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Despite the chronic and increasingly prevalent nature of actinic keratosis (AK) and existing evidence supporting assessment of the entire cancerization field during clinical management, a standardized definition of the AK field to aid in the understanding and characterization of the disease is lacking. The objective of this review was to present and appraise the available evidence describing the AK cancerization field, with the aim of determining a precise definition of the AK field in terms of its molecular (including genetic and immunological), histological and clinical characteristics. Eight European dermatologists collaborated to conduct a review and expert appraisal of articles detailing the characteristics of the AK field. Articles published in English before August 2016 were identified using PubMed and independently selected for further assessment according to predefined preliminary inclusion and exclusion criteria. In addition, a retrospective audit of patients with AK was performed to define the AK field in clinical terms. A total of 32 review articles and 47 original research articles provided evidence of sun-induced molecular (including genetic and immunological) and histological skin changes in the sun-exposed area affected by AK. However, the available literature was deemed insufficient to inform a clinical definition of the AK field. During the retrospective audit, visible signs of sun damage in 40 patients with AK were assessed. Telangiectasia, atrophy and pigmentation disorders emerged as 'reliable or very reliable' indicators of AK field based on expert opinion, whereas 'sand paper' was deemed a 'moderately reliable' indicator. This literature review has revealed a significant gap of evidence to inform a clinical definition of the AK field. Therefore, the authors instead propose a clinical definition of field cancerization based on the identification of visible signs of sun damage that are reliable indicators of field cancerization based on expert opinion.

RationaleUsing indoor tanning devices is associated with substantial health consequences, such as an increased risk of melanoma and other skin cancers. Many people including minors and some at high risk of skin cancer continue to use these devices. In the absence of effective restrictions on use, it is important that behaviour change interventions are designed to reduce indoor tanning.ObjectiveTo explore reasons for use of indoor tanning devices and the acceptability of alternatives in adult users residing in North-West England.MethodsParticipants were required to be current indoor tanners aged 18 years and above and were recruited online. Twenty-one participants took part in either a focus group or semi-structured interview. An inductive thematic analysis was conducted.ResultsSix themes were identified: psychological benefits; improving physical health; denial of health risks; alternatives do not meet psychological needs; alternatives do not meet physical needs; and perceived side-effects. Participants used indoor tanning devices to improve their self-esteem and to prevent sun damage to their skin (by gaining a ‘base tan’). Participants appeared to justify their usage by responding defensively to avoid accepting they were at risk, exaggerating the benefits of indoor tanning, and discounting alternatives to indoor tanning. Alternatives to indoor tanning were perceived as risky for health, inadequate to provide the desired aesthetic, and incapable of meeting their self-esteem needs.ConclusionsInterventions to reduce indoor tanning behaviour should increase sources of self-esteem other than appearance, increase media literacy and address defensive responses to information around indoor tanning and alternatives. Further research is needed to develop these interventions and assess their feasibility.

Dermoscopy is a non-invasive, in vivo technique that allows the visualization of subsurface skin structures in the epidermis, at the dermoepidermal junction, and in the upper dermis. Dermoscopy brought a new dimension in evaluating melanocytic skin neoplasms (MSN) also representing a link between clinical and pathologic examination of any MSN. However, histopathology remains the gold standard in diagnosing MSN. Dermoscopic–pathologic correlation enhances the level of quality of MSN diagnosis and increases the level of confidence of pathologists. Melanoma is one of the most genetically predisposed among all cancers in humans. The genetic landscape of melanoma has been described in the last years but is still a field in continuous evolution. Melanoma genetic markers play a role not only in melanoma susceptibility, initiation, and progression but also in prognosis and therapeutic decisions. Several studies described the dermoscopic specific criteria and predictors for melanoma and their histopathologic correlates, but only a few studies investigated the correlation among dermoscopy, pathology, and genetic of MSN. The aim of this work is to review the published data about dermoscopic features of melanoma, their histopathological correlates with regards also to genetic alterations. Particularly, this review will focus on low-CSD (cumulative sun damage) melanoma or superficial spreading melanoma, high-CSD melanoma, and nevus-associated melanoma.

