Determinación de los hábitos de exposición solar y prácticas de fotoprotección, en individuos que se ejercitan al aire libre, en la región andina venezolana / Determination of sun exposure and photoprotection habits in individuals who perform outdoor exercises, in the Venezuelan Andean region

Resumen Introducción: la exposición solar frecuente e indiscriminada ha determinado un incremento en las tasas de cáncer de piel a nivel global. En Venezuela, son limitados los reportes que evalúan las prácticas de exposición solar y el empleo de medidas de fotoprotección. Objetivo: determinar los hábitos de exposición solar, las prácticas de fotoprotección y su asociación con el nivel de conocimiento y actitudes, en individuos que se ejercitan al aire libre en la región andina venezolana, durante el año 2020. Métodos: estudio descriptivo de corte transversal. A través de un cuestionario de llenado digital, se evaluaron datos demográficos, fototipo cutáneo, antecedentes de quemaduras solares, hábitos de exposición solar, prácticas de fotoprotección, percepciones y conocimientos. Resultados: la muestra estuvo constituida por 94 participantes. Las mujeres emplean el protector solar con mayor frecuencia que los hombres, y hacen mejor uso de este. El 48,9 % ha sufrido en promedio entre 1 a 10 quemaduras por entrenamientos al aire libre. El 70,2 % realiza actividades físicas de 3 a 5 días por semana. El 59,2 % no emplea el protector solar en días nublados. Se determinó un alto riesgo (13,8 %) y muy alto riesgo (4,3 %) de desarrollar melanoma a futuro. Conclusiones: la población evaluada posee un grado aceptable de conocimiento sobre fotoprotección, hace uso frecuente pero inadecuado del protector solar, y posee hábitos de exposición solar que implican dosis considerables de radiación ultravioleta; por lo que es necesario profundizar en campañas de concienciación, que promuevan la adopción de hábitos de exposición solar saludables.

Abstract Background: Frequent and indiscriminate sun exposure has determined an increase in skin cancer rates globally. In Venezuela, reports evaluating sun exposure practices and the use of photoprotection measures are limited. Objective: To determine sun exposure habits, photoprotection practices and their association with the level of knowledge and attitudes, in individuals who perform outdoor exercises in the Venezuelan Andean region, throughout 2020. Methods: Descriptive cross-sectional study. Using a digital survey, demographic data, skin phototype, history of sunburn, sun exposure habits, photoprotection practices, perceptions and knowledge were evaluated. Results: The sample consisted of 94 participants. Women use sunscreen more often than men, and they make a better use of it. 48.9% have suffered on average about 1 to 10 burns due to outdoor exercises. 70.2% practice physical activities 3 to 5 days per week. 59.2% do not use sunscreen on cloudy days. There was a high risk (13.8%) and a very high risk (4.3%) of developing future melanoma. Conclusions: The population evaluated has an acceptable level of knowledge about photoprotection. They make frequent but inappropriate use of the sunscreen, and have sun exposure habits that imply considerable doses of ultraviolet radiation; therefore, it is necessary to implement awareness campaigns that promote the adoption of healthy sun exposure habits.

Research progress and directions in photodermatology / 中华皮肤科杂志

As an important subdiscipline of dermatology, photodermatology has developed rapidly in recent years. It is not only theoretical science of photodamage-related dermatoses, but also practical science of treatment of photodamage-related dermatoses. This article introduces the basis of photobiology, the pathogenesis of photodamage-related dermatoses, and research hotspots in sunscreens, and elaborates new progress in the clinical application of targeted phototherapy and home phototherapy, with a view to providing a theoretical basis and practical guidance for the treatment of photodamage-related dermatoses.

Extrato de Polypodium leucotomos em fotoproteção tópica e oral: dez anos de experiência brasileira / Polypodium leucotomos extract in topical and oral photoprotection: ten years of Brazilian experience

O extrato de Polypodium leucotomos foi inicialmente descrito na literatura internacional há 55 anos, demonstrando ação anti-inflamatória em dermatoses como vitiligo e psoríase. Atualmente, está disponível como fotoprotetor oral e tópico em mais de 26 países e é utilizado na prevenção e no tratamento de dermatoses decorrentes da radiação solar, como erupção polimorfa à luz, melasma, queratoses actínicas, câncer de pele, fotoenvelhecimento, entre outras. No Brasil, o extrato patenteado das folhas de Polypodium leucotomos foi registrado pela Agência Nacional de Vigilância Sanitária (Anvisa) como medicamento em 2012. Decorridos 10 anos de sua introdução no Brasil, sua recomendação por dermatologistas brasileiros está consagrada e será apresentada neste artigo

