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1.
Photodiagnosis Photodyn Ther ; : 101681, 2020 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-32032781

RESUMO

BACKGROUND: Photodynamic therapy with Protoporphyrin IX (PpIX) is well-established for keratinocyte dysplasia. PpIX fluorescence can be quantified at the skin surface and within skin layers, but their relation is previously undescribed. The study objective was to assess the relation between skin surface PpIX fluorescence and PpIX fluorescence in epidermis and dermis. METHODS: Normal buttocks skin was tape-stripped and incubated with 20% methyl aminolevulinate cream and 20% hexyl aminolevulinate cream under occlusion. After 3 hours, skin surface PpIX fluorescence photographs were captured and 4 mm punch biopsies sampled. PpIX fluorescence microscopy was measured in regions of interest (ROI) in epidermis and superficial dermis. All PpIX fluorescence intensities were calculated in arbitrary units (AU). RESULTS: Skin surface PpIX fluorescence intensity expressed a positive, linear relation to ROI-epidermis PpIX fluorescence (HAL- and MAL-incubated skin, p < 0.001, r2 = 0.60), but not to PpIX fluorescence intensities in ROI-superficial dermis (p = 0.112). PpIX fluorescence microscopy identified higher fluorescence intensities in ROI-epidermis (median 92 AU) compared to lower fluorescence intensities in ROI-superficial dermis (median 37 AU) (p < 0.001). HAL reached higher median PpIX fluorescence intensities than MAL when measured by skin surface photographs (10230 vs. 5630 AU, p < 0.001), and by fluorescence microscopy in ROI-epidermis (107 vs. 52.5 AU, p < 0.001) or ROI-superficial dermis (40 vs. 30.5 AU, p = 0.04). CONCLUSION: The positive linear relation between skin surface PpIX fluorescence photographs and epidermal PpIX fluorescence microscopy indicates that skin surface PpIX fluorescence predominantly derives from epidermis.

2.
Anticancer Res ; 40(1): 511-518, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31892606

RESUMO

BACKGROUND/AIM: This review examined the implications of using sunscreen photoprotection on 25(OH)D formation and determined the best photoprotective method to reduce the risk of skin cancer caused by ultraviolet radiation (UVR). Based on previous studies on 25(OH)D formation after use of different amounts of sunscreen and different doses of UVR for approximately one week to different body areas it is possible to estimate the amount of 25(OH)D formed after a week's holiday in Southern and Northern Europe. CONCLUSION: The best method of photoprotection by sunscreen is two consecutive applications before sun exposure, ensuring the use of sufficient amounts of sunscreen and minimizing the unprotected skin areas. The double application method simultaneously ensures a high photoprotection against erythema from sun exposure. Despite the use of sunscreen, the calculated serum 25(OH)D levels clearly increase to similar levels as those measured after sun vacations.


Assuntos
Protetores Solares/farmacologia , Vitamina D/análogos & derivados , Humanos , Pele/efeitos da radiação , Banho de Sol , Raios Ultravioleta , Vitamina D/metabolismo , Organização Mundial da Saúde
3.
Anticancer Res ; 40(1): 557-564, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31892612

RESUMO

BACKGROUND/AIM: Ultraviolet radiation (UVR) causes solar lentigines (SL) and skin cancer (SC) in humans. The association between measured lifetime UVR dose and SC has not been investigated. This study investigated this relation through their common relationship to SL. MATERIALS AND METHODS: First we investigated the association between lifetime UVR dose and SL for 16,897 days in 38 healthy participants, and secondly, the relation between SL and SC was investigated in 2,898 participants, including 149 with SC. By combining both studies, SC risk related to lifetime UVR dose and skin phototype was estimated. RESULTS: A positive association was found between SL and lifetime UVR dose (p=0.060). Skin phototype (p=0.001) and SL (p<0.001) were associated with SC. Combined SC risk increased 1.23 by doubling the average lifetime UVR dose and was 34.9 times higher for those with very fair skin compared to dark Mediterranean skin. CONCLUSION: The estimate of SC risk shows that skin phototype is of greater relative importance than lifetime UVR dose.