Despite the increasing prevalence of social media usage in health care contexts, its impact on skin cancer prevention and awareness has not been largely investigated. We conducted a review of literature on this topic with the objective of summarizing and analyzing the role of social media in skin cancer and sun damage awareness and to identify the uses, benefits, and limitations of different social media platforms on skin cancer prevention. In today’s technological society, it is critical to understand and study the best form of communication. Specific platforms like Instagram, Twitter, Facebook, YouTube, and TikTok vary in originators of material, target demographics, messaging strategies, and reliability of information with regards to skin cancer, sun, and indoor tanning damage. Our results demonstrate that social media interventions have shown promise in skin cancer prevention and continue to escalate by the day. Dermatologists should keep pace with the latest dermatological content on social media and examine its evolution to target the right audience with the proper messages. Further research is needed to evaluate the effectiveness and true impact of social media on meaningful and lasting behavior change for skin cancer prevention.

Actinic keratosis (AK) lesions are surrounded by field cancerization (areas of subclinical, non-visible sun damage). Existing AK grading tools rely on AK counts, which are not reproducible. An Actinic Keratosis Field Assessment Scale (AK-FAS) for grading the severity of AK/field was developed. Standardized photographs of patients representing the full range of AK severity were collected. Six investigators independently rated each photograph according to 3 criteria: AK area (total skin area affected by AK lesions), hyperkeratosis and sun damage. Inter-rater reproducibility was good for all 3 criteria. Validation of the AK-FAS showed good reproducibility for AK area and hyperkeratosis, even for dermatologists untrained on use of the scale. In conclusion, the AK-FAS is objective, easy to use and implement, and reproducible. It incorporates assessment of the entire field affected by AK instead of relying on lesion counts. Use of the AK-FAS may standardize AK diagnosis, making it relevant to routine clinical practice.

Extensive promotion on the internet and in the media has led to an increase in public awareness that too much exposure to sun can cause photodamage and skin cancers. However, there are gaps in knowledge regarding the selection of the right sunscreen, recommended dose and daily application schedule. The labels of sunscreens are often difficult to understand and consumers remain unaware about the potential photodamage caused by infrared (IR) and high-energy visible light (HEVL). Patients are becoming increasingly conscious about skin health and aesthetics, but they often seek help only after a significant amount of sun damage has already occurred. There are still many discrepancies related to the correct method of sunscreen application and the best times for reapplication. Much more research is needed to study the harmful effects of sunscreen ingredients on systemic absorption, if any, in areas such as safety in pregnant and breastfeeding women, and the relationship to various skin cancers and diseases. This article discusses the types and formulations of sunscreens for ultraviolet light, IR and HEVL protection. It also covers sunscreen labels, application techniques, recommended doses, safety and possible health hazards, related controversies, product shelf life and the importance of patient education.

Background Sunscreens are known to protect from sun damage; however, their effects on the reversal of photodamage have been minimally investigated. Objective The aim of the prospective study was to evaluate the efficacy of a facial sun protection factor (SPF) 30 formulation for the improvement of photodamage during a 1-year use. Methods Thirty-two subjects applied a broad spectrum photostable sunscreen (SPF 30) for 52 weeks to the entire face. Assessments were conducted through dermatologist evaluations and subjects' self-assessment at baseline and then at Weeks 12, 24, 36, and 52. Results Clinical evaluations showed that all photoaging parameters improved significantly from baseline as early as Week 12 and the amelioration continued until Week 52. Skin texture, clarity, and mottled and discrete pigmentation were the most improved parameters by the end of the study (40% to 52% improvement from baseline), with 100% of subjects showing improvement in skin clarity and texture. Conclusion The daily use of a facial broad-spectrum photostable sunscreen may visibly reverse the signs of existing photodamage, in addition to preventing additional sun damage.

Clinicians practising within the medical aesthetic sector commonly advise patients to apply topical sun protection factor to protect their skin from sun damage. However, it is a little known fact that certain orally consumed nutrients can play an important role in helping to protect the skin from damage induced by ultraviolet (UV) light exposure. When provided at therapeutic doses, antioxidants, probiotics, B vitamins and fish oils have all been shown to exert photoprotective effects. The mechanisms by which these nutrients can help to protect the skin against UV radiation are many and varied. They include protecting against UV-induced free radical damage and inflammation, as well as modulating cutaneous immune function. In this review, the author discusses the specific nutrients that can provide protoprotection, which are widely available in supplemental form to both aesthetic practitioners and patients alike.

