Sun protection factor persistence during a day with physical activity and bathing

Background/purpose: The persistence of sunscreens during a day with physical activity and bathing is often debated. We wished to examine the durability of the protection achieved by one sunscreen application. Methods: Seven areas were marked on the back of 24 volunteers. One area was phototested to determine UV sensitivity. Six areas were treated with either an organic or an inorganic sunscreen (2 mg/cm²). The participants performed physical activities, were exposed to a hot environment and bathing during 8 h and were phototested with ultraviolet‐B (UVB) radiation 30 min, 4 and 8 h after sunscreen application. The minimal erythema dose (MED) was determined 24 h after irradiation. The sun protection factor (SPF) was calculated, as MED on protected skin/MED on unprotected skin. Results: The SPFs of the inorganic and organic sunscreen, respectively, were reduced by 38% and 41% after 4 h and by 55% and 58% after 8 h. Conclusion: One application of either an inorganic or an organic sunscreen reduced the erythema caused by UVB during a day with physical activity and bathing. After 8 h the sunscreens still provided approximately 43% of the initial protective effect. This might simulate what happens during a day at the beach.     

The physiological and phenotypic determinants of human tanning measured as change in skin colour following a single dose of ultraviolet B radiation

Please cite this paper as: The physiological and phenotypic determinants of human tanning measured as change in skin colour following a single dose of ultraviolet B radiation. Experimental Dermatology 2010; 19 : 667–673. Abstract: Experimental study of the in vivo kinetics of tanning in human skin has been limited by the difficulties in measuring changes in melanin pigmentation independent of the ultraviolet‐induced changes in erythema. The present study attempted to experimentally circumvent this issue. We have studied erythemal and tanning responses following a single exposure to a range of doses of ultraviolet B irradiation on the buttock and the lower back in 98 subjects. Erythema was assessed using reflectance techniques at 24 h and tanning measured as the L* spectrophotometric score at 7 days following noradrenaline iontophoresis. We show that dose (P < 0.0001), body site (P < 0.0001), skin colour (P < 0.0001), ancestry (P = 0.0074), phototype (P = 0.0019) and sex (P = 0.04) are all independent predictors of erythema. Quantitative estimates of the effects of these variables are reported, but the effects of ancestry and phototype do not appear solely explainable in terms of L* score. Dose (P < 0.0001), body site (P < 0.0001) and skin colour (P = 0.0365) or, as an alternative to skin colour, skin type (P = 0.0193) predict tanning, with those with lighter skin tanning slightly more to a defined UVB dose. If erythema is factored into the regression, then only dose and body site remain significant predictors of tanning: therefore neither phototype nor pigmentary factors, such as baseline skin colour, or eye or hair colour, predict change in skin colour to a unit erythemal response.     

含牛油果树果脂等植物成分的保湿产品改善皮肤干燥的安全性及有效性评价

目的：探讨一种含牛油果树果脂等植物成分的保湿产品改善皮肤干燥的临床有效性和安全性。方法：采用前瞻性多中心自身前后对照试验进行研究,共收集196例受试者。受试者在双侧小腿胫前皮肤使用该保湿产品,每日1次,共14 d。分别在使用前、使用后1 h、4 h、24 h、7 d及14 d进行受试区皮肤生理指标检测及干燥程度的主观评分。结果：受试者单次使用研究产品后1 h、4 h及24 h,受试区皮肤角质层含水量较基线水平显著增加,分别升高17.11±6.72、13.98±6.36、10.79±6.28（P<0.001）,保湿时效≥24 h。使用7 d和14 d后,角质层含水量分别为41.18±8.70和43.48±8.84,较基线水平（26.53±8.68）明显升高;经皮水分丢失分别为（6.48±2.33）g/h/m²和（6.46±3.43）g/h/m²,较基线水平[（7.36±3.96）g/h/m²]减少;pH值改变分别为5.28±0.60和5.37±0.53,较基线水平（5.51±0.70）降低并保持稳定;皮肤干燥程度主观...     

