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Tod B, Whitaker D, Visser W, Isaacs T, Jacobs T, Wiid K, Dlova NC, Wright CY. Integrated sun protection advice for the South African population. Int J Dermatol 2024; 63:277-287. [PMID: 38124402 DOI: 10.1111/ijd.16980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/30/2023] [Accepted: 12/02/2023] [Indexed: 12/23/2023]
Abstract
Exposure to solar ultraviolet radiation (UVR) is associated with several cutaneous adverse effects. However, to the best of our knowledge, in South Africa there are no formal guidelines on sun protection. A group of South African dermatologists and researchers convened over the course of 1 year to deliberate on integrated advice for sun protection among the multi-ethnic South African population. For people with light skin and those with genetic skin disorders (e.g., oculocutaneous albinism), sun protection was identified as critical to prevent sunburn, skin cancer, and photoaging. The evidence is less clear for people with medium and darker skin types, especially the latter, in whom melanin may confer a degree of protection against some parts of the solar spectrum. Recent studies have demonstrated that visible light can cause pigmentary changes in individuals with darker skin types in particular. Sun protection for people of all skin colors is beneficial to protect against photoaging and ocular damage. Herein sun protection advice is suggested for South Africans of all skin colors to reduce morbidity and mortality from sun exposure, particularly relating to skin cancer. Several knowledge gaps are identified as future research priorities.
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Affiliation(s)
- Bianca Tod
- Division of Dermatology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | | | - Willie Visser
- Division of Dermatology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Thuraya Isaacs
- Division of Dermatology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | | | - Kim Wiid
- L'Oréal Dermatological Beauty, Johannesburg, South Africa
| | - Ncoza C Dlova
- Dermatology Department, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Caradee Y Wright
- Climate Change and Health Research Programme, Environment and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa
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2
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Song X, Guo S, Han L, Zhao Y, Cekderi AB, Wang G. Dermoscopic image colour correction based on gamma correction and multi-scale image fusion. J Eur Acad Dermatol Venereol 2024; 38:e172-e174. [PMID: 37708569 DOI: 10.1111/jdv.19516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 09/08/2023] [Indexed: 09/16/2023]
Affiliation(s)
- Xiaowei Song
- School of Automation, Beijing Institute of Technology University, Beijing, China
| | - Shuli Guo
- School of Automation, Beijing Institute of Technology University, Beijing, China
| | - Lina Han
- Department of Cardiology, The Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yuanyuan Zhao
- School of Automation, Beijing Institute of Technology University, Beijing, China
| | - Anil Baris Cekderi
- School of Automation, Beijing Institute of Technology University, Beijing, China
| | - Guowei Wang
- School of Automation, Beijing Institute of Technology University, Beijing, China
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Davis AE, Kennelley GE, Amaye-Obu T, Jowdy PF, Ghadersohi S, Nasir-Moin M, Paragh G, Berman HA, Huss WJ. The phenomenon of phototoxicity and long-term risks of commonly prescribed and structurally diverse drugs. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY 2024; 19:100221. [PMID: 38389933 PMCID: PMC10883358 DOI: 10.1016/j.jpap.2023.100221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024] Open
Abstract
Photosensitivity to structurally diverse drugs is a common but under-reported adverse cutaneous reaction and can be classified as phototoxic or photoallergic. Phototoxic reactions occur when the skin is exposed to sunlight after administering topical or systemic medications that exhibit photosensitizing activity. These reactions depend on the dose of medication, degree of exposure to ultraviolet light, type of ultraviolet light, and sufficient skin distribution volume. Accurate prediction of the incidence and phototoxic response severity is challenging due to a paucity of literature, suggesting that phototoxicity may be more frequent than reported. This paper reports an extensive literature review on phototoxic drugs; the review employed pre-determined search criteria that included meta-analyses, systematic reviews, literature reviews, and case reports freely available in full text. Additional reports were identified from reference sections that contributed to the understanding of phototoxicity. The following drugs and/or drug classes are discussed: amiodarone, voriconazole, chlorpromazine, doxycycline, fluoroquinolones, hydrochlorothiazide, nonsteroidal anti-inflammatory drugs, and vemurafenib. In reviewing phototoxic skin reactions, this review highlights drug molecular structures, their reactive pathways, and, as there is a growing association between photosensitizing drugs and the increasing incidence of skin cancer, the consequential long-term implications of photocarcinogenesis.