Assuntos
Lentigo/epidemiologia , Neoplasias Cutâneas/epidemiologia , Raios Ultravioleta , Adulto , Idoso , Relação Dose-Resposta à Radiação , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco
4.
Photodiagnosis Photodyn Ther ; : 101582, 2019 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-31809913

RESUMO

BACKGROUND: Erythropoietic protoporphyria (EPP) is a rare, genetic disease with reduced ferrochelatase activity causing protoporphyrine IX (PpIX) to accumulate in erythrocytes. PpIX activation by daylight causes skin erythema, edema, burning, and stinging. No treatment exists to reduce PpIX. AIM: To introduce a method that reduces PpIX in erythrocytes to relieve skin symptoms in patients with EPP. METHOD: A case series of 7 patients with EPP constituted this explorative study. Erythrocyte PpIX was inactivated by illuminating the patients' heparinized blood outside their body, then returning it to the patient. About 3 litres of blood was illuminated with 630 nm light, 20 J/cm2. The effect was measured as a reduction in erythrocyte PpIX. The patients reported the number of minutes in daylight tolerated before and after intervention. RESULTS: This procedure reduced PpIX by about 30% and daylight tolerance was, on average, increased by 14 times. The subsequently excreted photoproducts resulted in some liver toxicity. Three treatments during spring and early summer were sufficient to reduce the patients' symptoms throughout the year in Northern Europe. CONCLUSION: Extracorporeal erythrocyte photodynamic therapy is the first treatment to successfully reduce the amount of PpIX in the blood of EPP patients, thus "normalizing" their daylight tolerance.

5.
Sci Rep ; 9(1): 12217, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31434955

RESUMO

The tape stripping technique is increasingly used in research regarding skin barrier function. However, number of tape strips varies between studies, and literature considering advancement into stratum corneum/epidermis in relation to number of tape strips is scarce. The aim of this pilot study was to assess the advancement through epidermis using tape stripping technique in healthy volunteers. A total of ten healthy volunteers were included. From all volunteers 0, 5, 15 and 35 consecutive tape strips (D-squame) were taken from four adjacent skin areas on the middle volar forearm, followed by Reflectance Confocal Microscopy (RCM) of the four areas to assess epidermal thickness. Squame Scan was used to determine amount of protein removed. Stratum corneum was completely removed in all volunteers after 35 tape strips. Advancement into epidermis was predominantly achieved by the first 15 tape strips, removing 25% of the total epidermis, whereas 35 tape strips removed 33% of epidermis. Protein removal per tape decreased with increasing depth. Information on advancement into the epidermis according to number of tape strips taken, is a significant step forward. The possibility to obtain samples from different layers of epidermis may lead to an improved understanding of skin barrier properties.

6.
Photodermatol Photoimmunol Photomed ; 35(5): 344-353, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31166629

RESUMO

BACKGROUND: The inter-individual variation in 25(OH)D3 increase (Δ25(OH)D3 ) after vitamin D3 supplementation was determined and compared with the UVB irradiation response. METHODS: Nineteen Danish participants received 85 µg vitamin D3 (cholecalciferol) daily for nine weeks with regular serum 25(OH)D3 measurements. These participants had three years earlier taken part in a 9-week controlled UVB study. The Δ25(OH)D3 was not confounded by ambient UVB, BMI or ethnicity. RESULTS: Δ25(OH)D3 was 53 nmol L-1 and almost identical to Δ25(OH)D3 (52 nmol L-1 ) after UVB. Δ25(OH)D3 ranged from 17 to 91 nmol L-1 (span 74 nmol L-1 ) and was about half of that observed after UVB irradiation (span 136 nmol L-1 ). The interquartile ranges for vitamin D3 supplementation (38.8-71.4 nmol L-1 , span: 32.6 nmol L-1 ) and UVB irradiation (35.7-65.4 nmol L-1 , span: 29.7 nmol L-1 ) were similar indicating a comparable response of the two interventions. As the 25(OH)D3 start levels (R2  = 0.398, P = 3.8 × 10-3 ), 25(OH)D3 end levels (R2  = 0.457, P = 1.5 × 10-3 ) and Δ25(OH)D3 (R2  = 0.253, P = 0.028) between both interventions were correlated, this suggested a possible common individual background for the variation. Four pigment SNPs influenced the variation in the vitamin D3 -induced and UVB-induced Δ25(OH)D3 . A combined model including the influence of these four SNPs and the 25(OH)D3 start level explained 86.8% (P = 1.6 × 10-35 ) of the individual variation after vitamin D3 supplementation. CONCLUSION: The inter-individual variation in the two interventions was comparable and had no common demographic but a partly common genetic background.