Comparison of turbo‐PUVA and conventional American‐style PUVA in the treatment of psoriatic patients

Background: Ultraviolet (UV)A protective properties of dihydroxyacetone (DHA) have been used as a topical UV‐resisting barrier to optimize psoralens and UVA (turbo‐PUVA). Starting doses and increments were based on the DHA diffuse reflectance spectroscopy‐derived protection factor. Objective: To evaluate the efficacy of turbo‐PUVA in psoriatic patients using a simpler method for determining starting doses and increments, in comparison to the conventional American‐style PUVA photochemotherapy. Methods: Thirty psoriasis patients (15 on American‐style PUVA and 15 on turbo‐PUVA) were evaluated, each receiving PUVA twice weekly. Starting UVA dose was determined according to skin phototype for the American‐style PUVA group and according to the patient's skin phototype × DHA SPF 3 in turbo‐PUVA group. UVA increments used were 0.5–1.5 J/cm² per treatment in American‐style PUVA and 25% of the previous dose in turbo‐PUVA. Results: Turbo‐PUVA group showed a significantly lower mean cumulative dose, a significantly higher psoriasis area and severity index score reduction, lesser mean number of treatment sessions, and less duration of treatment till remission (188.44±106.2 J/cm², 92.164±1.975%, 11.2±3.52 session, and 1.4±0.44 months, respectively) than conventional American‐style PUVA group (255.13±18.304 J/cm², 74.725±10.976%, 30±0.00 sessions, and 3.75±0.00 months, respectively). Conclusion: Turbo‐PUVA is more effective and time convenient for the treatment of psoriasis with less cumulative dose than the conventional American‐style PUVA.     

Pheomelanin and eumelanin in human skin determined by high-performance liquid chromatography and its relation to in vivo reflectance measurements

BACKGROUND/PURPOSE: Clinical experience has shown that red haired, fair-skinned people have an increased frequency of skin cancer and in addition a relatively high content of pheomelanin and low content of eumelanin in their skin. Of these, eumelanin is presumed photoprotective, and pheomelanin phototoxic. Thus, a fast, easy, and non-invasive method for determining skin content of eumelanin and pheomelanin was sought. METHODS: Skin reflectance measurements using a UV-Optimize apparatus were performed before taking suction blisters of the same skin area. Each skin sample was freeze dried and submitted to alkaline hydrogen peroxide degradation. Two eumelanin degradation compounds:Pyrrole-2,3-dicarboxylic acid (PDCA) and pyrrole-2,3,5-tricarboxylic acid (PTCA), and two pheomelanin degradation compounds: Thiazole-4,5-dicarboxylic acid (TDCA) and 1,3-thiazole-2,4,5-tricarboxylic acid (TTCA) were determined in a single chromatographic analysis. Each degradation compound was correlated to reflectance measurements of red (660 nm), green (555 nm), and blue (488 nm) light and additionally correlated to the pigmentation % and redness % given by UV-Optimize. RESULTS: Neither of the investigated parameters were significantly correlated to either PDCA or TTCA. Contrarily, a highly significant correlation was found for the eumelanin marker, PTCA (r2=0.79, P<0.0001). The pheomelanin marker, TDCA, was likewise found to be significantly correlated (r2=0.43, P<0.0001). CONCLUSION: Based on the coefficients of determination it was concluded that in vivo spectrophotometric reflectance measurements of human skin were highly useful for determining the eumelanin content of skin and to classify the pheomelanin content of skin non-invasively. This may be used individually and in population-based studies.     

