White Skin Research Articles

Representation of diverse skin tones in Nelson's Textbook of Pediatrics.

Physicians are trained to visually recognize disease using images. Many pediatric dermatologic conditions are initially identified and treated by pediatricians, who need to diagnose on varied skin tones. The objective was to evaluate if figures depicting cutaneous disease in the preeminent pediatrics textbook reflect diverse skin tones. Figures depicting dermatologic findings in Nelson's Textbook of Pediatrics were assessed using the Fitzpatrick, Massey-Martin, and Color Bar scales. The distribution was compared to the US population using American National Election Survey 2012 data. The three scales were compared for concordance. Statistical analysis included chi square with P < 0.05 significant. Of 515 figures, 484 were classifiable. Light skin tones were depicted in 453 (93.6%) by Fitzpatrick, 364 (75.2%) by Massey-Martin, and 406 (83.9%) by Color Bar, moderate tones in 92 (19.0%) by Massey-Martin and 53 (11.0%) by Color Bar, and dark tones in 31 (6.4%) by Fitzpatrick, 28 (5.8%) by Massey-Martin, and 25 (5.2%) by Color Bar. The textbook skin tone distribution did not reflect the US population: light 75.2% vs. 63.3%, moderate 19.0% vs. 25.8%, dark 5.8% vs. 11.0%, respectively (P < 0.00001). The three scales yielded consistent proportions for light/moderate vs. dark tones (P = 0.71). Certain conditions were mostly depicted on dark (burns, leprosy, urticaria pigmentosa) or light skin (psoriasis, acne, hemangioma, molluscum, herpes, keloid). Figures demonstrating dermatologic manifestations are predominantly depicted on light skin tones, and are not representative of the US population. Certain conditions were more commonly shown on dark or light skin tones, unrelated to epidemiology.

Are you what you emoji? how skin tone emojis and profile pictures shape attention and social inference processing

Emojis can express emotions and some aspects of the sender’s identity; however, only limited research has explored how the choice of skin tone in emojis influences the perceptions of the users. We examined the interaction between emoji skin tones and profile pictures in instant messaging, using self-reported and eye tracking measures. White participants viewed 14 screenshots of conversations (9 target and 5 fillers) where the sender used an emoji in a Darker or Lighter skin tone, or the default Yellow; alongside profile pictures displaying a Black or White individual, or a landscape as a neutral condition. Results showed that Black senders using Darker emojis were seen as warmer and closer to the receiver, but less competent, suggesting a dimensional compensation effect. Conversely, Black senders using Lighter emojis appeared more competent, but less warm. In the Neutral condition, Lighter emojis improved warmth and relationship quality, but reduced competence inferences, unlike Yellow and Darker emojis, suggesting a black sheep effect (in-group strictness). Yellow emojis were assumed to be sent by White individuals. Eye-tracking measures revealed an implicit bias towards White senders using Darker emojis, although such an impact was not observed for Black senders using Lighter emojis. Overall, findings indicate that skin tone emojis and profile pictures influence sender perception and challenge the neutrality of Yellow emojis.

Formulasi dan Evaluasi Ekstrak Aseton Kulit Putih Semangka Merah Non Biji (Citrullus Vulgaris S) dengan Niacinamide sebagai Gel Pelembab Kulit dengan Uji Kelembapan

This research was carried out with the aim of identifying the content of phytochemical compounds of alkaloids, flavonoids, tannins and saponins in the acetone extract of seedless red watermelon rind (Citrullus vulgaris), knowing the results of evaluating the physical properties of the acetone extract gel of seedless red watermelon rind (Citrullus vulgaris) with niacinamide against various concentrations of moisturizing gel preparations, and comparing the best moisture test concentration on acetone extract gel preparations of seedless red watermelon rind (Citrullus vulgaris) in providing optimal results. This research is a laboratory study of the experimental formulation of acetone extract of seedless red watermelon rind (Citrullus vulgaris) to determine the formulation and concentration of the best extract produced. The research results showed that acetone extract from the white skin of red seedless watermelon (Citrullus vulgaris) contained phytochemical compounds alkaloids, flavonoids, and polyphenol as well as lycopene in the white skin of red seedless watermelon (Citrullus vulgaris). The results of the evaluation of the physical properties of the acetone extract gel of seedless red watermelon rind (Citrullus vulgaris) in the negative control, 2.5% concentration, 5% concentration, and 7.5% concentration met the test requirements but did not meet the spreadability test requirements. And the best concentration of water content test in the acetone extract gel preparation of seedless red watermelon rind (Citrullus vulgaris) in providing optimal results is found in the gel preparation with a concentration of 7.5%.