Assuntos
Calcifediol/sangue , Colecalciferol/administração & dosagem , Estações do Ano , Raios Ultravioleta/efeitos adversos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
7.
Pigment Cell Melanoma Res ; 32(6): 809-816, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31233275

RESUMO

Melanin in the skin can be divided into eumelanin and pheomelanin subtypes. Simultaneous quantification of these subtypes could clarify their relation to skin type and skin cancer development. We describe a novel, sensitive liquid chromatography-tandem mass spectrometry method to quantify two eumelanin markers, pyrrole-2,3,5-tricarboxylic acid (PTCA) and pyrrole-2,3-dicarboxylic acid (PDCA), and two pheomelanin markers, thiazole-4,5-dicarboxylic acid (TDCA) and thiazole-2,4,5 tricarboxylic acid (TTCA), performed in a single run using the same biopsy. Volunteers with either Fitzpatrick skin type (FST) I/II or III/IV (n = 30) each provided a 4-mm punch biopsy from the buttock. Upon analysis, the FST I + II group had significantly less of all four melanin biomarkers (PTCA, 0.75 ng/mm2 ; PDCA, 0.08 ng/mm2 ; TTCA, 0.24 ng/mm2 ; and TDCA, 0.10 ng/mm2 ) versus the FST III + IV group (PTCA, 4.89 ng/mm2 ; PDCA, 0.22 ng/mm2 ; TTCA, 2.61 ng/mm2 ; and TDCA, 0.72 ng/mm2 ), p ≤ 0.003. We find that this new LC-MS/MS method is sensitive enough to quantify eumelanin and pheomelanin markers even in the lightest skin types.

9.
Lasers Surg Med ; 2019 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-30835885

RESUMO

INTRODUCTION: Topical application of gold microparticles (GMPs) for selective photothermolysis is a recently FDA-cleared therapy for acne vulgaris. Current evidence indicates the potential of optical imaging to non-invasively visualize GMPs and describe photothermal tissue effects. OBJECTIVES: To qualitatively and quantitatively describe GMP delivery in vivo and visualize laser-mediated thermal effects of GMPs in facial skin of acne patients and healthy participants, using reflectance confocal microscopy (RCM) and optical coherence tomography (OCT). METHODS: Patients with facial acne (n = 14), and healthy participants (n = 7) were included. RCM and OCT images were acquired at baseline, after GMP application, and after diode laser exposure. All images were evaluated qualitatively and quantitatively with regards to GMP delivery in skin layers and morphological thermal effects. Lastly, skin biopsies were obtained to compare RCM and OCT findings to histology. RESULTS: GMPs were delivered equally in healthy participants and acne patients, and in lesional and non-lesional acne skin. In RCM images, GMPs appeared as hyperreflective aggregates inside hair follicles and eccrine ducts, corresponding to natural skin openings (NSOs). The fraction of NSOs with hyperreflective content increased significantly after GMP application compared to baseline (50-75% increase, P = 8.88 × 10-16 ). Similarly, in OCT images, GMPs appeared as hyperreflective columns inside hair follicles and were not detected in surrounding skin. GMPs reached a maximum depth of 920 µm (median 300 µm). After laser exposure, RCM and histology revealed selective perifollicular tissue changes around NSOs. CONCLUSION: Optical imaging visualizes GMP delivery and thermal tissue response following laser exposure and enables bedside monitoring of transfollicular microparticle delivery. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