Randomized controlled trial testing the impact of high-protection sunscreens on sun-exposure behavior

OBJECTIVE: High-protection sunscreens have been suspected to prompt people to increase sun exposure, and thus to increase skin cancer risk. We tested the influence of both the actual protection (sun protection factor [SPF]) and the information about protection (label) on sun-exposure behavior. DESIGN: Randomized controlled trial. SETTING: Four French seaside resorts during summer 2001. PARTICIPANTS: A total of 367 healthy subjects during their 1-week holiday. Outcome was assessable in 98% of them. INTERVENTION: Subjects were offered free sunscreens, with randomization into the following study arms: (1) SPF 40 labeled as "high protection"; (2) SPF 40 labeled as "basic protection"; and (3) SPF 12 labeled as "basic protection." Arm 4, ie, SPF 12 labeled as "high protection," was not implemented for ethical reasons. Subjects were not aware of the real target of the study and were blinded to the SPF value. MAIN OUTCOME MEASURE: Duration of sunbathing exposure during 1 week. Secondary outcomes were occurrence of sunburns and amount of sunscreen used. Influences of SPF and label were assessed separately. RESULTS: Compared with the low-SPF group, the high-SPF group did not have longer sunbathing exposure (12.9 +/- 7.2 h/wk for high SPF vs 14.6 +/- 6.7 h/wk for low SPF; P = .06), experienced fewer sunburns (14% vs 24%; P = .049), and used less sunscreen (median, 30 g vs 109 g; P<.001). The label "high protection" or "basic protection" had no influence on these end points. CONCLUSIONS: In this adult population, higher SPF had no influence on duration of sun exposure and offered better protection against sunburns. Although higher SPF may increase sun exposure duration in specific populations, this effect cannot be viewed as a universal side effect of high-SPF sunscreens.     

补充维生素D3协同第二代抗组胺药物治疗慢性自发性荨麻疹的临床疗效观察和作用机制研究

目的：评价补充维生素D3（VD3）协同第二代抗组胺药物对控制慢性自发性荨麻疹（CSU）临床症状的疗效。方法：① 90例CSU患者,21例慢性可诱导性荨麻疹(CIndUI)和55例健康自愿者选自武汉大学人民医院皮肤科门诊（2017年10月至2018年10月）;② 受试者进行血清25羟维生素D3［25-(OH)D3］,血浆D-二聚体(D-dimer)、纤维蛋白降解产物（FDP）,血沉（ESR）等实验室检查,并给予荨麻疹活动度评分（UAS7）;③ 分离和体外培养正常人与CSU患者各15例外周血单个核细胞（PBMC）,经1 nM和10 nM 1α,25-(OH)2D3处理后用实时荧光定量PCR技术检测白介素-6(IL-6)和维生素D受体（VDR）mRNA的表达水平;④ VD3严重缺乏（血清浓度<10 ng/mL）的患者补充大剂量(2400 IU/d)VD3,缺乏者(10~20 ng/mL)给予补充小剂量（800 IU/d）VD3,设未补充患者作对照,于6周和12周时再行UAS7评分。结果：与健康对照组相比,CSU患者血清25-(OH)D3水平明显减少,D-dimer、FDP及ESR水平明显增加,且与UAS7评分呈正相关;qPCR结果显示15例CSU患者PBMC IL-6和VDR mRNA表达水平较正常人明显增加;经1α,25-(OH)2D3处理后,IL-6 mRNA表达减少,VDR mRNA表达增加(P<0.05);与未补充组比较,VD3严重缺乏组给予补充大剂量VD3 12周,UAS7评分明显下降(P<0.0001)。结论：补充VD3有助于协同控制CSU的临床症状,可能与其抑制了荨麻疹亚临床炎症有关。     

OnabotulinumtoxinA treatment of moderate to severe glabellar lines in Chinese subjects after laser therapy: A prospective,open-label,noncomparative study