Knowledge, Prevalence and Determinants of the Use of Skin-Lightening Creams among University Undergraduates in Babcock University

The quest for lighter skin has become a dangerous obsession fueled by societal beauty standards and cultural norms. The purpose of this study was to analyze the inspiration prompting the use of these products among undergraduate students using descriptive research surveys. This study examined the knowledge, prevalence and determinant of the use of skin lightening creams among three hundred and thirty (330) undergraduates of Babcock University, Ilishan-Remo. through a simple random sampling technique using self-structured questionnaires. Data was collected with the use of SPSS and frequency count. Pearson correlation was used to draw conclusions on the hypothesized statement of study. The researcher found a significant relationship between knowledge of skin lightening creams and its determinant of use, with over half of respondents (56.37%) agreeing that lightening creams could cause kidney failure. Treatment of hyperpigmentation was the motivating factor among 57.58% of respondents. There is therefore a need for undergraduate students to be provided with adequate education regarding the dangers of skin lightening creams and be encouraged to visit appropriate health facilities for skin disorders instead of self-meditating.

Dermoid Cysts of the Auricle: A Review of the Literature.

Dermoid cysts are congenital anomalies that contain ectodermal elements such as teeth, bone, and nerves. The purpose of this study was to identify trends in the characteristics of dermoid cysts of the auricle and the demographics of the patient population they affect. A PubMed and EMBASE search for English-language publications that included cases of dermoid cyst(s) of the auricle from database inception to October 2022 was performed. A total of 38 cases of dermoid cysts of the auricle were identified from 20 publications. The age, sex, and Fitzpatrick skin type of the patients, locations of the dermoid cysts, associated anomalies, treatment methods, and postoperative outcomes were examined. Patients' ages ranged from 0 to 63 years, with 27.6% (8/29) in the 0-17 age range. 56.8% (21/37) were reported as male. Dermoid cysts were frequently present on the postauricular surface (18/24, 75.0%) and on light skin (Fitzpatrick types I-III; 18/22, 81.8%). Unilateral dermoid cysts were more commonly reported on the right ear (17/22, 77.3%); only one patient had bilateral cysts. Associated anomalies included microtia, prominent ears, foot polysyndactyly, hemifacial microsomia, and cryptotia. All auricular dermoid cysts were managed with complete surgical excision, and no postoperative complications or recurrences were reported. Dermoid cysts of the auricle are reported more frequently in individuals with lighter skin; however, this is likely due to reporting bias. Complete surgical excision can be used to treat patients successfully, with a very low risk of complications and no need for preoperative imaging.

Why robot embodiment matters: questions of disability, race and intersectionality in the design of social robots.

A growing minority of those with disabilities are people of color (POC), with, for example, autism diagnosis rates now higher for children of color than for white children in the USA. This trend underscores the need for assistive technologies, especially socially assistive robots, to be designed with intersectional users in mind. Outside of Japan, most robots are designed with white synthetic skin and able-bodied features, failing to reflect the diverse users they are meant to assist. This paper explores the concept of the "engineering imaginary," the historical and cultural influences that shape these designs, and which tend to limit robot embodiment to white, able-bodied forms. Drawing on work from scholars like Lucy Suchman, Jennifer Rhee, Neda Atanasoski and Kalindi Vora, the paper critiques this engineering bias. A key historical moment in the production of the engineered imaginary of artificial humans is provided by Ovid's myth of Pygmalion and its influence on representations across literature, film, and then robotics. Furthermore, the physicality of the robot, and its role in the production of nonverbal communication (NVC) for more inclusive interaction with humans is explored, seeing these as steps toward what some roboticists are calling Artificial Empathy (AE). Through case studies like Bestic, Bina48, and HuggieBot 3.0, the paper explores what I call the poverty of the engineering imaginary, how current robotics design fails to properly address issues of race, gender, and disability. Ultimately, the paper argues for more inclusive robot designs that accommodate diverse bodies and social dynamics, questioning the pervasive norm of white, able-bodied robotic embodiment.