Sun-injury (=sunburn) on apples is an important physiological disorder affecting all cultivars grown in semi-arid climates. Both, high light and elevated temperatures during the fruit-growing season are responsible for the symptoms. Therefore, a crop water stress index (CWSI), calculated from infrared images, and chlorophyll fluorescence were assessed as early predictors, when no symptoms of sun-damage were yet visible. Fifty fruit of each cv. (Royal Gala, Granny Smith, Fuji) were tagged at 50 days after full bloom (DAFB) in different orchards. Infrared images were taken weekly and used for CWSI calculation. A similar number of fruit (Royal Gala, Fuji) were tagged after 80 DAFB for chlorophyll fluorescence measurements carried out every 2 weeks. The proposed CWSI was able to predict the occurrence of severe sunburn symptoms in Granny Smith apples as early as 86 DAFB, 42 days before symptoms were visible. In Fuji, this occurred as early as 122 DAFB, 25 days prior visible symptoms. The threshold value of CWSI required for sunburn development on the fruit was 0.5. The maximum quantum efficiency of photosystem II (Fv/Fm) was also able to detect early sun damage, at 100 DAFB, before symptoms appearance, with a threshold value of 0.6. The results would imply that early events in photooxidative stress leading to sun injury have a profound effect on tissue physiology and biochemistry, which can be assessed using chlorophyll fluorescence and a thermography-based index, such as the CWSI. Both, the CWSI and Fv/Fm ratio could be used as non-destructive, fast and reliably field tools to monitor sun-injury when no symptoms have yet developed.

In the 60 years since the inaugural edition of the International Journal of Radiation Biology, much of our understanding of the biological effects of solar radiation has changed. Earlier in the cen...

Ultraviolet (UV) radiation is associated with negative health effects, including sun damage and skin cancer. The purpose of this study is to compare the protective effects of the shade provided by a sun umbrella versus that provided by a tree. Sun sensors that register the level and dose of UV radiation were placed in the shade and in direct sunlight. Measurements were recorded every half hour between the hours of 12:30 p.m. and 3:00 p.m. in Sacramento, California. The results suggest that the level of UV radiation in the shade is not zero. The sensors located in tree shade indicated that over 5% of UV radiation was detected in the shade. The sensors located in sun-umbrella shade showed that greater than 17% of UV radiation reached the shade. The sun sensors used in our study collected UV radiation data relevant to UV index; however, they did not differentiate between UVA, UVB, visible, and infrared light. The amount of UV radiation detected in the shade is not zero, thus regular sunscreen use and other sun protective practices should be followed to reduce the risk of sun damage and skin cancer.

Marine mammal eyes are adapted for underwater and air environments by increasing the mucins in tear film and having flatter corneas and round crystalline lenses. The cornea and lens are most commonly affected by environmental imbalances. Lack of shade and excessive exposure to sunlight are significant risk factors for keratopathy in pinnipeds, and likely true in cetaceans. Natural aging is also important, as sun damage and exposure to other oxidative stressors can cause cumulative damage to the cornea over time. By diminishing UV exposure and optimizing environmental factors, surface ocular disease in marine mammals can be diminished.

Chronic erosive pustular dermatitis with a predilection for the scalp is a hallmark of ectodermal dysplasias (EDs) caused by mutations in TP63, including Rapp-Hodgkin and Hay-Wells EDs. It is among the most troublesome and symptomatic complications and is typically refractory to classic wound care approaches. We report two cases of Rapp-Hodgkin ED with refractory scalp erosions that markedly improved with the use of potent topical steroids. We also note marked similarities between this scalp inflammation and "erosive pustular dermatosis of the scalp," a condition more typically found in elderly individuals with severe scalp sun damage, and speculate about possible shared pathogenetic mechanisms.