Polypodium leucotomos extract was first described in the literature 55 years ago, demonstrating anti-inflammatory action in dermatoses such as vitiligo and psoriasis. It is currently available as an oral and topical photoprotection agent in more than 26 countries to prevent and treat dermatoses resulting from solar radiation, such as polymorphous light eruption, melasma, actinic keratoses, skin cancer, and photoaging, among others. In Brazil, ANVISA registered the patented Polypodium leucotomos extract in 2012. After 10 years of its launch, its recommendation by Braziliandermatologists is well established and is presented in this review paper

Sunscreen lotions in the dermatological prescription: review of concepts and controversies

Abstract The skin is regularly exposed to several environmental aggressions, including solar radiation, whose biological effects can induce sunburn, dyschromia, skin aging and cancer. Among the photoprotection measures, sunscreens comprise a relevant part of the strategy aimed to prevent solar radiation damage and, for effective action, the patient must adhere to the product use and the latter, in turn, must follow technical parameters to promote adequate protection. This review article brings together the most current and relevant concepts about photoprotection for dermatological use, including the challenges for their formulation, the risks of certain photoprotective active substances for individual and environmental safety and the importance of stringency in determining the product efficacy, considering the regulatory aspects, highlighting relevant differences between Brazil and other countries. Thus, when assessing a sunscreen, not only the visual aspects and sensory perception will be immediately evaluated, but also the quality and suitability of the vehicle, the chemical composition of the formulation, the environmental risks, the photostability of the screening system, and the measurement of its protection spectrum. Technical knowledge of sunscreens can help dermatologists in this important role of educating patients about the best photoprotective strategies in each situation.

Efficacy of sunscreen with photolyase or regular sunscreen associated with topical antioxidants in treating advanced photodamage and cutaneous field cancerization: a randomized clinical trial

Abstract Background Several treatments are available for skin with advanced photodamage, which is characterized by the presence of actinic keratoses (AK). Objectives Evaluate the efficacy of using sunscreen with photolyase compared to regular sunscreen, as well as to compare the combination of a topical formulation of antioxidants versus placebo in the treatment of advanced photodamage. Methods This was a randomized, double-blind, factorial clinical trial. Participants with AKs on their forearms were randomized to apply regular sunscreen (SC) or sunscreen with photolyase (SC+P) on both forearms during the day. One of the forearms in each group was randomized again to receive topical antioxidants (AOx), and the other forearm received a placebo cream (both for night application). The four groups were SC/AOx, SC/placebo, SC+P/AOx, and SC+P/placebo. The duration of treatment was 8 weeks. Primary outcomes were total AK clearance, decrease in Forearm Photoaging Scale (FPS), and AK severity scores. Secondary outcomes were reduction in AK count, partial clearance rate, and safety. Results Forty participants (80 forearms) were included. All groups showed significant improvement in outcomes at week eight. There were no significant differences between SC and SC+P for either outcome. AOx led to a significant reduction in AK count (22%; p < 0.05). Partial clearance was obtained in 18 (47.4%) forearms treated with AOx and in 9 (23.7%) treated with placebo (p < 0.05). All groups reduced the FPS score, without significant differences among them. Conclusions There is no difference in the treatment of advanced photodamage skin when comparing the use of sunscreen with photolyase and regular sunscreen, and topical antioxidants were more efficient in reducing AK count than placebo. Study limitations Short interval of follow-up and absence of re-evaluation in the absence of treatment were limitations of the present study.

Actividad fotoprotectora de una crema con extracto acuoso liofilizado de Lepidium meyenii (MACA) frente a la irradiación ultravioleta en piel de ratones / Photoprotective activity of a cream containing lyophilized aqueous extract of Lepidium meyenii (MACA) against ultraviolet irradiation on mouse skin

RESUMEN Objetivos: Evaluar la actividad fotoprotectora de una crema con extracto acuoso liofilizado de maca (ELM) frente a la irradiación ultravioleta (UV) en la piel de ratones. Materiales y métodos: Se realizó un estudio experimental en 35ratones BALB/c. Los tratamientos fueron aplicados por vía tópica en el dorso de los animales y posteriormente irradiados con rayos ultravioleta B, para luego medir el grosor en micras (µm) de muestras histológicas de la piel de los ratones. Se asignaron siete grupos divididos en no irradiado: blanco (G1) e irradiados con luz UV: sin tratamiento (G2); con protector solar comercial con factor de protección solar (FPS) 30 (G3); crema (placebo) (G4); ELM al 15% en agua (G5); ELM al 5% en crema (G6); y ELM al 15% en crema (G7). Se determinó el FPS in vitro, mediante el método de Mansur. Se realizaron las lecturas de las absorbancias en un espectrofotómetro ultravioleta-visible (UV-VIS) y se determinaron los FPS para las siguientes formulaciones: ELM al 5% en crema, benzofenona-4 (BZF-4) y bloqueador solar comercial FPS 30. Resultados: El grosor de piel de ratón en micras (µm) fue de 27,28 en G2; 18,31 en G3; 27,33 en G4; 19,51 en G5 y 18,04 en G6; no hubo diferencia significativa entre el grupo no expuesto a la radiación (G1) y el grupo ELM al 15% en crema (G7), ambos presentaron los menores grosores (12,76 y 14,20 µm, respectivamente). El FPS de ELM al 15% en crema fue 5,480 ± 0,020. Conclusiones: La formulación con ELM en crema presentó actividad fotoprotectora frente a la irradiación UV, los alcaloides fueron los componentes fitoquímicos mayormente encontrados y la formulación fue compatible con el activo (ELM).

