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De Los Santos Gomez P, Costello L, Goncalves K, Przyborski S. Comparison of photodamage in non-pigmented and pigmented human skin equivalents exposed to repeated ultraviolet radiation to investigate the role of melanocytes in skin photoprotection. Front Med (Lausanne) 2024; 11:1355799. [PMID: 38698778 PMCID: PMC11063240 DOI: 10.3389/fmed.2024.1355799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/20/2024] [Indexed: 05/05/2024] Open
Abstract
Introduction Daily solar ultraviolet (UV) radiation has an important impact on skin health. Understanding the initial events of the UV-induced response is critical to prevent deleterious conditions. However, studies in human volunteers have ethical, technical, and economic implications that make skin equivalents a valuable platform to investigate mechanisms related to UV exposure to the skin. In vitro human skin equivalents can recreate the structure and function of in vivo human skin and represent a valuable tool for academic and industrial applications. Previous studies have utilised non-pigmented full-thickness or pigmented epidermal skin equivalents to investigate skin responses to UV exposure. However, these do not recapitulate the dermal-epidermal crosstalk and the melanocyte role in photoprotection that occurs in vivo. In addition, the UV radiation used in these studies is generally not physiologically representative of real-world UV exposure. Methods Well-characterised pigmented and non-pigmented skin equivalents that contain human dermal fibroblasts, endogenous secreted extracellular matrix proteins (ECM) and a well-differentiated and stratified epidermis have been developed. These constructs were exposed to UV radiation for ×5 consecutive days with a physiologically relevant UV dose and subsequently analysed using appropriate end-points to ascertain photodamage to the skin. Results We have described that repeated irradiation of full-thickness human skin equivalents in a controlled laboratory environment can recreate UV-associated responses in vitro, mirroring those found in photoexposed native human skin: morphological damage, tanning, alterations in epidermal apoptosis, DNA lesions, proliferation, inflammatory response, and ECM-remodelling. Discussion We have found a differential response when using the same UV doses in non-pigmented and pigmented full-thickness skin equivalents, emphasising the role of melanocytes in photoprotection.
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Affiliation(s)
| | - Lydia Costello
- Department of Biosciences, Durham University, Durham, United Kingdom
| | - Kirsty Goncalves
- Department of Biosciences, Durham University, Durham, United Kingdom
| | - Stefan Przyborski
- Department of Biosciences, Durham University, Durham, United Kingdom
- Reprocell Europe Ltd., Glasgow, United Kingdom
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2
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Lee KJ, Soyer HP, Stark MS. The Skin Molecular Ecosystem Holds the Key to Nevogenesis and Melanomagenesis. J Invest Dermatol 2024; 144:456-465. [PMID: 37921715 DOI: 10.1016/j.jid.2023.09.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/24/2023] [Accepted: 09/18/2023] [Indexed: 11/04/2023]
Abstract
Early detection of melanoma is critical to good patient outcomes, but we still know little about the mechanisms of early melanoma development. Normal epidermis has many of the sequence variants and genetic architecture disruptions found in both benign nevi, melanomas, and other skin cancers, yet continues to behave more or less normally. One hypothesis is that many melanocytes in this context are "tumor competent" but are regulated by the microenvironment provided by the surrounding keratinocytes to inhibit progress to nevi or melanoma. There is evidence of accumulating disorder in several measures of the genomic and epigenomic landscape from normal skin through nevi to melanoma that may be key to promoting nevogenesis and melanomagenesis.
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Affiliation(s)
- Katie J Lee
- Frazer Institute, the University of Queensland, Dermatology Research Centre, Queensland, Australia.
| | - H Peter Soyer
- Frazer Institute, the University of Queensland, Dermatology Research Centre, Queensland, Australia; Department of Dermatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Mitchell S Stark
- Frazer Institute, the University of Queensland, Dermatology Research Centre, Queensland, Australia
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3
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Young AR. The adverse consequences of not using sunscreens. Int J Cosmet Sci 2023; 45 Suppl 1:11-19. [PMID: 37799076 DOI: 10.1111/ics.12897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/10/2023] [Indexed: 10/07/2023]
Abstract
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.
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Affiliation(s)
- Antony R Young
- St John's Institute of Dermatology, King's College London, London, UK
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Keurentjes AJ, Kezic S, Rustemeyer T, Hulshof CTJ, van der Molen HF. Stimulating Sunscreen Use Among Outdoor Construction Workers: A Pilot Study. Front Public Health 2022; 10:857553. [PMID: 35433569 PMCID: PMC9010717 DOI: 10.3389/fpubh.2022.857553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background Outdoor workers (OW) receive a higher dose of ultraviolet radiation (UVR) compared to indoor workers (IW) which increases the risk of non-melanoma skin cancer (NMSC). Regular sunscreen use reduces the NMSC risk, however, adequate sun-safety behavior among OW is poor. The main objective was to conduct method- and intervention-related elements of a future intervention trial among OW, based on providing sunscreen and assessing sunscreen use on group- and individual level. Methods This pilot study was conducted at a construction site in the Netherlands from May-August 2021. Nine dispensers with sunscreen (SPF 50+) were installed at the worksite. OW (n = 67) were invited to complete two (cross-sectional) questionnaires on sun-safety behavior, before and after providing sunscreen. Stratum corneum (SC) samples for the assessment of UV-biomarkers were collected from the forehead and behind the ear from 15 OW and 15 IW. The feasibility of the following elements was investigated: recruitment, (loss to) follow-up, outcome measures, data collection, and acceptability of the intervention. Results The first questionnaire was completed by 27 OW, the second by 17 OW. More than 75 percent of the OW were aware of the risks of sun exposure, and 63% (n = 17) found sunscreen use during worktime important. The proportion of OW never applying sunscreen in the past month was 44.4% (n = 12) before, and 35.3% (n = 6) after providing sunscreen. A majority of OW (59.3%, n = 16) found sunscreen provision encouraging for sunscreen use, the dispensers easy to use (64.7%, n = 17) and placed in practical spots (58.8%, n = 18). Collecting SC-samples was fast and easy, and several UV-biomarkers showed higher levels for sun-exposed compared to less exposed body parts. There was no significant difference in UV-biomarker levels between OW and IW. Conclusions This pilot study revealed low sunscreen use among OW despite providing sunscreen, overall satisfaction with the sunscreen, and the sufficient awareness of the risks of UVR-exposure. Collecting SC-samples at the workplace is feasible and several UV-biomarkers showed to be promising in assessing UVR-exposure. The low participation rate and high loss to follow-up poses a challenge for future intervention studies.