The process of aging leads to countless bodily changes on both a macro- and microscopic scale. No organ system is unaffected; however, the nose is especially susceptible. Sun damage, hormone levels, regenerative capability, tissue elasticity, bone resorption, and the effects of gravity contribute to produce classic signs and symptoms. Rhinoplasty of the aging nose requires a comprehensive understanding of aging facial anatomy combined with surgical techniques designed to resist these ubiquitous remodeling forces over time.

Ultraviolet filters (UV Filters) are compounds that are widely employed in personal care products such as sunscreens to protect the skin from sun damage, but they are also added to other products, such as food packaging, plastics, paints, textiles, detergents, etc. The continuous use of these products causes the release of a substantial amount of these products into the marine environment through direct input or wastewater discharge, and thus they are becoming an important class of contaminants of emerging concern. A correlation between their occurrence and different negative effects on marine biota has been reported. Taking into account all the possible impacts on the environment, knowledge of their presence and distribution in the different compartments of the ecosystems, ranging from waters and sediments to aquatic organisms, which potentially suffer from bioaccumulation and biomagnification processes, is essential. High concentrations of ultraviolet filters have been found in samples collected from across the entire planet, even in polar regions, revealing their global distribution. Therefore, interest in the sensitive determination of ultraviolet filters in several marine matrices has increased. In this article, an overall review of the more recently reported analytical chemistry methods for identifying and quantifying these compounds in marine environmental samples is presented. We compare and discuss the potential advantages and disadvantages of every step involved in the analytical procedure, including the pre-treatment, treatment and extraction processes that are required to avoid matrix effects. Moreover, we describe the worldwide occurrence and distribution of those most important UV filters.

Climate change negatively influences many human activities and one of the most affected is agriculture. In the apple industry, water availability, elevated temperatures and altered phenology will transform fruit production in traditional growing regions. Extended periods of intense solar radiation and high temperatures during the growing season cause problems in fruit quality increasing losses and reducing sustainability and profitability. Photooxidative and heat stress stimulate sunburn development on apple fruit in the field growing under increasingly stressful conditions. In particular, apples growing in semi-arid conditions are frequently exposed to high solar irradiance and elevated temperature during the growing season that promote the development of sun-related skin disorders. Furthermore, regions that have traditionally not faced sunburn pressure may begin to experience losses in this area. Apple cultivars differ in their susceptibility to sun damage, which is evidenced, in part, by the timing of symptom development and severity. Some studies attribute genotypic variation to physiological and morphological differences while others do to antioxidant-related metabolic differences between them. Here, we discuss the physiological and molecular progress and gaps in knowledge of sunburn damage and the development of sunburn resistance in apple fruit. This information will help develop stronger sunburn mitigation strategies and enhance breeding efforts to address challenges associated with sunburn in apple production.

Children and adolescents may be vulnerable to increased ultraviolet radiation exposure and greater risk for subsequent sun-related pathologies. This study examined the demographic, geographic, and phenotypic factors influencing sun exposure and protective behaviors among children and adolescents living in the United States. A cross-sectional survey on perceived sun exposure and protective behaviors was administered at three sports medicine clinics in California, Colorado, and Hawaii. Responses were measured with a 5-item frequency scale: Never, Rarely (25% of the time or less), Sometimes (50% of the time), Often (75% of the time or more), and Always. Sun protective behavior was examined using univariate and multivariate analyses. In total, 860 surveys were collected (52% female, 48% male; mean age 12.7 years). Females reported significantly greater frequency of using sunscreen (p = 0.001), staying in the shade or using an umbrella while in the sun (p = 0.004), and tanning (p