ABSTRACT Objectives: To evaluate the photoprotective activity of a cream with lyophilized aqueous extract of maca (LEM) against ultraviolet (UV) irradiation in the skin of mice. Materials and methods: An experimental study was carried out on 35 BALB/c mice. Treatment was applied topically on the dorsum of the animals, which were subsequently irradiated with ultraviolet B rays, and then we measured the thickness in microns (μm) of histological samples of the skin of the mice. Seven groups were assigned, divided into non-irradiated: Blank (G1) and irradiated with UV light: no treatment (G2); with commercial sunscreen with sun protection factor (SPF) 30 (G3); cream (placebo) (G4); LEM at 15% in water (G5); LEM cream at 5% (G6); and LEM cream at 15% (G7). In vitro SPF was determined using the Mansur method. Absorbance readings were taken in an ultraviolet- visible spectrophotometer (UV-VIS) and SPFs were determined for the following formulations: LEM cream at 5%, benzophenone-4 (BZF-4) and commercial sunscreen SPF 30. Results: Mouse skin thickness in microns (μm) was 27.28 in G2; 18.31 in G3; 27.33 in G4; 19.51 in G5 and 18.04 in G6. There was no significant difference between the group not exposed to radiation (G1) and the 15% LEM cream group (G7), both had the lowest thicknesses (12.76 and 14.20 μm, respectively). The SPF of LEM cream at 15% was 5.480 ± 0.020. Conclusions: The formulation with LEM cream showed photoprotective activity against UV irradiation, alkaloids were the phytochemical components mostly found and the formulation was compatible with the active principle (LEM).

Conocimientos y prácticas sobre foto protección en bañistas de ocho playas de Lima / Knowledge and practices of photoprotection in bathers of eight beaches of Lima

Resumen INTRODUCCIÓN : La radiación ultravioleta solar puede resultar perjudicial para la salud y provocar desde quemaduras hasta enfermedades como el cáncer, por ello, el cuidado frente a la alta radiación solar es importante. OBJETIVOS : El objetivo general del presente estudio fue determinar si existe asociación entre los conocimientos y las prácticas sobre foto protecciónen los bañistas peruanos. MATERIALES Y MÉTODOS : Se realizó un estudio trasversal analítico con 380 bañistas peruanos en ocho playas de Lima. Los participantes respondieron un cuestionario donde se recopiló información de los conocimientos y las prácticas de foto protección. Los conocimientos se categorizaron en altos y bajos, y las prácticas en adecuadas e inadecuadas. Para el análisis se empleó la prueba de Chi cuadrado de Pearson y el modelo de regresión de Poisson ajustado por la edad, sexo, nivel educativo y estado civil. RESULTADOS : Se encontró que la práctica de protección adecuada más frecuente fue el uso de foto protector(63%) y la menos frecuente fue el uso adecuado de manga larga y pantalón largo (9,7%). También se evidenció una relación entre los conocimientos altos y tres prácticas fundamentales: uso de foto protector, sombrilla y lentes de sol. CONCLUSIONES : En la muestra de bañistas peruanos, los participantes reportaronde manera general prácticas de foto proteccióndeficientes; además, el poseer conocimientos acerca de la protección solar no aseguró una práctica adecuada de todas las medidas de foto protección.

