Assessment of Natural Sunlight Protection Provided by 10 High-SPF Broad-Spectrum Sunscreens and Sun-Protective Fabrics.

In 1978, the FDA Advisory Panel proposed both indoor and natural sunlight SPF testing methods but reverted to indoor testing only in 1993. Today's sunscreen sun protection and broad-spectrum claims are based on mandated clinical tests using solar simulators and in vitro spectrophotometers. This research evaluated the protection of 10 high-SPF (30-110), broad-spectrum sunscreen products, as well as 6 sun-protective fabrics against natural sunlight in Arequipa, Peru. Each of the 17 subjects was exposed to natural sunlight for 1 h and 59 min under clear skies, with temperatures and humidity similar to those in an indoor clinical laboratory. Test sites were photographed 16-24 h later. Four dermatologists evaluated the photographs for erythema and persistent pigment darkening (PPD). Perceptible sun-induced skin injury (sunburn and/or pigmentation) was detected at 97% of the sunscreen-protected scores. The most sun-sensitive subjects obtained the least erythema protection. The higher the SPF was, the higher the erythema protection, but the intensity of PPD was also higher. The 2 sunscreens using only FDA-approved sunscreen filters rated 30 SPF and 45+ SPF performed poorly: Eighty-one percent of the 136 scores were graded 1 minimal erythema dose or higher erythema, achieving, at a maximum, SPF of 5-7 in natural sunlight. Sun-protective fabrics tested provided excellent sun protection. The erythema and PPD observed through the sunscreens in less than 2 h are incongruous with the broad-spectrum, high-SPF sunscreen claims. Reapplying these sunscreens and staying in the sun longer, as stated on the product labels, would have subjected the subjects to even more UV exposure. High-SPF, broad-spectrum sunscreen claims based on indoor solar simulator testing do not agree with the natural sunlight protection test results.

Pararamosis: Disease of the Rubber Plantations.

Pararamosis is a medical condition, described in the latex extracting areas of the Amazon (rubber tree regions), resulting from contact with the caterpillar of the Premolis semirufa moth. The disease can present itself in an acute form-similarly to other erucisms (injuries caused by moth larvae in humans)-or in a chronic form, typically characterized by the occurrence of changes in the joints of the hands. Because of its importance, in the context of tropical diseases, the objective of this article was to review the main facets of the disease, emphasizing the different pathogenic aspects of the interaction between the arthropod and man.

Photoprotective effect of verbascoside from Buddleja cordata in SKH-1 mice exposed to acute and chronic UV-B radiation / Efecto fotoprotector del verbascósido de Buddleja cordata en ratones SKH-1 expuestos de forma aguda y crónica a laradiación UV-B

Ultraviolet radiation (UVR) is involved in both sunburn and the development of skin cancer, which has a high incidence worldwide. Strategies to reduce these effects include the use of photoprotective substances. The aim of this work was to investigate the photoprotective effect of verbascoside isolated from the methanolic extract of Buddleja cordata (BCME) in SKH-1 mice exposed to acute and chronic UV-B radiation. The mouse dorsal area was evaluated macroscopically and microscopically for diagnosis; verbascoside penetration into mouse skin was investigated in vivo by the tape stripping method. After acute UV-B exposure, 100 percent of irradiated mice that had been protected with verbascoside showed no signs of sunburn or of inflammatory processes. After chronic exposure, 100 percent of unprotected mice showed skin carcinomas; in contrast, in mice topically treated with either BCME or verbascoside, the presence of lesions was decreased by 90 percent. These results prove that verbascoside penetrates through the skin of mice and suggest that verbascoside and BCME may potentially prevent photodamage on mice’s skin after acute and chronic UVR exposure.

La radiación ultravioleta (RUV) provoca quemaduras solares y el desarrollo de cáncer de piel. El objetivo de este trabajo fue investigar el efecto fotoprotector del verbascósido obtenido del extracto metanólico de Buddleja cordata (EMBC) en ratones SKH-1 expuestos a RUV-B de manera aguda y crónica. El diagnóstico histológico se llevó a cabo en la piel de la zona dorsal de los ratones. La penetración del verbascósido fue cuantificada mediante la técnica de la cinta adhesiva. En el experimento agudo, el 100 por ciento de los ratones protegidos con verbascósido no evidenciaron signos de quemadura ni procesos inflamatorios. En el experimento crónico los ratones sin protección e irradiados presentaron carcinomas cutáneos. En contraste en los ratones protegidos con EMBC o verbascósido las lesiones disminuyeron un 90 por ciento en ambos grupos. El verbascósido penetró en la piel del ratón. Los resultados sugieren que el EMBC y el verbascósido previenen el fotodaño en la piel de ratones expuestos de forma aguda o crónica a la RUV.