Prevalence and Associated Risk Factors of Vitamin D Deficiency Among Female Adolescents in Sulaimaniyah, Iraq: A Community-Based Cross-Sectional Study

Objectives: This study aims to examine the prevalence and risk factors related to VD deficiency among female adolescents. Methods: This cross-sectional study was done in secondary and preparatory schools in Sulaimaniyah, Iraq, from May 2022 to July 2023. A total of 120 schools were included in the study, with a calculated sample size of 340 female adolescents using a probability multistage random sampling method. Data was collected through a validated questionnaire, and blood samples were analyzed for VD levels. Results: In a study of 340 female adolescents aged 14-18 years, the findings showed that 39.4% of participants had severe VD deficiency, 42.6% were deficient, and 17.9% had insufficiency. The mean VD level was 13.29±6.45 ng/mL. Seasonal variation significantly impacted VD level (p=0.001), with the highest levels seen in summer and the lowest in winter. Skin colour also significantly influenced VD level (p=0.020), as individuals with lighter skin have higher levels. There were positive correlations between VD levels, milk intake (r=0.138, p=0.011), and cheese consumption (r = 0.135, p=0.013). The use of sunscreen had mixed effects. Interestingly, there was a positive correlation between SPF 15 and VD level (r=0.132, p=0.015), while higher SPF values were associated with lower levels. Conclusion: The findings highlight the importance of seasonal adjustments, improved dietary habits, and lifestyle changes to address VD deficiency in the population effectively.

Histological and histopathological structural changes in the skin of the Basal Cells Carcinoma patients

Background: Basal Cell Carcinoma (BCC) is the most common type of skin carcinoma and is considered an epidemic disease due to its increasing frequency in many countries. The most important problem of BCC is local invasion It grows in a “silent” way into immediately adjacent tissue. It rarely metastasizes. The early tumors are commonly small, translucent or pearly, raised and rounded areas located on a few dilated, superficial vessels. There are six subtypes of BCC that include nodular, pigmented, superficial, morphea form, cystic. The most important risk factor for basal cell carcinoma is exposure to UV-radiation. Outdoor workers with a long history of work-related UV-exposure are at increased risk of developing BCC. Other risk factors include family history of skin carcinoma, light skin phototypes, advanced age. Objective: The current study investigated pathological and histological changes in tissue sections to identify the factors contributing to the infection frequency. Patients and Methods: Thirty-three BCC patients' samples have been collected from the main care center at al-Baquba Teaching Hospital of Diyala Province, Iraq. All patient groups were clinically diagnosed as BCC by dermatologists. Results: The study showed macroscopic and microscopic histological changes. An ulcerated macroscopic appearance of the lesion was shown. The tumor lesions are located on the face. It was noted that the percentage of patients was higher in men than women and higher in light skin than dark skin. The study also showed that the age group 66-74 years had a higher infection percentage, while the lower percentage was of the age group &gt; 83 years. Conclusion: These findings pave the way for future research endeavors aimed at prevention, early detection, and targeted treatment strategies for this prevalent skin carcinoma.

Gender and Ethnicity Bias of Text-to-Image Generative Artificial Intelligence in Medical Imaging, Part 2: Analysis of DALL-E 3.

