSED: To assess the compliance of solarium centres in metropolitan Adelaide with the Australia/ New Zealand Standard, specifically determining the access of different groups, skin cancer warnings and the use of consent forms. METHODS: Three groups of research assistants approached 30 solarium centres by telephone and in person. Centres were assessed on recommendations/claims made, warnings given and access to a solarium. RESULTS: There was an extremely low level of compliance with the standard. Sixty per cent of centres allowed access to under-aged clients, 93% of centres allowed access to fair-skinned clients, and only 53% consistently required clients to sign a consent form. Restriction of under-age and fair skin access was greatly over-reported over the telephone compared to actual access. CONCLUSIONS: The results highlight the need to increase adherence to the standard.

Urticaria solar y erupción lumínica polimorfa con el uso de cámaras de bronceado / Tanning-beds and tanning cabins-induced solar urticaria and polymorphic light eruption

El uso de cabinas de bronceado se relaciona con diversos efectos secundarios, incluida la exacerbación de fotodermatosis previas. En este artículo se presentan 2 casos de urticaria solar y uno de erupción lumínica polimorfa en personas sin antecedentes de fotosensibilidad, coincidiendo con el uso continuado de cabinas de bronceado. En ambos casos se realizó fototest y determinaciones analíticas sanguíneas para excluir otras posibles causas de fotosensiblidad. Se lleva a cabo una revisión de las bibliografías sobre urticaria solar y erupción lumínica polimorfa relacionadas con el uso de cabinas de bronceado (AU)