[EN] During academic year 2017/2018 the project: “Sun damage protection tent” take place as a Service-Learning Methodology. In this experience, diverse agents are involved, creating an interdisciplinary space in which pharmacy students are going to participate. This project is presented in order to motivate the students to create a didactic material, a leaflet, and a website with the awareness campaign ideas to present in the annual “Sun damage protection tent” that promotes the “Colegio Oficial de farmacéuticos de Zaragoza”(C.O.F.)and “Asociación Española Contra el Cáncer”(A.E.C.C.) Pharmacy students are going to be the creative force of the campaign. Also, they are going to be part of the participating volunteers of the “Sun damage protection tent” and to complete the activities of the project, it will be close with the location of a “sun tent” on Universidad San Jorge´s campus. There, the students can share the knowledge acquired during the experience, their communication skills and try to educate their colleagues and other member of the academic staff in sun protection. The participation of the students will consist in the design, training, diffusion, implementation and assessment of the project. Varied innovative methodologies are used in this experience: Service-Learning and Information and communications technology, [ES] Durante el curso académico 2017/2018 se lleva a cabo el servicio de Aprendizaje-Servicio “Carpa de protección solar”. La dermofarmacia como herramienta para la concienciación y prevención del cáncer de piel. En esta experiencia intervienen diferentes agentescreando un espacio interdisciplinar en el que van a participar los estudiantes de farmacia. El presente proyecto motiva a los alumnos a crear un material didáctico, un folleto y una página web que contengan las principales ideas de la campaña anual “Carpa solar” que el Colegio Oficial de Farmacéuticos de Zaragoza(C.O.F.) organiza junto ala Asociación Española contra el Cánces (A.E.C.C.) Los alumnos van a formar parte de la de la campaña desde su creación hasta la participación como voluntarios en las carpas solares. Para completar el proyecto, se finalizará con la instalación de una carpa solar en el campus universitario. Los estudiantes podrán compartir su aprendizaje adquirido sobre protección solar, tanto con sus compañeros de otros grados como con el personal académico. La participación de los alumnos consistirá en el diseño, práctica, difusión y evaluación del proyecto. Se aplican metodologías innovadoras como el Aprendizaje-Servicio(APS) y las tecnologías de la Información y la Comunicación (TICs)

Sunburn in apples is caused by excessive solar radiation and high temperatures. Shade netting is used to control sun damage in apple (Malus domestica Borkh.) orchards. The physiological aspects of the effectiveness of this technique have not yet been fully understood. The objective was to study the variation in chlorophyll fluorescence in apples exposed to environmental conditions of radiation and temperature under netting, to better understand the physiological aspects in the effectiveness of this technique to control sun damage. From 50 and up to 150 d after flowering (DAF), maximum photochemical quantum efficiency of photosystem II (Fv/Fm), incidence of photosynthetically active radiation (PAR, µmol m-2 s-1), and fruit surface temperature (FST, °C) were evaluated in netted and non-netted ‘Fuji’ and ‘Gala’ apple orchards with 20% shade netting, as well as at harvest in fruit picked from the tree. Netting reduced sunburn by 9% for ‘Gala’ and 5% for ‘Fuji’. For ‘Gala’, netting reduced FST from 2 to 5 °C and 2 to 3 °C for ‘Fuji’ compared to the control (P < 0.05). The PAR decreased by 27% for ‘Gala’ and 22% for ‘Fuji’ compared to the control (P < 0.05). The mean value of Fv/Fm was 12% in ‘Gala’ and 3% in ‘Fuji’ lower than under netting. This difference in Fv/Fm was maintained in fruit picked from the tree and was 13% in ‘Gala’ and 8% in ‘Fuji’. The effectiveness of nets as a measure to control sun damage in apples is related to the ability of this technique to reduce the photo-inhibition process on the fruit skin.

Background/Objectives To assess the sun-protection practices of undergraduates at the Australian National University. Methods We sent emails with links to the questionnaire on the use of five sun-protection practices in the last fortnight of the summer to 3341 randomly selected students aged 18–24 years in this cross-sectional study. The response rate was 19% and 507 students met the inclusion criteria. Results The sample consisted of 338 female and 169 male students with a mean age of 20.5 years (SD ± 1.9). Any method of sun protection was used always or often by 32% of respondents. The commonest method used was shade (58%) while the least common was wearing a hat (8%). Domestic students (44%) used sunglasses more than the international students (23%, P

This study estimated minimum air temperatures for potential sun damage for sunburn browning (non-netted and netted) and sunburn necrosis (non-netted) for Royal Gala apple in Australia. The approach estimated when conditions may be conducive to the development of sun damage in some fruit. The approach provides a measure of potential damage. This allows for more flexible analyses of potential sun damage which current models are unable to produce due to data limitations. The air temperature thresholds determined were 34.1 and 38.7 °C, respectively, for browning and necrosis for non-netted fruit and 37.9 °C for browning under netting. These air temperature thresholds were applied across southern Australia from 1911–2013 demonstrating different risk profiles between sites, inter-annual variability and the benefit of installing netting via a reduction in potential damage days. The results can be further extended to estimate impacts from climate change and assess the benefit of installing netting to adapt to inc...