Disparity among gender and ethnicity remains an issue across medicine and health science. Only 26%-35% of trainee radiologists are female, despite more than 50% of medical students' being female. Similar gender disparities are evident across the medical imaging professions. Generative artificial intelligence text-to-image production could reinforce or amplify gender biases. Methods: In March 2024, DALL-E 3 was utilized via GPT-4 to generate a series of individual and group images of medical imaging professionals: radiologist, nuclear medicine physician, radiographer, nuclear medicine technologist, medical physicist, radiopharmacist, and medical imaging nurse. Multiple iterations of images were generated using a variety of prompts. Collectively, 120 images were produced for evaluation of 524 characters. All images were independently analyzed by 3 expert reviewers from medical imaging professions for apparent gender and skin tone. Results: Collectively (individual and group images), 57.4% (n = 301) of medical imaging professionals were depicted as male, 42.4% (n = 222) as female, and 91.2% (n = 478) as having a light skin tone. The male gender representation was 65% for radiologists, 62% for nuclear medicine physicians, 52% for radiographers, 56% for nuclear medicine technologists, 62% for medical physicists, 53% for radiopharmacists, and 26% for medical imaging nurses. For all professions, this overrepresents men compared with women. There was no representation of persons with a disability. Conclusion: This evaluation reveals a significant overrepresentation of the male gender associated with generative artificial intelligence text-to-image production using DALL-E 3 across the medical imaging professions. Generated images have a disproportionately high representation of white men, which is not representative of the diversity of the medical imaging professions.

Gender and Ethnicity Bias of Text-to-Image Generative Artificial Intelligence in Medical Imaging, Part 1: Preliminary Evaluation.

Generative artificial intelligence (AI) text-to-image production could reinforce or amplify gender and ethnicity biases. Several text-to-image generative AI tools are used for producing images that represent the medical imaging professions. White male stereotyping and masculine cultures can dissuade women and ethnically divergent people from being drawn into a profession. Methods: In March 2024, DALL-E 3, Firefly 2, Stable Diffusion 2.1, and Midjourney 5.2 were utilized to generate a series of individual and group images of medical imaging professionals: radiologist, nuclear medicine physician, radiographer, and nuclear medicine technologist. Multiple iterations of images were generated using a variety of prompts. Collectively, 184 images were produced for evaluation of 391 characters. All images were independently analyzed by 3 reviewers for apparent gender and skin tone. Results: Collectively (individual and group characters) (n = 391), 60.6% were male and 87.7% were of a light skin tone. DALL-E 3 (65.6%), Midjourney 5.2 (76.7%), and Stable Diffusion 2.1 (56.2%) had a statistically higher representation of men than Firefly 2 (42.9%) (P < 0.0001). With Firefly 2, 70.3% of characters had light skin tones, which was statistically lower (P < 0.0001) than for Stable Diffusion 2.1 (84.8%), Midjourney 5.2 (100%), and DALL-E 3 (94.8%). Overall, image quality metrics were average or better in 87.2% for DALL-E 3 and 86.2% for Midjourney 5.2, whereas 50.9% were inadequate or poor for Firefly 2 and 86.0% for Stable Diffusion 2.1. Conclusion: Generative AI text-to-image generation using DALL-E 3 via GPT-4 has the best overall quality compared with Firefly 2, Midjourney 5.2, and Stable Diffusion 2.1. Nonetheless, DALL-E 3 includes inherent biases associated with gender and ethnicity that demand more critical evaluation.

Diagnosis of a suspicious Spitzoid nevus

The mortality rate of cutaneous melanoma in the United States continues to increase year over year. Research supports that the development of melanoma is determined by genetics, the environment, and an individual’s behavior with certain phenotypic features, such as fair skin, red hair, multiple moles, and a prior history of sunburns, placing some individuals at greater risk of developing melanoma. New treatments have improved the survival rate of individuals with melanoma; however, the proper diagnosis of this deadly cancer is imperative. Histopathology remains the gold standard for diagnosing melanoma, sometimes with the help of immunohistochemistry staining. When a clear diagnosis cannot be made, genomic testing can be a helpful tool to differentiate between a benign and malignant lesion. Here, we present the case of a 27-year-old male patient with Fitzpatrick skin type III who presented to the dermatology clinic with a growing pink bump on his left upper arm. After a shave biopsy, the dermatopathologist reported that the lesion was a suspicious-looking Spitzoid nevus, for which a wide excision by surgical oncology was recommended. The immunohistochemistry staining did not secure a diagnosis of benign or malignant. As the diagnosis was inconclusive, the specimen was sent for a gene expression profile test, which came back positive, indicating malignant melanoma. This case illustrates how diagnostic and prognostic genomic testing can be used to identify a malignant melanoma and determine the likelihood of metastasis, thus guiding the patient's follow-up plan. It also illustrates how genomic testing might help the patient avoid unnecessary and costly medical procedures with potential side effects.

