Photoaging and cosmeceutical solutions in sun-overexposed countries: The experience of Australia and Brazil.

Skin aging is the result of physiological changes determined by genetically driven processes and intrinsic factors, and exacerbated by a combination of multiple environmental factors, the main one being sun exposure. The effects of photoaging are particularly apparent on the face, where the appearance of aging signs can have a significant impact on the emotions conveyed and well-being. Photoprotection and facial skin care for managing photoaging signs are thus of particular importance for both physical and mental health. Countries, like Australia and Brazil, where the level of sun exposure is high and the populations have predominantly outdoor lifestyles, are particularly aware of the harms of photoaging and have implemented several measures to help reduce the risk of skin cancer in their populations. However, sun-seeking behaviours are difficult to change, and it takes time before interventions provide perceptible results. Australia still has some of the highest skin cancer incidence and mortality rates in the world. Solutions that target individuals can also be used for minimizing the clinical signs of facial aging and for improving skin quality, with the ultimate aim being not only to improve the appearance of the skin but also to mitigate the occurrence of pre-malignant and malignant lesions. This review summarizes the features of facial skin photoaging in photo-exposed populations, based on evidence gained from studies of Australian individuals, and discusses the various available solutions for skin photoaging, in particular those that are most popular in Brazil, which is a country with many years of experience in managing photoaged skin.

Sunproofing from within: A deep dive into oral photoprotection strategies in dermatology.

BACKGROUND: Photoprotection is the first measure in the prevention and treatment of the deleterious effects that sunlight can cause on the skin. It is well known that prolonged exposure to solar radiation leads to acute and chronic complications, such as erythema, accelerated skin aging, proinflammatory and procarcinogenic effects, and eye damage, among others. METHODS: A better understanding of the molecules that can protect against ultraviolet radiation and their effects will lead to improvements in skin health. RESULTS: Most of these effects of the sunlight are modulated by oxidative stress and proinflammatory mechanisms, therefore, the supplementation of substances that can regulate and neutralize reactive oxygen species would be beneficial for skin protection. Current evidence indicates that systemic photoprotection should be used as an adjunctive measure to topical photoprotection. CONCLUSION: Oral photoprotectors are a promising option in improving protection against damage induced by UVR, as they contain active ingredients that increase the antioxidant effects of the body, complementing other photoprotection measures. We present a review of oral photoprotectors and their effects.

Conjunctival ultraviolet autofluorescence as a biomarker of outdoor exposure in myopia: a systematic review and meta-analysis.

Outdoor exposure is considered the primary modifiable risk factor in preventing the development of myopia. This effect is thought to be attributed to the light-induced synthesis and release of dopamine in the retina. However, until recent years, there was no objective quantifiable method available to measure the association between time spent outdoors and myopia. It is only recently that the conjunctival ultraviolet autofluorescence (CUVAF) area, serving as a biomarker for sun exposure, has begun to be utilized in numerous studies. To provide a comprehensive summary of the relevant evidence pertaining to the association between the CUVAF area and myopia across different geographic regions and age groups, a systematic review and meta-analysis were conducted. The search encompassed multiple databases, including MEDLINE, SCIENCE DIRECT, GOOGLE SCHOLAR, WEB OF SCIENCE, and SCOPUS, and utilized specific search terms such as "conjunctival ultraviolet autofluorescence", "CUVAF", "UVAF", "objective marker of ocular sun exposure", "myopia", "degenerative myopia", and "high myopia". The bibliographic research included papers published between the years 2006 and 2022. A total of 4051 records were initially identified, and after duplicates were removed, 49 articles underwent full-text review. Nine articles were included in the systematic review. These studies covered myopia and outdoor exposure across different regions (Australia, Europe and India) with a total population of 3615 individuals. They found that myopes generally had smaller CUVAF areas compared to non-myopes. The meta-analysis confirmed this, revealing statistically smaller CUVAF areas in myopic patients, with a mean difference of - 3.30 mm2 (95% CI - 5.53; - 1.06). Additionally, some studies showed a positive correlation between more outdoor exposure and larger CUVAF areas. In terms of outdoor exposure time, myopic patients reported less time outdoors than non-myopic individuals, with a mean difference of - 3.38 h/week (95% CI - 4.66; - 2.09). Overall, these findings highlight the connection between outdoor exposure, CUVAF area and myopia, with regional variations playing a significant role. The results of this meta-analysis validate CUVAF as a quantitative method to objectively measure outdoor exposure in relation with myopia development.

