Excessive Sun Exposure Research Articles

UJI AKTIVITAS GEL TABIR SURYA EKSTRAK ETANOL KULIT BUAH MANGGIS (Garcinia mangostana L.) DENGAN VARIASI GELLING AGENT CARBOPOL 940 SECARA IN VITRO

Excessive sun exposure is dangerous for humans because it has many detrimental effects on the eyes, immune system as well as on the skin. Sunscreen can prevent the harmful effects of UV radiation and free radicals. Flavonoid compounds in mangosteen rind have natural sunscreen activity. The purpose of this study was to determine the physical quality and stability and activity of the ethanol extract gel of mangosteen peel in vitro with variations of carbopol 940. The extract was obtained from the maceration process using 70% ethanol. The gel was formulated using 0.1% extract and 0.5% gelling agent variations; 1%; and 1.5%. Gel test parameters including organoleptic test, homogeneity, viscosity, pH, spreadability, adhesion stability test cycling test, and sunscreen gel activity test were carried out in vitro by measuring the value of Sun Protection Factor (SPF) using UV spectrophotometry. The results showed that the 0.1% mangosteen rind ethanol extract gel formulation with variations of the gelling agent carbopol 940 0.5;1 and 1.5% had good physical quality and stability as well as sunscreen activity with an SPF value of 41,099; 39,898; 39,270 with the ultra category.

A COMPARATIVE STUDY OF EFFICACY BETWEEN MODIFIED KLIGMANS FORMULA AND DERMAROLLER WITH TRANEXAMIC ACID IN TREATMENT OF MELASMA

Background:Melasma is a common hyperpigmentation disorder characterised by symmetrical, marginated, light to dark brown patches that occur mostly in sun exposed areas of skin, mostly on the face, occasionally affecting the neck and forearms. The exact cause of melasma is unknown, however many factors have been implicated in its etiopathogenesis, mainly sunlight, genetic predisposition, pregnancy and certain drugs. Among the factors mentioned above, excessive sun exposure is the most common cause. Objectives: To compare the therapeutic efficacy of topical tranexemic acid (TXA) with Microneedling versus topical modified kligmanÂ’s regimen in the treatment of melasma. Methodology: Patients diagnosed with Melasma of the face attending the Outpatient department Department of Dermatology, explained about the study procedure and benefits of the study before enrolment. Patients fulfilling the inclusion criteria were recruited for the study. Written informed consent was obtained from all patients who are willing to participate in the study in a prescribed format and well explained in the regional language before starting the study. Detailed medical history, clinical examination and essential lab investigations were performed on the participants. This study was conducted on 60 patients with melasma, randomly divided into two groups. In group A, each patient was subjected to a series of 3 sessions of skin microneedling and TXA application, whereas in group B , modified kligmanÂ’s regimen applied daily in the night . Results: At the end of 12 weeks melasma area severity index(MASI ) score was significantly decreased in both groups with statistically significant higher reduction of score in study group compared with control group . No significant adverse effect were observed in both treated sides. Conclusion: The result of the study show that topical tranexemic acid along with Microneedling could be safe and effective in melasma treatment.

KNOWLEDGE ATTITUDE AND PRACTICE ABOUT SUN-PROTECTION AND SUNSCREEN USAGE AMONG NURSING STUDENTS

Background: Photoprotection refers to safeguarding against UV rays as well as secondary variables like oxidative stress with the use of antioxidants, etc. Additionally, the harm done by UV radiations is one of the factors contributing to the public's rising rate of skin illnesses. Sunscreens are employed as photoprotective measures to guard against these dangerous UV rays. The effectiveness of it is signicantly inuenced by the sun protection factor. It is crucial that individuals are aware of the importance of wearing sunscreen, and numerous research have been done to examine this issue. To assess knowledge, attitude and practice towards sun protection and Objectives: sunscreen usage among nursing students. A cross-sectional, descriptive study using a specially designed Materials and Methods: questionnaire was conducted among nursing students in a tertiary care center. The questionnaire was completed and r Results: eturned by 200 females in the age range of 15-25 years. Only 88 out of 200 females were using sunscreens. Majority of the patients, 136(68%) belonged to rural background. Assessment of the sun exposure revealed that 130(65%)respondents reported daily sun exposure whereas 70 (35%) had occasional sun exposure. Assessment of the knowledge revealed that all of them 200 (100%) are aware of the adverse effects of excessive sun exposure but only 56(28%) were aware of the carcinogenic effect of sunlight.62 (31%) respondents reported that they use sunscreen on a daily basis.53 (26.5%) patient mentioned sunscreens are expensive and is the reason for not using them. Media was the most common source of information. 26 (13%) of them think sunscreens are harmful to the skin. 64 (32%) of them agree that wearing sunscreen can cause vitamin D deciency. Conclusion: This study shows that proper method of use of sunscreens is low among young females and suggests need of proper training about sunscreen and their usage and also need for general public health education program.