Introduction: This study evaluated safety and efficacy of onabotulinumtoxinA for moderate to severe glabellar lines (GL) following laser therapy in Chinese subjects. Materials and Methods: Subjects (n = 173) were followed for 120 days following a single onabotulinumtoxinA (20 U) treatment for GL after recent laser therapy. Subjects completed validated patient-reported outcomes, including Facial Lines Outcome 11-item (FLO-11) Questionnaire and Facial Lines Satisfaction Questionnaire (FLSQ). Physicians and subjects assessed GL severity at maximum frown and at rest using the Facial Wrinkle Scale with Asian Photonumeric Guide (FWS-A). Results: Mean total FLO-11 scores increased from 47.7 (baseline) to 75.9 (day 120) (p < 0.0001), with mean improvement of at least two grades for most items maintained to day 120. Most subjects were mostly or very satisfied, per the FLSQ. Percentages of subjects with at least one-grade improvement in FWS-A (responders) at maximum frown per subjects and physicians were 93.1% and 97.1%, respectively, at day 30, and 72.3% and 81.5% at day 120 (all, p < 0.0001). More than 70% were FWS-A responders at day 120. All adverse events were mild or moderate; none were related to onabotulinumtoxinA. Conclusions: A single onabotulinumtoxinA (20 U) treatment following laser therapy was safe and effective in correcting GL for up to 120 days.     

Self-tanning lotions: are they a healthy way to achieve a tan?

Self-tanning creams utilize dihydroxyacetone (DHA) as an active agent, to produce a temporary staining of the skin. DHA is a 3-carbon sugar that interacts with the protein-rich stratum corneum to produce melanoidins, which are brown chromophores. Lower concentrations of DHA produce lighter skin-staining, while higher concentrations produce darker skin-staining, resulting in the simulation of a tan for persons of all skin types. DHA is well tolerated, for both internal ingestion and topical application, with the exception of infrequent allergic reaction in some patients. However, self-tanning creams only offer a sun protection factor (SPF) of 3 to 4, with protection at the low end of the visible spectrum and limited ultraviolet A protection. In addition, this SPF is only present for several hours after application of the product, and does not last for the duration of the tan. Self-tanning creams are a method of safely simulating the appearance of a tan without photoprotection. However, other sun protection will be required.     

Nle4-D-Phe7]-alpha-melanocyte-stimulating hormone significantly increased pigmentation and decreased UV damage in fair-skinned Caucasian volunteers

Epidermal melanin reduces some effects of UV radiation, the major cause of skin cancer. To examine whether induced melanin can provide protection from sunburn injury, 65 subjects completed a trial with the potent synthetic melanotropin, [Nle4-D-Phe7]-alpha-melanocyte-stimulating hormone ([Nle4-D-Phe7]-alpha-MSH) delivered by subcutaneous injection into the abdomen at 0.16 mg/kg for three 10-day cycles over 3 months. Melanin density, measured by reflectance spectroscopy, increased significantly in all [Nle4-D-Phe7]-alpha-MSH-treated subjects. The highest increases were in volunteers with lowest baseline skin melanin levels. In subjects with low minimal erythemal dose (MED) skin type, melanin increased by an average of 41% (from 2.55 to 3.59, P < 0.0001 vs placebo) over eight separate skin sites compared with only 12% (from 4.18 to 4.70, P < 0.0001 vs placebo) in subjects with a high-MED skin type. Epidermal sunburn cells resulting from exposure to 3 MED of UV radiation were reduced by more than 50% after [Nle4-D-Phe7]-alpha-MSH treatment in the volunteers with low baseline MED. Thymine dimer formation was also shown to be reduced by 59% (P = 0.002) in the epidermal basal layer. This study has shown for the first time the potential ability of a synthetic hormone that augments melanin production to provide photoprotection to people who normally burn in direct sunlight.     