Abstract INTRODUCTION : Ultraviolet rays can have damaging health effects and cause from sunburn all the way up to diseases such as cancer. Thus, precautionary measures against intense solar radiation are important. OBJECTIVES: The overall objective of this study was to determine whether there is an association between photoprotection knowledge and practices in Peruvianbeach-goers. MATERIALS AND METHODS : An analytical cross-sectional study comparing survey and observational data obtained from 380 Peruvians at eight beaches in Lima was conducted. The participants answered a questionnaire where knowledge was categorized into high and low, and reported practices were dichotomized as appropriate and inappropriate. For variable analysis, Chi square test of Pearson and Poisson regression model adjusted for age, sex, education level and marital status were used. RESULTS : It was found that the most common reported appropriate practice of photoprotection was the use of sunscreen (63%) and the least frequent was the appropriate use of a long sleeve t-shirt and long pants (9.7%). It was also evident that there is a significant relationship between high knowledge and three core practices, including use of sunscreen, beach umbrellas and sunglasses. CONCLUSIONS : In this sample of Peruvian beach-goers, participants generally reported poor photoprotection practices; furthermore, knowledge about sun protection did not assure the practice of all photoprotection measures.

Quantifying the inovation of cosmetic formulations that contains phenolic rich fruit extracts as fotoprotective bioactives / Quantificando a inovação de formulações cosméticas que contêm extratos de frutas ricas em substâncias fenólicas como bioativos fotoprotetivos

Introduction: sunscreen is a cosmetic used to protect human skin from the deleterious effects of UV radiation and thus minimize the risks of developing skin cancer. Extracts produced from fruits, such as Abiu, Guava, Rambutan and Grape, have significant concentrations of chromophores and phenolic substances that have the ability to absorb UV light and neutralize free radicals. The production of cosmetics from naturally occurring substances with such activities will be of great importance for Brazilian industry and could reduce the cost of production, given the large existing biodiversity in the country. Objectives: carry out a patent search for formulations and cosmetic products that contains phenolic rich fruit extracts as photoprotective and antioxidant bioactives. Methodology: a survey of patents was carried out in the database of the National Institute of Intellectual Property (INPI) and the European Patent Office (EPO), covering a time period between 2008 and 2018, using a combination of keywords related to herbal cosmetics and sunscreens. Results: this research identifies a significant number of patents related to plant extract in association with sunscreen product, however, no patent filings were identified for cosmetic products containing extracts of the evaluated fruits, either alone or in combination, for photoprotective and antioxidant purposes. Conclusion: the Brazilian and international market for sun care products moves millions to billions of dollars annually and have a significant annual growth prospect. Considering the great biodiversity existing in the country, the production of cosmetics from naturally occurring substances with such activities will be of great importance for the Brazilian industrial sector.

Introdução: os filtros solares são cosméticos usados para proteger a pele humana dos efeitos deletérios da radiação UV e assim, minimizar os riscos de desenvolvimento de câncer de pele. Extratos produzidos a partir de frutos, como Abiu, Goiaba, Rambutan e Uva, têm concentrações significativas de cromóforos e substâncias fenólicas que têm a capacidade de absorver a radiação UV e neutralizar os radicais livres. A produção de cosméticos a partir de substâncias naturais com essas atividades será de grande importância para a indústria brasileira e poderá reduzir o custo de produção, dada a grande biodiversidade existente no país. Objetivos: realizar uma busca de registros de patentes de formulações e produtos cosméticos que contêm extratos de frutos ricos em fenólicos como bioativos fotoprotetores e antioxidantes. Metodologia: foi realizado um levantamento de patentes no banco de dados do Instituto Nacional de Propriedade Intelectual (INPI) e do Escritório Europeu de Patentes (EPO), abrangendo um período de tempo entre 2008 e 2018, utilizando uma combinação de palavras-chave relacionadas a cosméticos à base de plantas e protetores solares. Resultados: esta pesquisa identificou um número significativo de patentes relacionadas ao extrato de plantas em associação ao produto protetor solar, no entanto, não foram identificados pedidos de patente para produtos cosméticos que contenham extratos das frutas avaliadas, isoladamente ou em combinação, para fins fotoprotetores e antioxidantes. Conclusão: o mercado brasileiro e internacional de produtos de proteção solar movimenta milhões a bilhões de dólares anualmente e tem a perspectiva de crescimento anual significativa. Considerando a grande biodiversidade existente no país, a produção de cosméticos a partir de substâncias naturais com essas atividades será de grande importância para o setor industrial brasileiro.