Enzymes for dermatological use.

Skin is the ultimate barrier between body and environment and prevents water loss and penetration of pathogens and toxins. Internal and external stressors, such as ultraviolet radiation (UVR), can damage skin integrity and lead to disorders. Therefore, skin health and skin ageing are important concerns and increased research from cosmetic and pharmaceutical sectors aims to improve skin conditions and provide new anti-ageing treatments. Biomolecules, compared to low molecular weight drugs and cosmetic ingredients, can offer high levels of specificity. Topically applied enzymes have been investigated to treat the adverse effects of sunlight, pollution and other external agents. Enzymes, with a diverse range of targets, present potential for dermatological use such as antioxidant enzymes, proteases and repairing enzymes. In this review, we discuss enzymes for dermatological applications and the challenges associated in this growing field.

Metastasis of skin squamous cell carcinoma in kidney transplant recipients.

Cutaneous squamous cell carcinoma (cSCC) is the most common skin malignancy in kidney transplant recipients (KTRs) as a result of immunosuppression. A worldwide increase in kidney transplantation justifies the determination of prognostic biomarkers by collecting detailed patient data on metastasis development. This study aims to characterize the clinical, epidemiological, and histopathological profiles of KTRs who developed metastasis of cSCC. We conducted a retrospective single-center study on 18 KTRs and 21 immunocompetent patients (ICs) with metastatic cSCC, using data from 2004 to 2021. ICs were older (median age 70.5 years) than KTRs (median age: 59.5 years). Both groups were predominantly male with Fitzpatrick skin phototype I/II. The primary tumor appeared around 83.5 months post-transplant, usually in sun-exposed areas (61.1%), though some non-exposed areas in ICs (23.8%) contradicted literature findings. KTRs took longer to develop metastasis (median: 11.0 months) compared to ICs (median: 5.5 months). The mean size of the primary tumor was smaller in KTRs (2.50 cm2) compared to ICs (4.55 cm2). The main lymph node chain affected by metastasis was parotid lymph nodes in KTRs (27.8%) and cervical/axillar lymph nodes in ICs (both 19.0%). Both groups exhibited similar primary tumor grades and metastasis evolution, but KTRs had a higher prevalence of lymphovascular invasion. Metastasis of cSCC was more common in males with low skin phototype, in KTRs, particularly on the head and neck. The study suggests a possible link between lymphovascular invasion and metastasis development in KTRs.

Fixed Sunlight Eruption: A Series of 13 Cases in Bogotá, Columbia. / Erupción fija por luz solar, una serie de 13 casos en Bogotá, Colombia.

Few reports describing an association between UV radiation and fixed skin eruptions have been published since 1975. These reactions have received various names, including fixed sunlight eruption, fixed exanthema due to UV radiation, and broad-spectrum abnormal localized photosensitivity syndrome. We present a series of 13 patients (4 men [30.8%] and 9 women [69.2%]) aged between 28 and 56 years who were evaluated for fixed eruptions induced by UV radiation at a dermatology referral hospital in Bogotá, Colombia. The lesions were located on the inner thighs, buttocks, popliteal region, anterior and posterior axilla, and dorsum of the feet. Photoprovocation reproduced lesions in all the affected areas, and histopathology showed changes similar to those seen in fixed drug eruptions. While these UV-provoked reactions may be a type of fixed skin eruption, we cannot rule out that they may also be a distinct condition that simply shares a pathogenic mechanism with fixed eruptions.

Unraveling the complex link between vitamin D levels and cancer: A crucial understanding for designing future supplementation approaches

Abstract Numerous studies have underscored the essential role of sunlight in vitamin D synthesis, while other studies have examined the association between dietary supplementation and vitamin D levels in different oncologic indications. In certain oncologic types, low levels of vitamin D correlate with a higher risk of cancer progression or poorer outcomes. On the contrary, the protective role of vitamin D remains ambiguous for some cancers. Given that the majority of cancer patients exhibit vitamin D deficiency or insufficiency, there have been suggestions to adopt supplementation strategies. However, vitamin D modulates and interacts with several molecular pathways. Therefore, it is crucial to contextualize the level and circumstances in which the action of vitamin D is observed. Distinct outcomes may emerge based on factors such as the method of assessing vitamin D levels, the size of the study populations, their genetic background, and the specific cancer type under investigation. In this article, we summarize some of the relevant studies examining the relationship between vitamin D levels and cancer. We further briefly outline the process of vitamin D synthesis and its effects on specific cellular pathways involved in cancer progression, highlighting essential considerations for future vitamin D assessments and supplementation approaches.