The Efficacy of Intense Pulsed Light Therapy in Postoperative Recovery from Eyelid Surgery.

BACKGROUND: The purpose of this study was to evaluate the efficacy of postoperative intense pulsed light therapy on patients who undergo bilateral eyelid surgery. METHODS: Patients presenting over a 3-month period for bilateral eyelid surgery were asked to participate in an institutional review board-approved study. Intense pulsed light therapy was administered three times to the same randomly assigned side on postoperative days 1 to 2, 5 to 7, and 10 to 12. Sham light therapy was administered to the contralateral side. Patient surveys and physician ratings were obtained based on photographic evaluation of ecchymosis, edema, and erythema. Three physicians, including the senior author (A.E.W.), submitted ratings, and these ratings were assessed for interobserver reliability. RESULTS: Twenty-eight patients who underwent bilateral eyelid surgery followed by intense pulsed light therapy were enrolled. The mean age of the patients was 66 years (range, 44 to 81 years). Eighty-six percent of patients were female. The change in ratings between postoperative days 1 to 2 and 10 to 12, in the treatment and control groups, was statistically significant for severity of bruising by both patient and physician assessment and for color of bruising only by patient assessment. The interobserver reliability reached the greatest agreement in the ecchymosis category at each time point for the treatment group. CONCLUSION: In a series of patients who underwent eyelid surgery, intense pulsed light therapy decreased the degree of ecchymosis compared with sham treatment in postoperative eyelid surgery patients. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.

In vivo photoprotective effects of cosmetic formulations containing UV filters, vitamins, Ginkgo biloba and red algae extracts.

The aim of this study was to assess the photoprotective effects of cosmetic formulations containing UV filters, red algae, Porphyra umbilicalis, extracts and combinations of the extract with vitamins and Ginkgo biloba through the use of in vivo preclinical studies. For this study, 4 groups of 4 hairless mice each were treated with topical formulations applied on the dorsum for 5 days as follows: group 1 - control (no treatment); group 2 - application of the formulation F (sunscreen formulation containing only UV filters); group 3 - application of the formulation FA (sunscreen formulation with red algae extract); and group 4 - application of the formulation FVGA (sunscreen formulation with red algae extract, G. biloba and vitamins A, C and E). The effects of these formulations were evaluated by determining the transepidermal water loss (TEWL) and erythema index. Apoptosis was detected by immunohistochemical staining with anti-p53 and anti-caspase-3 antibodies. The results showed that the formulations protected the skin from erythema when exposed to UV radiation. The group that received the formulation FVGA presented a greater TEWL than did the other groups, suggesting that this formulation was involved in cell renewal. Immunohistochemical analysis showed that UV radiation caused an increase in the expression of p53 and active caspase-3, confirming that the damage caused by UV radiation exposure led to apoptosis. The application of all formulations studied resulted in a statistically significant reduction in the expression of p53 and caspase-3, with a more pronounced effect observed following treatment with FA. In conclusion, extracts from the red algae P. umbilicalis could be considered effective ingredients to be used in sunscreen formulations. The combination of vitamins A, E, C and G. biloba along with red algae extracts can improve significantly the performance of the sunscreens, preventing UV-induced DNA damage and inflammation. Thus, they should be considered an interesting combination for an effective photoprotective formulation with anti-aging properties.

Lycopene not in pill, nor in natura has photoprotective systemic effect.