Vendedores ambulantes en Cochabamba: desafían al cáncer de piel

Introducción: El cáncer de piel es una afección donde se forma células cancerígenas en los tejidos de la piel. Estar expuestos a luz solar puede aumentar el riesgo de presentar cáncer de piel. El objetivo de este estudio es determinar características de riesgo y protección de los vendedores ambulantes en Cocha-bamba. Metodología: El trabajo presenta un diseño descriptivo, transversal, observacional y prospectivo, el cual fue realizado en los mercados populares y calles comerciales de Cochabamba. La población de estudio fueron 277 comerciantes ambulantes Resultados: 5,8% refieren tener familiares con antecedente de cáncer de piel, el 80,9% indica tener conocimiento que la exposición excesiva a rayos ultravioleta genera cáncer de piel. El 28,2% personas utilizan protector solar y 71,8% no. El tiempo de exposición a los rayos ultravioleta es; 7,2% indica menos de 4 horas, 38,3% 4 a 5 horas, 0,4% de 5 a 6 horas, 49,1% de 6 a 7 y el 5,1% mayor a 10 horas. El 84.1% usa indumentaria adecuada de protección contra los rayos ultravioleta y el 15.9% no. Discusión: Las radiaciones solares ejercen efectos perjudiciales sobre la piel, de modo que existe una clara relación entre la radiación ultravioleta y el cáncer de piel; se puede prevenir con educación dirigida a la población sobre dichos efectos y búsqueda activa que permita la detección temprana.

Summary Introduction: Skin cancer is a condition where cancer cells form in the skin tissues. Being exposed to sunlight can increase the risk in the skin cancer developing. The study objective is to determine the risk and protection characteristics of street sellers in Cochabamba. Methodology: The work presents a descriptive, transversal, obser-vational and prospective design, which was carried out in the popular markets and commercial streets from Cochabamba. The study population was 277 street sellers. Results: 5.8% report having relatives with skin cancer background, 80.9% indicate having knowledge about excessive exposure to ultraviolet rays generates skin cancer. 28.2% of people use sunscreen and 71.8% do not. The exposure time to ultraviolet rays is; 7.2% indicates less than 4 hours, 38.3% 4 to 5 hours, 0.4% 5 to 6 hours, 49.1 % 6 to 7 and 5.1 % greater than 10 hours. 84.1 % wear suitable protective clothing against ultraviolet rays and 15.9% do not. Discussion: Solar radiation exerts harmful effects on the skin, so that there is a clear relationship between ultraviolet radiation and skin cancer; It can be prevented with education directed at the population about these effects and an active search that allows early detection.

Introdução: O câncer de pele é uma doença em que as células cancerosas se for-mam nos tecidos da pele. Aexposição à luz solar pode aumentar o risco de desenvolver câncer de pele. O objetivo deste estudo é determinar as características de risco e proteção dos vendedores ambulantes em Cochabamba. Metodologia: O trabalho apresenta um desenho descritivo, transversal, observacional e prospectivo, realizado nas feiras populares e ruas comerciais de Cochabamba. A população do estudo foi de 277 vendedores ambulantes Resultados: 5,8% relatam ter familiares com histórico de câncer de pele, 80,9% indicam ter conhecimento que a exposição excessiva aos raios ultravioleta gera câncer de pele. 28,2% das pessoas usam protetor solar e 71,8% não. O tempo de exposição aos raios ultravioleta é: 7,2%, que indica menos de 4 horas; 38,3%, 4 a 5 horas; 0,4%, 5 a 6 horas; 49,1%, 6 a 7 e 5,1%, maiorque 10 horas. 84,1% usam roupas de proteção adequadas contra os raios ultravioleta e 15,9% não. Discussão: A radiação solar exerce efeitos nocivos sobre a pele, fazendo com que haja uma relação clara entre a radiação ultravioleta e o câncer de pele. Pode ser prevenida com educação direcionada à população sobre esses efeitos e uma busca ativa que permita a detecção precoce..

Conocimientos y hábitos de exposición solar en comerciantes ambulantes de un mercado de Chiclayo, Perú / Knowledge And Habits Of Solar Exposure In Street Traders Of A Market In Chiclayo, Peru

Objetivo: Determinar los conocimientos y hábitos de exposición solar en comerciantes ambulantes alrededor de un mercado de Chiclayo. Métodos: Se aplicó un cuestionario a 291 comerciantes ambulantes ubicados alrededor del mercado Modelo de Chiclayo, que evaluaron los hábitos de exposición solar, medidas de foto protección, antecedentes de quemaduras solares y cáncer de piel, asi como conocimientos de radiación ultravioleta y fuentes de información. Resultados: Las edades fueron, 18-25 (42,3%), 36-54 (38,1%), 55 -78 (19,6%). En nivel de educación, el 13,1% tiene primaria completa, el 32,6% tiene secundaria completa y el 8,2% superior completa. Al momento del estudio el 71,9% llevaban más de 3 años trabajando como comerciantes ambulantes. Los fototipos de los participantes fueron fototipo I (0,3%), fototipo II (4,5%), fototipo III (24,7%), fototipo IV (48,8%), fototipo V (19,6%), fototipo VI (2,15). Un 90 ± 3,5% reconoce que causa cáncer de piel, un 53,6% reconoce que una característica del envejecimiento de la piel por radiación son las manchas y verrugas, un 56% respondió que la radiación solar causa cataratas, un 52,92% respondió que la gente de piel blanca es más sensible a los rayos del sol. Un 48,5% de ellos declararon exponerse más de 6 horas a los rayos solares, un 24,7% se expone de 3 ­ 6 horas al día, mientras que el 8,6% registraron el menor tiempo de exposición solar (0 ­ 2 horas). El 75,3% no utiliza bloqueador solar. Conclusión: Los conocimientos y hábitos de exposición solar en los comerciantes ambulantes son de regular a adecuado y los hábitos deficientes.

