Sun protection for children and adolescents

The Amphibian Antimicrobial Peptide Temporin B Inhibits In Vitro Herpes Simplex Virus 1 Infection

The herpes simplex virus 1 (HSV-1) is widespread in the population, and in most cases its infection is asymptomatic. The currently available anti-HSV-1 drugs are acyclovir and its derivatives, although long-term therapy with these agents can lead to drug resistance. Thus, the discovery of novel antiherpetic compounds deserves additional effort. Naturally occurring antimicrobial peptides (AMPs) represent an interesting class of molecules with potential antiviral properties. To the best of our knowledge, this study is the first demonstration of the in vitro anti-HSV-1 activity of temporin B (TB), a short membrane-active amphibian AMP. In particular, when HSV-1 was preincubated with 20 μg/ml TB, significant antiviral activity was observed (a 5-log reduction of the virus titer). Such an effect was due to the disruption of the viral envelope, as demonstrated by transmission electron microscopy. Moreover, TB partially affected different stages of the HSV-1 life cycle, including the attachment and the entry of the virus into the host cell, as well as the subsequent postinfection phase. Furthermore, its efficacy was confirmed on human epithelial cells, suggesting TB as a novel approach for the prevention and/or treatment of HSV-1 infections.

[Update on photoprotection in children]

Children are one of the population groups in which the photo-protection must be maximised. Firstly, because they take part in outdoor activities more often than adults. Secondly, because the principal risk factor for all types of skin cancer is ultraviolet radiation, and in particular, cumulative exposure during childhood. Hence, decreasing exposure to ultraviolet radiation in childhood has the potential to significantly lower the incidence of most forms of skin cancer. Photoprotection includes behavioural measures to protect the skin from sun exposure, e.g. sun protective clothes, hats, sunglasses, and sunscreens. It is necessary to provide information on aphotoprotection to parents, and, above all, to children, using educational campaigns to increase knowledge of photoprotection to help change attitudes towards sun exposure. Dermatologists and Paediatricians play a essential role in this educational work. In this article we review the latest information regarding paediatric sun protection, the new sunscreens, and the recent sun protection educational programs.

Skin cancer prevention behaviours during summer holidays in 14 and 18-year-old Belgian adolescents

A cross-sectional study was conducted among 602 Belgian adolescents to analyse their sun protection habits. The results show that Belgian adolescents stay in the sun for a long time, even in periods when ultraviolet radiation is very damaging. Of all respondents, 70% exposed themselves for at least 3 h to the sun on sunny days. Most respondents (49%) exposed themselves between 1200 and 1500 h. Almost two-thirds of the respondents (59.3%) reported at least one sunburn in the past year and 26.5% got sunburnt at least twice; 24% used sunbeds more than 6 times per year. Applying sunscreen every 2 h was the most commonly used method by adolescents to protect themselves, although 70% did not use sunscreen regularly. Female students used sunscreen more regularly than male students, and sunbed use was higher among 18-year-olds than 14-year-olds. Our results clearly suggest that respondents with fair skin types are at increased risk of developing skin cancer, because of various high exposure activities accompanied by relatively few protection behaviours. A second risk group consists of students from the two lower educational levels, again because of high exposure levels and less frequent protection behaviours. The risks of sunbed use should be communicated clearly to older adolescents. Hence, these two groups need to receive high priority for cancer prevention activities in Belgium.

Oral and perioral herpes simplex virus type 1 (HSV-1) infection: review of its management

Herpes simplex virus type 1 (HSV-1) gives rise to a variety of clinical disorders and is a major cause of morbidity and mortality worldwide. HSV-1 infections are common in oral and perioral area. The aim of the present report was to critically examine the published literature to evaluate the advantages and limitations of therapy of HSV-1 infection in both immunocompetent and immunocompromised patients. Systemic antiviral therapy has been widely accepted as effective for primary herpetic gingivostomatitis. Aciclovir (ACV) 5% cream seems to be the accepted standard topical therapy for herpes labialis, being both effective and well tolerated, although penciclovir 1% cream has been proposed as a potentially useful treatment. Systemic ACV may be effective in reducing the duration of symptoms of recurrent HSV-1 infection, but the optimal timing and dose of the treatment are uncertain. Aciclovir and famciclovir may be of benefit in the acute treatment of severe HSV-1 disease in immunocompromised patients. There is also evidence that prophylactic oral ACV may reduce the frequency and severity of recurrent attack of herpetic infection in immunocompromised patients, but the optimal timing and duration of treatment is uncertain and can vary in different situations.

Skin cancer prevention: behaviour and motives of Dutch adolescents

Skin cancer incidence is rising in the Netherlands and prevention programmes are needed. We analysed sun protection behaviours and beliefs in 500 adolescents aged 15-20 years using the Integrated Model for Change. The results show that adolescents with the fairest skin type exposed themselves significantly less to the sun, but had more burns than groups with a darker skin type. Sunscreen was the most commonly used method by adolescents to protect themselves and 77% of adolescents frequently used this strategy. Sunscreen use was also higher in females than in males. Wearing protective clothing (34%) and seeking shade between 1200 and 1500 h (26%) were less popular and used by adolescents in our study. Frequent use of sunscreen was most strongly predicted by positive intentions to use sunscreen, parental support, a positive attitude towards using sunscreen, support of friends and perceiving skin cancer risks. Wearing protective clothing was predicted most strongly by parental support, having a positive attitude towards wearing protective clothing, seeking shade, support of friends, high self-efficacy levels, low exposure to the sun and being male. Seeking shade was most strongly predicted by a positive attitude towards seeking shade, support of friends, using protective clothing, high self-efficacy, parental support, a negative attitude towards tanning, and perceiving skin cancer risks. Implications for Dutch skin cancer prevention programmes are that the efficacy and advantages of all protective methods need to be outlined more clearly in health education programmes on skin cancer prevention.

Intermittent oral cyclosporin for recurrent herpes simplex-associated erythema multiforme

Recurrent erythema multiforme is one of three distinct clinical subtypes of erythema multiforme. We present a 42-year-old man with a 10-year history of recurrent herpes simplex virus-induced erythema multiforme. Our patient was debilitated by the frequency of his attacks and the associated pain, for which he often required leave from work. The frequency, duration and morbidity of the attacks were poorly controlled using oral prednisone and oral aciclovir. Three episodes of his recurrent herpes simplex virus-induced erythema multiforme were treated with intermittent oral cyclosporin. Oral cyclosporin rapidly reduced his symptoms and led to rapid resolution of his erythema multiforme, provided the cyclosporin was commenced on day 1 or 2 of the erythema multiforme episode. Consequently, his quality of life has dramatically improved. We recommend the use of intermittent oral cyclosporin for recurrent, debilitating episodes of erythema multiforme.