Factors influencing sunless tanning with dihydroxyacetone

BACKGROUND: Sunless tanning preparations have been used for more than 50 years and are still very popular because they provide temporary pigmentation resembling an ultraviolet-induced tan. The pigment is the product of reactions between dihydroxyacetone (DHA) and amino acids in the stratum corneum. OBJECTIVES: To understand the factors that influence the reactions of DHA with amino acids in the stratum corneum with the ultimate goal of producing pigmentation with greater photoprotection. METHODS: The influence of hydration and/or oxygen on the development of DHA-induced pigment was assessed in vivo using an occlusive dressing and ex vitro on human epidermal preparations. Two spectroscopic techniques, diffuse reflectance and fluorescence emission, were used to monitor the extent of pigment development. The optimal relative humidity for DHA-induced pigmentation was assessed on the epidermal preparations. The formation of products from reactions between DHA and nine amino acids was studied in solutions buffered at pH 5 and 7. RESULTS: Development of DHA-induced pigmentation was inhibited by a 24-h occlusive dressing but appeared after its removal, indicating that DHA was still present. High hydration but not the absence of oxygen inhibited coloration of occluded skin. The extent of pigmentation did not vary in a simple manner with hydration, as pigment formation was positively correlated with humidity from 0 to 75% but negatively correlated from 75 to 100%. Lysine, glycine and histidine reacted most rapidly with DHA, with reaction rates greater at pH 7 than at pH 5. The products absorbed with maxima at wavelengths up to 340 nm. CONCLUSIONS: These results indicate that extent of hydration, pH and availability of certain amino acids influence the development of DHA-induced pigmentation in the stratum corneum and suggest that manipulation of these factors might produce pigmentation with greater photoprotection.     

The influence of the amount of sunscreen applied and its sun protection factor (SPF): evaluation of two sunscreens including the same ingredients at different concentrations

Background: To estimate labeled sun protection factor (SPF) for sunscreen, the amount of product applied on volunteers, according to food and drug administration (FDA) and International protocols, is 2 mg/cm². However, different studies have shown that consumers actually apply much less product when exposed to the sun. Previous studies have reported contradictory findings in an attempt to correlate the amount applied in relation to SPF. The objective of the present study was to estimate the influence of the quantity of sunscreen applied in the determination of SPF, according to the FDA methodology.
Subjects and methods: Forty volunteers were included in two groups (SPF 15 and 30). The selected sunscreen was then applied in four different quantities (2, 1.5, 1.0 and 0.5 mg/cm²). All areas were irradiated with a solar simulator. After 24 h, the minimal erythemal dose (MED) and SPF were determined.
Results: In both groups, we observed that the SPF decreased when the amount of sunscreen applied was decreased. The differences between the 2 mg/cm² area and the others were significant in both groups ( P <0.001). The correlation between specified SPF and applied amount grew exponentially.
Conclusion: The protection provided by sunscreen is related to the amount of product applied. It is essential to educate consumers to apply larger amounts of sunscreen for adequate photoprotection.     

BALB/c小鼠系统感染白念珠菌血清IL-18,IL-4,IFN-γ的动态变化

目的探讨BALB/c小鼠系统感染白念珠菌后IL-18,IL-4,IFN-γ的动态变化。方法BALB/c小鼠随机分成4组:高菌量感染组,低菌量感染组,免疫功能低下组,正常对照组。分别于系统感染白念珠菌1,4,7天后应用ABC-ELISA检测各组小鼠的IL-18,IL-4,IFN-γ的水平。结果IL-18水平从感染第1天骤降后(但仍高于免疫功能低下组,P<0.05~0.001),至感染后第7天达正常水平;而IFN-γ始终高于正常对照组及免疫功能低下组(P<0.05);IL-4于感染1天后低于正常对照组(但仍高于免疫功能低下组,P<0.05~0.001),感染4天后则与正常对照组差异无显著性,7天后高于正常对照组(P<0.05)。结论高低菌量白念珠菌感染的BLAB/c小鼠,免疫系统早期多以Th1型细胞应答为主;后期Th1/Th2型细胞因子均升高,表明细胞免疫和体液免疫均参与了抗白念珠菌感染。     

Melanin and facial skin fluorescence as markers of yellowish discoloration with aging

