Langerhans cells orchestrate apoptosis of DNA-damaged keratinocytes upon high-dose UVB skin exposure.

Ultraviolet (UV) irradiation of the skin causes mutations that can promote the development of melanoma and nonmelanoma skin cancer. High-dose UVB exposure triggers a vigorous skin reaction characterized by inflammation resulting in acute sunburn. This response includes the formation of sunburn cells and keratinocytes (KC) undergoing programmed cell death (apoptosis) when repair mechanisms of DNA damage are inadequate. The primary objective of this research was to clarify the involvement of Langerhans cells (LC) in the development of acute sunburn following intense UVB skin irradiation. To address this, we subjected the dorsal skin of mice to a single high-dose UVB exposure and analyzed the immediate immune response occurring within the skin tissue. Acute sunburn triggered an activation of LC, coinciding with a rapid influx of neutrophils that produced TNF-α. Furthermore, our investigation unveiled a marked increase in DNA-damaged KC and the subsequent induction of apoptosis in these cells. Importantly, we demonstrate a crucial link between the inflammatory cascade, the initiation of apoptosis in DNA-damaged KC, and the presence of LC in the skin. LC were observed to modulate the chemokine response in the skin following exposure to UVB, thereby affecting the trafficking of neutrophils. Skin lacking LC revealed diminished inflammation, contained fewer TNF-α-producing neutrophils, and due to the prevention of apoptosis induction, a lingering population of DNA-damaged KC, presumably carrying the risk of enduring genomic alterations. In summary, our results underscore the pivotal role of LC in preserving the homeostasis of UVB-irradiated skin. These findings contribute to a deeper understanding of the intricate mechanisms underlying acute sunburn responses and their implications for UV-induced skin cancer.

Transcriptomic and Metabolomic Analysis Reveals the Potential Roles of Polyphenols and Flavonoids in Response to Sunburn Stress in Chinese Olive (Canarium album).

Sunburn stress is one of the main environmental stress factors that seriously affects the fruit development and quality of Chinese olive, a tropical and subtropical fruit in south China. Therefore, the understanding of the changes in physiological, biochemical, metabolic, and gene expression in response to sunburn stress is of great significance for the industry and breeding of Chinese olive. In this study, the different stress degrees of Chinese olive fruits, including serious sunburn injury (SSI), mild sunburn injury (MSI), and ordinary (control check, CK) samples, were used to identify the physiological and biochemical changes and explore the differentially expressed genes (DEGs) and differentially accumulated metabolites (DAMs) by using transcriptomics and metabolomics. Compared with CK, the phenotypes, antioxidant capacity, and antioxidant-related enzyme activities of sunburn stress samples changed significantly. Based on DEG-based KEGG metabolic pathway analysis of transcriptomics, the polyphenol and flavonoid-related pathways, including phenylpropanoid biosynthesis, sesquiterpenoid, and triterpenoid biosynthesis, monoterpene biosynthesis, carotenoid biosynthesis, isoflavonoid biosynthesis, flavonoid biosynthesis, were enriched under sunburn stress of Chinese olive. Meanwhile, 33 differentially accumulated polyphenols and 99 differentially accumulated flavonoids were identified using metabolomics. According to the integration of transcriptome and metabolome, 15 and 8 DEGs were predicted to regulate polyphenol and flavonoid biosynthesis in Chinese olive, including 4-coumarate-CoA ligase (4CL), cinnamoyl-CoA reductase (CCR), cinnamoyl-alcohol dehydrogenase (CAD), chalcone synthase (CHS), flavanone-3-hydroxylase (F3H), dihydroflavonol 4-reductase (DFR), and anthocyanidin synthase (ANS). Additionally, the content of total polyphenols and flavonoids was found to be significantly increased in MSI and SSI samples compared with CK. Our research suggested that the sunburn stress probably activates the transcription of the structural genes involved in polyphenol and flavonoid biosynthesis in Chinese olive fruits to affect the antioxidant capacity and increase the accumulation of polyphenols and flavonoids, thereby responding to this abiotic stress.