10.
Photochem Photobiol Sci ; 18(2): 448-458, 2019 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-30633296

RESUMO

Skin pigmentation is believed to contribute to the generally low serum 25-hydroxyvitamin D (25(OH)D) concentrations observed in darker-skinned persons. The influence of measured skin pigmentation on UVB-induced 25(OH)D increase was investigated together with 9 demographic and 13 genetic parameters (pigment SNPs). Forty participants representing a wide range in measured skin pigmentation were exposed to identical UVB doses on identical body areas over nine weeks with weekly measurements of serum 25(OH)D. This study took place in Denmark during winter, a period with negligible ambient UVB, so variation in 25(OH)D synthesis was not influenced by latitude, season, sun and clothing habits. The increase in 25(OH)D concentration displayed considerable variation (range: 2.9 to 139 nmol L-1). Constitutive and facultative skin pigmentation exerted separate influence on the variation of the UVB-induced linear 25(OH)D increase. However, this influence was statistically non-significant in the presence of separate significant pigment SNPs. The variation in the 25(OH)D increase in the combined linear model was not explained by measured skin pigmentation but by sex, height, age and seven SNPs located in the ASIP, MTAP, MIR196A29 and Solute Carrier Family genes. This linear model including individual intercepts and the 10 parameters influencing the slope explained 77.4% of the variation. This study confirmed the influence of sex, age and height on 25(OH)D increase and found that pigment genes provided a better relation to UVB-induced 25(OH)D increase compared to the actual measured skin pigmentation. Therefore, only investigating skin pigmentation obscures other causal parameters for low 25(OH)D.


Assuntos
Pigmentação da Pele/genética , Pigmentação da Pele/efeitos da radiação , Raios Ultravioleta , Vitamina D/análogos & derivados , Adulto , Feminino , Técnicas de Genotipagem , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Estações do Ano , Vitamina D/sangue , Vitamina D/metabolismo , Adulto Jovem
11.
Photodermatol Photoimmunol Photomed ; 35(2): 116-123, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30312498

RESUMO

BACKGROUND/PURPOSE: Fitzpatrick phototype (FST) classification (based on ability to tan and tendency to burn) is widely used for evaluating skin cancer risk; however, it was not developed for that purpose and has been criticised scientifically. The purpose of the present study was a first approach in establishing a new skin cancer phototype (SCP) classification with direct relation to skin cancer risk, based on the questions originally proposed by Fitzpatrick. However, contrary to Fitzpatrick, the questions are in the present study kept separate. METHODS: Validated information on skin cancer and answers about participants' tendency to burn (4 answers) and ability to tan (4 answers) were obtained from 2869 Danes. The 16 (4 × 4 answers) possible answers formed a matrix, on which a logistic regression was carried out. Successively, the matrix neighbours which were insignificantly different were identified; of which the neighbours with the mutual lowest difference were merged. The merging resulted in four different SCP classes. RESULTS: There was a linear relationship between SCP classes and skin cancer risk. Further, SCP was as good a predictor of skin cancer as objectively measured skin phototype. CONCLUSION: As skin phototype is an important factor in skin cancer research, SCP has great potential in investigative studies of skin cancer risk.


Assuntos
Neoplasias Cutâneas/classificação , Neoplasias Cutâneas/enzimologia , Pigmentação da Pele , Inquéritos e Questionários , Dinamarca/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
12.
J Photochem Photobiol B ; 188: 1-5, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30173090

RESUMO

BACKGROUND: Skin autofluorescence and pigmentation can estimate photodamage and sun exposure. These techniques may quantify differences in actinic damage between high-risk organ transplant recipients (OTRs) and immunocompetent patients. METHODS: Age and gender-matched OTRs (n = 15) and immunocompetent controls (n = 15) with a new keratinocyte carcinoma (KC) were included. We measured skin autofluorescence (370 nm excitation, F370) and skin pigmentation at five standardized body sites; and determined black light-evaluated solar lentigines on the shoulders and photosensitivity to UVA and simulated solar radiation (SSR) as minimal erythema doses (MED). RESULTS: F370 autofluorescence values were enhanced at KC site versus other body sites in OTRs (2208 vs. 1458-1898 AU, p < 0.05). Compared with non-OTRs, OTRs expressed higher F370 autofluorescence at KC site (2208 vs. 1385 arbitrary units AU, p = 0.01) and the shoulder (1898 vs. 1525, p = 0.05). Likewise, OTRs had increased skin pigmentation (25.0 vs. 20.8 pigment%, p = 0.05) and solar lentigines (3.5 vs. 3.0, p = 0.048) on the shoulders. MED tests showed increased UVA photosensitivity in OTRs (2.4 vs. 1.7 times higher than expected, p = 0.03), whereas SSR photosensitivity was similar. CONCLUSION: Quantified F370 autofluorescence, skin pigmentation, and density of solar lentigines could serve to assess photodamage in OTR. Increased UVA photosensitivity may account for higher skin photodamage.