Nutraceuticals are defined as a food, or part of a food, that provides medical or health benefits, including the prevention and/or treatment of a disease. Specific nutraceuticals have been proven beneficial in optimising skin health and promoting healthy skin ageing. This article discusses the evidence surrounding nutrients that are essential for skin collagen synthesis and skin cell renewal. It also investigates nutrients that have been proven capable of providing anti-inflammatory and antioxidant effects in the skin, as well as protection from sun damage, and the promotion of skin hydration. In this paper, the author suggests key considerations when recommending nutraceuticals to aesthetic patients, including the importance of choosing well-researched nutrients, provided in bioavailable forms, at a dose proven to be effective. When combined with a healthy, balanced diet and the use of high-quality cosmeceuticals, nutraceuticals can help provide a global approach to optimising skin health and delaying signs of ageing.

Previous studies on the association of solar lentigines with ultraviolet radiation (UVR) exposure have been based on retrospective questionnaires about UVR exposure. We aimed to investigate the association between solar lentigines and UVR exposure in healthy individuals using objective measurements, and to investigate the association between solar lentigines and cutaneous malignant melanoma (CMM). Forty-eight patients with CMM and 48 controls that matched the patients individually by age, sex, constitutive skin type and occupation participated. Solar lentigines on the shoulders and upper back were counted and graded into 3 categories using black light photographs to show sun damage. Current UVR exposure in healthy controls was assessed by personal electronic UVR dosimeters that measured time-related UVR and by corresponding exposure diaries during a summer season. Sunburn history was assessed by interviews. Among controls, the number of solar lentigines was positively associated with daily hours spent outdoors between noon and 3 pm on holidays (P = 0.027), days at the beach (P = 0.048) and reported number of life sunburns (P < 0.001). Compared with matched controls CMM patients had a higher number of solar lentigines (P = 0.044). There was a positive association between CMM and higher solar lentigines grade; Category III versus Category I (P = 0.002) and Category II versus Category I (P = 0.014). Our findings indicate that solar lentigines in healthy individuals are associated with number of life sunburns, as well as time spent outdoors around noon on holidays and beach trips during a summer season, most likely reflecting past UVR exposure, and that solar lentigines are a risk factor for CMM.

Fig 1. Hypertrophic lupus erythematosus. A, Clinical image of extensive verrucous plaques on the right postauricular area, pinna, and cheek. B, Discoid lesion on the left cheek, demonstrating a scaly peripheral edge and central whitish-pink atrophic area. C, Polarized contact dermoscopic view of the scaly anterior edge of the discoid plaque pictured in (B) showing numerous white-to-yellow hyperkeratotic follicles, confluent scaly areas, whitish perifollicular haloes, blurred reddish vascular areas (arrows), and linear vessels. D, Central atrophic area of the same lesion revealing homogeneous white-to-pinkish areas with dotted (circle), hairpin (rectangle), and linear vessels (arrow). The dermoscopic features depicted in (C) suggest active DLE, whereas the features in (D) are consistent with advanced DLE.

Most skin cancers, which are among the most common malignancies in the UK, follow excessive exposure to ultraviolet (UV) radiation and are, therefore, potentially preventable. In general, most people receive much of their lifetime UV exposure as children and adolescents, and sun damage during childhood markedly increases the risk of developing skin cancer in later life. This article considers elements that nurses could include in their school's safe sun policies and when educating pupils, parents and staff. In addition, school nurses could encourage the curriculum and timetable to consider sun protection and inform architectural discussions. Sunlight is, however, the main source of vitamin D in the UK. People who avoid all sun exposure should consider having their serum vitamin D measured. If levels are reduced or deficient, nurses could consider suggesting increasing vitamin D intake.