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Affiliation(s)
- Anna E Davis
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Gabrielle E Kennelley
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
- College of Medicine, Central Michigan University, Mt. Pleasant, MI 48858, USA
| | - Tatiana Amaye-Obu
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Peter F Jowdy
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Sarah Ghadersohi
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Mehr Nasir-Moin
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Gyorgy Paragh
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
- Department of Cell Stress Biology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Harvey A Berman
- Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- Romanell Center for the Philosophy of Medicine and Bioethics, Park Hall University at Buffalo, Buffalo, NY 14260, USA
| | - Wendy J Huss
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
- Department of Cell Stress Biology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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Tsai J, Chien AL. Reinforcing Photoprotection for Skin of Color: A Narrative Review. Dermatol Ther (Heidelb) 2023; 13:1935-1958. [PMID: 37495857 PMCID: PMC10442306 DOI: 10.1007/s13555-023-00982-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/11/2023] [Indexed: 07/28/2023] Open
Abstract
Skin of color (SOC) is characterized by increased tendency for tanning and decreased likelihood of sunburns due to the attenuation of sunlight by epidermal melanin. Although this contributes to the decreased incidence of skin cancer among SOC populations, individuals with SOC remain susceptible to various health consequences associated with sun exposure, including non-melanoma skin cancer, photoaging, pigmentary disorders, and photodermatoses - many of which not only present differently, but also disproportionately affect SOC. Prior epidemiological studies have found lower prevalence of sun protection behaviors among individuals with SOC, particularly in sunscreen use, signifying an unmet area for improvement in the prevention of sun-induced dermatologic conditions in these populations. The objective of this narrative review was to summarize the biology and health consequences of sun exposure in SOC, as well as cognitive and behavioral factors that affect the practice of photoprotection behaviors in SOC populations. We also review prior interventions that have been used to enhance photoprotection knowledge and behaviors among individuals with SOC, either in racially and ethnically diverse communities or within specific SOC populations.
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Affiliation(s)
- Jerry Tsai
- Department of Dermatology, Johns Hopkins University School of Medicine, 601 N Caroline Street, Suite 8060C, Baltimore, MD, 21287, USA
| | - Anna L Chien
- Department of Dermatology, Johns Hopkins University School of Medicine, 601 N Caroline Street, Suite 8060C, Baltimore, MD, 21287, USA.
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Yang LH, Saeed U, Kuang YQ, Li YY. Clinical characteristics of patients with human immunodeficiency virus and immune-mediated photodermatoses: A retrospective study of 39 patients. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2023; 39:140-146. [PMID: 36537697 DOI: 10.1111/phpp.12853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 11/27/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND HIV/AIDS patients are susceptible to various infectious and inflammatory dermatoses. No systemic work has been done on HIV/AIDS patients with immune-mediated photodermatoses in China. Here, we aim to determine the clinical features of immune-mediated photodermatoses in HIV/AIDS patients. METHODS A retrospective analysis of HIV/AIDS patients with immune-mediated photodermatoses was carried out with demographic data, clinical characteristics, laboratory data, and follow-up data at the First Affiliated Hospital of Kunming Medical University between 2012 and 2019. The data were subjected to statistical analysis. RESULTS A total of 39 HIV/AIDS patients with immune-mediated photodermatoses were enrolled, including 22 cases of polymorphic light eruption (PLE), 16 cases of chronic actinic dermatitis (CAD), and one actinic reticuloid. The CD4 count at the visit of the HIV-positive CAD group was lower than the PLE group (p = .049). The HIV-positive CAD group was more sensitive toward UVB than the PLE group (p = .020) and had a lower MED-UVB value (p = .044). There was no significant difference in UV tests among different categories of skin types. CONCLUSION Immune-mediated photodermatoses are a manifestation of the advanced symptom of HIV infection, and sometimes also the presenting feature of HIV infection. Compared with HIV-positive PLE patients, CAD patients showed higher sensitivity to UVB radiation and had a lower MED-UVB value. The primary treatment for immune-mediated photodermatoses in HIV/AIDS patients is HAART and sun avoidance.