Cosmetic Products with Potential Photoprotective Effects Based on Natural Compounds Extracted from Waste of the Winemaking Industry.

Grape marc is a by-product resulting from the winemaking industry that still contains beneficial compounds that can be valorized. Thus, we report here the possibility of using polyphenolic extracts of grape marc origin to obtain sun protection creams. The extractions were performed in ethanol and acetone solutions using pomace from different grape varieties (Merlot, Bläufrankisch, Feteasca Neagra, Isabella) as a raw material. The obtained extracts were analyzed in order to determine the total phenolic content, the antioxidant activity, and the sun protection factor (SPF) via Mansur spectrophotometric assay. The best results were achieved using 70% ethanol in water as a solvent. The extracts with the highest potential photoprotective effects are from the Merlot variety (SPFspectrophotometric = 7.83 ± 0.76). The sunscreens were prepared using the 70% ethanolic extract of the Merlot variety evaporated to dryness, redissolved in either distilled water or ethanol. The SPF estimated in vitro via the COLIPA method showed values of 14.07 ± 1.50 and 11.46 ± 1.32 for the aqueous and ethanolic extracts, respectively, when working with a cream to polyphenolic extract a ratio of 1/1 (w/w). At the same time, the use of aqueous polyphenolic extracts ensures the better stability of creams compared with the ethanolic ones.

Participants' Experiences and Satisfaction With Sun Protection Factor (SPF) 100 Sunscreen in Actual Use Conditions.

Background and objective Exposure to sunlight's ultraviolet (UV) radiation poses various health risks, including sunburn, skin damage, and heightened skin cancer risk. Sunblock usage has surged due to widespread advertising campaigns. Individuals spending time outdoors should employ protective measures like wearing hats, applying sunblock with a high sun protection factor (SPF), covering exposed skin, and seeking shade to mitigate UV exposure's harmful effects. This study's objective is to assess participants' experiences and satisfaction with SPF 100 sunscreen in actual use conditions. Methodology This study employed a prospective, single-center design involving 100 participants aged 18 to 70 years. Eligible individuals had Fitzpatrick skin types I-III and were engaged in outdoor activities, excluding those with certain medical conditions or medication use. Each participant received sunscreen tubes (Solero SPF 100, Helix Pharma Pvt. Ltd., Karachi, Pakistan), and clinical evaluations were conducted on the day before and after and day 22 visits, with sunblock application and UV-induced erythema assessments performed. Results Our study enrolled participants with a mean age of 25.6 ± 7.1 years, ranging from 15 to 55 years, with females comprising 84% (84) of the sample. Results revealed widespread satisfaction and acceptance of SPF 100 sunscreen, without any reported adverse reactions. A significant majority expressed their willingness to purchase and recommend the sunscreen to others. Furthermore, the majority of healthcare providers expressed satisfaction with prescribing this sunscreen.  Conclusions In conclusion, SPF 100 sunscreen demonstrated excellent tolerability and acceptability among participants, suggesting its potential utility in both personal sun protection routines and clinical settings.

Sunscreens Part 1: Mechanisms and Efficacy.

As our knowledge of the harmful effects of ultraviolet radiation continues to evolve, sunscreen remains an integral part of a comprehensive photoprotection strategy against multiple endpoints of ultraviolet-mediated damage. Part 1 of this review covers sunscreen active and additive ingredient properties, mechanisms of action and gaps in coverage. Following an overview of sunscreen's efficacy in protecting against sunburn, photocarcinogenesis, photoaging, pigmentary disorders, and idiopathic photodermatoses, we highlight considerations for product use and selection in children and individuals with skin of color.

Ichthyosiform Lichen Planus Pigmentosus in a 19-Year-Old Male Patient: Case Report.