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Affiliation(s)
- Anne J. Keurentjes
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- *Correspondence: Anne J. Keurentjes
| | - Sanja Kezic
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Thomas Rustemeyer
- Department of Dermatology and Allergology, Amsterdam University Medical Centers (UMC), Amsterdam, Netherlands
| | - Carel T. J. Hulshof
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Henk F. van der Molen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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5
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Keurentjes AJ, Jakasa I, van Dijk A, van Putten E, Brans R, John SM, Rustemeyer T, van der Molen HF, Kezic S. Stratum corneum biomarkers after in vivo repeated exposure to sub-erythemal dosages of ultraviolet radiation in unprotected and sunscreen (SPF 50+) protected skin. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2021; 38:60-68. [PMID: 34278599 DOI: 10.1111/phpp.12717] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 06/16/2021] [Accepted: 07/04/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND There is a need for non-invasive biomarkers to assess in vivo efficacy of protective measures aiming at reducing ultraviolet radiation (UVR) exposure. Stratum corneum (SC) biomarkers showed to be promising markers for internal UVR dose and immune response. PURPOSE To establish a dose-response relationship for SC biomarkers and explore their suitability for in vivo assessment of the blocking effect of two sunscreens with a high sun protection factor (SPF) (50+). METHODS Twelve volunteers were exposed to a broad-spectrum UVB (280-320 nm), five times a week, during one week. Unprotected back skin was irradiated with 0.24, 0.48, 0.72 and 1.44 standard erythema dose (SED) and sunscreen-protected skin with 3.6 SED. SC samples for determination of the relative amount of cis-urocanic acid (cUCA) and thirteen immunological makers including cytokines and matrix metalloproteinases (MMP) were collected after each irradiation. RESULTS cUCA sharply increased after the first irradiation in a dose-dependent fashion. However, it levelled-off after subsequent exposures and reached a plateau for the highest UV-dose after the third irradiation. None of the immunological markers showed dose-dependency. However, MMP-9, IL-1β and CCL27 increased gradually from baseline during repetitive exposures to the highest UV-dose. Assessed from cUCA, both sunscreens blocked >98% of the applied UV-dose. CONCLUSIONS cUCA is a sensitive, non-invasive marker of the internal UVR dose enabling in vivo assessment of the blocking effect of high SPF sunscreens in the UVB-region. Immunological SC markers show low sensitivity in detecting immune response at sub-erythemal UVR dosages, suggesting they might be suitable only at higher and/or repetitive UVR exposure.
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Affiliation(s)
- Anne Josephine Keurentjes
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Ivone Jakasa
- Department of Chemistry and Biochemistry, Laboratory for Analytical Chemistry, Faculty of Food Technology and Biotechnology, University of Zagreb, Zagreb, Croatia
| | - Arjan van Dijk
- Center for Environmental Safety and Security, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Edith van Putten
- Center for Environmental Safety and Security, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Swen Malte John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Thomas Rustemeyer
- Department of Dermatology and Allergology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Henk F van der Molen
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Sanja Kezic
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
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6
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Diffey B. Erythema and Acclimatization Following Repeated Sun Exposure: A Modeling Study. Photochem Photobiol 2021; 97:1558-1567. [PMID: 34118062 DOI: 10.1111/php.13466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 06/09/2021] [Indexed: 02/02/2023]
Abstract
The development of a computational model is described that allows time-varying erythema and acclimatization to be determined following repeated exposure to solar ultraviolet (UV) radiation. Good agreement was observed between experimental data and model predictions. Results are presented that illustrate how daily, adventitious sun exposure over the course of a year can result in occasional erythema generally in the late spring/early summer, while at the same time showing how the photoadaptive response of the skin changes throughout the year at different latitudes and for different sun-reactive skin types. The model is predicated on three physiological responses; the erythemal response as a function of increasing UV dose, the time courses of erythema and adaptation in response to a single UV exposure. Mathematical models complement observational data and the outputs from the model may help in planning future experimental studies, as well as providing insights into mechanistic responses.
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Affiliation(s)
- Brian Diffey
- Dermatological Sciences, Newcastle University, Newcastle Upon Tyne, UK
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7
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Keurentjes AJ, Kezic S, Rustemeyer T, Hulshof CTJ, van der Molen HF. Protection Against Solar Ultraviolet Radiation in Outdoor Construction Workers: Study Protocol for a Non-randomized Controlled Intervention Study. Front Public Health 2021; 9:602933. [PMID: 33748058 PMCID: PMC7969508 DOI: 10.3389/fpubh.2021.602933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 02/10/2021] [Indexed: 01/18/2023] Open
Abstract
Introduction: Non-melanoma skin cancer (NMSC) incidence is increasing, and occupational solar exposure contributes greatly to the overall lifetime ultraviolet radiation (UVR) dose. This is reflected in an excess risk of NMSC showing up to three-fold increase in outdoor workers. Risk of NMSC can be reduced if appropriate measures to reduce UVR-exposure are taken. Regular use of sunscreens showed reduced risk of NMSC. However, sun-safety behavior in outdoor workers is poor. The objective of this study is to investigate the effectiveness of an intervention aiming at increasing sunscreen use by construction workers. Methods: This non-randomized controlled intervention study is comprised of two intervention and two control groups recruited at four different construction sites in the Netherlands. The study population comprises ~200 construction workers, aged 18 years or older, followed during 12 weeks. The intervention consists of providing dispensers with sunscreens (SPF 50+) at construction sites and regular feedback on the application achieved by continuous electronic monitoring. All groups will receive basic information on UV-exposure and skin protection. Stratum corneum (SC) samples will be collected for measurement of biomarkers to assess internal UV-dose. External UV-dose will be assessed by personal UV-sensors worn by the workers during work-shifts in both groups. To detect presence of actinic keratosis (AK) or NMSC, a skin check of body parts exposed to the sun will be performed at the end of the study. The effect of the intervention will be assessed from data on self-reported sunscreen use by means of questionnaires collected on baseline and after 12 weeks of intervention (primary outcome). Levels of SC biomarkers of internal UV-dose, external UV-dose, number of sunburn episodes, and prevalence of NMSC including AK will be assessed as secondary outcomes. The electronically monitored sunscreen consumption will be assessed as process outcome. Discussion: This study is intended to provide evidence of the effectiveness of a technology-driven intervention to increase sunscreen use in outdoor construction workers. Furthermore, it will increase insight in the UV-protective behavior, external and internal UV-exposure, and the prevalence of NMSC, including AK, in construction workers. Trial Registration: The Netherlands Trial Register (NTR): NL8462 Registered on March 19, 2020.