Clinicodermoscopic Study of Idiopathic Guttate Hypomelanosis at a Tertiary Care Hospital in Central India

Introduction: Depigmented skin lesions are commonly encountered in day-to-day practice and can cause significant social stigma. They are challenging to diagnose clinically and histopathologically. Idiopathic Guttate Hypomelanosis (IGH), a pigmentary condition commonly affecting older individuals, can lead to cosmetic deformity and have a significant psychological impact. Dermoscopic evaluation offers a quick and easy way to resolve diagnostic confusion and prevent unnecessary biopsies. Aim: To study the clinical and dermoscopic features of IGH. Materials and Methods: This cross-sectional observational study was conducted in the Department of Dermatology, Venereology, and Leprosy at Chirayu Medical College and Hospital, Bhopal, Madhya Pradesh (MP), India from July 2021 to June 2022. A total of 180 patients with IGH lesions underwent a detailed clinical history, dermatological and systemic examinations, followed by dermoscopic examination. The collected data were statistically analysed using Statistical Package for Social Sciences (SPSS) version 20.0, and the results were tabulated in terms of distribution, frequency, and mean±Standard Deviation (±SD). Results: Among the 180 patients, the most affected age group was 51-60 years. A total of 108 (60%) were females and 72 (40%) were males. The most common site of involvement was the distal part of the lower extremity in 152 (84.4%) cases, followed by the distal part of the upper extremity in 115 (63.8%) cases. A total of 46 (25.5%) patients had a history of excessive sun exposure. Additionally, 21 (11.6%) patients had other associated features of photoaging, such as xerosis, solar lentigo, seborrhoeic keratosis, freckles, and actinic keratosis. The most common dermoscopic pattern observed was amoeboid in 103 (57.2%) patients, followed by feathery in 41 (22.7%), petaloid in 23 (12.7%), nebuloid in 13 (7.2%), and a combination of patterns in six percent of patients. Conclusion: The IGH was more common in females and older age groups, with the distal parts of the lower extremity being the most frequently involved site. Excessive sun exposure was a common risk factor for IGH, and several patients may have associated signs of photoaging. The most common dermoscopic pattern observed was amoeboid. Therefore, clinical dermoscopic examination can be helpful in identifying IGH and differentiating it from other depigmented lesions.

Unilateral maculopathy after excessive sun exposure

Unilateral maculopathy after excessive sun exposure

Proportion of Co-morbidities in Patients with and without Bullous Pemphigoid: A Cross-sectional Study

