Beyond the violet

UV and SkinKaren Zapata Montenegro

Dermatology and Dermatology surgeryCSS

IntroductionUV RadiationConcept

UV radiation damagePhotoprotection

Topics

Volcan Baru

Boca Brava

Horconcitos

Gavilla Beach

Hornito

UV Radiation

Concept

• Isaac Newton. • “Colors phenomenon”

1666

• William Herschel. • Infrared radiation1800

• Johann Ritter.• Ultraviolet radiation 1801

Diffey B. Methods. 2002; 28: 4-13

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

UV Radiation sources

Natural source

Artificial source

Less than 9% UV

Haga clic en el icono para agregar una imagen

Elliptical orbit ◦3.4 % perihelion (January 3)

◦Aphelion (July 5)◦7% UVR variation

UV radiation

UV Radiation

Hour

Month of the year

Geographic position

Sun Position

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

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

Reflection on the surfaces

Snow Desert area

90%

5% 15-30%

60 cm underwater

Climatic changes

Photosynthesis

Food Chain

Living forms

Energy source

Prudent solar exposure

Elevates mood and improves energy

5 to 20 minutes of daily exposure

Vitamin D production

UV skin damage Skin cancer

Skin and UVR

Mutagenic effects

Eye Damage

Immune system

alteration

Skin cancer

ICAM-1

Immune System alteration

DNA

Mutagenic effects

Malignancy

Melanin

Risk of cancer

Genetics

EnvironmentFamily History

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

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

UV radiation and type of skin cancer

• Intermittent exposure• Childhood exposure

CBC

• Chronic exposure

CEC

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

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

Melanoma and exposureChronic and intermittent

Indoor tanning Skin cancer risk factor since 2009

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

Other diseases

PhotoprotectionKey points

Gilaberte Y, González S. Actas Dermo-Sifiliográficas. 2010; 101: 659-72

Gilaberte Y, González S. Actas Dermo-Sifiliográficas. 2010; 101: 659-72

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

Absorption

Dispersion

UVR

Chemical or physical filters

Reflection

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

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

SunscreensFILTROS ACCIÓN ESPECTRO

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%

SunscreensFILTROS ACCIÓ

NESPECTRO

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

Correct sunscreen

20 min before and 2 - 3 hours

SPF 30 (97.5 UVB)◦ 370nm

High UVA protection

SPF 30 UVA high protection

Children and UV protection

50- 80% solar damage is before 18

Correct solar protection

Walker D. Journal of Pediatric nursing. 2011 Article in press

Appropriate clothing

UPF higher than 40 Dark colors, nylon and polyester

New agents

DFMO: difluorometilornitina

Camp et al. Semin Cutan Med Surg. 2011; 30: 6-13

Children solar protection

Prudent solar exposure

Thanks