Análise do perfil clínico de pacientes portadores de neoplasia ocular escamosa atendidos em hospital referência de oculoplástica / Analysis of the clinical profile of patients with squamous ocular neoplasms attended at a reference hospital of oculoplastics

RESUMO Objetivo Analisar o perfil clínico de pacientes portadores de neoplasias escamosas da superfície ocular. Métodos Foram avaliados os principais fatores de risco envolvidos na gênese das neoplasias escamosas da superfície ocular, as características clínicas dos pacientes e os hábitos comportamentais associados. Foram incluídos neste trabalho de coorte histórica 80 pacientes com diagnóstico anatomopatológico de neoplasia escamosa da superfície ocular atendidos entre os anos de 2010 e 2020 em um hospital referência em oculoplástica e segmento anterior de Santa Catarina. Os dados clínicos e desfechos foram avaliados por meio da análise de prontuário e entrevista, sendo posteriormente tabulados no Excel e submetidos à analise estatística por meio do software Statistical Pakage for the Social Sciences, versão 16. Resultados Foi observado que 73,8% (n=59) eram do sexo masculino. A média de idade da amostra foi de 62 anos. Quanto ao fototipo de pele, de acordo com a escala de Fitzpatrick, constatou-se que a maioria apresentou os fototipos 1 e 2 (22; 27,5% e 44; 55%, respectivamente). Em relação à exposição ocupacional ao sol/radiação, 48% (n=60) apresentaram história de exposição ocupacional, sendo que, destes, 28 pacientes trabalhavam no setor de agricultura. Dos pacientes da amostra, 33 (41,2%) apresentavam histórico pessoal de neoplasias de pele, sendo que, destes, três apresentavam diagnóstico de xeroderma pigmentoso. Quanto ao hábito de uso de fatores de proteção solar, 61% (n=49) da amostra negou o hábito. Foi evidenciada associação estatisticamente significativa entre o hábito de usar fatores de proteção solar e histórico pessoal de neoplasias de pele. Em relação ao tipo de neoplasia escamosa, a maioria dos pacientes (72; 90%) apresentou diagnóstico anatomopatológico de carcinoma espinocelular ocular. Conclusão O perfil clínico epidemiológico dos pacientes portadores de neoplasias escamosas da superfície ocular neste estudo, predominantemente de carcinoma espinoceular ocular, foi de homens, idosos, de pele clara (fototipo 2) e com histórico importante de exposição aos raios solares ultravioleta A e B. Comorbidades imunodepressoras (HIV e transplante de órgão sólido) e doenças dermatológicas (albinismo e xeroderma pigmentoso) associaram-se ao aparecimento das neoplasias escamosas da superfície ocular em idade mais precoce. Em pacientes com histórico pessoal prévio de neoplasias de pele, foi evidenciado o hábito de uso de fatores de protetor solar mais presente em relação aos demais.

ABSTRACT Objective To analyze the clinical profile of patients with ocular surface squamous neoplasms (OSSN). Methods The main risk factors involved in the genesis of the ocular surface squamous neoplasms, the clinical features, and the behavioral habits associated were evaluated. This historical cohort study included 80 patients with anatomopathological diagnosis of OSSN who were treated between 2010-2020 at a reference hospital in oculoplastic and anterior segment in Santa Catarina. The clinical data and outcomes were evalated through the analysis of medical records and interviews, being later tabulated in Excel and analyzed using the SPSS 16 software. Results Regarding the clinical profile of the patients in the sample, 73.8% (n = 59) were male. The mean age of the sample was 62 years old. As for the skin phototype, according to the Fitzpatrick scale, most of the sample presented the phototype 1 and 2 (27.5% n = 22; and 55% n = 44 respectively). Regarding occupational exposure to the sun / radiation, 48% (n = 60) had history of occupational exposure, and of these, 28 patients worked in the agricultural area. Of the patients of the sample, 33 (41.2%) had a personal history of skin neoplasms, and of these, 3 had diagnosis of xeroderma pigmentosum. As for the habit of using sun protection factors, 61% (n = 49) of the sample denied the habit. A statistically significant association was evidenced between the habit of using sun protection factors and people's history of skin cancer. Regarding the type of squamous neoplasia, most patients in the 90% sample (n = 72) had an anatomopathological diagnosis of ocular squamous cell carcinoma. Conclusion The clinical epidemiological profile of patients with OSSN in this study, predominantly ocular squamous cell carcinoma, was men, elderly, fair-skinned (phototype 2) and with an important history of exposure to UVA and UVB rays. Immunosuppressive comorbidities (HIV, solid organ transplant) and dermatological diseases (albinism, xeroderma pigmentosum) are associated with the appearance of OSSN at an early age. In patients with a previous personal history of skin neoplasms, the habit of using sunscreen factors was more present than in the other patients.