Lichen planus pigmentosus (LPP) is a condition characterized by persistent and asymptomatic brownish-black-to-blue or purple-gray pigmentation, predominantly in the face and sun-exposed areas, commonly in dark-skinned individuals. Several clinical variants of LPP have been reported. However, the ichthyosiform type of LPP has not been reported. We present a 19-year-old male patient who presented with a 7-year history of asymptomatic grayish macules; patches with fine scales on the face, trunk, and upper extremities; and grayish plaques with thick "ichthyosiform" scales on the lower extremities. The diagnosis of LPP was proven by histopathological findings on both the macular and ichthyosiform plaques. Cluster differentiation (CD) 68 stain highlights the same density of pigment-laden macrophages in both the gray macule and the ichthyosiform plaque. The cause of LPP is unknown. Transcription factor anomalies may play a role in increased keratinization of lichen planus lesions. It can be assumed that the mechanism of the altered distribution of keratinization may occur on the ichthyosiform lesions in this patient. The terminology "ichthyosiform lichen planus pigmentosus" is hereby proposed to be added to the clinical variants of LPP.

Alternative autophagy dampens UVB-induced NLRP3 inflammasome activation in human keratinocytes.

Sunlight exposure results in an inflammatory reaction of the skin commonly known as sunburn, which increases skin cancer risk. In particular, the ultraviolet B (UVB) component of sunlight induces inflammasome activation in keratinocytes to instigate the cutaneous inflammatory responses. Here, we explore the intracellular machinery that maintains skin homeostasis by suppressing UVB-induced inflammasome activation in human keratinocytes. We found that pharmacological inhibition of autophagy promoted UVB-induced NLRP3 inflammasome activation. Unexpectedly, however, gene silencing of Atg5 or Atg7, which are critical for conventional autophagy, had no effect, whereas gene silencing of Beclin1, which is essential not only for conventional autophagy but also for Atg5/Atg7-independent alternative autophagy, promoted UVB-induced inflammasome activation, indicating an involvement of alternative autophagy. We found that damaged mitochondria were highly accumulated in UVB-irradiated keratinocytes when alternative autophagy was inhibited, and they appear to be recognized by NLRP3. Overall, our findings indicate that alternative autophagy, rather than conventional autophagy, suppresses UVB-induced NLRP3 inflammasome activation through the clearance of damaged mitochondria in human keratinocytes and illustrate a previously unknown involvement of alternative autophagy in inflammation. Alternative autophagy may be a new therapeutic target for sunburn and associated cutaneous disorders.

Awareness and knowledge of sun exposure and use of sunscreen among adults in Aseer region, Saudi Arabia.

Background: Excessive sun exposure and inadequate sunscreen use can lead to skin cancer and other harmful effects on the skin, eyes, and immune system. Purpose: This observational cross-sectional study aimed to assess awareness and knowledge of sun exposure and sunscreen use among adults in the Aseer region, Saudi Arabia. This study also focused on evaluating the risks of skin cancer and participants' sun-protective attitudes and practices. Methods: A population-based cross-sectional study was conducted among adults in the Aseer region, Saudi Arabia. Data were collected using a questionnaire from November 2022 to January 2023 that assessed participants' knowledge, practices, and beliefs regarding sun exposure and sunscreen use. A total of 400 participants were selected for the study. Approval for the study was granted by the Local Research Ethics Committee of the University of Bisha, Saudi Arabia. Results: The results revealed that (59.8 %) of the participants were female, while (40.3 %) were male. Regarding age, the majority fell within the 26-35 age range (37.5 %), with (16.0 %) of participants using sunscreen regularly, with a total of (74.0 %) of participants using sunscreen. Men exhibited a higher prevalence of negative attitudes towards sun protection, while women demonstrated more favourable sun protection practices. In addition, (1.25 %) of the participants had skin cancer in the past; (81.0 %) of participants agreed that skin cancer could cause death, while (19.0 %) were unsure of the effects of skin cancer. Moreover, the results indicated that sun exposure had a significant positive effect on awareness levels (p < 0.05), indicating that increased sun exposure was associated with higher awareness of the harmful effects of the sun. Additionally, awareness level significantly positively affected sunscreen use (p < 0.01), suggesting that individuals with higher awareness were more likely to use sunscreen. Conclusion: There was an average awareness of sun exposure and its detrimental effects. In addition, a significant portion of the population demonstrates proactive measures to minimize sunlight exposure. However, sunscreen usage among Saudi adults was low despite having knowledge and awareness. Future research must enhance sun protection practices and reduce sun-related skin damage in the Aseer region.