Assuntos
Neoplasias Cutâneas/patologia , Pigmentação da Pele , Pele/química , Idoso , Feminino , Humanos , Imunocompetência , Masculino , Pessoa de Meia-Idade , Pele/efeitos da radiação , Neoplasias Cutâneas/metabolismo , Pigmentação da Pele/efeitos da radiação , Espectrometria de Fluorescência , Estatísticas não Paramétricas , Transplantados , Raios Ultravioleta
13.
Photodiagnosis Photodyn Ther ; 22: 223-226, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29733914

RESUMO

INTRODUCTION: Necrobiosis lipoidica (NL) is a rare, treatment-resistant, granulomatous skin disease of unknown origin, frequently seen in patients with diabetes. METHODS: In this retrospective study we evaluated the long-term efficacy of methyl aminolaevulinate-based photodynamic therapy (MAL-PDT), including 80 treatments (70 conventional and 10 daylight PDT), on 65 unselected NL patients treated routinely in our clinic. Superficial curettage, avoiding skin oozing or bleeding, was performed prior to MAL application. RESULTS: Conventional MAL-PDT had a 100% cure rate (CR) in 64% (45/70) of the treatment series. With daylight PDT we observed a 100% CR in 80% of the treatment series (8/10), an insignificant difference compared to conventional PDT (p = 0.48). The overall cure rate was 66% (53/80). We observed no correlation between CR and gender, age at first PDT treatment, duration of NL prior to PDT treatment, number of NL elements, or diabetes. New lesions faded, whereas old lesions were clearly visible after inactivation of NL. DISCUSSION: MAL-PDT proved to have full efficacy in 66% of the treatments, with conventional PDT and daylight PDT producing an almost identical result. We observed no correlation between CR and time of follow-up. However, we recommend at least six months to pass before final evaluation of treatment effect.


Assuntos
Ácido Aminolevulínico/análogos & derivados , Necrobiose Lipoídica/tratamento farmacológico , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Adolescente , Adulto , Idoso , Ácido Aminolevulínico/uso terapêutico , Criança , Curetagem/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Luz Solar , Adulto Jovem
14.
Int Wound J ; 15(2): 212-217, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29464916

RESUMO

The aims of the study were to determine the prevalence of skin tears in the extremities and to explore factors associated with development of skin tears in inpatients at a Danish hospital. The study was designed as a point prevalence survey and included 202 patients in the age range 19-99 (mean: 70·7, SD: 16·5). The patients were assessed for presence of skin tears, numbers, locations and previous skin tears. Data were collected using a data collection sheet developed for a previous study. The survey team consisted of four specialist nurses. Data were collected over a period of 24 hours spread over 3 days. Of the 202 patients, 23 had skin tears, yielding a prevalence of 11·4%. In total, 40 skin tears were observed. Multiple logistic regression analysis showed that previous skin tears (odds ratio (OR): 9·3, 95% confidence interval (CI): 2·6-33·4, P < 0·001), ecchymosis (OR: 5·6, CI: 1·4-23·2, P < 0·017) and risk of falling (OR: 3·8, CI: 1·2-12·0, P < 0·021) were significantly associated with development of skin tears. The prevalence of skin tears in this study (11·4%) matches other international observations. The following risk factors were recognised: previous skin tear, ecchymosis and risk of falling. These factors could be used to identify patients requiring prevention of skin tears.