Carotenoids are endogenous antioxidant agents. It has been reported that oral lycopene reduces immediate erythema induced by ultraviolet B radiation. The objective was to evaluate and compare the photoprotective effect of lycopene in capsule and tomato paste. This was an interventional, randomized, comparative 10-week study that included 20 subjects, divided in two groups: 10 for capsule and 10 for tomato paste intake. Blood samples were collected for serum lycopene dosage by high-performance liquid chromatography. Chromatometer was used to measure minimal erythematous dose 24 h after only ultraviolet B irradiation and the variation of color a (maximum erythema, 24 h after irradiation compared to normal skin). Evaluations were made at baseline and after 4, 8, and 10 weeks. Data were analyzed by ANOVA with repeated measures. Three subjects dropped out after 4 weeks. Serum lycopene demonstrated great variability; significant, higher levels for tomato after 4 weeks (p = 0.027) as compared to capsule and significant increase along the study just for tomato (p = 0.044) were detected. No visual change for minimal erythematous dose was observed in all evaluations, for both groups. Chromatometer measures showed no difference in the mean of minimal erythematous dose at baseline between groups. Slight variation of color a after 10 weeks was observed [marginally significant (p = 0.054)], with a tendency to be greater for capsule use [marginally significant (p = 0.066)] and no adverse effects. Lycopene regular intake was safe and demonstrated no effect for systemic photoprotection against ultraviolet B; no correlation with serum lycopene was detected.

Reducing transcranial direct current stimulation-induced erythema with skin pretreatment: considerations for sham-controlled clinical trials.

OBJECTIVES: Transcranial direct current stimulation (tDCS)-induced erythema (skin reddening) has been described as an adverse effect that can harm blinding integrity in sham-controlled designs. To tackle this issue, we investigated whether the use of topical pretreatments could decrease erythema and other adverse effects associated with tDCS. MATERIALS AND METHODS: Thirty healthy volunteers were recruited, and four interventions were applied 30 min prior to tDCS in a Latin square design: placebo, ketoprofen 2%, hydroxyzine 1%, and lidocaine 5%. TDCS was applied for 30 min (2 mA, anode and cathode over F3 and F4, respectively) in two active sessions with a minimum 1-week interval. The Draize erythema scoring system scale was used to assess erythema intensity; a tDCS questionnaire was used to assess other adverse effects (e.g., tingling, itching, burning sensation, and pain). RESULTS: We found that ketoprofen (but not hydroxyzine or lidocaine) significantly attenuated tDCS-induced erythema regarding intensity and duration, with a medium effect compared with placebo. Erythema was overall mild, short-lived (lasting 18-24 min after tDCS ending), and more intense under the anode. Subjects with darker skin color also tended to present less intense tDCS-induced erythema. The prevalence of other adverse effects was low and did not differ between dermatological groups. CONCLUSIONS: Ketoprofen 2% topical pretreatment might be an interesting strategy to reduce tDCS-induced erythema and might be useful for blinding improvement in further sham-controlled tDCS trials.

The use of nanoencapsulation to decrease human skin irritation caused by capsaicinoids.

Capsaicin, a topical analgesic used in the treatment of chronic pain, has irritant properties that frequently interrupt its use. In this work, the effect of nanoencapsulation of the main capsaicinoids (capsaicin and dihydrocapsaicin) on skin irritation was tested in humans. Skin tolerance of a novel vehicle composed of chitosan hydrogel containing nonloaded nanocapsules (CH-NC) was also evaluated. The chitosan hydrogel containing nanoencapsulated capsaicinoids (CH-NC-CP) did not cause skin irritation, as measured by an erythema probe and on a visual scale, while a formulation containing free capsaicinoids (chitosan gel with hydroalcoholic solution [CH-ET-CP]) and a commercially available capsaicinoids formulation caused skin irritation. Thirty-one percent of volunteers reported slight irritation one hour after application of CH-NC-CP, while moderate (46% [CH-ET-CP] and 23% [commercial product]) and severe (8% [CH-ET-CP] and 69% [commercial product]) irritation were described for the formulations containing free capsaicinoids. When CH-NC was applied to the skin, erythema was not observed and only 8% of volunteers felt slight irritation, which demonstrates the utility of the novel vehicle. A complementary in vitro skin permeation study showed that permeation of capsaicinoids through an epidermal human membrane was reduced but not prevented by nanoencapsulation.