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Affiliation(s)
- Anne J Keurentjes
- Amsterdam University Medical Centers, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Sanja Kezic
- Amsterdam University Medical Centers, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Thomas Rustemeyer
- Department of Dermatology and Allergology, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Carel T J Hulshof
- Amsterdam University Medical Centers, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Henk F van der Molen
- Amsterdam University Medical Centers, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
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8
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Abstract
During leisure time, people can decide if they want to expose themselves to solar ultraviolet (UV) radiation and to what extent. While working, people do not have this choice. Outdoor workers are exposed to solar UV radiation (UVR) on a daily basis. This may pose a certain health risk, which can be estimated when the personal solar UVR exposure (PE) is known. During past decades, a variety of studies were conducted to measure PE of outdoor workers and our knowledge of the PE of outdoor workers has increased remarkably. As shown by this review, studies clearly indicate that PE of most outdoor workers exceeds the internationally proposed threshold limit value, which is comparable to 1.0 to 1.3 standard erythema dose (SED), respectively, to 1.1 to 1.5 UV Index received over one hour. Besides working in a high UVR environ, monotonic workflow (limited movement, nearly static posture) is a risk factor. In such cases, PE can be higher than ambient UVR. In this review, we provide also a list of milestones, depicting the progress and the most important findings in this field during the past 45 years. However, in many respects our knowledge is still rudimentary, for several reasons. Different measuring positions have been used so that measured PE is not comparable. Few studies were designed to enable the extension of measured PE to other locations or dates. Although the importance of a proper calibration of the measuring devices in respect to the changing solar spectrum was pointed out from the beginning, this is often not performed, which leads to high uncertainties in the presented PE levels. At the end of our review, we provide some key points, which can be used to evaluate the quality of a study respectively to support the design of future studies.
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9
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Keurentjes AJ, Jakasa I, John SM, Ulrich C, Bekkenk MW, Rustemeyer T, Kezic S. Tape stripping the stratum corneum for biomarkers of ultraviolet radiation exposure at sub-erythemal dosages: a study in human volunteers. Biomarkers 2020; 25:490-497. [PMID: 32657162 DOI: 10.1080/1354750x.2020.1792551] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE Prevalence of skin cancer is rapidly increasing. There is a need for non-invasive biomarkers to assess efficacy of prevention strategies aiming at reduction of exposure to ultraviolet radiation (UVR). Recently, stratum corneum (SC) biomarkers were applied in various inflammatory skin diseases. Here, we explore their suitability as candidate biomarkers for UVR. MATERIAL AND METHODS Twelve volunteers were exposed to a UVB-dose of 0.72 SED, three times a week, during three weeks. As candidate biomarkers, cis-isomers of urocanic acid (cUCA) and 25 immunological mediators were measured in the SC. RESULTS Eight immunological markers significantly changed from baseline. Of them, IL-1RA/IL-1α and a placental growth factor (PIGF) showed gradual changes during UVR-exposure (p < 0.01 for linear trend). cUCA increased sharply already after the first exposure, however, reached a plateau in the second week. CONCLUSIONS SC represents a promising, non-invasive alternative to skin biopsy in detecting UVR-induced changes. cUCA is the marker of choice for assessment of single UVR-exposure; however, it is less suitable for cumulative UVR-dose. Immunological markers including IL-1RA/IL-1α and PIGF showed gradual changes, and therefore are convenient for monitoring chronic UVR-exposure. These candidate biomarkers might facilitate assessment of the efficacy of preventive measures in the workplace and general population.
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Affiliation(s)
- Anne J Keurentjes
- Coronel Institute of Occupational Health, Amsterdam University Medical Centers, Location AMC, Amsterdam, The Netherlands
| | - Ivone Jakasa
- Department of Chemistry and Biochemistry, Faculty of Food Technology and Biotechnology, Laboratory for Analytical Chemistry, University of Zagreb, Zagreb, Croatia
| | - Swen M John
- Department of Dermatology, Environmental Medicine, University of Osnabrueck, Osnabrueck, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), Lower-Saxonian Institute of Occupational Dermatology (NIB), University of Osnabrück, Osnabrueck, Germany
| | - Claas Ulrich
- Skin Cancer Centre/HTCC, Hautklinik der Charité, Berlin, Germany
| | - Marcel W Bekkenk
- Department of Dermatology, Amsterdam University Medical Centers, Location AMC, Amsterdam, The Netherlands
| | - Thomas Rustemeyer
- Department of Dermatology and Allergology, Amsterdam University Medical Centers, Location AMC, Amsterdam, The Netherlands
| | - Sanja Kezic
- Coronel Institute of Occupational Health, Amsterdam University Medical Centers, Location AMC, Amsterdam, The Netherlands
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10
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Kim S, Carson KA, Chien AL. Prevalence and correlates of sun protections with sunburn and vitamin D deficiency in sun-sensitive individuals. J Eur Acad Dermatol Venereol 2020; 34:2664-2672. [PMID: 32453868 DOI: 10.1111/jdv.16681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 05/12/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Sun sensitivity is an inherent risk factor for skin cancer. Sun protection is important in sun-sensitive individuals to reduce sunburns for skin cancer prevention. However, concerns have arose regarding the possible impact of sun protection on vitamin D deficiency. OBJECTIVE To examine the prevalence and correlates of sun-protective behaviours (staying in the shade, using sunscreen and wearing long sleeves) with sunburn and vitamin D deficiency in sun-sensitive individuals. METHODS This was a cross-sectional study of 2390 US non-Hispanic white adults aged 20-59 years in the National Health and Nutrition Examination Survey 2011-2014. Sun sensitivity was defined as self-reported tendency to severe sunburn when exposed to the sun for half an hour after months of non-sun exposure, and single serum 25(OH)D levels less than 50 nmol/L was determined as vitamin D deficiency. We calculated adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) using multivariable logistic regression taking into account the complex survey design. RESULTS Sun-sensitive individuals had higher odds of frequently staying in the shade (aOR = 3.08; 95% CI 2.19-4.33) and using sunscreen (aOR = 1.93; 1.44-2.59) but not associated with sun exposure time (aOR = 0.91; 0.62-1.32). Yet, sun-sensitive individuals had significantly higher likelihood of sunburns (aOR = 1.93; 1.45-2.55), and no increased likelihood of vitamin D deficiency (aOR = 1.15; 0.84-1.58). Among sun-sensitive individuals, being younger, male and spending more time outdoors were associated with increased odds of sunburns and the risk of sunburn was reduced with frequently staying in the shade and engaging in multimodal sun protections. CONCLUSION Sun-sensitive individuals more frequently used sun protection methods yet they still were significantly more likely to experience sunburns and the risk of vitamin D deficiency was not increased. Education on proper application of sunscreen combined with other sun-protective techniques is important to reduce sunburn in sun-sensitive populations.