Background: Although one clinical sign of aging and/or photoaging is a yellowish discoloration of the facial skin, little is known about the cause of this change. In addition to the increase in the epidermal melanin content, it has been suggested that advanced glycation end products (AGEs), which are known to accumulate in photoaged skin, may affect this discoloration. Aim: The objective of this pilot study was to non‐invasively investigate the roles of melanin and AGEs in this yellowish discoloration of the facial skin. Methods: We examined the spectral reflectance at the cheek in 40 healthy Japanese women of various ages (mean age, 38.1 years) using a reflectance spectrophotometer and a spectrofluorimeter. The degree of yellowish tint was evaluated in terms of b^*. The amount of melanin in the skin was evaluated by calculating the melanin index (MI) A₆₄₀–A₆₇₀ [A_λ: log₁₀ (1/reflectance) at a wavelength of λ]. The amount of AGEs was roughly evaluated using the AGEs index, which is thought to linearly correlate with the amount of intrinsic fluorescence markers irrespective of the concentration of melanin and is defined as follows: AGEs index=I₅/SQR (I₁×I₂). In this equation, the intensities of reflectance are I₁ at an excitation wavelength of 335 nm, I₂ at an emission wavelength of 390 nm and I₅ at 390 nm under an excitation wavelength of 335 nm. Results: Both b^* and the AGEs index were significantly correlated with subject age (r=0.34, P<0.05 and r=0.68, P<0.0001, respectively). Significant correlations were also observed between MI and b^* (r=0.63, P<0.0001) and between the AGEs index and b^* (r=0.53, P<0.0005). However, no significant correlations were seen between MI and the AGEs index. Conclusion: The AGEs index does not appear to be influenced by the amount of melanin and may be utilized as an indicator of the amount of AGEs in the skin. AGEs are likely to play a role in the yellowish discoloration of skin with aging.     

Time course of ultraviolet-induced skin reactions evaluated by two different reflectance spectrophotometers: DermaSpectrophotometer and Minolta spectrophotometer CM-2002

BACKGROUNDS: Many attempts have been made to quantify ultraviolet (UV)-induced erythema and pigmentation, but most studies have been focused on the initial changes of reaction for a few hours or days and neglected the later events. METHODS: : A time course of skin colour changes induced by fluorescent sunlamp with a broad band of UVA and UVB radiation was evaluated in 15 Korean male volunteers using two different reflectance spectrophotometers for 28 days. The results were presented by E (erythema)- and M (melanin)-index as well as values converted to the L*a*b* system recommended by the CIE (Commission Internationale de l'Eclairage). RESULTS: The mean individual typology angle of the subjects was 46.6 degrees, which indicated "light" group in constitutional skin colour category. A day after UV exposure, the L* and b* values decreased significantly, following the colour direction of persistent pigment darkening. The values went in the opposite direction persistently until after the 1st week, when maximum tanning was obtained. They then shifted toward their original positions, parallel to the constitutive melanization axis. The a* index showed a significant increase toward the mean colour of haemoglobin on day 1. It returned to its original value along the constitutive melanization axis. The E-index showed a maximum value at day 1, then returned to baseline. The value of M-index reached a peak at day 7. There was no significant difference between the two instruments, but each has its own characteristic features. CONCLUSION: These promising quantitative methods should enable us to achieve objective measurement of the dermatophysiologic changes and to evaluate the efficacy of therapeutic modalities on skin disorders without the inherent errors associated with subjective judgement. Our results provide standard data on a time course of UV-induced skin erythema and pigmentation.     