#4Corners4Health Social Media Cancer Prevention Campaign for Emerging Adults: Protocol for a Randomized Stepped-Wedge Trial.

BACKGROUND: Many emerging adults (EAs) are prone to making unhealthy choices, which increase their risk of premature cancer morbidity and mortality. In the era of social media, rigorous research on interventions to promote health behaviors for cancer risk reduction among EAs delivered over social media is limited. Cancer prevention information and recommendations may reach EAs more effectively over social media than in settings such as health care, schools, and workplaces, particularly for EAs residing in rural areas. OBJECTIVE: This pragmatic randomized trial aims to evaluate a multirisk factor intervention using a social media campaign designed with community advisers aimed at decreasing cancer risk factors among EAs. The trial will target EAs from diverse backgrounds living in rural counties in the Four Corners states of Arizona, Colorado, New Mexico, and Utah. METHODS: We will recruit a sample of EAs (n=1000) aged 18 to 26 years residing in rural counties (Rural-Urban Continuum Codes 4 to 9) in the Four Corners states from the Qualtrics' research panel and enroll them in a randomized stepped-wedge, quasi-experimental design. The inclusion criteria include English proficiency and regular social media engagement. A social media intervention will promote guideline-related goals for increased physical activity, healthy eating, and human papillomavirus vaccination and reduced nicotine product use, alcohol intake, and solar UV radiation exposure. Campaign posts will cover digital and media literacy skills, responses to misinformation, communication with family and friends, and referral to community resources. The intervention will be delivered over 12 months in Facebook private groups and will be guided by advisory groups of community stakeholders and EAs and focus groups with EAs. The EAs will complete assessments at baseline and at 12, 26, 39, 52, and 104 weeks after randomization. Assessments will measure 6 cancer risk behaviors, theoretical mediators, and participants' engagement with the social media campaign. RESULTS: The trial is in its start-up phase. It is being led by a steering committee. Team members are working in 3 subcommittees to optimize community engagement, the social media intervention, and the measures to be used. The Stakeholder Organization Advisory Board and Emerging Adult Advisory Board were formed and provided initial input on the priority of cancer risk factors to target, social media use by EAs, and community resources available. A framework for the social media campaign with topics, format, and theoretical mediators has been created, along with protocols for campaign management. CONCLUSIONS: Social media can be used as a platform to counter misinformation and improve reliable health information to promote health behaviors that reduce cancer risks among EAs. Because of the popularity of web-based information sources among EAs, an innovative, multirisk factor intervention using a social media campaign has the potential to reduce their cancer risk behaviors. TRIAL REGISTRATION: ClinicalTrials.gov NCT05618158; https://classic.clinicaltrials.gov/ct2/show/NCT05618158. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/50392.

Skin cancer prevention in extreme sports: Intervention in a 24-h race.

INTRODUCTION: Excessive sun exposure and sunburns are the main preventable causes of skin cancer. The growing popularity of outdoor sports in developed countries has motivated the objective of this work to study the risk of photoexposure and the skin cancer prevention needs of athletes in an extreme race and evaluate an intervention targeted at this population. METHODS: An observational study was conducted during the XXIII edition of the 101 km de Ronda race, which consisted of trail running and mountain biking categories. Environmental and personal dosimetry, monitoring of meteorological conditions, evaluation of the athletes' photoprotection and skin examination habits, a dermatological checkup, and a satisfaction questionnaire were performed. RESULTS: The ultra-endurance race was carried out under adverse conditions (maximum ultraviolet index (UVI) = 9.2, temperatures above 30°C, and relative humidity >35%). The mean effective erythema dose received by race athletes (n = 11) was 2959.2 ± 404.2 J/m2 , equivalent to 29.6 standard erythema doses (SED). The CHACES questionnaire (n = 1145) showed a sunburn rate of 58% and poor protective habits: 62.9% of athletes do not usually use sunscreen and 67.2% do not self-examine their skin. Actinic keratoses (4.7%) and suspicious skin cancer lesions (4.2%) were found in dermatologic screening exams (n = 170). On the satisfaction questionnaire (n = 111), this intervention was rated as excellent (95.5%). CONCLUSION: This research highlights the extreme risk of photoexposure that athletes are subjected to during ultra-endurance competitions. In the same way, it shows the need to carry out interventions aimed at the acquisition of healthy photoprotection habits and skin surveillance in this target group.