Introduction: Bullous Pemphigoid (BP) is the most common subepidermal immunobullous disorder. It has been found to be associated with various co-morbidities. Only a few studies have been done previously, to find out the association between BP and these co-morbidities. A better understanding of the various comorbidities in BP patients, enables to implement better treatment strategies, which will be more efficacious and less toxic. Aim: To compare the proportion of co-morbidities in patients with and without BP and to study the triggering factors associated with BP. Materials and Methods: This was a hospital based crosssectional study conducted in the Department of Dermatology and Venereology at Government Medical College and Hospital, Trivandrum, Kerala, India. The duration of the study was one year and six months, from January 2020 to June 2021. A total of 80 patients were included in the present study, out of which 40 patients with BP were included in case group and 40 patients without BP in control group. Clinical data such as age, gender, habits, co-morbidities and factors triggering BP were recorded. Categorical and quantitative variables were expressed as frequency (percentage) and mean±SD respectively. Chi-square test and Fisher’s-exact test were used to find association between categorical variables and (p-value<0.05) was considered as statistically significant. Results: The mean age of the study participants was 60.8±10.5 years. A total of 23 (57.5%) patients and 20 (50%) normal subjects had a history of co-morbid illness. Diabetes, hypertension, neurological disorders, Coronary Artery Disease (CAD) and Chronic Kidney Disease (CKD) were the co-morbidities reported by the patients. Diabetes was the most commonly observed co-morbidity among the patients. A statistically significant difference was noted between the case and control group in terms of diabetes (p-value=0.039) and neurological disorders (p-value=0.011). A total of 34 (85%) patients had atleast one factor which triggered the onset of the disease, and the most common triggering factor was drug intake in 22 (55%) patients. Conclusion: The most commonly observed co-morbidity among patients with BP in the present study was diabetes. A prompt surveillance and adequate control of glycaemic status is needed in these patients in order to avoid further worsening of diabetes with corticosteroid therapy. Avoidance of various exogenous triggers such as disease worsening drugs, stress, excessive sun exposure etc., will help in achieving better control of the disease.

Bunch protection techniques against thermal increase linked to climate change

Increases in temperature and solar radiation, associated with climate change, can cause damage to the berry that causes processes of discoloration, dehydration, cracking or raisining, which can have a negative impact on the oenological potential of the harvest. This damage is called “sunburn” and occurs with some frequency in sensitive varieties such as Graciano. In order to mitigate these impacts, a shading technique has been proposed using protection nets that try to prevent the bunches from receiving excessive sun exposure. The experience shown in this work has been carried out during the years 2021 and 2022, using nets with shading capacity of 50% and 70%. The results have shown that the nets have significantly reduced the temperature of the bunch, also avoiding damage from sunburn. Besides, the organic acid content of the must has reached slightly higher values in the treatments with netting, compared to the control, but not significantly. In wine, the polyphenolic load has shown a variable behavior depending on the year, possibly conditioned by the variations in yield linked to the sunburn. The tasting panel has shown a certain inclination towards the wines from the net treatments in both campaigns.

A postulated model for photoimmunopathogenesis of chronic actinic dermatitis around adaptive immunity, including Th17 cells, Tregs, TRMs, cytotoxic T cells, and/or common-γ chain receptor+ cells.

The pathogenesis of chronic actinic dermatitis (CAD) is more complicated than other photodermatoses. However, the relationship between the clinical severity of CAD and the offending photocontact or contact allergens or both, and the correlations of CAD immunopathogenesis with the immunoregulatory molecules involved in adaptive immunity are yet to be investigated. We performed phototesting with broad-spectrum ultraviolet (UV) B, UVA, and visible light to establish the presence of photosensitivity in 121 patients with CAD, together with photopatch and contact patch testing. Nine patients with CAD were selected according to their clinical severity score for CAD (CSS-CAD), and triple direct immunofluorescence analysis was performed with paraffin-embedded skin biopsy samples. As CSS-CAD was closely correlated with the multiplicity of photo(contact) allergens, particularly photoallergens, three or more photoallergens were detected in the severe CAD group (52.5%); less in the moderate group (32.8%); and only one in the mild group (14.8%; P=.025). In the groups showing greater severity of disease, the absolute numbers of IFN-γ+ , IL-17+ , CD4+, CD8+, common-γ chain receptor (common-γCR)+ , and CD69+ tissue-resident memory cells increased on average; there was also an increase in the CD4+/CD8+ cell ratio, with the more severely affected groups. However, the levels of TNF-α+ and FoxP3+ regulatory T (Treg) cells and the mean IL-17/IFN-γ cell ratio decreased in the more severely affected CSS-CAD subgroups. Based on the clinical analysis and immunopathogenic results, avoidance of excessive sun exposure, and topical and systemic blocking agents for photo(contact) allergens are recommended. Additionally, conventional immunomodulators and emerging agents including JAK-STAT inhibitors may be administered for CAD treatment in the future.

