Outdoor sunscreen testing with high-intensity solar exposure in a Chinese and Caucasian population.

BACKGROUND: Currently, sunscreens' sun protection factor (SPF) and ultraviolet (UV) A protection are tested separately under indoor conditions, without considering external conditions that may affect performance. Studies are often conducted in Caucasian individuals; other racial groups may respond differently. METHODS: An outdoor, double-blind, intra-individual study was performed in 63 healthy Chinese and Caucasian volunteers in Singapore. Subjects underwent one outdoor sun exposure lasting 2-3 hours. ISO reference products P3 (SPF 15), P5 (SPF 30), and P8 (SPF 50+) applied at 2 mg/cm2 were compared against each other and against an untreated exposed area (positive control) and an unexposed area (negative control). Endpoints were investigator global assessment (IGA) of erythema at 24 hours, IGA of pigmentation at 1 week, and colorimetry (a*, L*, and ITA) at 24 hours and 1 week. RESULTS: Clinical erythema and pigmentation scores were statistically significantly different among the three sunscreens, with the highest SPF product providing the highest protection, confirming the discriminatory capacity of the model used. Colorimetric assessment correlated well with clinical evaluation. CONCLUSION: This study confirmed the feasibility of ranking sunscreens (at 2 mg/cm2 ) based on clinical effects of high-intensity outdoor solar radiation. Larger studies are needed to look at differences in erythema and pigmentation reactions between Chinese and Caucasian individuals, which could be relevant for photoprotection.

Patient-Reported Outcomes in Acne Patients With Skin of Color Using Adapalene 0.3%-Benzoyl Peroxide 2.5%: A Prospective Real-World Study

Background: Patients with skin of color (SOC) and Fitzpatrick skin types (FST) IV­VI frequently develop acne. Objective: Evaluate subject-reported outcomes after treatment with adapalene 0.3%/ benzoyl peroxide 2.5% gel (0.3% A/BPO) in subjects with SOC and moderate to severe acne vulgaris. Methods: This was an open-label interventional study conducted in 3 countries (Mauritius, Singapore, and USA) in subjects of Asian, Latin-American, or black/African-American ethnicity, with an Investigator's Global Assessment (IGA) of moderate or severe facial acne (enrollment 2:1), and FST IV to VI. For 16 weeks, subjects applied 0.3% A/BPO (once daily) and utilized a skin care regimen (oil control foam wash and oil control moisturizer SPF30). Assessments included quality of life (QoL) and subject questionnaires, IGA, Investigator's Global Assessment of Improvement (GAI), postinflammatory hyperpigmentation (PIH; if present at baseline), and safety. Results: Fifty subjects were enrolled: 20 Asians, 17 black/African-Americans, and 13 Latin-Americans. Most had FST IV (74%) or V (22%), with moderate (70%; IGA 3) or severe (30%; IGA 4) acne. At week 16, 77% of subjects were satisfied or very satisfied with treatment, 56% of subjects had an IGA of 0 or 1 (clear/almost clear), and 87% had a good to excellent improvement in GAI. QoL improved throughout the study for all subjects; subject selection of "no effect at all" of acne on QoL increased from 16% of subjects at baseline to 55% at week 16. Of those with baseline PIH (60%), all were rated very mild to moderate. By week 16, the majority (75%) had no or very mild PIH, and the mean decrease in PIH was 27%. There were no adverse events leading to study discontinuation. Conclusion: Patients with SOC and moderate or severe facial acne reported high satisfaction with 0.3% A/BPO treatment and experienced good tolerability, improved QoL, treatment efficacy, and improvement in PIH. Clinicaltrials.gov number: NCT02932267 J Drugs Dermatol. 2019;18(6):514-520.

Clinicopathological and diagnostic characterization of confluent and reticulate papillomatosis of Gougerot and Carteaud: a retrospective study in a South-East Asian population.

BACKGROUND: Confluent and reticulate papillomatosis of Gougerot and Carteaud (CRP) is a rare dermatological condition, which has not been reported widely in Asian populations. AIM: To characterize the clinicopathological and diagnostic features of CRP in a South-East Asian population. METHODS: The medical records of 29 patients accorded the diagnosis of CRP at the National Skin Centre, Singapore, from 1990 to 2011, were analyzed. RESULTS: The male to female ratio was 2.6:1. Eight patients were Indians. The mean age at the onset of skin eruptions was 29.1 years (range 16-55 years), while the mean duration was 19.9 months (range 0.5-120 months). CRP itself was the most common preliminary diagnosis. Fungal smears were negative in all 22 instances. All 29 patients had received a trial of antifungal therapy before being seen at our center. Antifungal therapy was repeated in three subjects, and the response was uniformly poor. Conversely, the treatment response with tetracyclines was excellent, yielding more than a 50% response in all 14 patients. Four patients suffered recurrence of CRP. According to the diagnostic criteria set forth by Davis et al., 25/29 patients (86.2%) and 19/29 patients (65.6%) fulfilled at least three and four criteria, respectively. CONCLUSION: A predilection for male gender and Indian ethnicity were noted in our study. The diagnosis of CRP was often made clinically, and investigations were mainly ancillary. The treatment response was poor with antifungal agents but excellent with tetracyclines. The diagnostic criteria proposed by Davis et al. were found to be useful in our cohort of patients.