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Affiliation(s)
- S Kim
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Dermatology, Soonchunhyang University Seoul Hospital, Seoul, South Korea
| | - K A Carson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - A L Chien
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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11
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Sunscreens in the United States: Current Status and Future Outlook. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1268:355-379. [DOI: 10.1007/978-3-030-46227-7_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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12
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Passeron T, Bouillon R, Callender V, Cestari T, Diepgen TL, Green AC, van der Pols JC, Bernard BA, Ly F, Bernerd F, Marrot L, Nielsen M, Verschoore M, Jablonski NG, Young AR. Sunscreen photoprotection and vitamin D status. Br J Dermatol 2019; 181:916-931. [PMID: 31069788 PMCID: PMC6899926 DOI: 10.1111/bjd.17992] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2019] [Indexed: 12/16/2022]
Abstract
Background Global concern about vitamin D deficiency has fuelled debates on photoprotection and the importance of solar exposure to meet vitamin D requirements. Objectives To review the published evidence to reach a consensus on the influence of photoprotection by sunscreens on vitamin D status, considering other relevant factors. Methods An international panel of 13 experts in endocrinology, dermatology, photobiology, epidemiology and biological anthropology reviewed the literature prior to a 1‐day meeting in June 2017, during which the evidence was discussed. Methods of assessment and determining factors of vitamin D status, and public health perspectives were examined and consequences of sun exposure and the effects of photoprotection were assessed. Results A serum level of ≥ 50 nmol L−1 25(OH)D is a target for all individuals. Broad‐spectrum sunscreens that prevent erythema are unlikely to compromise vitamin D status in healthy populations. Vitamin D screening should be restricted to those at risk of hypovitaminosis, such as patients with photosensitivity disorders, who require rigorous photoprotection. Screening and supplementation are advised for this group. Conclusions Sunscreen use for daily and recreational photoprotection does not compromise vitamin D synthesis, even when applied under optimal conditions. What's already known about this topic? Knowledge of the relationship between solar exposure behaviour, sunscreen use and vitamin D is important for public health but there is confusion about optimal vitamin D status and the safest way to achieve this. Practical recommendations on the potential impact of daily and/or recreational sunscreens on vitamin D status are lacking for healthy people.
What does this study add? Judicious use of daily broad‐spectrum sunscreens with high ultraviolet (UV) A protection will not compromise vitamin D status in healthy people. However, photoprotection strategies for patients with photosensitivity disorders that include high sun‐protection factor sunscreens with high UVA protection, along with protective clothing and shade‐seeking behaviour are likely to compromise vitamin D status. Screening for vitamin D status and supplementation are recommended in patients with photosensitivity disorders.
Linked Comment: https://doi.org/10.1111/bjd.18126. https://doi.org/10.1111/bjd.18494 available online
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Affiliation(s)
- T Passeron
- Department of Dermatology, CHU Nice, Université Côte d'Azur, CHU Nice, 151, route de Ginestière, 06200, Nice, France.,C3M, INSERM U1065 Université Côte d'Azur, 151, route de Ginestière, 06200, Nice, France
| | - R Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Gasthuisberg, 3000, Leuven, Belgium
| | - V Callender
- Callender Dermatology & Cosmetic Center, 12200 Annapolis Road, Suite 315, Glenn Dale, MD, 20769, U.S.A
| | - T Cestari
- Federal University of Rio Grande do Sul, Hospital de Clinicas de Porto Alegre, Ramiro Barcellos 2350 zone 13, Porto Alegre, RS, 90035-903, Brazil
| | - T L Diepgen
- Department of Clinical Social Medicine, University of Heidelberg, Voßstr. 2, 69115, Heidelberg, Germany
| | - A C Green
- Cancer and Population Studies Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4006, Australia.,CRUK Manchester Institute and Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, M13 9NQ, U.K
| | - J C van der Pols
- School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, QLD, 4059, Australia
| | - B A Bernard
- L'Oréal R&I, Scientific Directorate, 9 rue Pierre Dreyfus, 92110, Clichy, France
| | - F Ly
- Faculty of Medicine, Pharmacy and Odontology, University Cheikh Anta Diop of Dakar, BP 5825, Dakar, Senegal
| | - F Bernerd
- L'Oréal R&I, 1 Avenue Eugène Schueller, 93600, Aulnay-sous-bois, France
| | - L Marrot
- L'Oréal R&I, 1 Avenue Eugène Schueller, 93600, Aulnay-sous-bois, France
| | - M Nielsen
- L'Oréal R&I, Scientific Directorate, 9 rue Pierre Dreyfus, 92110, Clichy, France
| | - M Verschoore
- L'Oréal R&I, Scientific Directorate, 9 rue Pierre Dreyfus, 92110, Clichy, France
| | - N G Jablonski
- Department of Anthropology, The Pennsylvania State University, 409 Carpenter Building, University Park, PA, 16802, U.S.A
| | - A R Young
- St John's Institute of Dermatology, King's College London, London, SE1 9RT, U.K
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Garmyn M, Young AR, Miller SA. Mechanisms of and variables affecting UVR photoadaptation in human skin. Photochem Photobiol Sci 2018; 17:1932-1940. [PMID: 29926025 DOI: 10.1039/c7pp00430c] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Humans have been exposed to solar UV radiation since their appearance on Earth and evolution has enabled most individuals to adapt to this exposure, to some degree. UV radiation produces several deleterious effects in human skin and light-skinned individuals are at greatest risk for both acute and long-term negative effects such as DNA damage, sunburn, immune suppression and skin cancer. The benefits of photoadaptation, which leads to a decreased response after acclimatization, are that humans who have skin that is capable of photoadaptation can work and play in the sun with reduced fear of painful sunburn. However, the effects of photoadaptation on DNA damage and development of skin cancer are quite complex and less well-understood. In this article, we have reviewed the current state of knowledge of UVR photoadaptation in human skin. However, more studies are needed to explore the use of UVR photoadaptation to protect against critical endpoints, such as skin cancer.
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Affiliation(s)
- M Garmyn
- Katholieke University, Leuven, Belgium
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14
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Narbutt J, Philipsen PA, Harrison GI, Morgan KA, Lawrence KP, Baczynska KA, Grys K, Rogowski-Tylman M, Olejniczak-Staruch I, Tewari A, Bell M, O'Connor C, Wulf HC, Lesiak A, Young AR. Sunscreen applied at ≥ 2 mg cm -2 during a sunny holiday prevents erythema, a biomarker of ultraviolet radiation-induced DNA damage and suppression of acquired immunity. Br J Dermatol 2018; 180:604-614. [PMID: 30307614 DOI: 10.1111/bjd.17277] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND Sun protection factor (SPF) is assessed with sunscreen applied at 2 mg cm-2 . People typically apply around 0·8 mg cm-2 and use sunscreen daily for holidays. Such use results in erythema, which is a risk factor for skin cancer. OBJECTIVES To determine (i) whether typical sunscreen use resulted in erythema, epidermal DNA damage and photoimmunosuppression during a sunny holiday, (ii) whether optimal sunscreen use inhibited erythema and (iii) whether erythema is a biomarker for photoimmunosuppression in a laboratory study. METHODS Holidaymakers (n = 22) spent a week in Tenerife (very high ultraviolet index) using their own sunscreens without instruction (typical sunscreen use). Others (n = 40) were given SPF 15 sunscreens with instructions on how to achieve the labelled SPF (sunscreen intervention). Personal ultraviolet radiation (UVR) exposure was monitored electronically as the standard erythemal dose (SED) and erythema was quantified. Epidermal cyclobutane pyrimidine dimers (CPDs) were determined by immunostaining, and immunosuppression was assessed by contact hypersensitivity (CHS) response. RESULTS There was no difference between personal UVR exposure in the typical sunscreen use and sunscreen intervention groups (P = 0·08). The former had daily erythema on five UVR-exposed body sites, increased CPDs (P < 0·001) and complete CHS suppression (20 of 22). In comparison, erythema was virtually absent (P < 0·001) when sunscreens were used at ≥ 2 mg cm-2 . A laboratory study showed that 3 SED from three very different spectra suppressed CHS by around ~50%. CONCLUSIONS Optimal sunscreen use prevents erythema during a sunny holiday. Erythema predicts suppression of CHS (implying a shared action spectrum). Given that erythema and CPDs share action spectra, the data strongly suggest that optimal sunscreen use will also reduce CPD formation and UVR-induced immunosuppression.