Reliability assessment and validation of the post-acne hyperpigmentation index (PAHPI) in a population from Sub-Saharan Africa in Senegal

BackgroundA post-acne hyperpigmentation index (PAHPI) has been developed in the United States to better compare therapeutic modalities. Our aim in this study was to validate the PAHPI score in patients with skin type VI from sub-Saharan Africa.Patients and methodsThe study was conducted in Dakar, Senegal. Twenty-one patients with Fitzpatrick skin type VI, aged 17 to 55 years, presenting hyperpigmentation secondary to acne were included. Ongoing use of skin bleaching products or acne treatments was allowed. Four trained dermatologists rated the patients using the PAHPI. A narrow-band reflectance spectrophotometer (Mexameter MX-18, Cologne, Germany) was used to measure the degree of pigmentation of involved and adjacent skin on 6 representative facial lesions.ResultsThe average inter-rater reliability (weighted Kappa) showed substantial agreement for intensity (0.67), moderate agreement for number (0.53) and fair agreement for lesion size (0.28). Inter-rater reliability for the total PAHPI was excellent for both day 1 and day 2 (interclass correlation coefficient of 0.87 and 0.85, respectively; P < 0.0001). Intra-rater reliability for total PAHPI ranged from 0.83 to 0.93 (P < 0.0001). PAHPI scoring thus demonstrated excellent reliability both between and within raters. The association was moderate to substantial for all raters on both days (range for rho on day 1: 0.531 to 0.815; range for rho on day 2: 0.448 0.762). The correlations between the Mexameter (Courage and Khazaka) measurements and PAHPI scores showed moderate to substantial agreement.ConclusionAlthough tested primarily in African American women to date, PAHPI is also valid for patients from sub-Saharan Africa.     

Tonality of suntan vs sunless tanning with dihydroxyacetone

Background/aims: Although there is an increasing awareness of the detrimental effects of solar irradiation on skin, a tanned look is still in fashion. To achieve the tanned look without sun exposure various sunless tanning formulations have become available. Most of these contain dihydroxyacetone (DHA) which binds to the proteins of the stratum cornium and imparts a brown color to skin. This color is similar to a suntan but can be somewhat more yellow, making it appear unnatural. The aim of this study was to determine a quantitative method to define a “natural” tan and to study methods to improve the tonality of sunless tanning on skin. Methods: Tonality of suntan was determined as the marker for a “natural” tan. In order to achieve this, human volunteers were exposed to the sun and the change in skin color was observed after 3 days. Color measurements obtained with the Minolta Chromameter were plotted in two standard graphs labeled as the “natural universe of tan”, which depicted a balance between Chroma and change in reflectance, while the “natural universe of color” determined the balance between changes in yellow and red components of the suntan. Change in skin color after treatment with DHA was then inserted in these graphs to observe how “natural” the tonality of sunless tan appeared relative to suntan. Results: Results show a good balance between Chroma and change in reflectance for suntanned skin in the “natural universe of tan”. Conversely, the “natural universe of color” exhibited a good balance between increase in yellow and red components of suntan. Sunless tan data inserted in these graphs showed that for several subjects with skin types I‐II the tonality is not within the realm of “natural” but is unnaturally yellow. Addition of antioxidants, especially caffeic acid phenethyl ester (CAPE) in DHA formulation significantly shifted the tonality towards the center of the “natural universe of color”. Conclusions: The “natural universes of tan and color” exhibit a simple and quantitative assessment of tonality of suntan and sunless tan. Although skin tonality from DHA‐induced sunless tan can often lie outside the realm of the “natural” tan, it is possible to improve this tonality to a more “natural” look by addition of strong antioxidants in the DHA formulations.     

Sun protection factor persistence on human skin during a day without physical activity or ultraviolet exposure

Background/purpose: Recently, we showed that the sun protection factor (SPF) decreases by a constant factor to reach 55% during a day with activities. Organic sunscreens but not inorganic ones are absorbed through the skin. We wished to determine the SPF decrease caused by absorption by investigating the difference in SPF decreases between an organic and an inorganic sunscreen, assuming that the sunscreens are stable, and that the SPF decrease is time dependent if caused by absorption.
Methods: Sunscreens were used on the backs of 22 participants, who were physically inactive at 22 °C. SPF testing was performed 30 min, 4, and 8 h after application of 2 mg/cm² sunscreen. Whether cream evaporation changed the ultraviolet (UV) transmission was studied in vitro .
Results: The SPFs of the organic and inorganic sunscreens were reduced by about 25% after 8 h. Evaporation of the cream did not cause a change in UV transmission in vitro .
Conclusion: A similar decrease in SPF of the organic and inorganic sunscreen was seen during 8 h without activities, and is thus not likely to be caused by absorption or evaporation from the skin. The SPF decrease after 8 h is about 55% when the participants perform activities and 25% without activities.
Trial registration: Registered at http://www.clinicaltrials.gov . Register name: 'Sunscreen: Persistence of Sun Protection Factor and the Influence on Vitamin D'. Register number H-B-2007-120.     