Childhood sunburn and risk of melanoma and non-melanoma skin cancer: a Mendelian randomization study.

Previous evidence has suggested that childhood sunburn could be a risk factor for cutaneous malignant melanoma (MM) and non-melanoma skin cancer (NMSC). However, existing observational studies could not reveal the causal associations genetically. This study aimed to investigate whether there was a genetic causal relationship between childhood sunburn and skin cancers. Univariable Mendelian randomization (MR) and Causal Analysis Using Summary Effect analysis was carried out for causal estimates and evaluation for the horizontal pleiotropy. Multivariable MR and the mediation effects analysis were used to test whether the causal associations were mediated by potential confounders. A suggestively significant causal association between childhood sunburn and MM was indicated (OR = 4.74; 95% CI: 1.31-17.19; p = 1.79E-02). Genetically predicted childhood sunburn was significantly associated with increased risk of overall melanoma in situ (MIS) (OR = 4.02; 95% CI: 2.00-8.08; p = 9.40E-05), MIS of face (OR = 18.28; 95% CI: 5.28-63.35; p = 4.59E-06), and MIS of trunk (OR = 7.05; 95% CI: 2.06-24.13; p = 1.88E-03). Similar trends were found for childhood sunburn and NMSC (OR = 8.16; 95% CI: 6.07-10.99; p = 1.53E-20), including both basal cell carcinoma (BCC) (OR = 3.76; 95% CI:2.96-4.77; p = 2.19E-08) and squamous cell carcinoma (SCC) (OR = 7.44; 95% CI: 5.09-10.87; p = 2.19E-08). After adjustment for hair and skin color, facial ageing, vitamin D levels, body mass index, alcohol consumption, and smoking status, childhood sunburn showed an independent association with MIS, MIS of face, MIS of trunk, as well as NMSC, including both BCC and SCC. Mediation analysis showed no significant mediation effect. This study demonstrated a causal relationship between childhood sunburn and the risk of both MM and NMSC, which suggested that enhanced screening and prevention for childhood sunburn could contribute to the early detection and decreased risk of MM and NMSC.

Sun exposure practices, attitudes and knowledge among students and teachers at a University School of Health Sciences in Ecuador.

Skin cancer incidence is increasing worldwide. Late adolescence and young adulthood are fundamental stages of life to acquire good sun exposure practices, regarding both personal involvement in skin cancer prevention and being a role model for others, especially in a health education environment. This descriptive cross-sectional study is based on the validated CHACES questionnaire to study sun exposure and photoprotection behavior among students and teachers at the School of Health Sciences in the National University of Chimborazo, Riobamba (Ecuador). University members (814 students (89.8 %) and 93 teachers (10.2 %)) were studied, with a predominance of females and light-skin phototypes in both groups. Similar results were obtained regarding sun exposure, with higher recreative exposure in the teachers' group and higher occupational exposure in students. However, students significantly showed lower avoiding midday sun (41.9 % vs 60.9 %), and lower use of sunglasses (10.1 % vs. 41.6 %). Attitudes towards the sun and photoprotection knowledge issues were also equivalent between students and teachers (6.1/10 vs 6.2/10). Students' sunburn rate last year reaches 88.4 % and 52.7 % in teachers (p < 0.001). Using a multivariable logistic regression model, we identified risk factors associated with a greater risk of sunburn in our population. This study highlights areas to be improved regarding knowledge, attitudes and, especially, practices of photoprotection, among students and teachers at the University of Chimborazo. These results point out that awareness-raising campaigns should be implemented to reduce sunburns, morbidity and mortality of skin cancer in this environment.