Innovative, Modular Building Facades - as a Tool to Counteract The Effects of and to Prevent Climate Change

The paper presents original research, encompassing the results of analyses of modular building façade solutions, as well as innovative design concepts based on these results by students of the Faculty of Architecture at the Poznań University of Technology. Adapting architecture to climate change is the main objective behind research and innovative designs. Reduction of carbon dioxide emissions, thermal comfort of buildings, better thermal environment ergonomics for users of buildings’ interiors, increased energy efficiency together with the use of renewable energy sources are major challenges for today’s designers. Dealing with rainwater, wind and pressure changes are already absolute necessities. Contemporary trends in modern construction in urban areas were identified on the basis of results of analyses of selected existing buildings, presented using tables, graphs and statistical tools. Conclusions from the demonstrated correlations of quantitative data with social, economic and environmental factors became the basis for the students’ conceptual assumptions. The selected innovative façade designs presented in the article demonstrate a variety of solutions for modern modular systems which protect buildings from excessive sun exposure, help insulation resist external factors, generate energy, ventilate buildings, use pressure differences, collect water, purify air, protect fauna, etc. As a result, the developed concepts may be indicative of a contemporary approach to sustainable building design, based not only on reducing any negative environmental impact and conserving natural resources, but also on designing aesthetic buildings based on classic notions of beauty.

Test the Potential of Macadamia Nut Oil (Macadamia F. Muell) As Sunscreen in Cream Preparations In Vitro

Background: Sunlight has a beneficial effect by activating provitamin D3 found in the epidermis of the skin to become vitamin D3. However, excessive sun exposure can also have detrimental effects, especially on the skin. Macadamia nut oil contains vitamin E (tocotrienols and tocopherols) which are natural antioxidants. Macadamia nut oil also contains linoleic acid which is great for softening the skin, regenerating skin cells, moisturizing the skin, and is a natural anti-inflammatory. and helps restore skin barrier function and reduce transepidermal water loss (TEWL). Objectives: To determine whether there is a sunscreen potential from macadamia nut oil, the difference in the SPF value is significant between cream preparations with the addition of macadamia nut oil in various concentrations and to determine the sunscreen category of each macadamia nut oil formulation. Methods: This research was carried out experimentally, including the preparation of macadamia nut oil lotion, pH test, irritation test, and in vitro determination of the SPF (sun protection factor) number using a UV-Vis spectrophotometer. Results: The addition of macadamia nut oil combined with oxybenzone and octylmetoxycinamate in cream preparations has an average SPF value of F1 (blank) of 9.97; F2 (blank + 2% oxybenzone + 5% octyl methoxycinamate) of 23.14; F3 (1% macadamia nut oil) of 29.39; F4 (5% macadamia nut oil) of 32.99; and F5 (10% macadamia nut oil) of 37.59. The addition of macadamia nut oil in various concentrations gave a significant difference in increasing the SPF value between each formula combined with oxybenzone and octylmetoxycinamate. Conclusion: The addition of macadamia nut oil can increase the effectiveness of the combination oxybenzone and octylmetoxycinamate sunscreen in cream preparations.

TO ASSESS THE EFFECTIVENESS OF SHORT BURST APPLICATION OF 0.05% FLUTICASONE CREAM IN PREVENTING DYSCHROMIA DUE TO SUPERFICIAL CUTANEOUS PROCEDURES

Background Topical corticosteroids are known for their anti-inammatory effect. Post-procedural dyschromia is a very common in skin of colour and people with excessive sun exposure. In our study we assessed the effect of prior application of uticasone 0.05 % cream in different time period on post procedural dyschromia. This was a single-center, open-label, prospective c Methods ase-control study in which consecutive subjects suffering from small lesion of face (DPN or Milia), belonging to the age group of 18 years and above were recruited. The three equal study Groups-A, -B and -C received 4 hours, 12 hours and no application of uticasone 0.05% cream prior to procedure. Clinical progression and effect on post procedural dyschromia was assessed in follow-up visit after 1 week and 2 week respectively. In our study, we could not found any Results signicant effect of prior applicantion of topical corticosteroid cream over post procedural dyschromia. Our study suggests that Conclusion: uticasone 0.05% cream is ineffective in preventing post procedural dyschromia Summary: Ÿ Post procedural dyschromia is a major complication after removal of smaller leions of face. Ÿ No study was available to address the effect of prior application of topical corticosteroid over the appearance of Post procedural dyschromia Ÿ We have assessed efcacy of short burst application of uticasone 0.05% cream in preventing post-procedural dyschromia (hyper and hypopigmentation)

Chronic actinic dermatitis: A 5-year clinical analysis of 488 patients in China.