Impact of Skin Pigmentation on Pulse Oximetry Blood Oxygenation and Wearable Pulse Rate Accuracy: Systematic Review and Meta-Analysis.

Photoplethysmography (PPG) is a technology routinely used in clinical practice to assess blood oxygenation (SpO2) and pulse rate (PR). Skin pigmentation may influence accuracy, leading to health outcomes disparities. This systematic review and meta-analysis primarily aimed to evaluate the accuracy of PPG-derived SpO2 and PR by skin pigmentation. Secondarily, we aimed to evaluate statistical biases and the clinical relevance of PPG-derived SpO2 and PR according to skin pigmentation. We identified 23 pulse oximetry studies (n=59,684; 197,353 paired SpO2-arterial blood observations) and 4 wearable PR studies (n=176; 140,771 paired PPG-electrocardiography observations). We evaluated accuracy according to skin pigmentation group by comparing SpO2 accuracy root-mean-square values to the regulatory threshold of 3% and PR 95% limits of agreement values to +5 or -5 beats per minute (bpm), according to the standards of the American National Standards Institute, Association for the Advancement of Medical Instrumentation, and the International Electrotechnical Commission. We evaluated biases and clinical relevance using mean bias and 95% CI. For SpO2, accuracy root-mean-square values were 3.96%, 4.71%, and 4.15%, and pooled mean biases were 0.70% (95% CI 0.17%-1.22%), 0.27% (95% CI -0.64% to 1.19%), and 1.27% (95% CI 0.58%-1.95%) for light, medium, and dark pigmentation, respectively. For PR, 95% limits of agreement values were from -16.02 to 13.54, from -18.62 to 16.84, and from -33.69 to 32.54, and pooled mean biases were -1.24 (95% CI -5.31 to 2.83) bpm, -0.89 (95% CI -3.70 to 1.93) bpm, and -0.57 (95% CI -9.44 to 8.29) bpm for light, medium, and dark pigmentation, respectively. SpO2 and PR measurements may be inaccurate across all skin pigmentation groups, breaching U.S. Food and Drug Administration guidance and industry standard thresholds. Pulse oximeters significantly overestimate SpO2 for both light and dark skin pigmentation, but this overestimation may not be clinically relevant. PRs obtained from wearables exhibit no statistically or clinically significant bias based on skin pigmentation.

Cultural imperialism of the Korean Wave and its impact on Thai society

As the Korean Wave in Thailand continues to gain sensational popularity, along with the development of the Korean Wave, the negative influence of the Korean Wave in Thailand has also been highlighted. The beauty of Korean-style whitening provides a new symbol of beauty in Thailand, and the desire to unconsciously imitate Korean beauty can be said to have political implications that go beyond simply personal desires and superficial issues. This research analyzes how the whitewashing of K-pop as a cultural imperialist element of the Korean Wave is affecting Thai society. Specifically, in-depth interviews were conducted with Thai Korean Wave fans who envy K-pop idols. Based on the interview results, it analyzed Thai beauty standards and perceptions of whitewashing that have become typical through K-pop and the political meaning of the stereotypical beauty standard of “white skin” and its influence on Thai society.

Exploring everyday racist symbolism in community recreation spaces: a critical race content analysis

ABSTRACT There has been a palpable shift in the public’s collective consciousness about the realities of racism in recent years. Community recreation organizations, like all other institutions, are not exempt from promoting racial inequity through taken for granted policies and practices. The purpose of this study was to explore some of the racist symbolism found within everyday artifacts at local community centres in a sub-urban area of Ontario, Canada. A Critical Race Content Analysis methodology was used to analyze bandages, promotional materials, and sunscreen. This study found that bandages in first aid supplies were exclusively for White skin tones, images in promotional materials featured mostly White people, and the sunscreen products stocked were not made for dark skinned folx. A discussion on the implications of each finding is provided followed by limitations and recommendations for research and practice.