Ultraviolet sun exposure and sun protection behaviors in outdoor rock climbers.

BACKGROUND: Overexposure to sunlight and sunburn are the main preventable causes of skin cancer. Outdoor sports are associated with significant levels of sunlight exposure. AIMS: We sought to quantify the sun radiation exposure received by outdoor rock climbers and assess their sun exposure habits, sun protection behaviors, attitudes, and knowledge regarding skin cancer. METHODS: From April to June 2021, outdoor rock climbers contacted via email completed an online validated self-reported questionnaire on sun related habits, behaviors, attitudes and knowledge. As a pilot trial, ten participants wore a personal dosimeter during two outdoor climbing weekends in May and November 2021. Ambient ultraviolet radiation (UVR) was also recorded. RESULTS: A total of 217 outdoor rock climbers (103 women), mean age 36.8 ± 8.8 years (range 20-70 years) and median climbing practice per week of 8 h (IQR 7.5) were studied. Two in three (65.9%) participants reported at least one sunburn event during the previous rock climbing season. Of the survey respondents, 49.3% reported using sunscreen with SPF ≥ 15, 47% wore sunglasses, and 14.3% indicated they reapplied sunscreen every two hours. The median personal UVR dose measured during the two outdoor climbing weekends analyzed was 5.2 (IQR 1.8) and 8.8 (IQR 1.1) standard erythemal doses, respectively. CONCLUSIONS: The high rates of sunburn, the elevated personal UVR measured and the clearly insufficient sun protection practices followed during rock climbing together with unsatisfactory attitudes towards tanning reveal the need to develop explicit sun protection campaigns and educational strategies to reduce the risk of skin cancer among the athletes studied.

The adverse consequences of not using sunscreens.

The adverse effects of solar ultraviolet radiation (UVR) on normal skin are well established, especially in those with poorly melanized skin. Clinically, these effects may be classified as acute, such as erythema or chronic such as keratinocyte and melanocyte skin cancers. Apart from skin type genetics, clinical responses to solar UVR are dependent on geophysical (e.g., solar intensity) and behavioural factors. The latter are especially important because they may result in 'solar overload' with unwanted clinical consequences and ever greater burdens to healthcare systems. Correctly used, sunscreens can mitigate the acute and chronic effects of solar UVR exposure. Laboratory studies also show that sunscreens can inhibit the initial molecular and cellular events that are responsible for clinical outcomes. Despite public health campaigns, global trends continue to show increasing incidence of all types of skin cancer. Large-scale epidemiological studies have shown the benefits of sunscreen use in preventing skin cancer, though it is likely that sunscreen use has not been optimal in such studies. It is evident that without substantial changes in sun-seeking behaviour, sunscreen use is a very important part of the defence against the acute and chronic effects of solar exposure. Ideally, sunscreens should be able to provide the level of protection that reduces the risk of skin cancer in susceptible skin types to that observed in heavily melanized skin.

Les effets indésirables des rayons ultraviolets (UVR) du soleil sur une peau saine sont bien établis, en particulier chez les personnes dont la peau est faiblement concentrée en mélanine. Sur le plan clinique, ces effets peuvent être classés comme aigus, comme un érythème, ou chroniques, comme des cancers de la peau kératinocytaires et mélanocytaires. Outre la génétique du type de peau, les réponses cliniques aux UVR du soleil dépendent de facteurs géophysiques (par exemple, intensité du soleil) et comportementaux. Ces réponses sont particulièrement importantes, car elles peuvent entraîner un « trop-plein de soleil ¼ avec des conséquences cliniques indésirables et des charges de plus en plus importantes pour les systèmes de santé. Utilisés correctement, les protections solaires peuvent atténuer les effets aigus et chroniques de l'exposition aux UV du soleil. Des études en laboratoire montrent également que les protections solaires peuvent inhiber les événements moléculaires et cellulaires initiaux, qui sont responsables des effets cliniques. Malgré les campagnes de santé publique, les tendances mondiales continuent de montrer une incidence croissante de tous les types de cancer de la peau. Des études épidémiologiques à grande échelle ont montré les bénéfices de l'utilisation d'une protection solaire dans la prévention du cancer de la peau, même s'il est probable que l'utilisation d'une protection solaire n'a pas été optimale dans ces études. Il est évident que, sans changements substantiels du comportement d'exposition au soleil, l'utilisation d'une protection solaire est un aspect très important de la défense contre les effets aigus et chroniques de l'exposition au soleil. Idéalement, les protections solaires devraient pouvoir offrir aux types de peau sensibles le niveau de protection qui réduit le risque de cancer de la peau observé pour les peaux fortement concentrées en mélanine.