Chronic actinic dermatitis (CAD) is a spectrum of diseases with chronic photosensitivity occurring mostly among middle-aged and older men. We seek to explore the characteristics and pathogenesis of CAD among the Chinese population. The medical records of 488 CAD cases diagnosed by phototesting at Huashan Hospital, Fudan University from January 2014 to December 2018 were analyzed retrospectively. Among the 488 patients, 344 were male and 144 were female. 84.8% of the cases were over 40 years old at the age of onset, while the remaining with an early age of onset had a prevalence of atopic history of 21.6%. Up to 45.0% of the patients reported excessive sun exposure and outdoor activities before the initiation of symptoms. The typical skin lesions were erythema, papules and plaques laid predominantly in sun-exposed areas. 42.8% of the cases showed sensitivity to UVB only, 20.7% were both sensitive to UVA and UVB, and 18.2% had UVA sensitivity only. The most predominant photoallergens were chlorpromazine (80.1%), thimerosal (17.2%), potassium dichromate (12.7%), etc. The most prevalent patch test allergens were potassium dichromate (24.4%), thimerosal (20.5%), formaldehyde (16.8%), etc. CONCLUSIONS: CAD was more commonly seen in males over 40 years old. The action spectrum of Chinese patients is primarily in the UVB range. Exposure to excessive sunlight or contact allergens and photoallergens are important risk factors. Photobiology tests are essential in detecting photosensitivity and recognizing potential photosensitizers. Early avoidance of confirmed photoallergens and sun exposure may prevent photosensitive reactions from progressing into persistent photosensitivity.

Development of Emulsion Gel Sunscreen Containing Olive Oil and Clove Oil

Sunlight contributes to the healing of multiple health conditions, including in respiratory diseases such as Covid-19, by boosting the immune system. Nevertheless, too much sun exposure can cause sunburn and lead to skin cancer. To minimize the harms of excessive sun exposure, the skin needs to be strictly shielded with the use of sunscreen. This study aimed to develop an olive oil and clove oil emulsion gel preparation and determine its sun protective factor (SPF) value. Olive oil was formulated into an emulsion gel with varying concentrations of 2%, 4%, and 6%, and then 5% of clove oil was added. Physicochemical properties such as organoleptic, homogeneity, pH values, viscosity, and spreadability were tested. Further, UV protection was examined based on determining the SPF value, and the stability of preparation was evaluated using real-time and freeze-thaw methods. The results showed that the preparation had a good physicochemicality, while the SPF value was 20.91 ± 0.29, 22.52 ± 0.52, and 23.39 ± 0.45, respectively. However, the results of the stability test showed a significant change in the pH and SPF value after storage. It can be concluded that the emulsion gel of olive oil and clove oil preparation could be considered to have a medium level of protection of sunscreen.
 Keywords: olive oil, clove oil, emulsion gel, sunscreen, UV protection, stability

33127 A cross sectional examination of sunburn incidence in the context of race/ethnicity and skin type

Sun exposure is physiologically necessary, yet excessive amounts can be detrimental to skin, causing photoaging, sunburn, and skin cancer. Sunburn, presenting as delayed onset erythema, has been partially characterized for Caucasians, however the impact of excessive sun exposure has been less studied across race/ethnicity and skin tones. Herein, we present findings from a survey conducted across the United States, where sunburns were examined in a racially and ethnically diverse sample of 3597 participants spanning the Fitzpatrick skin phototype (FSP) scale.