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Affiliation(s)
- J Narbutt
- Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, Medical University of Łódź, 90-647, Łódź, Poland
| | - P A Philipsen
- University of Copenhagen, Bispebjerg Hospital, Department of Dermatological Research, Copenhagen, 2400, Denmark
| | - G I Harrison
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
| | - K A Morgan
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
| | - K P Lawrence
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
| | - K A Baczynska
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, OX11 0RQ, U.K
| | - K Grys
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
| | | | - I Olejniczak-Staruch
- Dermoklinika Centrum Medyczne, Łódź, 90-436, Poland.,Department of Dermatology and Venereology, Medical University of Łódź, 90-647, Łódź, Poland
| | - A Tewari
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
| | - M Bell
- Walgreens Boots Alliance Inc., Nottingham, NG90 5EF, U.K
| | - C O'Connor
- Walgreens Boots Alliance Inc., Nottingham, NG90 5EF, U.K
| | - H C Wulf
- University of Copenhagen, Bispebjerg Hospital, Department of Dermatological Research, Copenhagen, 2400, Denmark
| | - A Lesiak
- Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, Medical University of Łódź, 90-647, Łódź, Poland
| | - A R Young
- King's College London, St John's Institute of Dermatology, London, SE1 9RT, U.K
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15
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Lawrence KP, Douki T, Sarkany RPE, Acker S, Herzog B, Young AR. The UV/Visible Radiation Boundary Region (385-405 nm) Damages Skin Cells and Induces "dark" Cyclobutane Pyrimidine Dimers in Human Skin in vivo. Sci Rep 2018; 8:12722. [PMID: 30143684 PMCID: PMC6109054 DOI: 10.1038/s41598-018-30738-6] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 08/03/2018] [Indexed: 12/14/2022] Open
Abstract
The adverse effects of terrestrial solar ultraviolet radiation (UVR) (~295–400 nm) on the skin are well documented, especially in the UVB region (~295–320 nm). The effects of very long-wave UVA (>380 nm) and visible radiation (≥400 nm) are much less known. Sunscreens have been beneficial in inhibiting a wide range of photodamage, however most formulations provide very little protection in the long wave UVA region (380–400 nm) and almost none from shortwave visible wavelengths (400–420 nm). We demonstrate photodamage in this region for a number of different endpoints including cell viability, DNA damage (delayed cyclobutane pyrimidine dimers), differential gene expression (for genes associated with inflammation, oxidative stress and photoageing) and induction of oxidizing species in vitro in HaCaT keratinocytes and in vivo in human volunteers. This work has implications for phototherapy and photoprotection.
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Affiliation(s)
- Karl P Lawrence
- St. John's Institute of Dermatology, King's College London, Guy's Hospital, London, SE1 9RT, UK.
| | - Thierry Douki
- University Grenoble Alpes, CEA, CNRS, INAC-SyMMES/CIBEST, 38000, Grenoble, France
| | - Robert P E Sarkany
- St. John's Institute of Dermatology, King's College London, Guy's Hospital, London, SE1 9RT, UK
| | | | - Bernd Herzog
- BASF Grenzach GmbH, Grenzach-Whylen, 79639, Germany
| | - Antony R Young
- St. John's Institute of Dermatology, King's College London, Guy's Hospital, London, SE1 9RT, UK.
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16
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Narbutt J, Philipsen PA, Lesiak A, Sandberg Liljendahl T, Segerbäck D, Heydenreich J, Chlebna-Sokol D, Olsen P, Harrison GI, Pearson A, Baczynska K, Rogowski-Tylman M, Wulf HC, Young AR. Children sustain high levels of skin DNA photodamage, with a modest increase of serum 25-hydroxyvitamin D 3 , after a summer holiday in Northern Europe. Br J Dermatol 2018; 179:940-950. [PMID: 29691848 DOI: 10.1111/bjd.16668] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Childhood solar ultraviolet radiation (UVR) exposure increases the risk of skin cancer in adulthood, which is associated with mutations caused by UVR-induced cyclobutane pyrimidine dimers (CPD). Solar UVR is also the main source of vitamin D, essential for healthy bone development in children. OBJECTIVES To assess the impact of a 12-day Baltic Sea (54° N) beach holiday on serum 25-hydroxyvitamin D3 [25(OH)D3 ] and CPD in 32 healthy Polish children (skin types I-IV). METHODS Blood and urine were collected before and after the holiday and assessed for 25(OH)D3 and excreted CPD, respectively, and personal UVR exposure was measured. Diaries were used to record sunbathing, sunburn and sunscreen use. Before- and after-holiday skin redness and pigmentation were measured by reflectance spectroscopy. RESULTS The average ± SD daily exposure UVR dose was 2·4 ± 1·5 standard erythema doses (SEDs), which is borderline erythemal. The mean concentration of 25(OH)D3 increased (× 1·24 ± 0·19) from 64·7 ± 13·3 to 79·3 ± 18·7 nmol L-1 (P < 0·001). Mean CPD increased 12·6 ± 10·0-fold from 26·9 ± 17·9 to 248·9 ± 113·4 fmol μmol-1 creatinine (P < 0·001). Increased 25(OH)D3 was accompanied by a very much greater increase in DNA damage associated with carcinogenic potential. Overall, skin type had no significant effects on behavioural, clinical or analytical outcomes, but skin types I/II had more CPD (unadjusted P = 0·0496) than skin types III/IV at the end of the holiday. CONCLUSIONS Careful consideration must be given to the health outcomes of childhood solar exposure, and a much better understanding of the risk-benefit relationships of such exposure is required. Rigorous photoprotection is necessary for children, even in Northern Europe.