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.

Sun exposure and sun protection behaviors among teenagers and adults in Mexico City.

OBJECTIVE: To know the prevalence of sun exposure and protection behaviors in a group of adolescents and to compare them with a group of adults in Mexico City. MATERIAL AND METHODS: Descriptive, cross-sectional study in students aged 16 to 18 years and in adults older than 18 years. RESULTS: Seven-hundred and forty-eight students were surveyed; 60 % were females and 40 % males; 90 % seek shade, 70.1 % avoid exposing themselves to the sun from 10.00 to 16.00 hours and 30.6 % use sunscreen. Out of 620 adults, 67.5 % were women and 32.4 % were men; 82.6 % seek shade, 60.2 % avoid the sun from 10.00 to 16.00 hours and 48.1% use sunscreen; 72.9 % of adults and 80.8 % of adolescents are exposed to the sun due to domestic activities. DISCUSSION: There is a similar trend in sun protection and exposure behaviors in adolescents and adults. The prevalence of sunscreen use in adults is high in comparison with adolescents.

OBJETIVO: Conocer la prevalencia de las conductas exposición y protección solar en un grupo de adolescentes y compararlos con un grupo de adultos en la Ciudad de México. MATERIAL Y MÉTODOS: Estudio transversal descriptivo en estudiantes de 16 a 18 años y en adultos mayores de 18 años. RESULTADOS: Se encuestaron 748 alumnos, 60 % mujeres y 40 % hombres. El 90 % busca la sombra, el 70.1 % evita exponerse al sol de las 10 a las 16 horas y el 30.6 % usa filtro solar. De 620 adultos, 67.5 % mujeres y 32.4 % hombres, el 82.6 % buscan la sombra, el 60.2 % evita el sol de las 10 a las 16 horas y el 48.1 % utiliza filtro solar. El 72.9 % de adultos y el 80.8 % de adolescentes se exponen al sol debido a actividades domésticas. DISCUSIÓN: Existe una tendencia similar en las conductas de protección y exposición solar en adolescentes y adultos. Es alta la prevalencia de uso de fotoprotector en adultos en comparación con los adolescentes.

Conductas de exposición y protección solar en adolescentes y adultos de la Ciudad de México / Sun exposure and sun protection behaviors among teenagers and adults in Mexico City

Resumen Objetivo: Conocer la prevalencia de las conductas exposición y protección solar en un grupo de adolescentes y compararlos con un grupo de adultos en la Ciudad de México. Material y métodos: Estudio transversal descriptivo en estudiantes de 16 a 18 años y en adultos mayores de 18 años. Resultados: Se encuestaron 748 alumnos, 60 % mujeres y 40 % hombres. El 90 % busca la sombra, el 70.1 % evita exponerse al sol de las 10 a las 16 horas y el 30.6 % usa filtro solar. De 620 adultos, 67.5 % mujeres y 32.4 % hombres, el 82.6 % buscan la sombra, el 60.2 % evita el sol de las 10 a las 16 horas y el 48.1 % utiliza filtro solar. El 72.9 % de adultos y el 80.8 % de adolescentes se exponen al sol debido a actividades domésticas. Discusión: Existe una tendencia similar en las conductas de protección y exposición solar en adolescentes y adultos. Es alta la prevalencia de uso de fotoprotector en adultos en comparación con los adolescentes.