// Alejandro Martin-Gorgojo 1, * , Marta Llinares 2, * , Amaya Viros 3, 4, * , Celia Requena 2 , Zaida Garcia-Casado 5 , Victor Traves 6 , Rajiv Kumar 7 and Eduardo Nagore 2, 8 1 Escuela de Doctorado, Universidad Catolica de Valencia “San Vicente Martir”, Valencia, Spain 2 Department of Dermatology, Instituto Valenciano de Oncologia (IVO), Valencia, Spain 3 Skin Cancer and Ageing Laboratory, CRUK Manchester Institute, Manchester, UK 4 Salford Royal NHS Foundation Trust, Manchester, UK 5 Department of Molecular Biology, Instituto Valenciano de Oncologia (IVO), Valencia, Spain 6 Department of Pathology, Instituto Valenciano de Oncologia (IVO), Valencia, Spain 7 Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany 8 Dermatology Department, School of Medicine, Universidad Catolica de Valencia “San Vicente Martir”, Valencia, Spain * These authors have contributed equally to this work Correspondence to: Eduardo Nagore, email: eduardo_nagore@ono.com Keywords: melanoma; nevus; risk; sunburn; solar elastosis Received: July 20, 2017 Accepted: September 23, 2017 Published: October 24, 2017 ABSTRACT There are at least two pathways driving cutaneous melanoma; one is linked to an inherent melanoma susceptibility to nevi development and the second to environmental cumulative ultraviolet light exposure. In this study, we examined the relation between nevus density, accrued sun damage and the site of primary melanoma excision. In a series of 888 consecutive cutaneous melanoma patients, melanomas appearing in skin areas with a high relative nevus density were most prominent in men, with an elevated nevus count, at sites without solar elastosis, but with an epidemiological history of previous sunburn. The present study associates melanoma development to sites with high nevus density. Our study supports more careful surveillance of body areas with increased nevus density in patients with high total body number of nevi, especially when they report a history of sunburns at these sites.

The use of lasers to reduce the effects of age and sun damage to facial skin has gained widespread acceptance (Fig. 7.1). A carbon dioxide (CO2) laser produce controlled cutaneous exfoliation with limited damage to surrounding tissue. Their wavelengths are highly absorbed by water, the main cellular constituent. Fractioned CO2 have mostly replaced the older full ablation CO2 models. These lasers allow a portion of the dermis to be treated with skip areas in between. This allows more rapid reepithelialization of the skin and minimizes the duration of postoperative hyperemia. Additionally, the depth of laser penetration can be altered to treat superficial or deeper rhytides.

High doses of oral vitamin D 3 attenuate skin inflammation following experimentally induced sun damage.

not present

RESUMEN El daño por sol y la falta de color de frutos producida por el exceso de radiación solar y altas temperaturas es el mayor problema productivo en los huertos de manzano en Chile. El objetivo de esta investigación fue evaluar el uso de mallas de colores como herramienta para el control de daño por sol y mejorar la coloración en manzanas. Durante la temporada 2012-13 y 2013-14 un huerto de manzanos ´Fuji´ y ´Gala´ fue cubierto con mallas de color Roja y Perla al 20% de sombreado, dejando árboles sin cubrir como control. Se realizó un registro de la temperatura del aire y fruto (ºC), humedad relativa (%) y radiación fotosintéticamente activa total (PARtotal) y difusa (PARdifusa) (µmol m-2 s-1). Al momento de cosecha se cuantificó la incidencia de daño por sol con escala visual (%) y el color de frutos a través de un equipo Color Hunter. En promedio, para ambas temporadas, la malla Roja redujo la transmisión de PARtotal en un 21%, mientras que la malla Perla en un 17%. La cantidad PARdifusa fue en promedio un 15% superior bajo la malla Perla que la malla Roja, incrementando con ello el desarrollo de color rojo de frutos en el cultivar Fuji. Durante la temporada 2012/13 ambas mallas redujeron en un 26% y 44% el daño por sol en frutos para los cultivares Gala y Fuji, respectivamente. Durante la temporada 2013/14 las mallas no redujeron significativamente el daño por sol en los frutos. Los resultados de este estudio sugieren que la malla Perla provee de mejores condiciones de luz para el desarrollo de color rojo de frutos en huertos de manzanos. No obstante, bajo las condiciones climáticas de Chile, ambas mallas (Roja y Perla) presentan una efectividad solo relativa para el control de golpe de sol en manzanas.