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Affiliation(s)
- Lu-Hui Yang
- Department of Dermatology and Venereology, First Affiliated Hospital of Kunming Medical University, Kunming, China.,NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming Medical University, Kunming, China
| | - Ummair Saeed
- Department of Dermatology and Venereology, First Affiliated Hospital of Kunming Medical University, Kunming, China.,NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming Medical University, Kunming, China
| | - Yi-Qun Kuang
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming Medical University, Kunming, China.,Scientific Research Laboratory Center, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yu-Ye Li
- Department of Dermatology and Venereology, First Affiliated Hospital of Kunming Medical University, Kunming, China.,NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming Medical University, Kunming, China
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Neale RE, Lucas RM, Byrne SN, Hollestein L, Rhodes LE, Yazar S, Young AR, Berwick M, Ireland RA, Olsen CM. The effects of exposure to solar radiation on human health. Photochem Photobiol Sci 2023:10.1007/s43630-023-00375-8. [PMID: 36856971 PMCID: PMC9976694 DOI: 10.1007/s43630-023-00375-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/13/2023] [Indexed: 03/02/2023]
Abstract
This assessment by the Environmental Effects Assessment Panel (EEAP) of the Montreal Protocol under the United Nations Environment Programme (UNEP) evaluates the effects of ultraviolet (UV) radiation on human health within the context of the Montreal Protocol and its Amendments. We assess work published since our last comprehensive assessment in 2018. Over the last four years gains have been made in knowledge of the links between sun exposure and health outcomes, mechanisms, and estimates of disease burden, including economic impacts. Of particular note, there is new information about the way in which exposure to UV radiation modulates the immune system, causing both harms and benefits for health. The burden of skin cancer remains high, with many lives lost to melanoma and many more people treated for keratinocyte cancer, but it has been estimated that the Montreal Protocol will prevent 11 million cases of melanoma and 432 million cases of keratinocyte cancer that would otherwise have occurred in the United States in people born between 1890 and 2100. While the incidence of skin cancer continues to rise, rates have stabilised in younger populations in some countries. Mortality has also plateaued, partly due to the use of systemic therapies for advanced disease. However, these therapies are very expensive, contributing to the extremely high economic burden of skin cancer, and emphasising the importance and comparative cost-effectiveness of prevention. Photodermatoses, inflammatory skin conditions induced by exposure to UV radiation, can have a marked detrimental impact on the quality of life of sufferers. More information is emerging about their potential link with commonly used drugs, particularly anti-hypertensives. The eyes are also harmed by over-exposure to UV radiation. The incidence of cataract and pterygium is continuing to rise, and there is now evidence of a link between intraocular melanoma and sun exposure. It has been estimated that the Montreal Protocol will prevent 63 million cases of cataract that would otherwise have occurred in the United States in people born between 1890 and 2100. Despite the clearly established harms, exposure to UV radiation also has benefits for human health. While the best recognised benefit is production of vitamin D, beneficial effects mediated by factors other than vitamin D are emerging. For both sun exposure and vitamin D, there is increasingly convincing evidence of a positive role in diseases related to immune function, including both autoimmune diseases and infection. With its influence on the intensity of UV radiation and global warming, the Montreal Protocol has, and will have, both direct and indirect effects on human health, potentially changing the balance of the risks and benefits of spending time outdoors.
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Affiliation(s)
- R. E. Neale
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD Australia ,School of Public Health, University of Queensland, Brisbane, QLD Australia
| | - R. M. Lucas
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT Australia
| | - S. N. Byrne
- School of Medical Science, Faculty of Medicine and Health, University of Sydney, Sydney, NSW Australia
| | - L. Hollestein
- Erasmus MC Cancer Institute, Rotterdam, The Netherlands ,Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - L. E. Rhodes
- Dermatology Research Centre, School of Biological Sciences, University of Manchester, Salford Royal Hospital, Northern Care Alliance NHS Trust, Manchester, UK
| | - S. Yazar
- Garvan Medical Research Institute, Sydney, NSW Australia
| | | | - M. Berwick
- University of New Mexico Comprehensive Cancer Center, Albuquerque, USA
| | - R. A. Ireland
- School of Medical Science, Faculty of Medicine and Health, University of Sydney, Sydney, NSW Australia
| | - C. M. Olsen
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD Australia ,Frazer Institute, University of Queensland, Brisbane, QLD Australia
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8
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Lee CN, Chen TY, Wong TW. The Immunogenetics of Photodermatoses. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1367:369-381. [DOI: 10.1007/978-3-030-92616-8_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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9
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The role of UVA radiation in ketoprofen-mediated BRAF-mutant amelanotic melanoma cells death - A study at the cellular and molecular level. Toxicol In Vitro 2021; 72:105108. [PMID: 33545343 DOI: 10.1016/j.tiv.2021.105108] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 01/08/2021] [Accepted: 02/01/2021] [Indexed: 12/27/2022]
Abstract
Malignant melanoma is the cause of 80% of deaths in skin cancer patients. Treatment of melanoma in the 4th stage of clinical advancement, in which inoperable metastasis occur, does not provide sufficient effects. Ketoprofen has phototoxic properties and it can be used as a new treatment option for skin cancers as a part of photochemotherapy. The present study was designed to investigate whether ketoprofen in combination with UVA induces cytotoxic, anti-proliferative and pro-apoptotic effects on melanoma cells. It was stated that co-treatment with 1.0 mM ketoprofen and UVA irradiation disturbed homeostasis of C32 melanoma cells by lowering its vitality (decrease of GSH level). Contrary to C32 cells, melanocytes showed low sensitivity to ketoprofen and UVA radiation, pointing selectivity in the mode of action towards melanoma cells. Co-treatment with ketoprofen and UVA irradiation has cytotoxic and anti-proliferative and pro-apoptotic effect on C32. The co-treatment triggered the DNA fragmentation and changed the cell cycle in C32 cells. In conclusion, it could be stated that local application of ketoprofen in combination with UVA irradiation may be used to support the treatment of melanoma and creates the possibility of reducing the risk of cancer recurrence and metastasis.