Assuntos
Extremidades/lesões , Pacientes Internados/estatística & dados numéricos , Lacerações/epidemiologia , Pele/lesões , Adulto , Idoso , Idoso de 80 Anos ou mais , Dinamarca/epidemiologia , Feminino , Hospitais/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Fatores de Risco , Adulto Jovem
15.
J Photochem Photobiol B ; 178: 577-583, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29272850

RESUMO

IMPORTANCE: Ultraviolet radiation (UVR)-induced skin cancers varies among organ transplant recipients (OTRs). To improve individual risk assessment of skin cancer, objectively quantified skin photodamage is needed. OBJECTIVES: We measured personal UVR-exposure dose in OTRs and assessed the relation between individual UVR exposure, skin cancer and objectively measured photodamage in terms of skin autofluorescence, pigmentation, and black light-evaluated solar lentigines. MATERIALS AND METHODS: Danish OTRs with (n=15) and without a history of skin cancer (n=15) kept sun diaries from May to September and wore personal dosimeters recording time-stamped UVR doses in standard erythema doses (SED). Photodamage was quantified as skin autofluorescence with excitation at 370nm (F370) and 430nm (F430), skin pigmentation (pigment protection factor, PPF), and black light-evaluated solar lentigines. RESULTS: OTRs with skin cancer received a higher UVR dose than OTRs without skin cancer (median 116 SED vs. 67 SED, p=0.07) and UVR exposure doses were correlated with increased PPF (p=0.052) and F370 on the shoulder (F370shoulder) (p=0.04). We found that skin cancer was associated with F370shoulder (OR 10.53, CI 3.3-31,938; p=0.018) and time since transplantation (OR 1.34, CI 0.95-1.91, p=0.097). A cut-off at 7.2 arbitrary units, 89% of OTRs with skin cancer had F370shoulder values above 7.2 arbitrary units and F370shoulder was additionally related to patient age (p=0.09) and black light-evaluated solar lentigines (p=0.04). CONCLUSION: F370 autofluorescence indicates objectively measured photodamage and may be used for individual risk assessment of skin cancer development in OTRs.


Assuntos
Neoplasias Cutâneas/etiologia , Pele/efeitos da radiação , Raios Ultravioleta , Adulto , Idoso , Feminino , Humanos , Lentigo/etiologia , Medições Luminescentes , Masculino , Pessoa de Meia-Idade , Razão de Chances , Transplante de Órgãos , Estações do Ano , Pele/química , Pigmentação da Pele/efeitos da radiação , Transplantados
16.
JAMA Dermatol ; 153(4): 270-278, 2017 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-28146245

RESUMO

Importance: Skin pretreatment is recommended for adequate penetration of topical photosensitizing agents and subsequent protoporphyrin IX (PPIX) accumulation in photodynamic therapy (PDT). Objective: To compare the relative potential of different physical pretreatments to enhance PPIX fluorescence in normal skin. Design, Setting, and Participants: This intraindividual, randomized clinical trial was performed from November 28 to December 20, 2014, at Bispebjerg Hospital, Copenhagen, Denmark, among 12 healthy volunteers 18 years or older. Analysis was based on intention to treat. All participants completed the study protocol. Interventions: Participants were each exposed to standardized skin preparation with curettage, microdermabrasion with abrasive pads, microneedling with dermarollers, ablative fractional laser (AFXL), non-AFXL, and no pretreatment, followed by 3 hours of methyl aminolevulinate hydrochloride incubation and subsequent red light illumination. Main Outcomes and Measures: The primary outcome measure was methyl aminolevulinate-induced PPIX fluorescence accumulation. Secondary outcome measures were PPIX photobleaching and clinical local skin reactions, supported by noninvasive reflectance measurements of percentage of skin redness, transepidermal water loss, and participant-assessed pain. Results: Among the 12 healthy study participants (8 men; 4 women; mean [SD] age, 33 [15] years), histologic findings confirmed standardization of interventions with partial removal of the stratum corneum after curettage and microdermabrasion and similar vertical penetration depths for microneedling, AFXL, and non-AFXL (median, 125 µm). PPIX fluorescence reached highest intensities in skin pretreated with AFXL (median, 8661 arbitrary units [AU]) compared with microdermabrasion (median, 6731 AU), microneedling (median, 5609 AU), and curettage (median, 4765 AU) (P < .001), among which similar enhancement was shown. Comparatively lower fluorescence levels were demonstrated for skin pretreated with non-AFXL (median, 2898 AU), methyl aminolevulinate-treated controls (median, 2254 AU), and untreated controls (median, 239 AU) (P < .03). Increasing laser densities (2% vs 4% vs 6%) and the number of pretreatment passes (1, 2, and 3 passes) did not enhance PPIX fluorescence. Local skin reactions were most intensified in AFXL-pretreated skin and correlated with PPIX fluorescence and degree of PPIX photobleaching. Conclusions and Relevance: Under standardized conditions, PPIX accumulation was most enhanced after AFXL pretreatment, followed by microdermabrasion, microneedling, and curettage. Increasing the number of pretreatment passes and laser densities did not further augment PPIX accumulation. These results may indicate relatively enhanced PDT response by AFXL pretreatment in diseased skin. Trial Registration: clinicaltrials.gov Identifier: NCT02372370.