Summary Background UV radiation protection is an important health issue. Sophisticated sunscreen formulations have been developed to improve compliance. However, sunscreen is still inadequately applied, leaving large body areas without effective protection. Aim This study aims to validate a newly developed sunscreen application technique for adults and children. Methods Fifty-eight volunteers were recruited to participate in a monocenter, intraindividual, sequential, comparative study. The covering potential of their currently used sunscreen application technique and of a newly developed systematized application technique (Dose, Apply, Spread) were compared. Evaluation criteria included the amount of product applied, the homogeneity of sunscreen application as measured by the Wood's lamp, and the volunteers' appreciation of the new technique. Results Fifty-eight volunteers participated in the study: 20 women, 19 men, and 19 children. Respecting the new application technique resulted in a statistically significant (P

Summary The aim of this study was to determine the frequency of Merkel cell Polyomavirus (MPyV) and p63 positivity by immu-nohistochemistry in a large cohort of primary Merkel cell carcinoma (MCC) from a region with high rates of actinic damage. We also aimed to determine whether there is any relationship between these markers and histological correlates of chronic sun exposure and to identify whether these markers have prognostic significance in our population. Ninety-five cases of primary cutaneous MCC were identified and stained with immunohistochemical markers for MPyV and p63. The presence of solar elastosis and squamous dysplasia in the overlying/adjacent skin were recorded as markers of actinic damage. Follow up data were obtained from the Western Australian Cancer Registry. MPyV was detected by immunohistochemistry in 23% of cases. There was a statistically significantly lower rate of positivity in tumours associated with markers of chronic sun damage as assessed by the presence of solar elastosis and squamous dysplasia. There was no association with overall or disease specific survival. p63 positivity was detected in 17% of cases. There was no association with markers of actinic damage or with overall or disease specific survival. Our data demonstrate a significant difference in rates of immunohistochemical positivity for MPyV between MCC in sun-damaged and non-sun-damaged sites. This may go some way to explaining previously identified geographical differences. When compared with a number of studies from Europe and North America, p63 positivity is less common in our population and does not show the strong prognostic significance that has been found in these other regions.

Periungual basal cell carcinoma is rare and needs to be differentiated from other common diseases that affect this region. Several factors are associated with the development of this tumor, and sun damage seems to play an important role in its pathogenesis. Dermoscopy of clinically indolent lesions on the nail unit can shorten the diagnostic process and avoid destructive treatment and functional damage.

This study was designed to investigate the impact of a facial-ageing intervention on women's sun protection attitudes and behavioural intentions, compared to a health literature intervention where participants viewed literature on the effect of ultraviolet (UV) exposure on health. Seventy women (35 in each condition) completed questionnaires at baseline and immediately post-intervention. The average age of the participants was 23.70 (SD = 5.03) years. Participants in the facial-ageing intervention condition scored significantly higher on intentions, negative attitudes and perceived sun damage susceptibility after taking part in the intervention, compared to those in the health literature intervention condition. The results are discussed in relation to suggestions for sun protection interventions aimed at women aged from 18 to 34. It is concluded that appearance-based interventions have a role to play in healthcare and educational settings with regard to UV exposure and sun protection intentions.

A variety of pathologic variants of cutaneous squamous cell carcinoma (SCC) has been reported, and the signet-ring variant of cutaneous SCC is extremely uncommon. We reported an 83-year-old man with signet-ring SCC arising on the back of the finger. As far as we know, only 4 cases have been described in detail, and one dermatopathologic report focused on the presence of signet-ring cells briefly described in clinical data of 6 cases. Interestingly, in these reports, the skin lesions of 10 cases occurred exclusively in the head and neck area. This case involved a skin lesion on the back of the finger and is thus the first reported case of signet-cell cutaneous SCC that did not arise in the head and neck area. The location of this lesion, together with the histological findings compatible with actinic keratosis, support the hypothesis that the development of signet-ring SCC is related to ultraviolet light-induced damage.