Abstract Objective: To know the prevalence of sun exposure and protection behaviors in a group of adolescents and to compare them with a group of adults in Mexico City. Material and methods: Descriptive, cross-sectional study in students aged 16 to 18 years and in adults older than 18 years. Results: Seven-hundred and forty-eight students were surveyed; 60 % were females and 40 % males; 90 % seek shade, 70.1 % avoid exposing themselves to the sun from 10.00 to 16.00 hours and 30.6 % use sunscreen. Out of 620 adults, 67.5 % were women and 32.4 % were men; 82.6 % seek shade, 60.2 % avoid the sun from 10.00 to 16.00 hours and 48.1% use sunscreen; 72.9 % of adults and 80.8 % of adolescents are exposed to the sun due to domestic activities. Discussion: There is a similar trend in sun protection and exposure behaviors in adolescents and adults. The prevalence of sunscreen use in adults is high in comparison with adolescents.

Actinic prurigo in a dermatological reference center in Colombia: 108 cases / Prurigo actínico en un centro dermatológico de referencia en Colombia: 108 casos.

Introduction: Actinic prurigo is a chronic photodermatosis. It affects the Latin American population more frequently, predominantly women, and involves the sun-exposed areas of the skin, conjunctiva, and lips. Objective: To update the information on the clinical-epidemiological characteristics and treatment of patients with actinic prurigo in Colombia. Materials and methods: We conducted a cross-sectional study including the medical records of patients with actinic prurigo treated in the Photodermatology Service of Hospital Universitario Centro Dermatológico Federico Lleras Acosta between 2011 and 2016. We described the demographic, clinical, histopathological, and treatment characteristics of the patients. Results: We included 108 patients, 77 (71.3%) were women and 31 (28.7%) men, mainly with phototypes III-IV (70%). The disease had begun during the first decade of life in 66.4% of the cases and 25% of the patients had a family history with the condition. The lesions predominated on the face (93.5%), forearms (79.6%), and back of the hands (70.4%). Ocular (87.9%) and lip (88.8%) involvement was also documented. A photo-provocation test with UVA was performed in 25% of the cases and skin biopsies in 19.4%. Physical and chemical photoprotection was indicated in all patients. Mild to moderate cases were treated with topical corticosteroids (91.7%) and calcineurin inhibitors (65.7%) while severe cases received thalidomide (33.3%) and pentoxifylline (14.8%). Conclusion: The characteristics of actinic prurigo patients in Colombia are similar to those reported in other Latin American countries: early onset of the disease, predominance in women, frequent involvement of conjunctiva and lips, and adequate response to topical and systemic treatment.

Introducción. El prurigo actínico es una fotodermatosis crónica. Afecta con mayor frecuencia a la población latinoamericana, predomina en mujeres y compromete la piel expuesta al sol, las conjuntivas y los labios. Objetivo. Actualizar la información sobre las características clínico-epidemiológicas y el tratamiento de pacientes con prurigo actínico en Colombia. Materiales y métodos. Se hizo un estudio de corte transversal que incluyó los registros clínicos de pacientes con prurigo actínico atendidos en el Servicio de Fotodermatología del Hospital Universitario Centro Dermatológico Federico Lleras Acosta entre el 2011 y el 2016, y se describieron sus características demográficas, clínicas e histopatológicas, así como su tratamiento. Resultados. Se incluyeron 108 pacientes, el 71,3 % de ellos mujeres y el 28,7% hombres, con predominio de los fototipos III-IV (70 %). La enfermedad se había iniciado durante la primera década de vida en el 66,4% de los casos y el 25 % de los pacientes tenía antecedentes familiares de la enfermedad. Las lesiones predominaban en el rostro (93,5 %), los antebrazos (79,6 %) y el dorso de las manos (70,4 %). También, se documentó compromiso ocular (87,9 %) y de los labios (88,8 %). Se hizo la prueba de fotoprovocación con radiación ultravioleta A en el 25 % de los casos y biopsia cutánea en el 19,4 %. Todos los pacientes se trataron con protección solar química y física. En los casos leves a moderados, se formularon corticoides tópicos (91,7 %) e inhibidores de la calcineurina (65,7 %), y en los graves, talidomida (33,3 %) y pentoxifilina (14,8 %). Conclusión. Las características de los pacientes colombianos con prurigo actínico son similares a las reportadas en otros países latinoamericanos: inicio temprano de la enfermedad, predominio en mujeres, compromiso frecuente de conjuntivas y labios, y adecuada respuesta al tratamiento tópico y sistémico.