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Bernhard GH, Neale RE, Barnes PW, Neale PJ, Zepp RG, Wilson SR, Andrady AL, Bais AF, McKenzie RL, Aucamp PJ, Young PJ, Liley JB, Lucas RM, Yazar S, Rhodes LE, Byrne SN, Hollestein LM, Olsen CM, Young AR, Robson TM, Bornman JF, Jansen MAK, Robinson SA, Ballaré CL, Williamson CE, Rose KC, Banaszak AT, Häder DP, Hylander S, Wängberg SÅ, Austin AT, Hou WC, Paul ND, Madronich S, Sulzberger B, Solomon KR, Li H, Schikowski T, Longstreth J, Pandey KK, Heikkilä AM, White CC. Environmental effects of stratospheric ozone depletion, UV radiation and interactions with climate change: UNEP Environmental Effects Assessment Panel, update 2019. Photochem Photobiol Sci 2020; 19:542-584. [PMID: 32364555 PMCID: PMC7442302 DOI: 10.1039/d0pp90011g] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 03/23/2020] [Indexed: 12/24/2022]
Abstract
This assessment, by the United Nations Environment Programme (UNEP) Environmental Effects Assessment Panel (EEAP), one of three Panels informing the Parties to the Montreal Protocol, provides an update, since our previous extensive assessment (Photochem. Photobiol. Sci., 2019, 18, 595-828), of recent findings of current and projected interactive environmental effects of ultraviolet (UV) radiation, stratospheric ozone, and climate change. These effects include those on human health, air quality, terrestrial and aquatic ecosystems, biogeochemical cycles, and materials used in construction and other services. The present update evaluates further evidence of the consequences of human activity on climate change that are altering the exposure of organisms and ecosystems to UV radiation. This in turn reveals the interactive effects of many climate change factors with UV radiation that have implications for the atmosphere, feedbacks, contaminant fate and transport, organismal responses, and many outdoor materials including plastics, wood, and fabrics. The universal ratification of the Montreal Protocol, signed by 197 countries, has led to the regulation and phase-out of chemicals that deplete the stratospheric ozone layer. Although this treaty has had unprecedented success in protecting the ozone layer, and hence all life on Earth from damaging UV radiation, it is also making a substantial contribution to reducing climate warming because many of the chemicals under this treaty are greenhouse gases.
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Affiliation(s)
- G H Bernhard
- Biospherical Instruments Inc., San Diego, California, USA
| | - R E Neale
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - P W Barnes
- Biological Sciences and Environment Program, Loyola University, New Orleans, USA
| | - P J Neale
- Smithsonian Environmental Research Center, Edgewater, Maryland, USA
| | - R G Zepp
- United States Environmental Protection Agency, Athens, Georgia, USA
| | - S R Wilson
- School of Earth, Atmospheric and Life Sciences, University of Wollongong, Wollongong, Australia
| | - A L Andrady
- Department of Chemical and Biomolecular Engineering, North Carolina State University, Raleigh, North Carolina, USA
| | - A F Bais
- Department of Physics, Aristotle University of Thessaloniki, Greece
| | - R L McKenzie
- National Institute of Water & Atmospheric Research, Lauder, Central Otago, New Zealand
| | - P J Aucamp
- Ptersa Environmental Consultants, Faerie Glen, South Africa
| | - P J Young
- Lancaster Environment Centre, Lancaster University, Lancaster, UK
| | - J B Liley
- National Institute of Water & Atmospheric Research, Lauder, Central Otago, New Zealand
| | - R M Lucas
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - S Yazar
- Garvan Institute of Medical Research, Sydney, Australia
| | - L E Rhodes
- Faculty of Biology Medicine and Health, University of Manchester, and Salford Royal Hospital, Manchester, UK
| | - S N Byrne
- School of Medical Sciences, University of Sydney, Sydney, Australia
| | - L M Hollestein
- Erasmus MC, University Medical Center Rotterdam, Manchester, The Netherlands
| | - C M Olsen
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - A R Young
- St John's Institute of Dermatology, King's College, London, London, UK
| | - T M Robson
- Organismal & Evolutionary Biology, Viikki Plant Science Centre, University of Helsinki, Helsinki, Finland
| | - J F Bornman
- Food Futures Institute, Murdoch University, Perth, Australia.