Eritema pigmentar fixo simulando herpes labial relacionado ao uso de fluconazol / Fixed drug eruption simulating herpes labialis related to fluconazole

O eritema pigmentar fixo geralmente representa uma reação cutânea adversa a medicamentos caracterizada pelo surgimento de lesões eritematosas arredondadas ou ovais que recorrem no mesmo sítio em minutos a horas após uma nova exposição ao medicamento previamente utilizado. As lesões podem ser únicas ou múltiplas e esmaecem em poucos dias deixando pigmentação hipercrômica residual, sendo os anti-inflamatórios e antibióticos, frequentes causadores. Já o herpes labial é causado principalmente pelo HSV1 e se manifesta com vesículas agrupadas sobre base eritematosa com posterior evolução para crostas e pode ser desencadeado por estresse, trauma etc. O objetivo do presente trabalho é demonstrar um caso de eritema pigmentar fixo simulando herpes labial, relacionado ao uso de fluconazol, visto que existem relativamente poucos relatos desta associação na literatura médica...

Sun protection factor: meaning and controversies.

The Sun Protection Factor (SPF) is the most important data to quantify the effectiveness of a sunscreen, being universally accepted. The method is based on determining the minimum erythematous dose (MED), defined as the smallest amount of energy required for triggering the erythema, in areas of protected and unprotected skin. The SPF value is then calculated as the ratio between the MED of protected and unprotected skin. The first publication of a method for determining the SPF was presented in 1978 by the U.S. FDA agency, followed by other publications of FDA and other international regulatory agencies. Although considered the reference method for quantification of sunscreen efficacy of topical products, there are controversies in literature about the method for determining the SPF and the implications of the real conditions of use in the protection achieved in practice by users.

Fator de proteção solar: significado e controvérsias / Sun protection factor: meaning and controversies

O Fator de Proteção Solar (FPS) é o principal dado para quantificação da eficácia fotoprotetora de um filtro solar, sendo universalmente aceito. Seu método é baseado na determinação da Dose Eritematosa Mínima (DEM), definida como sendo a menor quantidade de energia necessária para o desencadeamento de eritema, em áreas de pele protegidas e não protegidas pelo produto em estudo. O valor do FPS é, então, calculado como a razão numérica entre a DEM da pele protegida e a da pele não protegida. A primeira publicação demonstrando um método para determinação do valor do FPS foi apresentada em 1978 pela agência norte-americana FDA, seguida por outras publicações do próprio FDA e de outras agências regulatórias internacionais. Apesar de ser considerado o método referência para quantificação da eficácia fotoprotetora de produtos tópicos, existem controvérsias na literatura acerca do método para determinação do FPS e sobre as implicações das reais condições de uso na proteção atingida na prática pelos usuários.

The Sun Protection Factor (SPF) is the most important data to quantify the effectiveness of a sunscreen, being universally accepted. The method is based on determining the minimum erythematous dose (MED), defined as the smallest amount of energy required for triggering the erythema, in areas of protected and unprotected skin. The SPF value is then calculated as the ratio between the MED of protected and unprotected skin. The first publication of a method for determining the SPF was presented in 1978 by the U.S. FDA agency, followed by other publications of FDA and other international regulatory agencies. Although considered the reference method for quantification of sunscreen efficacy of topical products, there are controversies in literature about the method for determining the SPF and the implications of the real conditions of use in the protection achieved in practice by users.

Assessment of physical and antioxidant activity stability, in vitro release and in vivo efficacy of formulations added with superoxide dismutase alone or in association with alpha-tocopherol.

A topical formulation was added with different concentrations of superoxide dismutase (SOD) alone or in association with alpha-tocopherol (alpha-TOC). The physical stability was evaluated by rheological behavior of formulations stored at 4 degrees C, 30 degrees C/60% RH and 40 degrees C/70% RH for 6 months. SOD alone and formulations containing SOD 0.2%, 0.4% or 0.6% or SOD and alpha-TOC were stored in the same conditions and the enzymatic activity was evaluated by the superoxide anion scavenging using chemiluminescence measurement. In vitro release study was carried out using modified Franz diffusion cell and SOD formulations photoprotection against skin erythema was observed for 72 h. SOD and alpha-TOC formulation proved to be instable, since the interaction between the antioxidants led to both physical and enzymatic activity instability. SOD formulations showed to be physically stable and maintained the enzymatic activity for 6 months when stored at 4 and 30 degrees C/60% RH. Despite the fact of low SOD release from the formulation, it was effective in inhibiting the UVB-induced skin erythema for 48 h after a single application. Topical administration of antioxidants provides an efficient way to enrich the endogenous cutaneous protection system, and SOD formulations could be used for improving photoprotection of skin.