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Affiliation(s)
- J Narbutt
- Department of Dermatology, Paediatric Dermatology and Dermatological Oncology, Medical University of Łódź, 90-419, Łódź, Poland
| | - P A Philipsen
- Bispebjerg Hospital, Department of Dermatology D92, Bispebjerg Hospital, DK-2400, Copenhagen, NV, Denmark
| | - A Lesiak
- Department of Dermatology, Paediatric Dermatology and Dermatological Oncology, Medical University of Łódź, 90-419, Łódź, Poland
| | - T Sandberg Liljendahl
- Karolinska Institute, Department of Biosciences and Nutrition, S-141 83, Huddinge, Sweden
| | - D Segerbäck
- Karolinska Institute, Department of Biosciences and Nutrition, S-141 83, Huddinge, Sweden
| | - J Heydenreich
- Bispebjerg Hospital, Department of Dermatology D92, Bispebjerg Hospital, DK-2400, Copenhagen, NV, Denmark
| | - D Chlebna-Sokol
- Department of Paediatric Propedeutics and Bone Metabolic Diseases, Medical University of Łódź, 90-419, Łódź, Poland
| | - P Olsen
- Bispebjerg Hospital, Department of Dermatology D92, Bispebjerg Hospital, DK-2400, Copenhagen, NV, Denmark
| | - G I Harrison
- St John's Institute of Dermatology, King's College London, London, SE1 9RT, U.K
| | - A Pearson
- Public Health England, Laser and Optical Radiation Dosimetry Group, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxon, OX11 ORQ, U.K
| | - K Baczynska
- Public Health England, Laser and Optical Radiation Dosimetry Group, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxon, OX11 ORQ, U.K
| | | | - H C Wulf
- Bispebjerg Hospital, Department of Dermatology D92, Bispebjerg Hospital, DK-2400, Copenhagen, NV, Denmark
| | - A R Young
- St John's Institute of Dermatology, King's College London, London, SE1 9RT, U.K
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17
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Ivanov IV, Mappes T, Schaupp P, Lappe C, Wahl S. Ultraviolet radiation oxidative stress affects eye health. JOURNAL OF BIOPHOTONICS 2018; 11:e201700377. [PMID: 29603665 DOI: 10.1002/jbio.201700377] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 03/21/2018] [Indexed: 05/02/2023]
Abstract
In the eye, ultraviolet radiation (UVR) is not known to contribute to visual perception but to mainly damage multiple structures. UVR carries higher energy than visible light and high dose exposure to UVR causes direct cellular damage, which has an important role in the development of cancer. This review provides an overview on the most recent knowledge on the role of UVR in oxidative stress (OS) in relation to noncancer ocular pathologies: various corneal pathologies, cataract, glaucoma and age-related macular degeneration. Possible OS signaling streams and mechanisms in the aging eye are discussed. Excessive exposure to UVR through live may seriously contribute to increase in OS of various eye tissues and thus lead to the advancement of serious ocular pathologies. Children are especially vulnerable to UVR because of their larger pupils and more transparent ocular media: up to 80% of a person's lifetime exposure to UVR is reached before the age of 18. Therefore, efficient everyday protection of the sensitive tissues of the eye by wearing of sunglasses, clear UVR-blocking spectacles or contact lenses should be considered from early age on. Many initiatives are taken worldwide to inform and raise the population's awareness about these possible UVR hazards to the eye.
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Affiliation(s)
- Iliya V Ivanov
- Institute for Ophthalmic Research, University of Tuebingen, Tuebingen, Germany
| | - Timo Mappes
- Carl Zeiss Vision International GmbH, Aalen, Germany
| | | | | | - Siegfried Wahl
- Institute for Ophthalmic Research, University of Tuebingen, Tuebingen, Germany
- Carl Zeiss Vision International GmbH, Aalen, Germany
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18
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Olsen CM, Wilson LF, Green AC, Biswas N, Loyalka J, Whiteman DC. Prevention of DNA damage in human skin by topical sunscreens. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2017; 33:135-142. [DOI: 10.1111/phpp.12298] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/26/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Catherine M. Olsen
- Population Health Department; QIMR Berghofer Medical Research Institute; Herston Qld Australia
- School of Public Health; the University of Queensland; Herston Qld Australia
| | - Louise F. Wilson
- Population Health Department; QIMR Berghofer Medical Research Institute; Herston Qld Australia
| | - Adèle C. Green
- Population Health Department; QIMR Berghofer Medical Research Institute; Herston Qld Australia
- School of Public Health; the University of Queensland; Herston Qld Australia
- Cancer Research UK Manchester Institute and Institute of Inflammation and Repair; University of Manchester; Manchester UK
| | - Neela Biswas
- Population Health Department; QIMR Berghofer Medical Research Institute; Herston Qld Australia
| | - Juhi Loyalka
- Population Health Department; QIMR Berghofer Medical Research Institute; Herston Qld Australia
| | - David C. Whiteman
- Population Health Department; QIMR Berghofer Medical Research Institute; Herston Qld Australia
- School of Public Health; the University of Queensland; Herston Qld Australia
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19
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Ichihashi M, Ando H. The maximal cumulative solar UVB dose allowed to maintain healthy and young skin and prevent premature photoaging. Exp Dermatol 2014; 23 Suppl 1:43-6. [DOI: 10.1111/exd.12393] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2014] [Indexed: 10/24/2022]
Affiliation(s)
| | - Hideya Ando
- Department of Applied Chemistry and Biotechnology; Okayama University of Science; Okayama Japan
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20
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Fukushima Y, Takahashi Y, Hori Y, Kishimoto Y, Shiga K, Tanaka Y, Masunaga E, Tani M, Yokoyama M, Kondo K. Skin photoprotection and consumption of coffee and polyphenols in healthy middle-aged Japanese females. Int J Dermatol 2014; 54:410-8. [DOI: 10.1111/ijd.12399] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
| | | | - Yusuke Hori
- Department of Clinical Research; TES Holdings Ltd; Tokyo Japan
| | - Yoshimi Kishimoto
- Institute of Environmental Science for Human Life; Ochanomizu University; Tokyo Japan
| | - Kaedeko Shiga
- Institute of Environmental Science for Human Life; Ochanomizu University; Tokyo Japan
| | - Yuiko Tanaka
- Institute of Environmental Science for Human Life; Ochanomizu University; Tokyo Japan
| | - Erika Masunaga
- Institute of Environmental Science for Human Life; Ochanomizu University; Tokyo Japan
| | - Mariko Tani
- Institute of Environmental Science for Human Life; Ochanomizu University; Tokyo Japan
| | | | - Kazuo Kondo
- Institute of Environmental Science for Human Life; Ochanomizu University; Tokyo Japan
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21
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Cole C, Appa Y, Ou-Yang H. A broad spectrum high-SPF photostable sunscreen with a high UVA-PF can protect against cellular damage at high UV exposure doses. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2014; 30:212-9. [PMID: 24806442 DOI: 10.1111/phpp.12124] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 05/05/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Advances in sunscreen technologies have yielded broad spectrum sunscreens at high-sun protection factor (SPF) and ultraviolet A protection factor (UVA-PF) levels that are photostable and powerful in protecting skin from erythema. Questions arise whether these sunscreens protect proportionally against cellular skin damage caused by high ultraviolet exposures. OBJECTIVE The objective of this study is to evaluate if high-SPF sunscreen can protect skin at a cellular level under UV exposure doses [>50 minimal erythema dose (MED)] similarly to the SPF value. METHODS Sunburn cells, Langerhans cells, thymine dimers, protein 53 (p53), and matrix metalloproteinase (MMP)-1 and MMP-9 endpoints were evaluated in biopsies from 12 subjects following four treatments: unprotected exposed to 0, 1 and 3 MED and sunscreen (SPF 55) protected exposed to 55 MED of UV radiation. RESULTS All the markers showed significantly more damage for the 3 MED-untreated sites when compared with non-irradiated control, and majority of the markers showed marked damage following unprotected 1 MED exposure. After 55 MEDs, sunscreen-protected sites showed significantly less p53 and MMP-9 (keratinocyte) staining than the 1 MED-exposed unprotected sites, while all the other biomarkers in sunscreen protected sites showed no statistical differences from 1 MED-exposed unprotected sites. CONCLUSIONS A high-SPF photostable sunscreen with high UVA-PF can provide proportionately high protection against multiple cellular damage markers.