Photoaged Skin Therapy with Adipose-Derived Stem Cells.

BACKGROUND: The major intrinsic cause of facial skin degeneration is age, associated with extrinsic factors such as exposure to sun. Its major pathologic causes are degeneration of the elastin matrix, with loss of oxytalan and elaunin fibers in the subepidermal region, and actinic degeneration of elastin fibers that lose their functional properties in the deep dermis. Therapy using autologous adipose mesenchymal stem cells for regeneration of extracellular matrix in patients with solar elastosis was addressed in qualitative and quantitative analyses of the dermal elastic fiber system and the associated cells. METHODS: Mesenchymal stem cells were obtained from lipoaspirates, expanded in vitro, and introduced into the facial skin of patients submitted after 3 to 4 months to a face-lift operation. In the retrieved skin, immunocytochemical analyses quantified elastic matrix components; cathepsin K; matrix metalloproteinase 12 (macrophage metalloelastase); and the macrophage M2 markers CD68, CD206, and hemeoxygenase-1. RESULTS: A full de novo formation of oxytalan and elaunin fibers was observed in the subepidermal region, with reconstitution of the papillary structure of the dermal-epidermal junction. Elastotic deposits in the deep dermis were substituted by a normal elastin fiber network. The coordinated removal of the pathologic deposits and their substitution by the normal ones was concomitant with activation of cathepsin K and matrix metalloproteinase 12, and with expansion of the M2 macrophage infiltration. CONCLUSION: The full regeneration of solar elastosis was obtained by injection of in vitro expanded autologous adipose mesenchymal stem cells, which are appropriate, competent, and sufficient to elicit the full structural regeneration of the sun-aged skin. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Histopathological features of photodamage and mast cell infiltrate in actinic cheilitis with different grades of epithelial dysplasia.

BACKGROUND: Actinic cheilitis is induced by chronic exposure to ultraviolet radiation and shows solar elastosis, a feature that has been associated with mast cell infiltrates. This study aimed to investigate the area of solar elastosis, collagen loss, and mast cell infiltrates in a series of actinic cheilitis. METHODS: We evaluated the epithelial dysplasia in 52 cases of actinic cheilitis and the solar elastosis with Weigert's resorcin-fuchsin. Collagen loss was evaluated with Picrosirius red, analyzed under polarized microscopy, and scored from 1 to 3. Elastosis proportionate area (EPA) was calculated with image software. Mast cells were highlighted with toluidine blue stain. RESULTS: EPA varied from 2% to 45%, with a mean of 17.1% in the cases, with no differences among epithelial dysplasia degrees. Most cases presented collagen loss scores of 2 or 3, and higher loss of type I collagen was associated with older age. Mast cell density was higher in severe epithelial dysplasia (P = 0.002) and in high-risk cases (P = 0.01). CONCLUSION: Actinic cheilitis presented variable EPA and marked loss of type I collagen; however, these features were not associated with the degrees of epithelial dysplasia. Besides, mast cell density increased with epithelial dysplasia worsening and this was not associated with elastosis area or collagen loss.

The Shadow Rule, the UV Index, and the 5S Steps in the Tropics.

Solar ultraviolet radiation (UVR) induces the production of vitamin D (VD), but it also causes erythema and skin cancer among other diseases. The amount of UVR to get benefit and avoid harm is unknown. Some principles were proposed to provide accessible information on how to avoid overexposure to the Sun. They are (1) the Shadow Rule (SR); (2) the UV Index (UVI); and (3) the Slip, Slop, Slap, Seek, Slide (5S) steps. This work discusses these principles in the tropics, considering measurements of solar UVR, total ozone column, and cloudiness. Indeed, the SR leads to overexposures. The UVI is adequate for cloudless skies, but it does not consider radiation enhancement events by clouds. "Seek shade" in the 5S steps should be more emphasized as it is both the most efficient step in terms of avoiding direct sun and the friendliest step toward the environment. Therefore, photoprotection attitudes in the tropics should focus on the UVI and the 5S steps in addition to considering both VD sufficiency and environmental outcomes. The SR is clearly inaccurate.

