Prolonged Sun Exposure Research Articles

Predicting Children's Sunscreen Use: Application of the Theories of Reasoned Action and Planned Behavior

Background. Skin cancer remains the most common form of cancer in the United States despite the fact that most cases can be prevented by limiting sun exposure. Childhood and adolescence are periods of life during which prolonged sun exposure is particularly common. Accordingly, promoting sun-protective behaviors during these formative years can be of critical importance in preventing skin cancer. The present study applied the theories of reasoned action and planned behavior to the understanding of children's sunscreen use. Based on these theories, it was hypothesized that attitudes, subjective norms, and perceived behavioral control would be related to intentions to use sunscreen, which, in turn, would be related to actual sunscreen use.Methods. Questionnaires measuring sun-related attitudes, beliefs, perceived control, and intentions were administered to 199 fourth graders (ages 9 to 13, mean = 10.3) attending public schools in Florida. Self-report measures of sun-related behavior were administered to the same subjects 1 month later.Results. Results of correlational analyses were consistent with study hypotheses. Higher rates of sunscreen use at follow-up were predicted by stronger intentions to use sunscreen assessed 1 month previously. In addition, stronger intentions to use sunscreen were found to be related to more favorable attitudes toward sunscreen use, stronger beliefs that peers and parents favored sunscreen use, and greater perceptions of personal control in using sunscreen. Path and multiple regression analyses identified direct and indirect relationships among study variables that partially confirmed those predicted by the theories and provided support for the use of an expanded model that included perceived behavioral control.Conclusions. The present study confirmed hypotheses derived from the theories of reasoned action and planned behavior regarding the relation of attitudes, subjective norms, and perceived behavioral control to sunscreen use among fourth graders. In addition to their theoretical significance, these findings suggest ways to intervene at the individual, classroom, and family levels to promote greater sunscreen use in this age group.

Palmar spiny keratoderma associated with type IV hyperlipoproteinemia

We report the case of a 35-year-old man with acquired palmar spiny keratoderma (SK) in association with type IV hyperlipoproteinemia. Cutaneous lesions appeared 11 years before with no history of any previous skin conditions, topical medication or systemic treatment with Vitamin A-derived drugs, x-irradiation, arsenic poisoning or prolonged sun exposure. Family aggregation for SK or other disorders of keratinization was ruled out. Blood chemistries demonstrated hypertriglyceridemia (422 mg/dl) and elevation in plasma concentration of the pre-β fraction (VLDL) of lipoproteins pattern compatible with a type IV hyperlipoproteinemia. Family aggregation for this metabolic defect was then confirmed. The histologic hallmark of the `spine' lesion was a compact column of hyperparakeratotic cells (columnar hyperparakeratosis) continuous with a hypogranular layer, without further evidence of dyskeratotic or vacuolated keratinocytes and inflammatory cells in the corresponding dermis. SK represents a well-definite entity which fulfills precise clinico-histologic criteria. However, three main questions are related to SK: differential diagnosis with porokeratosis on histologic examination (columnar hyperparakeratosis or hyperorthokeratosis alone in SK vs. cornoid lamella accompanied by remarkable dermoepidermal changes in porokeratosis); classificative scheme (proper nomenclature to avoid misleading and confounding names); and nosological arrangement (probably two subsets exist: hereditary or benign; and acquired, or idiopathic, which may be paraneoplastic in about 50% of the patients). To the best of our knowledge this is the first case reporting the association between SK and a metabolic impairment although the real connections linking these conditions are still unclear.