Objective: To determine the knowledge and habits of solar exposure in street vendors around a Chiclayo market. Methods: A questionnaire were applied to 291 street vendors located around the Chiclayo Model market, who evaluated the habits of sun exposure, photo protection measures, a history of sunburn and skin cancer, as well as knowledge of ultraviolet radiation and sources of information. Results: The ages were, 18-25 (42.3%), 36-54 (38.1%), 55 -78 (19.6%). At the educational level, 13.1% have a complete primary, 32.6% have a complete secondary and 8.2% have a complete superior. At the time of the study, 71.9% had been working as street vendors for more than 3 years. The phototypes of the participants were phototype I (0.3%), phototype II (4.5%), phototype III (24.7%), phototype IV (48.8%), phototype V (19.6%) , phototype VI (2.15). 90 ± 3.5% recognize that it causes skin cancer, 53.6% acknowledge that a characteristic of skin aging by radiation is spots and warts, 56% answered that solar radiation causes cataracts, 52.92% He replied that white-skinned people are more sensitive to the sun's rays. 48.5% of them declared that they were exposed to sunlight for more than 6 hours, 24.7% were exposed to 3-6 hours a day, while 8.6% had the shortest time of sun exposure (0 - 2 hours). 75.3% do not use sunscreen. Conclusion: The knowledge and habits of sun exposure in street traders are from fair to adequate and poor habits.

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

Non-use of sunscreen among adults and the elderly in southern Brazil

Abstract Background One of the main prevention methods against skin cancer is the use of sunscreen; however, incidence of this disease has not declined despite prevention campaigns. Objective Investigate the prevalence of non-use of sunscreen and its associated factors. Method A population-based cross-sectional study with individuals aged 18 years or over living in the urban area. Conducted between April and July of 2016. Participants were interviewed about socioeconomic, demographic, and behavioral questions. Non-use of sunscreen was considered as the outcome. For multivariate analysis, Poisson regression with robust adjustment for variance was used. Results Among the 1300 participants, prevalence of non-use of sunscreen was 38.2% (95% CI: 34.6-41.8). The variables independently associated with the outcome were male sex, older age, brown or black skin color, lower income, fewer years of education, no physical activity in leisure time, no medical consultations in the last year, and self-perception of health as regular or poor. Study limitations The prevalence may be underestimated by reports of more use of sunscreen than actually used, which could increase the figure in the outcome. Conclusion It was estimated that about four out of ten adults and elderly do not use sunscreen in this sample. Prevention strategies are needed to advance health policy and ensure that sun protection options are easily accessible.

Albinism: epidemiology, genetics, cutaneous characterization, psychosocial factors

Abstract Oculocutaneous albinism is an autosomal recessive disease caused by the complete absence or decrease of 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 increased risk of actinic damage and skin cancer. In Brazil, as in other parts of the world, albinism remains a little known disorder, both in relation to epidemiological data and to phenotypic and genotypic variation. In several regions of the country, individuals with albinism have no access to resources or specialized medical care, and are often neglected and deprived of social inclusion. Brazil is a tropical country, with a high incidence of solar radiation during the year nationwide. Consequently, actinic damage and skin cancer occur early and have a high incidence in this population, often leading to premature death. Skin monitoring of these patients and immediate therapeutic interventions have a positive impact in reducing the morbidity and mortality associated with this condition. Health education is important to inform albinos and their families, the general population, educators, medical professionals, and public agencies about the particularities of this genetic condition. The aim of this article is to present a review of the epidemiological, clinical, genetic, and psychosocial characteristics of albinism, with a focus in skin changes caused by this rare pigmentation disorder.