7669 Higher Serum Uric Acid Levels Are Associated With a Deleterious Metabolic and Inflammatory Profile in Brazilian Adolescents: An Exploratory Cross-Sectional Analysis

Abstract Disclosure: F.Q. Iorra: None. M.P. Guahnon: None. P.G. Rodrigues: None. A.T. Barcelos: None. F.V. Cureau: None. M. Drehmer: None. B.D. Schaan: None. Introduction: The association of high serum uric acid (sUA) with metabolic syndrome (MetS) and its components have been widely studied, but there are still gaps in how this breakdown product of purine metabolism might refine cardiovascular risk assessment and correlate with other cardiovascular disease biomarkers, especially in children and adolescents. Objective: To evaluate if sUA is associated with metabolic syndrome components and inflammatory markers in Brazilian adolescents. Methods: For this cross-sectional study, 786 individuals aged 12 to 17 years old, previously enrolled in the Study of Cardiovascular Risk in Adolescents (ERICA) - a Brazilian nationwide school based study, and who were from the city of Porto Alegre, had their sUA measured from blood samples that were stored in a biorepository. Anthropometric, biochemical and blood pressure data were collected. MetS diagnosis was based on the International Diabetes Federation age-specific criteria (2005), and insulin resistance was assessed by the HOMA-IR. In accordance with a non-parametric distribution, sUA was divided into quartiles (3.7 mg/dL, 4.4 mg/dL, 5.3 mg/dL for the 25th, 50th, and 75th percentiles, respectively) for the analysis. A linear regression model and a Poisson regression model with robust error variance were used, both adjusted for age, sex and skin color. Results: Participants were 14.8 ± 1.5 years-old, predominantly women (61.7%), self-identified as white skin color (72%) and eutrophic (66.9%). Through the linear regression model, significant positive associations were found between high sUA levels and body mass index Z-score, waist circumference, systolic and diastolic blood pressure, total cholesterol, triglycerides, HOMA-IR and C-reactive protein, and significant negative associations were observed for HDL cholesterol and adiponectin. No association was found between sUA and glucose or HbA1c. We also computed a metabolic risk score as the mean Z score of waist circumference, systolic blood pressure, HDL cholesterol (negative Z score), triglycerides and glucose, which was positive related to sUA (β ± SE = 0.13 ± 0.02; p &amp;lt; 0.001). Finally, the Poisson regression model was applied to estimate the prevalence ratios (PR) for MetS and its components, between adolescents with sUA in the 4th quartile to those in the 1st quartile. An association was observed for MetS (PR 6.37, 95% CI 1.39 - 29.21, p 0.017), high waist circumference (PR 4.61, 95% CI 2.55 - 8.36, p &amp;lt; 0.001) and increased triglycerides (PR 4.76, 95% CI 1.47 - 15.44, p 0.009). Conclusion: High sUA levels were associated with a worse metabolic and inflammatory profile, as well as a greater prevalence of MetS and some of its components in adolescents. Therefore, uric acid should be considered as a potential additional marker of cardiovascular risk in this population. Support: CNPq, CAPES, FIPE, FAPERGS. Presentation: 6/1/2024

9193 Higher Serum Uric Acid Levels Are Associated With a Deleterious Metabolic and Inflammatory Profile in Brazilian Adolescents: An Exploratory Cross-Sectional Analysis