Knowledge, attitudes and practices of the general puplic toward the harmful effects of sun exposure and protection

Background; Excessive unprotected sun exposure is a significant risk factor for skin damage and skin cancers. In recent decades, the incidence of skin cancer has increased dramatically worldwide, reaching epidemic proportions. Sun protection is a key primary preventive strategy against skin cancer and skin damage induced by sun exposure. Aim and objectives; was to determine the knowledge, attitudes and behaviors of individuals on the harmful effects of the sun and protection ways. Subjects and methods; this study was a cross-sectional study conducted on 104 males and 316 females who attended Menoufia university dermatology clinic and some of the employments (physicians , nurses and officers)in the Menoufia university hospitals and some of the students. Result; the mean age of the studied participant was 31.30±7.55 and the majority of them were females (75.2%). There were significant bad sun habits and lower sun protection behavior (indicated by increasing SEPI part I score which was 10.22±3.63). Also, there was significant decreasing propensity to increase sun protection (indicated by increasing SEPI score part II) in males than females, unmarried than married persons, with low levels of education in the studied participants.

Survey of Knowledge, Attitude, and Practice of Female High School Students Regarding Sun Protection in Birjand, Iran

Background: Excessive sun exposure in childhood and adolescence is an important factor in skin cancer. Objectives: This study aimed to determine the knowledge, attitude, and practice of female high school students in Birjand, Iran, regarding sun protection behaviors and investigate the effect of various environmental and demographic factors. Methods: This descriptive cross-sectional study was performed on female high school students in Birjand within October to January 2018 using the stratified cluster random sampling method. The data collection tool was a researcher-made questionnaire containing various items related to knowledge, attitude, and practice, the validity of which was confirmed. Information was also obtained on the geographical location of the school, field of study, grade, grade point average, and parents’ educational level. The data were analyzed using SPSS software (version 22) based on descriptive-analytical analyses. Results: Out of a total of 576 students, 26.7%, 89.1%, and 53.6% had good knowledge, attitude, and practice of skin protection against ultraviolet rays. The practice scores of southern and western school students with better socioeconomic status were higher than in other geographic regions (P < 0.001). The students in experimental sciences had higher knowledge (P = 0.01), and students in humanities had a higher attitude (P = 0.03) and practice (P = 0.007) than the other two disciplines. The third-grade students scored higher on knowledge (P < 0.001). The students whose mothers had university education scored higher in knowledge, attitude, and practice. Moreover, those whose fathers had a university education scored higher in practice. Knowledge and attitude had a significant relationship with practice; attitude had a higher coefficient. Conclusions: Practice can be improved by increasing the levels of knowledge and attitude. The educational level of the parents, especially mothers, is very important in this regard.

Revisiting the melanomagenic pathways and current therapeutic approaches.

Melanoma is one of the most aggressive forms of skin cancer with a steady increase in global incidence and mortality rate over the past five decades. Paradoxically, both reduced and excessive sun exposure has been linked to increased risk of melanoma incidence and death. Although the histological classification of melanoma is useful in diagnosis, its molecular subtypes are often determined by somatic mutations, which could be UV-dependent or -independent. Multiple genes involved in cancer development are often mutated dysregulating molecular pathways with concomitant phenotypic heterogeneity. Hence, treating melanoma has been a challenge, with patients experiencing poor clinical outcomes to current therapeutic options. This presents an unmet need to understand the interaction of molecular networks underpinning melanogenesis. This review describes the crosstalk of signaling cascades in melanoma development and the putative druggable targets, with the view of elucidating newer and better therapeutic strategies for the disease.

The Effects of Using the Sun Safe App on Sun Health Knowledge and Behaviors of Young Teenagers: Results of Pilot Intervention Studies.