Preparation and characterization of liposomes loaded with silver nanoparticles obtained by green synthesis

The objective of this work was to develop and characterize liposomes loaded with silver nanoparticles (LAgNPs) to show improvement in stability characteristics. AgNPs were prepared by the green synthesis method with Aloe vera gel extract and exposure to sunlight. Liposomes were prepared by the modified reverse phase method. Particle size, polydispersity index, zeta potential, as well as the scanning electron microscopy (SEM) morphological aspects of AgNPs and LAgNPs were evaluated. In addition, was used flame atomic absorption spectroscopy to determine the amount of AgNP that was encapsulated in liposomes. The AgNPs presented as amorphous and polydisperse structures, with a mean diameter of 278.46 nm and zeta potential of -18.3 mV. LAgNPs had a mean diameter between 321 and 373 nm, the polydispersity index close to 0.2 and a zeta potential around -40 mV, which indicates greater stability to the AgNPs. The images obtained by SEM show semicircular structures for AgNPs and well-defined spherical shape for LAgNPs. The percentage of encapsulation was between 51.81 to 58.83%. These results showed that LAgNPs were obtained with adequate physicochemical characteristics as a release system.

Maculopatia solar após o uso de LSD: relato de caso / Solar maculopathy after LSD use: a case report

Introdução: A maculopatia ou retinopatia solar é uma lesão foto-traumática da mácula causada pela observação direta ou indireta de fontes luminosas intensas, que ocorre comumente na presença de distúrbios psíquicos ou após o uso de drogas recreativas. O prognóstico visual varia e a conduta é expectante. Descrição do caso: Paciente V.V.A.M., sexo masculino, 20 anos, estudante, com queixa de escotoma central em ambos os olhos. Nega antecedentes patológicos e oculares. Solicitaram-se tomografia de coerência óptica (OCT) e retinografia, que revelaram uma lesão central, bilateral e simétrica na retina externa. Paciente relatou ter feito uso de Dietilamida de ácido lisérgico (LSD) e, sob influência da droga, ter olhado de forma direta para o sol por aproximadamente 40 minutos. Discussão: O prognóstico da retinopatia solar é variável e relaciona-se com o tempo de exposição e com o comprimento da onda da fonte de luz. A etiopatogênese é explicada pelo dano causado ao epitélio pigmentar da retina (EPR) pela radiação. Conclusões: Deve haver maior orientação ao público sobre os possíveis efeitos danosos de exposição a fontes de luz de origens diversas. Além disso, destaca-se a importância do OCT para a identificação da maculopatia solar. (AU)

Introduction: Solar maculopathy or retinopathy is photo-traumatic damage created on the macula, caused by direct or indirect observation of intense light sources, commonly occurring in the presence of psychic disorders or after the use of recreational drugs. The visual prognosis varies. There is currently no known treatment. Case report: A 20-year-old male with no previous complaints reported central scotoma in both eyes despite 20/20 uncorrected vision. Bilateral, symmetric, central changes could be seen in the macula in fundoscopy. Optical coherence tomography (OCT) confirmed loss of the external retina suggestive of Solar Maculopathy. The patient later claimed to have spent 40 minutes looking directly into the sun after use of Lysergic Acid Diethylamide (LSD). Discussion: The prognosis of solar retinopathy is related to the exposure time and to the wavelength of the light source, with those between 300-350 nm being the most harmful. Its etiopathogenesis is explained by damage caused to the retinal pigment epithelium (EPR) caused by radiation, interrupting the interdigitations between this layer and the external segment of the photoreceptors. Ophthalmoscopically, solar maculopathy is characterized by a small foveolar lesion that might become yellowish in the days following exposure, in the form of exudate or edema, followed by loss of foveal reflex and thinning of the fovea. The initial yellowed lesions are subsequently replaced by a spotted EPR or even by a lamellar orifice. Conclusions: There should be public guidance on the possible harmful effects of exposure to sources of light from diverse origins, as it usually occurs during solar eclipses, after exposure to certain types of lasers or observation of fires since this habit can cause severe and sometimes irreversible visual loss. (AU)

Productivity and morphological composition of Xaraés palisade grass under three light intensities / Produtividade e composição morfológica do capim-xaraés em três intensidades luminosas

The adaptation of Urochloa brizantha to Brazilian ecosystems and the use of artificial shading in low light production studies are important tools to obtain productive responses and to know the behavior of plants when used in integration with arboreal components. The experiment was conducted at the FMVZ - UNESP in Botucatu city, São Paulo state, Brazil. The study aimed to evaluate the yield of U. brizantha (syn Brachiaria brizantha) cv. Xaraés (Xaraés palisade grass) under three light intensities and four cuts. The experimental design was a randomized block with three treatments (natural luminosity, 30% light reduction, and 60% light reduction), three replicates and four cuts. The following morphological components were determined: leaf area index (LAI), forage accumulation rate (FAR), total forage mass (TFM), stem yield (SY), leaf yield (LY), and dead material yield (DMY). Light intensity influenced grass productivity, and the best performance was reached under 60% shading, which had higher values of TFM, LY, SY, LAI, and FAR if compared to natural luminosity. Thus, a reduction of 60% in light intensity showed to be the most productive and the best alternative under those conditions.