Assuntos
Ácido Aminolevulínico/análogos & derivados , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/administração & dosagem , Protoporfirinas/metabolismo , Pele/metabolismo , Adolescente , Adulto , Ácido Aminolevulínico/administração & dosagem , Ácido Aminolevulínico/farmacocinética , Curetagem/métodos , Dinamarca , Dermabrasão/métodos , Feminino , Fluorescência , Humanos , Terapia a Laser/métodos , Masculino , Pessoa de Meia-Idade , Fármacos Fotossensibilizantes/farmacocinética , Adulto Jovem
17.
Photodermatol Photoimmunol Photomed ; 32(4): 191-8, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27084577

RESUMO

BACKGROUND/PURPOSE: Sunbed use is a known risk factor for malignant melanoma and non-melanoma skin cancer. This study characterizes current and past female Danish sunbed users for the purpose of finding factors leading to cessation of sunbed use. METHODS: An online questionnaire was distributed via social media and email on February 25, 2014. 561 women responded. RESULTS: Sunbed use was found to be associated with smoking, light and light brown skin colour, and knowledge about the risks associated with sunbed use. Motivation for tanning was found to be increased attractiveness. Factors associated with cessation were: age above 24, medium to high level of education, non-smoking, not being bothered by appearing white on the beach, and being unconcerned about friends' sunbed use. Binary logistic regression further showed a significant association between cessation and low income, after adjusting for age. The most indicated reason for cessation was fear of skin cancer. CONCLUSION: Sunbed use could possibly be reduced by introducing a lower age limit of 18 and demanding staffed tanning salons. The age limit would allow young people to become more mature and self-confident before deciding on using a sunbed. Our results suggest that future interventions and campaigns against the use of sunbeds should target young women with no or little postschool education.


Assuntos
Pigmentação da Pele , Banho de Sol , Inquéritos e Questionários , Adolescente , Adulto , Fatores Etários , Dinamarca/epidemiologia , Feminino , Humanos , Melanoma/epidemiologia , Melanoma/prevenção & controle , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/prevenção & controle , Fumar/efeitos adversos , Fumar/epidemiologia
18.
Photodermatol Photoimmunol Photomed ; 32(3): 146-52, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26868849

RESUMO

BACKGROUND: Guidelines for photodynamic therapy (PDT) recommend pretreatment with curettage/debulking to enhance intracellular formation of protoporphyrin IX (PpIX). However, studies suggest that new chemical pretreatment procedures may replace curettage/debulking. PURPOSE: To investigate how pretreatment with curettage and two combination ointments containing calcipotriol/betamethasone and salicylic acid/betamethasone affect PpIX fluorescence after the application of methyl aminolevulinate MAL and 5-aminolevulinic acid (BF-200 ALA). METHODS: Four fields on the forearms of 30 healthy volunteers were pretreated with curettage or short-term application of calcipotriol/betamethasone or salicylic acid/betamethasone for 20 min. Two fields were not pretreated, thus serving as reference. After pretreatment, MAL or BF-200 ALA was applied for 24 h, and PpIX fluorescence was measured hourly from 1 to 5 h and after 18, 21 and 24 h. RESULTS: Curettage significantly enhanced PpIX fluorescence for MAL from 1 to 21 h (P < 0.0041). For BF-200 ALA, curettage enhanced fluorescence from 1 to 5 h (P < 0.000064), while fluorescence was lower from 18 to 24 h. Pretreatment with salicylic acid/betamethasone and calcipotriol/betamethasone before BF-200 ALA application did not increase PpIX fluorescence from 1 to 5 h compared to no pretreatment, and both were significantly inferior to curettage (P < 0.0017 and 0.0024, respectively). CONCLUSION: Curettage significantly enhances PpIX fluorescence from 1 to 5 h and is superior to short-term chemical pretreatment. Our results support curettage as standard pretreatment in PDT.