Development and validation of an instrument to assess the knowledge of general practitioners and pediatricians about photoprotection and solar radiation

Abstract Background The knowledge of general practitioners about photoprotection is unknown. Objectives To develop and validate an instrument to evaluate the knowledge of general practitioners and pediatricians about photoprotection, gauging the knowledge of these professionals. Methods The study followed the steps: (1) Literature identification and item elaboration related to the theme; (2) Content validation; (3) Apparent validation; (4) Construct validation: internal consistency analysis and discriminatory analysis; (5) Reliability analysis. In Step 4, the instrument was applied to 217 general practitioners and pediatricians who worked in the host city of the study; the scores were compared with dermatologists scores. Results The final instrument had 41 items and showed satisfactory internal consistency (Cronbach's alpha = 0.780), satisfactory reproducibility and good test-retest reliability (good-to-excellent kappa statistic in more than 60% of items). The discriminatory analysis registered a mean score of 54.1 points for dermatologists and 31.1 points for generalists and pediatricians, from a total of 82 possible points, representing a statistically significant difference (p < 0.001). Generalists and pediatricians demonstrated an understanding of the relationship between excessive sun exposure and skin cancer, but they revealed lack of technical information necessary for their professional practice. Study limitations The instrument evaluates only knowledge, without evaluating the conduct of the participants. Conclusion The results show that the instrument has good internal consistency and good reproducibility. It could be useful in the identification of general practitioners and pediatricians knowledge gaps on the subject, for the subsequent development of training and educational strategies.

Knowledge and habits of sun exposure in university students: a cross-sectional study in Southern Brazil

Abstract BACKGROUND: Excessive sun exposure is the major risk factor for skin cancer. Thus, sun exposure behavior is the major focus for prevention of this disease, since it is potentially modifiable. Increasing the knowledge on sun related habits and other skin cancer risk factors is fundamental in the development of preventive programs, especially when directed to young people. OBJECTIVES: To assess the photoprotection habits and the knowledge about skin cancer in college students. METHODS: We conducted a cross-sectional study from Oct. 16 to Feb. 17, including 371 students from the Federal University of Santa Maria, RS, Brazil, through a self-administered questionnaire. RESULTS: The level of knowledge about skin cancer and photoprotection was unsatisfactory in more than 10% of the students. The occurrence of sunburn was extremely high among students, and 25% reported at least one episode of second degree sunburn. Proper use of sunscreen was referred by only 34% of individuals. Students who reported having received photo education in college were associated with a more consistent use of sunscreen. STUDY LIMITATIONS: health area represented a large part of the sample; instrument validated outside Brazil. CONCLUSIONS: Young people are unaware of basic information about sun protection and exposure. Even among those with proper knowledge, the use of photoprotective measures is very low. The sun exposure has shown to be excessive in most of the students, which makes this population an important target for photo-educational measures.

Evaluation of vitamin D plasma levels after mild exposure to the sun with photoprotection

Abstract: Background: Most of the organism's vitamin D (VD) is obtained through the cutaneous synthesis after exposure to the sun's UVB radiation. Sunscreens are indicated for the prevention of actinic damage to the skin, however, there are few clinical trials assessing the synthesis of cutaneous VD in real-life situations of sun exposure with ordinary clothing and usual photoprotection. Objectives: To evaluate the synthesis of VD with suberythemal sun exposure in healthy adults using topical photoprotection (SPF 30). Methods: Quasi-experimental study, conducted at Rio de Janeiro (Brazil), during winter, with 95 healthy adults who had 25-OH-VD checked twice, 24 hours apart, and were exposed to the sun (UVB=20 mJ/cm2), according to a randomized grouping: SC - use of SPF 30 on the face, neck and chest (n=64), NO - no sunscreens (n=10), CO - confined from sun exposure for 24h (n=21). The groups were matched according to the propensity score related to gender, age, phototype, body mass index, glycosylated hemoglobin and baseline levels of VD. The outcome evaluated was the variation (ΔVD) in serum level of 25-OH-VD (ng/ml) between the groups. Results: A statistically significant difference was identified between CO and SC groups [median (p25-p75)]: ΔVD =1.4 (-0.3-3.6) vs. 5.5 (4.8-6.6); p<0.01. There was no difference between SC and NO groups: 5.4 (3.1-6.1) vs. 4.1 (2.5-6.0); p=0.17. Study limitations: Laboratory analysis technique (chemiluminescence) with great variability, loss of food intake standardatization, unbalanced groups. Conclusions: Suberythemal sun exposure with sunscreen (SPF 30) provides similar vitamin D serum variation than without photoprotection in healthy adults.

