Prevalence of premalignant and malignant skin lesions in oculocutaneous albinism patients

SUMMARY OBJECTIVE: Oculocutaneous albinism describes a group of pigmentary disorders that lead to skin sensitivity and predisposition to skin malignances. Aims: To analyze clinical and epidemiological data in oculocutaneous albinism patients and to determine the prevalence of malignant skin lesions, assessing possible risk factors for skin cancer. METHODS: Cross-sectional study evaluating epidemiological data, habits of sun exposure and sun protection, and clinical examination of albino patients followed in a reference dermatology outpatient clinic in Brasil. Our primary outcome was the occurrence of malignant skin lesions in biopsied tissues. RESULTS: Of 74 patients analyzed, 11 (15%) had one or more suspicious lesions and were biopsied, of which 8 (72.7%) patients presented with basal cell carcinomas, 7 (63.3%) presented with squamous cell carcinoma, and 1 (9%) presented with melanoma. Moreover, 32(43%) patients presented with actinic keratosis. Age, female gender, previous history of sunburn, history of malignant lesions and history of sun exposure without photoprotection were associated with the presence of malignant lesions. Limitations: Unicentric, non-aleatory sample. CONCLUSIONS: There was a high prevalence of malignant and pre-malignant lesions in this population. Some potentially modifiable risk factors were associated with the occurrence of malignant skin lesions.

Práticas de exposição e proteção solar de jovens universitários / Prácticas de exposición y protección solar de jóvenes universitários / Exposure and sun protection practices of university students

RESUMO Objetivo: conhecer práticas de exposição e proteção solar de jovens universitários. Método: estudo descritivo, transversal, realizado em uma universidade de São Paulo. Resultados: a amostra foi composta por 385 jovens e a coleta de dados realizada por meio de formulário. Do total, 239 (62%) jovens classificaram-se como fototipo III e IV e 69 (17,9%) afirmaram ter histórico de câncer de pele na família. A maioria afirmou exposição ao sol entre as 10 e 16 horas e por mais de uma hora de duração; 112 (29,1%) informaram não empregar meios de proteção. Dentre os que utilizam protetor solar, a minoria o faz regularmente. Conclusão: embora a amostra tenha sido constituída por pessoas com maior acesso a informações, constatou-se exposição e proteção solar de modo impróprio. Ações educativas, individuais e coletivas devem ser fortalecidas e priorizadas tendo em vista a incidência de câncer de pele no país.

RESUMEN Objetivo: conocer las prácticas de exposición y de protección solar de jóvenes universitarios. Método: estudio descriptivo, transversal, realizado en una universidad de São Paulo. Resultados: la muestra estuvo constituida por 385 jóvenes y la colecta de datos realizada a través de formulario. Del total, 239 (62%) jóvenes fueron clasificados como tipo de piel III y IV y 69 (17,9%) afirmaron tener cáncer de piel en la historia familia. La mayoría afirma exposición al sol entre las 10 y 16 horas y durante más de una hora; 112 (29,1%) reportaron no emplear métodos de protección. Entre los que usan protector solar, la minoría lo hace regularmente. Conclusión: a pesar de que la muestra haya sido constituída por personas con mayor acceso a informaciones, se constató exposición y protección solar de manera impropia. Acciones educativas, individuales y colectivas deben fortalecerse y priorizarse teniendo en cuenta la incidencia de cáncer de piel en el país.

ABSTRACT Objective: to learn exposure and sun protection practices for university students. Method: a descriptive, cross-sectional study performed at a university in São Paulo. Results: the sample consisted of 385 young and data collection conducted through a form. Of the total, 239 (62%) young people were classified as skin type III and IV and 69 (17.9%) affirmed to have a history of skin cancer in the family. Most affirmed exposure to the sun between 10 a.m and 04 p.m and for more than one hour; 112 (29.1%) informed not employ safeguards. Among those who use sunscreen, the minority does so regularly. Conclusion: although the sample was made up of people with greater access to information, it was found exposure and sunscreen improperly. Education, individual and collective actions should be strengthened and prioritized given the incidence of skin cancer in the country.

Brazilian Consensus on Photoprotection

Brazil is a country of continental dimensions with a large heterogeneity of climates and massive mixing of the population. Almost the entire national territory is located between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the south certainly makes Brazil one of the countries of the world with greater extent of land in proximity to the sun. The Brazilian coastline, where most of its population lives, is more than 8,500 km long. Due to geographic characteristics and cultural trends, Brazilians are among the peoples with the highest annual exposure to the sun. Epidemiological data show a continuing increase in the incidence of non-melanoma and melanoma skin cancers. Photoprotection can be understood as a set of measures aimed at reducing sun exposure and at preventing the development of acute and chronic actinic damage. Due to the peculiarities of Brazilian territory and culture, it would not be advisable to replicate the concepts of photoprotection from other developed countries, places with completely different climates and populations. Thus the Brazilian Society of Dermatology has developed the Brazilian Consensus on Photoprotection, the first official document on photoprotection developed in Brazil for Brazilians, with recommendations on matters involving photoprotection.