Assuntos
Anti-Inflamatórios/administração & dosagem , Betametasona/administração & dosagem , Calcitriol/análogos & derivados , Curetagem , Fármacos Dermatológicos/administração & dosagem , Ceratolíticos/administração & dosagem , Fotoquimioterapia/métodos , Ácido Salicílico/administração & dosagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ácido Aminolevulínico/análogos & derivados , Ácido Aminolevulínico/uso terapêutico , Calcitriol/administração & dosagem , Quimioterapia Combinada , Feminino , Fluorescência , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Pomadas , Fármacos Fotossensibilizantes/uso terapêutico , Protoporfirinas , Adulto Jovem
19.
J Photochem Photobiol B ; 151: 264-9, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26332747

RESUMO

Solar ultraviolet radiation (UVR) is known to be the main cause of skin cancer, the incidence of which is rising with national differences across Europe. With this observation study we aimed to determine the impact of nationality on sun behaviour and personal UVR exposure on sun and ski holidays. 25 Danish and 20 Spanish sun-seekers were observed during a sun holiday in Spain, and 26 Danish and 27 Austrian skiers were observed during a ski holiday in Austria. The participants recorded their location and clothing in diaries. Personal time-logged UVR data were recorded as standard erythema doses (SEDs) by an electronic UVR dosimeter worn on the wrist. Danish sun-seekers were outdoors for significantly longer, received significant higher percentages of ambient UVR, and received greater accumulated UVR doses than Spanish sun-seekers. Danish skiers were also outdoors for significantly longer than Austrian skiers, but the behaviour of the Danish skiers did not result in significantly greater accumulated UVR doses. Both Danish and Spanish sun-seekers and Danish and Austrian skiers received substantial UVR doses. The behaviour's influence on the UVR doses received by the Danish participants may indicate an explanation of the higher skin cancer incidence among Scandinavians compared with other European populations.


Assuntos
Exposição Ambiental/análise , Pele/efeitos da radiação , Luz Solar , Adulto , Áustria , Dinamarca , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Esqui , Neoplasias Cutâneas/etiologia , Espanha , Banho de Sol , Raios Ultravioleta/efeitos adversos
20.
Photochem Photobiol Sci ; 14(7): 1282-9, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26066309

RESUMO

BACKGROUND: Sun exposure is the main etiology of skin cancer. Differences in skin cancer incidence have been observed between rural and urban populations. OBJECTIVES: As sun exposure begins in childhood, we examined summer UVR exposure doses and sun behavior in children resident in urban, suburban, and rural areas. METHODS: Personal, electronic UVR dosimeters and sun behavior diaries were used during a summer (3.5 months) by 150 children (4-19 years of age) resident in urban, suburban, and rural areas. RESULTS: On school/kindergarten days rural children spent more time outdoors and received higher UVR doses than urban and suburban children (rural: median 2.3 h per day, median 0.9 SED per day, urban: median 1.3 h per day, median 0.3 SED per day, suburban: median 1.5 h per day, median 0.4 SED per day) (p ≤ 0.007). Urban and suburban children exhibited a more intermittent sun exposure pattern than rural children. Differences in UVR exposure doses were from high exposure days (e.g. beach days) outside Denmark. Suburban children had a total UVR exposure similar to rural children (suburban: median 109.4 SED, rural: median 103.1 SED), with days spent abroad contributing greatly to the total UVR exposure dose (total UVR on days spent abroad: suburban: median 48.0 SED, rural: median 8.0 SED). CONCLUSIONS: Differences in sun exposure patterns exist between children from different areas and may be the background for higher skin cancer incidences in urban populations.


Assuntos
Radiometria/instrumentação , População Rural , População Suburbana , Luz Solar , População Urbana , Adolescente , Criança , Pré-Escolar , Exposição Ambiental , Feminino , Humanos , Modelos Logísticos , Masculino , Modelos Teóricos , Raios Ultravioleta , Adulto Jovem
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