sunlight and skin cancer
DESCRIPTION
Presentation by Dr. Karen Zapata on sunlight and sun protectionTRANSCRIPT
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Beyond the violet
UV and SkinKaren Zapata Montenegro
Dermatology and Dermatology surgeryCSS
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IntroductionUV RadiationConcept
UV radiation damagePhotoprotection
Topics
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Volcan Baru
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Boca Brava
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Horconcitos
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Gavilla Beach
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Hornito
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UV Radiation
Concept
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• Isaac Newton. • “Colors phenomenon”
1666
• William Herschel. • Infrared radiation1800
• Johann Ritter.• Ultraviolet radiation 1801
Diffey B. Methods. 2002; 28: 4-13
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Ultraviolet light or ultraviolet radiation?
“beyond violet” Exposure to UV
and its several sequellae◦ 1932 Copenhaguen
UVC
Electromagnetic radiation spectrum
Maverakis E, et al. Journal of Autoimmunity. 2010; 34: 47-57
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UV Radiation sources
Natural source
Artificial source
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Less than 9% UV
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Elliptical orbit ◦3.4 % perihelion (January 3)
◦Aphelion (July 5)◦7% UVR variation
UV radiation
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UV Radiation
Hour
Month of the year
Geographic position
Sun Position
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UVB 5%UVA 95%
UVB causes 80% skin damage
Clouds decrease
UV radiation
Chlorofluorocarbon decreases ozone
layer
Maverakis E, et al. Journal of Autoimmunity. 2010; 34: 47-57
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Measure of the amount UVR at the surface, during maximum radiation
Scale 0-111 unit = 25 miliWatt/m2
Haga clic en el icono para agregar una imagen
UV-B index
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Reflection on the surfaces
Snow Desert area
90%
5% 15-30%
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60 cm underwater
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Climatic changes
Photosynthesis
Food Chain
Living forms
Energy source
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Prudent solar exposure
Elevates mood and improves energy
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5 to 20 minutes of daily exposure
Vitamin D production
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UV skin damage Skin cancer
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Skin and UVR
Mutagenic effects
Eye Damage
Immune system
alteration
Skin cancer
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ICAM-1
Immune System alteration
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DNA
Mutagenic effects
Malignancy
Melanin
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Risk of cancer
Genetics
EnvironmentFamily History
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Nonmelanoma Skin cancer
An estimaded 3.5 millions of new cases each year in USA. 1/5 during lifetime. The most common skin cancer.
Outdoor activities
UV artificial sources
Ozone layer
Camp et al. Semin Cutan Med Surg. 2011; 30: 6-13
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Nonmelanoma skin cancer Most common cancer in humans
3-8% of annual increase since 1960
Firm association with UV exposure
40 -50% recurrent CBC
80% older than 60 year
Madan V, Lear J, Szeimies R. Lancet. 2010; 375:373-85
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UV radiation and type of skin cancer
• Intermittent exposure• Childhood exposure
CBC
• Chronic exposure
CEC
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3-7% increase since 1970
Annual incidence 7.89
to 22.52 for each 100000
More related with mortality
UV radiation and melanoma
Kanavy H, Gerstenblith M. Seminars in cutaneous Medicine and surgery. 2011; 222-8
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Equatorial area
Melanoma geographical distribution is bigger next to this area. 1% decrease in ozone layer increase melanoma mortality 1-2%.
Kanavy H, Gerstenblith M. Seminars in cutaneous Medicine and surgery. 2011; 222-8
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Melanoma and exposureChronic and intermittent
Indoor tanning Skin cancer risk factor since 2009
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Melanoma and highlands
High-altitude regions tend to have a higher melanoma rate that may be related to the higher UV fluences (J/cm2) noted at these sites
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PhotoprotectionKey points
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Gilaberte Y, González S. Actas Dermo-Sifiliográficas. 2010; 101: 659-72
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Gilaberte Y, González S. Actas Dermo-Sifiliográficas. 2010; 101: 659-72
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Sunscreens are photochemical systems that absorb or reflect UV radiation.
Frequently use of sunscreens is the best photoprotection strategy.
The first sunscreen was marketed in 1930 Actually there are 28 chemical filters in
Australia, 26 in Europe and 14 in USA.
Key points
Kockler J, Oelgemoller M, Robertson S, Glass B. Journal of Photochemistry and Photobiology. 2012; 1-17
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Absorption
Dispersion
UVR
Chemical or physical filters
Reflection
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La capacidad de eritema depende◦ Longitud de onda de radiación◦ Fotosensibilidad del individuo◦ DEM uso estudios observacionales
Solar protection factor
SPF = ----------------MED protected
MED unprotected
Kockler J, Oelgemoller M, Robertson S, Glass B. Journal of Photochemistry and Photobiology. 2012; 1-17
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La capacidad de eritema depende◦ Longitud de onda de radiación◦ Fotosensibilidad del individuo◦ DEM uso estudios observacionales
Protection factor
UVA FP = ----------------MPD protected
MPD unprotected
DPM: dosis de pigmento mínima
Kockler J, Oelgemoller M, Robertson S, Glass B. Journal of Photochemistry and Photobiology. 2012; 1-17
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SunscreensFILTERS ACTION SPECTRUM
INORGÁNICOS- FÍSICOS
Dióxido de titanio al 25% 350 UVA, UVB
Óxido de cinc al 25% 350 UVA, UVB
ORGÁNICOS - QUÍMICOS
Filtros para UVA
Benzofenonas
Oxibenzonas al 6% 288-325 UVB, UVA II
Sulisobenzonas al 10% 366 UVA
Dioxibenzona al 3% 352 UVA
Dibenzolimetanos
Avobenzona 3% 360 UVA1
Antralatos
Medalimato al 3% 340 UVAII
Ecamsul (mexorilo SX) 345 UVB, UVA
Ácido terephtalilideno diaalcanforsulfínico al 10%
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SunscreensFILTERS ACTIO
NSPECTRUM
Filtros para UVB
Aminobenzoatos (derivados del PABA)
PABA al 1 5% 283 UVB
Padimato O (octil dimetil PABA) al 8% 311 UVB
Cinamatos
Cinoxato al 3% 289 UVB
Octinoxate (octil metoxicinamato) al 7.5% 311 UVB
Salicilatos
Octilsalate (octil salicilato) al 5% 307 UVB
Homosalat (homentil salicilato) al 15% 306 UVB
Trolamina salicilato al 12% 306 UVB
Otros
Octocrileno al 10% 303 UVB, UVAII
Ensulizolo al 4% 310
Metileno-bis-benzotriazolila Tetrametilbutifenol (Tinosorb M) al 10%
305-360
UVB, UVA Filtro inorgánico y orgánico
Bis-etilhexiloxifenol metoxifenil triazina (Tinosorb S) al 10%
310-340Moreno M, Moreno L. Rev Asoc Colomb Dermatol. 2009; 10: 1-9
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Correct sunscreen
20 min before and 2 - 3 hours
SPF 30 (97.5 UVB)◦ 370nm
High UVA protection
SPF 30 UVA high protection
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Children and UV protection
50- 80% solar damage is before 18
Correct solar protection
Walker D. Journal of Pediatric nursing. 2011 Article in press
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Appropriate clothing
UPF higher than 40 Dark colors, nylon and polyester
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New agents
DFMO: difluorometilornitina
Camp et al. Semin Cutan Med Surg. 2011; 30: 6-13
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Children solar protection
Prudent solar exposure
Thanks