Hell's Itch: A Unique Reaction to UV Exposure.

We present a survey-based exploration of Hell's Itch, a severe dermatologic reaction often mistaken for sunburn, that reveals distinct symptoms including intense pain, unrelenting itching, paresthesia, and even suicidal ideation, differentiating it from a typical sunburn.

Prevalence Of Sunscreen Usage And Perception About Sun Exposure And Sunscreen: A Lower-Middle-Income Country's Perspective.

Sunlight is required for vitamin D synthesis but is also responsible for various adverse effects on human skin, including photo aging, sunburn, and skin cancer. To avoid this, regular use of sunscreens is recommended. The aim of the study was to evaluate the knowledge of a subset of our local population about exposure to sun and assess the attitude about the importance of sunscreen usage. This prospective cross-sectional study was conducted at the dermatology outpatient clinic using a predesigned questionnaire filled by the participants. A total of 200 patients were selected, out of which 135 were females and 65 were males. Forty-nine percent of the participants claimed to use sunblock; however, the majority (54%) used it only occasionally. Fifty-one percent of the participants were not aware that exposure to sun can cause darkening of the skin but more than 100(50%) were aware that this exposure has multiple side effects on the skin. It was also observed that participants had good knowledge about the side effects of sunblock. The study results concluded that participants have good perception of the effectiveness and side effects of sunscreen, most of them used it occasionally. It necessitates the need for a health education programme.

Rapid Remission of Sunburn-Induced Guttate Psoriasis with Guselkumab.

Guselkumab is an anti-interleukin-23 monoclonal antibody that is approved for plaque psoriasis and psoriatic arthritis. We present a case of a 28-year-old female patient with acute onset of guttate psoriasis after a blistering sunburn. She had no personal or family history of psoriasis or chronic inflammatory skin disease. The guttate psoriasis was refractory to topical treatment. After the first dose of guselkumab (100 mg subcutaneous injection), the patient experienced near-clearance of her guttate psoriasis, with continued improvement and drug-free remission 8 months after cessation of treatment. Dermatologists could consider guselkumab as a treatment option for patients with guttate psoriasis. Future studies should examine the potential for guselkumab to induce drug-free remissions in guttate psoriasis.

Sun protection practices in India: Preliminary findings from a nationally representative sample.

Sun safety research has mainly been conducted in the West, whereas little is known about sun protection practices in India. Using a survey design with a representative sample, we aimed to understand the frequency of sun protection practices in India. We also examined associations between demographic covariates and sun safe behaviours. We surveyed a representative sample (N = 1560) from the Indian population in November 2022. The study variables included sun safe behaviours, sunburn experience, demographic information, and skin tone. We employed descriptive and regression analyses to examine the prevalence of behaviours and their associations. To mitigate potential sampling biases, we applied poststratification weights in the analyses. More than half of the participants (64.2%) routinely performed at least one sun safe behaviour, with only 4.9% of the sample reporting no engagement with sun safe behaviours in the last 12 months. Physical protection (e.g., long sleeves, shade/umbrella) were more common than sunscreen use. Regression analysis showed that higher subjective social status, being younger, and living in one of the Eastern Indian states were the strongest predictors of sun protection practices. Our findings fill an important knowledge gap in global sun safe research, highlighting the urgent need for public sun safety education. Scalable and targeted interventions are needed to promote sun safety awareness and practices among people.