Palmar spiny keratoderma associated with type IV hyperlipoproteinemia

We report the case of a 35-year-old man with acquired palmar spiny keratoderma (SK) in association with type IV hyperlipoproteinemia. Cutaneous lesions appeared 11 years before with no history of any previous skin conditions, topical medication or systemic treatment with Vitamin A-derived drugs, x-irradiation, arsenic poisoning or prolonged sun exposure. Family aggregation for SK or other disorders of keratinization was ruled out. Blood chemistries demonstrated hypertriglyceridemia (422 mg/dl) and elevation in plasma concentration of the pre-beta fraction (VLDL) of lipoproteins pattern compatible with a type IV hyperlipoproteinemia. Family aggregation for this metabolic defect was then confirmed. The histologic hallmark of the 'spine' lesion was a compact column of hyperparakeratotic cells (columnar hyperparakeratosis) continuous with a hypogranular layer, without further evidence of dyskeratotic or vacuolated keratinocytes and inflammatory cells in the corresponding dermis. SK represents a well-definite entity which fulfills precise clinico-histologic criteria. However, three main questions are related to SK: differential diagnosis with porokeratosis on histologic examination (columnar hyperparakeratosis or hyperorthokeratosis alone in SK vs. cornoid lamella accompanied by remarkable dermoepidermal changes in porokeratosis); classificative scheme (proper nomenclature to avoid misleading and confounding names); and nosological arrangement (probably two subsets exist: hereditary or benign; and acquired, or idiopathic, which may be paraneoplastic in about 50% of the patients). To the best of our knowledge this is the first case reporting the association between SK and a metabolic impairment although the real connections linking these conditions are still unclear.

High prevalence of skin cancer in World War II servicemen stationed in the Pacific theater

A large proportion of our World War II patients with skin cancer had been stationed in the Pacific. Our purpose was to determine whether a statistically greater number of World War II servicemen with skin cancer were stationed in the Pacific than the number stationed in Europe. In a consecutive survey of 370 World War II servicemen with skin cancer who were stationed abroad, place of service, skin cancer types, skin type, ethnic background, and estimated average hours outdoors per day during their lifetime were determined. The number of veterans stationed in the Pacific and the number stationed in Europe with respect to these data were analyzed with the chi-square test. A statistically significantly greater number of Pacific veterans than Europe veterans had basal cell or squamous cell carcinomas. A few months to a few years of prolonged sun exposure in a high-sun-intensity area may result in skin cancer development many years after exposure.

Ultraviolet carcinogenesis: environmental effects of ozone depletion.

Ultraviolet (UV) radiation is a useful agent in the study of skin carcinogenesis. The radiation administered in experiments may be selected for spectral composition and measured accurately (Forbes et al. 1982). The doses of UV radiation given to experimental animals may be in the same range as those received by people in daily life. The tumors induced appear on the skin and are accessible to observation from an early stage. In hairless mice, the tumors caused by UV radiation are predominantly squamous cell carcinomas, which are also found in human skin after prolonged sun exposure. Experimental studies make it possible to investigate the influence of wavelength, dose (de Gruijl et al. 1983), dose rate, etc. The wavelength-dependence, or “action spectrum,” is becoming known to a better approximation step by step. It extends throughout the entire UV wavelength range, with wavelengths differing in effectiveness by up to 4 orders of magnitude (de Gruijl and van der Leun 1992). The dose-effect relationship found in experiments with mice is basically of the same type as found in human epidemiology.

Intensification of ultraviolet-induced dermal damage by infrared radiation.

Abnormal dermal deposition of elastic fibers is the earliest and most striking effect of prolonged sun exposure (solar elastosis). The hyperplastic fibers are usually ascribed to ultraviolet (UV) rays. Nonetheless, other portions of the solar spectrum may play contributing roles. Heat, for example, enhances experimental UV tumorigenesis. Heat induces erythema ab igne in which the structural alterations resemble those of actinically damaged skin, including the development of premaligant and malignant lesions. In regions of high insulation, infrared radiation (IR) is a constant companion of UV. To assess the role of IR in actinic damage to the dermis, albino guinea pigs were irradiated for 45 weeks with UV-B and UV-A, with and without IR. Control animals received IR only or no irradiation at all. Unirradiated dermis contains small amounts of elastic fibers in the upper dermis with greater depositions around follicles and sebaceous glands. After irradiation with UV, the fibers became more numerous, thicker, and more twisted; IR alone produced many fine, feathery fibers. The addition of IR to UV resulted in dense matlike elastic fiber depositions that exceeded what was observed with either irradiation alone. In combination or alone UV and IR radiation produced a large increase in ground substance, a finding also seen in actinically damaged human skin. Infrared radiation, in the physiologic range, though pleasant is not innocuous.