Implementación de una metodología para la determinación del Factor de Protección Solar de dos productos antisolares nacionales / Methodology for the implementation of Sun Protection Factor measurement of two chilean sunscreen

El propósito de este estudio fue utilizar una adaptación de la técnica descrita por la Food and Drug Administration (FDA) para evaluar el FPS de dos protectores solares en 20 voluntarios sanos. Se determinó previamente la Dosis Eritematosa Mínima (DEM) en los voluntarios con y sin protector y posteriormente el FPS de los protectores solares. La DEM promedio de los voluntarios en piel sin protección y con protector solar A y B fue de 9,7 mJ/cm2, 271,7 mJ/cm2 y 429,9 mJ/cm2, respectivamente. Los valores de FPS promedio para los voluntarios con el protector solar A y B fueron de 26,5 (rango: 25,5-27,6) y de 44,5 (rango: 43,0-45,9), respectivamente, valores inferiores a los señalados por el fabricante.

[Efficacy of EMLA cream, effect of time and place of application]. / Eficacia de la crema EMLA, influencia del lugar y tiempo de aplicación.

OBJECTIVE: To evaluate the anesthetic efficacy of EMLA cream for alleviating pain associated with puncture and pressure in areas where venous catheters are normally inserted. MATERIAL AND METHODS: We performed a prospective, double blind study in 38 volunteers between 25 and 36 years of age, after obtaining informed consent. A 1.5 g dose of EMLA cream was applied to three sites on each patient: the back of the hand, the antecubital fossa and the side of the neck. Placebo cream with similar characteristics was applied to contralateral sites. Pain was evaluated on a visual analog scale (VAS, 0-10). Tactile sensitivity was assessed on a four-point scale (0 = no sensation; 1 = slight sensation; 2 = moderate, and 3 = strong). An analysis of variance study was performed to compare baseline scores to results over time, and placebo results to EMLA scores for each test site. RESULTS: The assessment of response to puncture and pressure gradually decreased over time for the sites where EMLA cream was applied, but not for the areas where placebo was applied. CONCLUSION: The efficacy of EMLA cream varies demonstrably depending on type of stimulus, site of application and time since application.

Prevención del eritema amoniacal por el detector de humedad ND en recién nacidos

En el presente trabajo de investigación se ensayó por primera vez un instrumento electrónico capaz de detectar inmediatamente la humedaad en los pañales de los infantes. La hipótesis planteada señala que la utilización de detector de la humedad ND disminuye la frecuencia del eritema amoniacal. El objetivo que se ha planteado en este trabajo de investigación es determinar la frecuencia del eritema amoniacal en recién nacidos utilizando el detector de humedad ND. El tipo de trabajo es prospectivo, longitudinal y experimental. Para conseguir lo propuesto se construyeron 20 detectores de humedad ND. Se seleccionaron a 100 infantes eutróficos, mayores de 3 días y menores de 30 días de nacidos, que no presentaban eritema amoniacal ni otra patología dermatológica, ni patología anatómica de vias urinarias y/o rectal, ni diarrea y que utilizaban pañales de algodon. Se establecieron un grupo de 50 infantes para el grupo experimental y control respectivamente. En el grupo experimental se cambió el pañal cada vez que el detector de humedad ND dio una respuesta objetivable por la presencia de orina y/o heces en éste. En el grupo control el cambio de pañal se realizó cada 24 horas por tres días consecutivos. Se concluyó que el detector de humedad ND evita la aparición del eritema amoniacal en recién nacidos

Efeito fotoprotetor de Apis mellifica em homeopatia / Photoprotective effect of Apis mellifica in homeopathy

No tratamento de quadros dermatologicos despertou-nos a atencao o bom resultado obtido nos casos de fotossensibilidade de variada etiologia; estes quadros, sem solucao na terapeutica academica, tem conseguido melhora e regressao definitiva dentro da lei dos semelhantes. Tem sido notavel a frequencia da indicacao de APIS MELLIFICA; posteriormente encontramos apoio num trabalho experimental de BASTIDE e COL. comprovando em cobaias o efeito anti-inflamatorio de APIS MELLIFICA, quando os animais sao submetidos a acao agressiva dos raios ultra-violetas