Testing high SPF sunscreens: a demonstration of the accuracy and reproducibility of the results of testing high SPF formulations by two methods and at different testing sites

BACKGROUND/PURPOSE: The goals of this study were (i) to demonstrate that existing and widely used sun protection factor (SPF) test methodologies can produce accurate and reproducible results for high SPF formulations and (ii) to provide data on the number of test-subjects needed, the variability of the data, and the appropriate exposure increments needed for testing high SPF formulations. METHODS: Three high SPF formulations were tested, according to the Food and Drug Administration's (FDA) 1993 tentative final monograph (TFM) 'very water resistant' test method and/or the 1978 proposed monograph 'waterproof' test method, within one laboratory. A fourth high SPF formulation was tested at four independent SPF testing laboratories, using the 1978 waterproof SPF test method. All laboratories utilized xenon arc solar simulators. RESULTS: The data illustrate that the testing conducted within one laboratory, following either the 1978 proposed or the 1993 TFM SPF test method, was able to reproducibly determine the SPFs of the formulations tested, using either the statistical analysis method in the proposed monograph or the statistical method described in the TFM. When one formulation was tested at four different laboratories, the anticipated variation in the data owing to the equipment and other operational differences was minimized through the use of the statistical method described in the 1993 monograph. CONCLUSIONS: The data illustrate that either the 1978 proposed monograph SPF test method or the 1993 TFM SPF test method can provide accurate and reproducible results for high SPF formulations. Further, these results can be achieved with panels of 20-25 subjects with an acceptable level of variability. Utilization of the statistical controls from the 1993 sunscreen monograph can help to minimize lab-to-lab variability for well-formulated products.     

Evaluation of sexual function in patients presenting with Behçet’s disease with or without depression

Aim Sexual dysfunction has been found in many disorders that are chronic or disabling. The aim of this study was to evaluate the sexual satisfaction levels, sexual function and their relationship with the mental state in a group of patients being followed‐up with a diagnosis of Behçet’s disease (BD). Method A total of 50 BD patients and 50 control‐group subjects were administered the Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), Golombok Rust Sexual Satisfaction Scale (GRISS) and Arizona Sexual Experiences Scale (ASEX). Results The ASEX, GRISS total, HDRS and HARS scores were significantly higher in the patient group than the control subjects (P = 0.0001, P = 0.007, P = 0.0001, P = 0.0001 respectively). Sexual dissatisfaction was seen in 40 (80%) of the patient‐group and 16 (32%) of the control‐group subjects according to the GRISS (P = 0.0001). Female study participants had higher mean scores than the control subjects for the ASEX, GRISS total scores and the GRISS satisfaction, avoidance, vaginismus and orgasm subscale scores (P = 0.0001, P = 0.002, P = 0.02, P = 0.001, P = 0.006, P = 0.03 respectively). Male study participants had different mean scores for the controls regarding the ASEX scores and the GRISS impotence, premature ejaculation, satisfaction and frequency subscale scores (P = 0.01, P = 0.01, P = 0.0001, P = 0.03, P = 0.007 respectively). Discussion The negative effect of the disorder on the biological and functional status and daily living activities in BD patients also influences the patients’ sexual experiences and satisfaction. The negative effects of chronic diseases such as BD should therefore be defined and the disorder evaluated from a wide perspective during the treatment process.