Fotoproteção em Agentes Comunitários de Saúde (ACS) de Belém-PA / Photoprotection of Community Health Workers (CHW) of Belém-PA / Fotoprotección en Agentes Comunitarios de Salud (ACS) de Belém-PA

Objetivo: Avaliar a fotoproteção dos Agentes Comunitários de Saúde (ACS) de 5 equipes da Estratégia Saúde da Família. Métodos: A casuística consistiu em 56 ACS, os quais foram submetidos a um questionário autoaplicável com perguntas sobre os hábitos de exposição solar e os conhecimentos acerca do assunto. Resultados: Verificou-se que 48,2% dos ACS se expunham ao sol durante 2 a 6 horas entre segunda e sexta-feira e que 55,4% deles tinham exposição entre 10 e 15 horas. Além disso, 58,9% dos ACS utilizam filtros solares raramente ou nunca e, entre esses, 53,6% os aplicam com frequência inadequada. Contudo, 100% dos pesquisados relataram conhecer as consequências negativas da exposição solar. Conclusão: A fotoproteção dos ACS foi considerada inadequada, já que poucos utilizam filtros solares e os que relataram o uso do produto o faziam de maneira inapropriada. Ademais, o conhecimento sobre os riscos e as consequências da exposição solar foi considerado excelente.

Objective: To evaluate the photoprotection of Community Health Agents (CHA) in five health units. Methods: A casuistry of 56 CHA was used, which were submitted to a self-administered questionnaire with questions about their solar exposure habits and their knowledge about this subject matter. Results: From the analysis of the obtained data, it was verified that 48.2% CHA exposed themselves to the sun during 2 to 6 hours between Monday and Friday and that 55.4% of them are exposed between 10 AM and 3 PM. Furthermore, 58.9% of CHA rarely or never use solar filters and among them, 53.6% apply the product with an inappropriate frequency. However, 100% of the CHA reported to know about the negative consequences and the risks of the solar exposure. Conclusion: The agents' photoprotection was considered inappropriate, since just a few of them use solar filters and the ones, which reported using the product, do it improperly. Besides that, their knowledge about the risks and consequences of the solar exposure was considered excellent.

Objetivo: Evaluar la fotoprotección de los Agentes Comunitarios de Salud (ACS) de cinco unidades estudiadas. Métodos: La casuística consistió en 56 ACS, los cuales han sido sometidos a un cuestionario autoaplicable con preguntas sobre los hábitos de exposición solar y los conocimientos sobre el asunto. Resultados: Se verificó que el 48,2% de los ACS se exponían al sol durante 2 a 6 horas entre el lunes y el viernes y que el 55,4% de ellos se exponen entre las 10 de la mañana y 3 de la tarde. Además, el 58,9% de los ACS utilizan filtros solares raramente o nunca, y, entre ellos, 53,6% los aplican con frecuencia inadecuada. Sin embargo, el 100% de los entrevistados relataron conocer las consecuencias negativas de la exposición al sol. Conclusión: La fotoprotección de los ACS fue considerada inadecuada, en razón de la poca utilización de filtros solares y los que relataron el uso del producto lo hacían de manera inadecuada. Además, el conocimiento sobre los riesgos y las consecuencias de la exposición solar fue considerado excelente.

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.

Photoprotection in adolescents: what they know and how they behave

Abstract: Background: The greatest sun exposure occurs until adolescence and this is the only factor involved in photocarcinogenesis subject to modification with photoprotection. Objective: The objective of this study was to evaluate the habits and knowledge of adolescents regarding photoprotection. Method: Cross-sectional study that included 512 students from primary and high school. Data were collected by questionnaires with questions about habits and knowledge on sun protection. For data analysis, Pearson's Chi-square test and Yates test were applied, with 5% level of significance. Results: We evaluated 512 students, with a mean age of 14 years old. The teenagers agreed that ultraviolet rays cause skin cancer and aging (96% and 70%, respectively). Knowledge about the occurrence of burns even on cloudy days was recorded in 68% of cases, as well as the need for photoprotection for sports in 72%. The source of information about sun protection were by parents in 55%. In 70% was observed previous occurrence of sunburn, the daily use of sunscreens was found in 15% and 67% used only at the beach. of sunscreens with SPF higher than 30 was reported by 70% of students and 57% reported going to the beach between 10h and 16h. In 68% of cases it was registered insufficient sun protection, attributed, in 57% of the time to forgetfulness. Study limitations: The sample refers to two schools of Curitiba (PR), Brazil. Conclusion: Teenagers know the risks of sun exposure, but they do not adopt the practices for adequate protection.

Pathogenesis and prevention of skin cancer

The incidence of skin cancer has continuously increased in Korea, probably due to sun exposure and increases in the aging population. Ultraviolet light, a well-known risk factor for skin cancer, can cause DNA damage, mutation, and immune suppression, followed by abnormal proliferation. To prevent photocarcinogenesis, the appropriate use of sunscreen should be emphasized. Using broad-spectrum sunscreens with sun protection factor values of 15 or higher and frequent reapplication are recommended. Controversy exists about whether vitamin D synthesis is inhibited by the use of sunscreen. However, considering that skin cancer most commonly develops on the head and neck area, applying it to the face and neck is reasonable in terms of balancing the risk-benefit ratio.