A adaptação da Urochloa brizantha aos ecossistemas brasileiros e a utilização de sombreamento artificial em estudos de produção sob baixas luminosidades são ferramentas importantes para se obter respostas produtivas e conhecer o comportamento das plantas quando utilizadas em integrações com componentes arbóreos. O experimento foi conduzido na FMVZ UNESP Botucatu, com objetivo de avaliar a produtividade da cultivar de Urochloa brizantha (syn Brachiaria brizantha) cv. Xaraés submetida a três intensidades luminosas e quatro cortes. O delineamento experimental foi em blocos ao acaso, sendo os tratamentos: luminosidade natural, redução de 30% e 60% de luz, com três repetições e quatro cortes. Foi realizada a separação morfológica, índice de área foliar e a taxa de acúmulo, também foi calculada a produção de massa seca total, colmo e folhas, além da produção de material morto. A produtividade foi influenciada pelos níveis de intensidade de luz, sendo o melhor desempenho obtido no tratamento com 60% de sombreamento, que apresentou maior produção de massa seca total, de folha e colmo, índice de área foliar e maior taxa de acúmulo em comparação ao pleno sol. O tratamento com 60% de redução de luminosidade foi o mais produtivo, sendo o melhor tratamento nestas condições.

Productivity and morphological composition of Xaraés palisade grass under three light intensities / Produtividade e composição morfológica do capim-xaraés em três intensidades luminosas

The adaptation of Urochloa brizantha to Brazilian ecosystems and the use of artificial shading in low light production studies are important tools to obtain productive responses and to know the behavior of plants when used in integration with arboreal components. The experiment was conducted at the FMVZ - UNESP in Botucatu city, São Paulo state, Brazil. The study aimed to evaluate the yield of U. brizantha (syn Brachiaria brizantha) cv. Xaraés (Xaraés palisade grass) under three light intensities and four cuts. The experimental design was a randomized block with three treatments (natural luminosity, 30% light reduction, and 60% light reduction), three replicates and four cuts. The following morphological components were determined: leaf area index (LAI), forage accumulation rate (FAR), total forage mass (TFM), stem yield (SY), leaf yield (LY), and dead material yield (DMY). Light intensity influenced grass productivity, and the best performance was reached under 60% shading, which had higher values of TFM, LY, SY, LAI, and FAR if compared to natural luminosity. Thus, a reduction of 60% in light intensity showed to be the most productive and the best alternative under those conditions.(AU)

A adaptação da Urochloa brizantha aos ecossistemas brasileiros e a utilização de sombreamento artificial em estudos de produção sob baixas luminosidades são ferramentas importantes para se obter respostas produtivas e conhecer o comportamento das plantas quando utilizadas em integrações com componentes arbóreos. O experimento foi conduzido na FMVZ UNESP Botucatu, com objetivo de avaliar a produtividade da cultivar de Urochloa brizantha (syn Brachiaria brizantha) cv. Xaraés submetida a três intensidades luminosas e quatro cortes. O delineamento experimental foi em blocos ao acaso, sendo os tratamentos: luminosidade natural, redução de 30% e 60% de luz, com três repetições e quatro cortes. Foi realizada a separação morfológica, índice de área foliar e a taxa de acúmulo, também foi calculada a produção de massa seca total, colmo e folhas, além da produção de material morto. A produtividade foi influenciada pelos níveis de intensidade de luz, sendo o melhor desempenho obtido no tratamento com 60% de sombreamento, que apresentou maior produção de massa seca total, de folha e colmo, índice de área foliar e maior taxa de acúmulo em comparação ao pleno sol. O tratamento com 60% de redução de luminosidade foi o mais produtivo, sendo o melhor tratamento nestas condições.(AU)