| | - M A K Jansen
- School of Biological, Earth and Environmental Sciences, University College Cork, Cork, Ireland
| | - S A Robinson
- Centre for Sustainable Ecosystem Solutions, University of Wollongong, Wollongong, Australia
| | - C L Ballaré
- Faculty of Agronomy and IFEVA-CONICET, University of Buenos Aires, Buenos Aires, Argentina
| | - C E Williamson
- Department of Biology, Miami University, Oxford, Ohio, USA
| | - K C Rose
- Department of Biological Sciences, Rensselaer Polytechnic Institute, Troy, New York, USA
| | - A T Banaszak
- Unidad Académica de Sistemas Arrecifales, Universidad Nacional Autónoma de México, Puerto Morelos, Mexico
| | - D -P Häder
- Department of Biology, Friedrich-Alexander University, Möhrendorf, Germany
| | - S Hylander
- Centre for Ecology and Evolution in Microbial Model Systems, Linnaeus University, Kalmar, Sweden
| | - S -Å Wängberg
- Department of Marine Sciences, University of Gothenburg, Gothenburg, Sweden
| | - A T Austin
- Faculty of Agronomy and IFEVA-CONICET, University of Buenos Aires, Buenos Aires, Argentina
| | - W -C Hou
- Department of Environmental Engineering, National Cheng Kung University, Tainan City, Taiwan, China
| | - N D Paul
- Lancaster Environment Centre, Lancaster University, Lancaster, UK
| | - S Madronich
- National Center for Atmospheric Research, Boulder, Colorado, USA
| | - B Sulzberger
- Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland
| | - K R Solomon
- Centre for Toxicology, School of Environmental Sciences, University of Guelph, Guelph, Canada
| | - H Li
- Institute of Atmospheric Environment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - T Schikowski
- Research Group of Environmental Epidemiology, Leibniz Institute of Environmental Medicine, Düsseldorf, Germany
| | - J Longstreth
- Institute for Global Risk Research, Bethesda, Maryland, USA
| | - K K Pandey
- Institute of Wood Science and Technology, Bengaluru, India
| | - A M Heikkilä
- Finnish Meteorological Institute, Helsinki, Finland
| | - C C White
- , 5409 Mohican Rd, Bethesda, Maryland, USA
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11
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Adult-Onset Still Disease Presenting With Dermatomyositis-Like Persistent Pruritic Lesions. Am J Dermatopathol 2019; 41:851-854. [PMID: 31634170 DOI: 10.1097/dad.0000000000001447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Adult-onset Still disease (AOSD) is a rare autoinflammatory condition. The presence of an evanescent, salmon-pink, nonpruritic rash is one of the major diagnostic criteria for the disease. The rash occurs with fever and subsides with defervescence. The presence of dyskeratotic keratinocytes in the upper one-third layer of the epidermis is a distinctive histopathological feature of persistent pruritic lesions associated with AOSD. Here, we report 2 cases of AOSD characterized by persistent pruritic lesions resembling those observed in dermatomyositis. Identifying the clinical and histopathological manifestation of the cutaneous lesions is essential for the early diagnosis of AOSD and for differentiating this condition from those presenting with dyskeratotic cells in the epidermis.
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12
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Abstract
Phototherapy in skin of color requires special consideration. Pigmented skin is an efficient ultraviolet filter. Hence, higher doses of ultraviolet radiation are generally more effective and well tolerated in skin of color. An objective and practical system has not yet been established to determine optimal phototherapy dosing in skin of color. The authors recommend obtaining a detailed history of each individual patient's response to sun exposure before prescribing a phototherapy dosing regimen. In addition, providers should consider the role of socioeconomic factors and their impact on phototherapy-related outcomes, including barriers to access and compliance.
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