Abstract Disclosure: F.Q. Iorra: None. M.P. Guahnon: None. P.G. Rodrigues: None. A.T. Barcelos: None. F.V. Cureau: None. M. Drehmer: None. B.D. Schaan: None. Introduction: The association of high serum uric acid (sUA) with metabolic syndrome (MetS) and its components have been widely studied, but there are still gaps in how this breakdown product of purine metabolism might refine cardiovascular risk assessment and correlate with other cardiovascular disease biomarkers, especially in children and adolescents. Objective: To evaluate if sUA is associated with metabolic syndrome components and inflammatory markers in Brazilian adolescents. Methods: For this cross-sectional study, 786 individuals aged 12 to 17 years old, previously enrolled in the Study of Cardiovascular Risk in Adolescents (ERICA) - a Brazilian nationwide school based study, and who were from the city of Porto Alegre, had their sUA measured from blood samples that were stored in a biorepository. Anthropometric, biochemical and blood pressure data were collected. MetS diagnosis was based on the International Diabetes Federation age-specific criteria (2005), and insulin resistance was assessed by the HOMA-IR. In accordance with a non-parametric distribution, sUA was divided into quartiles (3.7 mg/dL, 4.4 mg/dL, 5.3 mg/dL for the 25th, 50th, and 75th percentiles, respectively) for the analysis. A linear regression model and a Poisson regression model with robust error variance were used, both adjusted for age, sex and skin color. Results: Participants were 14.8 ± 1.5 years-old, predominantly women (61.7%), self-identified as white skin color (72%) and eutrophic (66.9%). Through the linear regression model, significant positive associations were found between high sUA levels and body mass index Z-score, waist circumference, systolic and diastolic blood pressure, total cholesterol, triglycerides, HOMA-IR and C-reactive protein, and significant negative associations were observed for HDL cholesterol and adiponectin. No association was found between sUA and glucose or HbA1c. We also computed a metabolic risk score as the mean Z score of waist circumference, systolic blood pressure, HDL cholesterol (negative Z score), triglycerides and glucose, which was positive related to sUA (β ± SE = 0.13 ± 0.02; p &amp;lt; 0.001). Finally, the Poisson regression model was applied to estimate the prevalence ratios (PR) for MetS and its components, between adolescents with sUA in the 4th quartile to those in the 1st quartile. An association was observed for MetS (PR 6.37, 95% CI 1.39 - 29.21, p 0.017), high waist circumference (PR 4.61, 95% CI 2.55 - 8.36, p &amp;lt; 0.001) and increased triglycerides (PR 4.76, 95% CI 1.47 - 15.44, p 0.009). Conclusion: High sUA levels were associated with a worse metabolic and inflammatory profile, as well as a greater prevalence of MetS and some of its components in adolescents. Therefore, uric acid should be considered as a potential additional marker of cardiovascular risk in this population. Support: CNPq, CAPES, FIPE, FAPERGS. Presentation: 6/1/2024

The association between ethnoracial characteristics and subjective well-being: a perspective considering social inequalities

ABSTRACT This study explored the association between subjective well-being (measured by life satisfaction) and ethnoracial characteristics (i.e. self-ascription, skin color, and speaking an Indigenous language) in Mexico and the role of socioeconomic inequalities in mediating this relationship. The emerging questions were: ‘What are the associations between subjective well-being and ethnoracial characteristics in Mexico?’ and ‘Are these associations affected by socioeconomic inequalities?.’ A multinomial logistic analysis was conducted, which estimates associations among multiple categories and predictor variables, using the data from the 2019 Project on Ethnoracial Discrimination in Mexico (PRODER, N = 7,037). The results indicated that Indigenous and white self-ascriptions were positively related to life satisfaction, whereas Mestizo and African Mexican identification did not have any association. Concerning skin color, the digital colorimeter measurements indicated that those with a lighter skin color had greater probabilities of having higher levels of life satisfaction. Additionally, those who reported speaking or who have parents speaking an Indigenous language were less likely to be in higher categories of life satisfaction. These results have central implications for the design and implementation of inclusive public policies, and for the design and modification of public programs.

Understanding and managing locally advanced basal cell carcinoma: insights into pathogenesis, therapeutic strategies, and the role of hedgehog pathway inhibitors.