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Affiliation(s)
- Curtis Cole
- Johnson & Johnson Consumer and Personal Products Inc., Skillman, NJ, USA
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22
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O’Leary RE, Diehl J, Levins PC. Update on tanning: More risks, fewer benefits. J Am Acad Dermatol 2014; 70:562-8. [DOI: 10.1016/j.jaad.2013.11.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Revised: 11/05/2013] [Accepted: 11/10/2013] [Indexed: 01/14/2023]
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23
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Petersen B, Datta P, Philipsen PA, Wulf HC. Sunscreen use and failures – on site observations on a sun-holiday. Photochem Photobiol Sci 2013; 12:190-6. [DOI: 10.1039/c2pp25127b] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Fourtanier A, Moyal D, Seite S. UVA filters in sun-protection products: regulatory and biological aspects. Photochem Photobiol Sci 2012; 11:81-9. [DOI: 10.1039/c1pp05152k] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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25
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UVA1 induces cyclobutane pyrimidine dimers but not 6-4 photoproducts in human skin in vivo. J Invest Dermatol 2011; 132:394-400. [PMID: 21975824 DOI: 10.1038/jid.2011.283] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
UVB readily induces cyclobutane pyrimidine dimers, mainly thymine dimers (TTs), and pyrimidine (6-4) pyrimidone photoproducts (6-4PPs) in DNA. These lesions result in "UVB signature mutations" found in skin cancers. We have investigated the induction of TTs and 6-4PPs in human skin in vivo by broadband UVA1, and have compared this with comparable erythemal doses of monochromatic UVB (300 nm). In vitro and ex vivo studies have shown the production of TTs, without 6-4PPs, by UVA1. We show that UVA1 induces TTs, without 6-4PPs, in the epidermis of healthy volunteers in vivo, whereas UVB induced both photoproducts. UVB induced more TTs than UVA1 for the same level of erythema. The level of UVA1-induced TTs increased with epidermal depth in contrast to a decrease that was seen with UVB. UVA1- and UVB-induced TTs were repaired in epidermal cells at a similar rate. The mechanism by which UVA1 induces TTs is unknown, but a lack of intra-individual correlation between our subjects' UVB and UVA1 minimal erythema doses implies that UVA1 and UVB erythema occur by different mechanisms. Our data suggest that UVA1 may be more carcinogenic than has previously been thought.
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26
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Green AC, Williams GM, Logan V, Strutton GM. Reduced melanoma after regular sunscreen use: randomized trial follow-up. J Clin Oncol 2010; 29:257-63. [PMID: 21135266 DOI: 10.1200/jco.2010.28.7078] [Citation(s) in RCA: 433] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Regular sunscreen use prevents cutaneous squamous cell carcinoma long term, but the effect on melanoma is highly controversial. We evaluated whether long-term application of sunscreen decreases risk of cutaneous melanoma. PARTICIPANTS AND METHODS In 1992, 1,621 randomly selected residents of Nambour, a township in Queensland, Australia, age 25 to 75 years, were randomly assigned to daily or discretionary sunscreen application to head and arms in combination with 30 mg beta carotene or placebo supplements until 1996. Participants were observed until 2006 with questionnaires and/or through pathology laboratories and the cancer registry to ascertain primary melanoma occurrence. RESULTS Ten years after trial cessation, 11 new primary melanomas had been identified in the daily sunscreen group, and 22 had been identified in the discretionary group, which represented a reduction of the observed rate in those randomly assigned to daily sunscreen use (hazard ratio [HR], 0.50; 95% CI, 0.24 to 1.02; P = .051). The reduction in invasive melanomas was substantial (n = 3 in active v 11 in control group; HR, 0.27; 95% CI, 0.08 to 0.97) compared with that for preinvasive melanomas (HR, 0.73; 95% CI, 0.29 to 1.81). CONCLUSION Melanoma may be preventable by regular sunscreen use in adults.
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Affiliation(s)
- Adèle C Green
- Queensland Institute of Medical Research, PO Royal Brisbane Hospital, Queensland 4029, Australia.
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27
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Chao Y, Xue-min W, Yi-mei T, Li-jie Y, Yin-fen L, Pei-lan W. Effects of sunscreen on human skin’s ultraviolet radiation tolerance. J Cosmet Dermatol 2010; 9:297-301. [DOI: 10.1111/j.1473-2165.2010.00525.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Springbett P, Buglass S, Young AR. Photoprotection and vitamin D status. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2010; 101:160-8. [PMID: 20444619 DOI: 10.1016/j.jphotobiol.2010.03.006] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2010] [Revised: 03/17/2010] [Accepted: 03/18/2010] [Indexed: 01/04/2023]
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29
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Seité S, Fourtanier A, Moyal D, Young A. Photodamage to human skin by suberythemal exposure to solar ultraviolet radiation can be attenuated by sunscreens: a review. Br J Dermatol 2010; 163:903-14. [DOI: 10.1111/j.1365-2133.2010.10018.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Schmalwieser AW, Cabaj A, Schauberger G, Rohn H, Maier B, Maier H. Facial Solar UV Exposure of Austrian Farmers During Occupation. Photochem Photobiol 2010; 86:1404-13. [DOI: 10.1111/j.1751-1097.2010.00812.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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31
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Marionnet C, Pierrard C, Lejeune F, Sok J, Thomas M, Bernerd F. Different oxidative stress response in keratinocytes and fibroblasts of reconstructed skin exposed to non extreme daily-ultraviolet radiation. PLoS One 2010; 5:e12059. [PMID: 20706594 PMCID: PMC2919404 DOI: 10.1371/journal.pone.0012059] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Accepted: 07/14/2010] [Indexed: 01/03/2023] Open
Abstract
Experiments characterizing the biological effects of sun exposure have usually involved solar simulators. However, they addressed the worst case scenario i.e. zenithal sun, rarely found in common outdoor activities. A non-extreme ultraviolet radiation (UV) spectrum referred as "daily UV radiation" (DUVR) with a higher UVA (320-400 nm) to UVB (280-320 nm) irradiance ratio has therefore been defined. In this study, the biological impact of an acute exposure to low physiological doses of DUVR (corresponding to 10 and 20% of the dose received per day in Paris mid-April) on a 3 dimensional reconstructed skin model, was analysed. In such conditions, epidermal and dermal morphological alterations could only be detected after the highest dose of DUVR. We then focused on oxidative stress response induced by DUVR, by analyzing the modulation of mRNA level of 24 markers in parallel in fibroblasts and keratinocytes. DUVR significantly modulated mRNA levels of these markers in both cell types. A cell type differential response was noticed: it was faster in fibroblasts, with a majority of inductions and high levels of modulation in contrast to keratinocyte response. Our results thus revealed a higher sensitivity in response to oxidative stress of dermal fibroblasts although located deeper in the skin, giving new insights into the skin biological events occurring in everyday UV exposure.