A balanced approach toward sun exposure and protection is needed by young people. Excessive sun exposure increases their risk for skin cancers such as melanoma, whereas some exposure is necessary for vitamin D and healthy bones. We have developed a new iOS smartphone app-Sun Safe-through a co-design process, which aims to support healthy and balanced decision-making by young teenagers (aged 12-13 years). The aim of this study was to test the capacity of Sun Safe to improve sun health knowledge and behaviors of young teenagers in 3 pilot intervention studies completed in 2020. Young teenagers (aged 12-13 years; N=57) were recruited through the web or through a local school via an open-access website and given access to Sun Safe (29/57, 51%) or a placebo (SunDial) app (28/57, 49%). Participants completed sun health questionnaires and knowledge quizzes before and after the 6-week intervention (either on the web or in class) and rated the quality of the app they used via a survey. Of the 57 participants, 51 (89%) participants (26, 51% for placebo arm and 25, 49% for the Sun Safe arm) completed these studies, with most (>50%) reporting that they used a smartphone to access their designated app either "once a fortnight" or "once/twice in total." Improved sun health knowledge-particularly about the UV Index-was observed in participants who were given access to Sun Safe compared with those who used the placebo (-6.2 [percentage correct] difference in predicted means, 95% CI -12.4 to -0.03; P=.049; 2-way ANOVA). Unexpectedly, there were significantly more sunburn events in the Sun Safe group (relative risk 1.7, 95% CI 1.1-1.8; P=.02; Fisher exact test), although no differences in time spent outdoors or sun-protective behaviors were reported. COVID-19 pandemic-related community-wide shutdowns during April 2020 (when schools were closed) reduced the time spent outdoors by >100 minutes per day (-105 minutes per day difference in predicted means, 95% CI -150 to -59 minutes per day; P=.002; paired 2-tailed Student t test). Sun Safe was well-rated by participants, particularly for information (mean 4.2, SD 0.6 out of 5). Access to the Sun Safe app increased sun health knowledge among young teenagers in these pilot intervention studies. Further investigations with larger sample sizes are required to confirm these observations and further test the effects of Sun Safe on sun-protective behaviors.

Prospecting In Vitro Antioxidant and Photoprotective Properties of Rosmarinic Acid in a Sunscreen System Developed by QbD Containing Octyl p-Methoxycinnamate and Bemotrizinol

Progressively growing diagnoses of skin cancer trigger public health concerns about excessive sun exposure, awareness of the deleterious effects of ultraviolet (UV) radiation on the skin, and the proper use of sunscreens. Studies show that bioactive molecules, such as rosmarinic acid (RA), may potentiate the photoprotective and antioxidant activity of topical formulations. This research presents the application of the concepts of quality by design (QbD) to evaluate the critical parameters of quality and the development of an optimized cosmetic formulation with RA by means of an understanding of product design space. Samples were developed using design of experiments (DoE) and they were evaluated for in vitro antioxidant activity and photoprotective efficacy, as well as for photostability through artificial irradiation. We were able to achieve the RA performance regarding antioxidant and SPF properties through in vitro experiments. We obtained the equations for predicting the in vitro antioxidant activity and SPF. Considering our sunscreen system, developed with octyl p-methoxycinnamate and bemotrizinol, the presence of RA increased its antioxidant capacity; however, the in vitro SPF was reduced when both UV filters were used. The development of multifunctional sunscreens is of utmost importance; moreover, there is a need for the rational development of formulations that ensure representative statistical tests of the effects and interactions among the components of a formulation on the desired critical quality attributes, including efficacy.

Topical Pharmacotherapy for Actinic Keratoses in Older Adults.

Actinic keratosis is caused by excessive lifetime sun exposure. It must be treated, regardless of thickness, because it is the biologic precursor of invasive squamous cell carcinoma, a potentially deadly malignancy. Physical ablative techniques such as cryotherapy, lasers, and curettage are the most used treatments for isolated lesions. Multiple lesions are treated with topical drugs, chemical peelings, and physical techniques. Drug preparations containing diclofenac plus hyaluronate, aminolevulinic acid, and methyl aminolevulinate and different concentrations of imiquimod and 5-fluorouracil are approved for this clinical indication. All treatments have a good profile of efficacy and tolerability although there are relevant differences in the clearance rate, tolerability, and type and frequency of adverse effects. In addition, they have very different mechanisms of action and treatment protocols. No differences in the efficacy and tolerability were found in older patients compared with younger patients, therefore no dose adjustments are needed. That said, older patients often need to be motivated to treat actinic keratoses and a careful attention to expectations, needs, and preferences should be used to obtain the maximal adherence and prevent treatment failure. This goal can be achieved with a careful evaluation not only of published efficacy, toxicity, and tolerability data but also of practical topics such as the frequency of daily applications, the overall duration of therapy, and the need for a caregiver. Finally, particular attention must be paid in the case of frail patients and immunosuppressed patients.