Queimadura solar em jovens: estudo de base populacional no Sul do Brasil / Sunburn in young people: population-based study in Southern Brazil

OBJETIVO: Analisar a prevalência e fatores de risco para queimadura solar em jovens com idade entre 10 e 29 anos. MÉTODOS: Estudo transversal de base populacional com amostragem em múltiplos estágios, realizado com residentes da zona urbana de Pelotas, Rio Grande do Sul, entre os meses de outubro e dezembro de 2005. Para a coleta de dados foram feitas entrevistas com 1.604 indivíduos, utilizando questionário padronizado e pré-codificado com informações sobre a família e outro questionário aos indivíduos com idade entre dez e 29 anos para avaliação da ocorrência de episódios de queimadura solar. Queimadura solar foi definida como ardência na pele após exposição ao sol. Para as comparações entre proporções, utilizou-se teste do qui-quadrado com correção de Yates. Na análise multivariada utilizou-se a regressão de Poisson com controle para efeito de delineamento e ajuste robusto da variância. RESULTADOS: Das pessoas com idade entre 10 e 29 anos, 1.412 relataram exposição ao sol no último verão. As perdas e recusas somaram 5,5 por cento. Queimadura solar no último ano foi relatada por 48,7 por cento dos entrevistados. As variáveis associadas à ocorrência de queimadura segundo a análise multivariada foram: cor da pele branca (RP=1,41; IC 95 por cento: 1,12;1,79), maior sensibilidade da pele quando exposta ao sol (RP=1,84; IC 95 por cento: 1,64;2,06), idade entre 15 e 19 anos (RP=1,30; IC 95 por cento: 1,12;1,50), pertencer ao quartil de maior renda (RP=1,20; IC 95 por cento: 1,01;1,42) e fazer uso irregular de fotoprotetor (RP=1,23; IC 95 por cento: 1,08;1,42). CONCLUSÕES: A prevalência de queimadura solar na população estudada foi alta, principalmente entre jovens, de pele branca, com maior sensibilidade da pele, de maior renda e que faziam uso irregular de fotoprotetor. A exposição solar em horários seguros e com métodos de proteção adequados deve ser estimulada.

OBJECTIVE: To assess the prevalence and risk factors for sunburn in young people. METHODS: Population-based cross-sectional study using a multiple-stage sampling carried out with people living in the urban area of Pelotas, Southern Brazil, between October and December 2005. Data was collected from interviews with 1.604 subjects using a standardized pre-coded questionnaire about their family and another questionnaire applied to those aged between ten and 29 years for assessing the occurrence of sunburn episodes. Sunburn was defined as skin burning after sun exposure. Chi-square test with Yates' correction was used to compare proportions and Poisson regression with design effect control and robust adjustment of variance was applied in the multivariate analysis. RESULTS: Of those aged between 10 and 29 years, 1,412 reported sun exposure in the last summer. Losses and refusals were 5.5 percent. A total of 48.7 percent of the interviewees reported sunburn in the last year. The following variables were associated with sunburn in the multivariate analysis: white skin (PR=1.41; 95 percent CI: 1.12;1.79); higher skin sensitivity to sun exposure (PR=1.84; 95 percent CI: 1.64;2.06); age between 15 and 19 years (PR=1.30; 95 percent CI: 1.12;1.50); belonging to the higher quartile of income (PR=1.20; 95 percent CI: 1.01;1.42); and irregular use of sunscreens (PR=1.23; 95 percent CI: 1.08;1.42). CONCLUSIONS: The prevalence of sunburn in the population studied was high mainly among white young people with higher skin sensitivity, higher income and who used sunscreens irregularly. Sun exposure during safe times and with adequate protection should be promoted.

Menores quemados por el sol y su relación con la radiación ultravioleta y la cubierta de ozono, durante seis veranos (1996 a 2001) en Santiago de Chile (33, 5 degrees S) / Association between sunburn in children and ultraviolet radiation and ozone layer, during six summers (1996-2001) in Santiago, Chile (33,5 degrees S)

BACKGROUND: During the recent 10 years the ozone layer has decreased while ultraviolet radiation has increased in Santiago, Chile. AIM: To determine whether the number of sunburns in children correlate with ultraviolet radiation in Santiago. SUBJECTS AND METHODS: During six Austral Summers (1996-2001) children below 15 years old, consulting for sunburn, were evaluated at the"Corporation for the Aid of Burned Children (COANIQUEM) in Santiago (33.5 degrees S). The number of children with sunburns during each Summer was compared with the corresponding UV-B radiation and the ozone thickness, to establish a probable relation between a geophysical change and its consequences in skin health. The ozone layer values were obtained from the NASA WEB-page and the ultraviolet radiation was measured with a four-channel medium resolution radiometer. RESULTS: In each Summer there was a predominance of sunburns among boys and among ages between 6 and 10 years. During the 96-97 Austral Summer, the highest number of children with sunburns (63) was diagnosed. That Summer also had the highest mean UV-305 nm radiation with an important amount of days with ozone < or = 260 Dobson Units. Only during that Summer an inverse correlation between ozone and UV-305 nm radiation was detected. At the same time the maximal values of Erythemal Dose Rate (33 muWatt cm2), UV Index (13) and Erythemal Daily Dose (7.500 Joule m2) were observed. CONCLUSIONS: In Santiago, Summers with a higher number of days with low ozone protection seem to reappear every 3 years. Understanding the interaction of physical processes that control the ozone layer, may help to design better photo-protection programs for human health.