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Abstract
The Sun Protection Factor (SPF) is a very popular instrument in the marketing of sunscreens. Unfortunately it is often not understood how sunscreens work and where the limitations of the SPF are. A lot of aspects of the SPF are confusing, e.g. the race for higher and higher numbers, the effect on SPF when less sunscreen is applied and if sunscreen should be used at all because they may block the Vitamin D synthesis. All this has a negative impact on compliance by the consumer or patient which is the most important influence factor in sun protection. This paper explains how sunscreens work, how the SPF is determined and where the limitations of the current methods exist. The dynamic view of 'UV radiation applied' and the 'UV dose transmitted' through the sunscreen onto the skin as well as onto a substrate in vitro help in the understanding and are also promising approaches in the in vitro assessment. A variation of the in vitro assessment of a sunscreen is the in silico calculation based on the absorption spectrum of the UV filters and an assumption about the irregular sunscreen film on the skin. The sunscreen simulator program can be used to determine how the SPF is affected by applying smaller amounts of sunscreen. Besides the SPF, UVA protection is also discussed. The degree of UVA protection determines the quality of the overall UV protection, whereas the SPF is an indication of the quantity of protection. Furthermore other protection factors such as IPF, iSPF, RSF and p53, and the inhibition of the Vitamin D3 synthesis by sunscreens are also discussed. In conclusion it is shown that the accuracy and robustness of the SPF and other Protection Factors will improve significantly with the availability of true broad-spectrum sunscreens rather than conventional UVB-biased sunscreens, because uniform protection profiles lead to protection independent of the action spectrum of the endpoint and the UV-radiation source.
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Seité S, Christiaens F, Bredoux C, Compan D, Zucchi H, Lombard D, Fourtanier A, Young AR. A broad-spectrum sunscreen prevents cumulative damage from repeated exposure to sub-erythemal solar ultraviolet radiation representative of temperate latitudes. J Eur Acad Dermatol Venereol 2010; 24:219-22. [DOI: 10.1111/j.1468-3083.2009.03332.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Norval M, Wulf H. Does chronic sunscreen use reduce vitamin D production to insufficient levels? Br J Dermatol 2009; 161:732-6. [DOI: 10.1111/j.1365-2133.2009.09332.x] [Citation(s) in RCA: 117] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
BACKGROUND The World Health Organization recommends that tanning parlors not be used by individuals under age 18 years. The impact of self-tanners on tanning parlor and sunscreen use by Canadian teens is unknown. OBJECTIVE To determine teens' use of, knowledge of, attitudes toward, and behavior regarding tanning parlors, self-tanning products, and sunscreen. METHODS Self-report questionnaire of grade 10 students in Thames Valley district, Ontario. RESULTS Indoor tanning parlors were used by 14%, self-tanners by 28%, and sunscreen daily or most days by 36%. Use was more common in females. There was a strong association between parental and child use of tanning parlors and use of self-tanners. Sixty-two percent believe that self-tanners give adequate photoprotection. CONCLUSIONS Further education is required to address teen tanning parlor use, infrequent sunscreen use, and lack of knowledge about the safety of tanning parlors and self-tanning products.
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Affiliation(s)
- Danielle Gordon
- Department of Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON.
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Bacqueville D, Mavon A. Caspase-3 Activation and DNA Damage in Pig Skin Organ Culture After Solar Irradiation. Photochem Photobiol 2008; 84:1164-71. [DOI: 10.1111/j.1751-1097.2008.00297.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Yamaguchi Y, Coelho SG, Zmudzka BZ, Takahashi K, Beer JZ, Hearing VJ, Miller SA. Cyclobutane pyrimidine dimer formation and p53 production in human skin after repeated UV irradiation. Exp Dermatol 2008; 17:916-24. [PMID: 18363705 DOI: 10.1111/j.1600-0625.2008.00722.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Substantial differences in DNA damage caused by a single UV irradiation were found in our previous study on skin with different levels of constitutive pigmentation. In this study, we assessed whether facultative pigmentation induced by repeated UV irradiation is photoprotective. Three sites on the backs of 21 healthy subjects with type II-III skin were irradiated at 100-600 J/m(2) every 2-7 days over a 4- to 5-week period. The three sites received different cumulative doses of UV (1900, 2900 or 4200 J/m(2)) and were biopsied 1 day after the last irradiation. Biomarkers examined included pigment content assessed by Fontana-Masson staining, melanocyte function by expression of melanocyte-specific markers, DNA damage as cyclobutane pyrimidine dimers (CPD), nuclear accumulation of p53, apoptosis determined by TUNEL assay, and levels of p21 and Ser46-phosphorylated p53. Increases in melanocyte function and density, and in levels of apoptosis were similar among the 3 study sites irradiated with different cumulative UV doses. Levels of CPD decreased while the number of p53-positive cells increased as the cumulative dose of UV increased. These results suggest that pigmentation induced in skin by repeated UV irradiation protects against subsequent UV-induced DNA damage but not as effectively as constitutive pigmentation.
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Affiliation(s)
- Yuji Yamaguchi
- Laboratory of Cell Biology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
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Proksch E, Jensen JM, Crichton-Smith A, Fowler A, Clitherow J. Rationale Behandlung von Patienten mit Verbrennungen 1. Grades. Hautarzt 2007; 58:604-10. [PMID: 17565478 DOI: 10.1007/s00105-007-1364-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
First-degree burns are the most common type of burn, but are often inadequately treated. The methods of treatment and the course of healing are poorly documented owing to the fact that first-degree burns are generally not considered to be a serious injury. First-degree burns can be caused by thermal injury or UV irradiation (sunburn). The pathophysiology and the therapeutic approach are similar, although the damage follows a different time course for each injury--immediate damage after contact with hot objects, liquids or fire, delayed damage after sun exposure. After initial cooling with water, aqueous emulsions with small amounts of well-tolerated lipids (O/W emulsions) are best suited for treating first-degree burns or sunburn. Water evaporates producing cooling and reducing inflammation; the lipids accelerate the repair of the damaged skin barrier and reduce drying. Foam sprays and lotions are ideal because they are easy and painless to apply. The use of topical corticosteroids is not recommended, as superiority to the vehicle has not been shown.
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Affiliation(s)
- E Proksch
- Universitäts-Hautklinik, Schittenhelmstrasse 7, 24105 Kiel, Germany.
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