Understanding and managing locally advanced basal cell carcinoma (BCC) is crucial given its substantial prevalence and potential for local tissue destruction. While BCC typically exhibits low metastatic potential, its high incidence underscores the need for enhanced therapeutic strategies. Locally advanced BCC presents unique challenges, often necessitating aggressive interventions to prevent disfigurement and functional impairment. The emergence of hedgehog pathway inhibitors (HHIs) offers promising therapeutic avenues by targeting aberrant hedgehog signaling, a key driver in BCC pathogenesis. Thus, elucidating the pathogenesis of locally advanced BCC and exploring the role of HHIs are critical endeavors in effectively managing this prevalent carcinoma. Epidemiologically, BCC primarily affects individuals with fair skin and chronic sun exposure, with an increasing incidence noted among younger age groups. Risk factors include UV radiation exposure, familial history of skin cancer, immunosuppression, and genetic syndromes such as basal cell nevus syndrome and xeroderma pigmentosum. Pathogenetically, BCC arises from cells in the skin's epidermis, with hedgehog pathway activation being a primary genetic driver, involving mutations in PTCH1 and SMO. Resistance to hedgehog inhibitors may occur due to genetic changes, complicating treatment strategies. BCC is characterized by low immunogenicity, which hinders immune response and contributes to treatment challenges. Enhanced understanding of the epidemiology, risk factors, and pathogenesis of locally advanced BCC, along with the development of targeted therapeutic approaches such as hedgehog pathway inhibitors, is essential for effectively managing this prevalent carcinoma and improving patient outcomes.

Human papillomaviruses in hand squamous cell carcinomas from Chilean patients

IntroductionCutaneous squamous cell carcinoma (SCC) accounts for 20% of all skin cancers and its incidence continues to increase globally. It represents 75% of non-melanoma skin cancer (NMSC) mortality. Risk factors include ultraviolet radiation (UVR) exposure, advanced age, chemical exposure, fair skin types, and immunosuppression. While most human papillomavirus (HPV) infections are associated with the development of warts, a subgroup is potentially implicated in the development of cutaneous SCC. The prevalence of alpha, beta, and gamma-HPV in Chilean patients with hand SCCs has not been previously addressed. The objective of this study was to evaluate the presence of HPV and genotyping in hand SCC from Chilean patients.Materials and methodsAn observational, cross-sectional, descriptive study was conducted. Alpha (α), beta (β) and gamma (γ)-HPV detection was performed by conventional polymerase chain reaction (PCR) in paraffin-embedded tissue samples from 52 patients diagnosed with hand SCC from Santiago, Chile. HPV genotyping was carried out via direct amplicon sequencing by Sanger method.ResultsThe most frequent carcinoma site was the dorsum of the hands (52.5%). α-HPV was not detected in these specimens, whereas β-HPV and γ-HPV were detected in 25% of the analyzed samples. The most frequent genotypes found were β-HPV 100 (38%) and γ-HPV 178 (15%). Additionally, γ-HPV 101, 162, HPV-mSK_016, HPV-mSK_083, HPV-mSK_213 and HPV-mSK249nr genotypes were detected, none of which had been previously described in cutaneous SCC.Conclusionβ-HPV and γ-HPV are detectable in 25% of hand SCCs from Chilean patients. It is important to conduct prospective studies to better elucidate the role of these viruses in the development of this disease.

Successful Microablative Fractional Carbon Dioxide Laser Therapy for Vulvar Lichen Sclerosus: A Case Report and Mini-review

Vulvar lichen sclerosus (VLS) is a chronic inflammatory skin disorder affecting the vulvar region. VLS predominantly affects women, and most cases occur after menopause. Common symptoms include itching, skin-whitening, pain, discomfort, fissures, and scarring. Treatment options include topical steroids, emollients, lifestyle modifications, regular follow-up, and surgical interventions. Carbon dioxide (CO2) laser treatment is a therapeutic option for managing lichen sclerosus. We report a case of VLS successfully treated with a fractional microablative CO2 laser. A 72-year-old female presented with a dry vagina and vulvar itching for 6 months. She visited a local medical clinic, and oral anti-itching medication and topical anti-itching ointment were administered. However, the condition did not improve, and she felt itching. She visited our outpatient department, and a pelvic examination showed bilateral labia minor, revealing a white skin color change and a hardening sensation. The patient was diagnosed with VLS. Microablative fractional CO2 laser therapy was subsequently administered. The treatment course comprised three laser therapy sessions (treatment day, 1 month, and 2 months after the first therapy). The vulvovaginal symptoms questionnaire-21 scores were 14, 6, and 2 for the first, second, and third courses of treatment, respectively. Vulvar itching improved significantly after laser treatment – no more steroid treatment needed. After 10 months of follow-up, the condition of the vulva was maintained well. Although the treatment protocol requires further exploration, CO2 laser treatment could be considered for VLS if topical steroids are ineffective.