北京市两地区中老年女性对日光防护行为的调查

【摘要】 目的 调查北京市中老年女性对日光的防护行为。方法 2016年5 - 6月选取北京市中心（宣武门地区）及边缘（延庆区）两个地区进行调查,采取随机抽样现场调查的方式,被调查者在皮肤科医生的帮助下完成问卷调查。结果 共调查400例40～90岁女性,其中宣武门地区190例,延庆区210例。受调查者中,每日户外活动时间平均为2 h;117人（29.2%）有主动日晒习惯,包括延庆区38人（18.1%）、宣武门地区79人（41.6%）,两地区之间主动日晒者比例差异有统计学意义（χ2 = 26.582,P < 0.001）;67人（16.8%）有过晒伤史;130人（32.5%）习惯使用防晒霜。受教育程度中等及以上者使用防晒霜的比例为45.2%（103人）,显著高于受教育程度低等及以下者［16.3%（28/172）,P < 0.001］;Ⅲ型皮肤者使用防晒霜的比例为41.2%（70/170）,显著高于Ⅳ型皮肤者［26.5%（61/230）,P = 0.002］;使用防晒霜者面部和手背皮肤老化评分均显著低于不使用者（Z = 18.536,P = 0.002;Z = 10.731,P = 0.026）。结论 北京市城乡中老年女性主动日晒习惯存在差异,防晒霜使用情况与受教育程度相关。     

中波高能紫外线最小红斑量值测定

目的探讨中波高能紫外线最小红斑量值(MED)范围及其与年龄、性别、皮肤日光反应类型的关系。方法以Dualight targeted Phototherapy System UV120-2的UVB作为照射光源,测定73名健康志愿者和35例白癜风患者腹部正常皮肤的MED值范围。结果108名受试者MED值为(189.17±56.156)mJ/cm2,范围为90～330mJ/cm2;Ⅲ型皮肤为(155.88±34.996)mJ/cm2(90～210mJ/cm2),Ⅳ型皮肤为(218.95±54.957)mJ/cm2(120～330mJ/cm2),Ⅲ型显著低于Ⅳ型(P<0.01)。男性受试者中,Ⅲ型为(154.29±39.443)mJ/cm2(90～210mJ/cm2),Ⅳ型为(224.4±54.854)mJ/cm2(150～330mJ/cm2),男性Ⅲ型显著低于Ⅳ型(P<0.01)。女性受试者中,Ⅲ型为(157±32.179)mJ/cm2(90～210mJ/cm2),Ⅳ型为(214.69±55.532)mJ/cm2(120～330mJ/cm2),女性Ⅲ型也显著低于Ⅳ型(P<0.01)。两性别组间和各年龄组间比较无统计学差异(P>0.05)。结论中波高能紫外线的MED值与性别和年龄无直接关系,皮肤日光反应类型是影响其重要因素。     

敏乐啶及复方敏乐啶局部治疗男型秃发的疗效观察

本院自 1991年 9月～ 1994年 8月分别局部应用敏乐啶洗剂 (ＴＭ )和复方敏乐啶洗剂 (ＴＭＣ) ,治疗男性男型秃发 (Ｍ ＭＰＡ) 50例 ,女性男型秃发 (Ｆ ＭＰＡ)2 3例 ,现将疗效报告如下。临床资料Ｍ ＭＰＡ50例 (不伴心血管、内分泌疾病 ) ,平均年龄 35.8岁 (15～ 6 1岁 ) ,平均病程 5.92± 6 .12年 (0 .5～ 2 3年 ) ,疗前发型 (ｈａｍｉｌｔｏｎ ｎｏｒｗｏｏｄ ,Ｈ Ｎ)分型[1] :Ⅲ型 9例 ,Ⅳ型 14例 ,Ⅴ型 13例 ,Ⅵ型 11例 ,Ⅶ型 3例 (其中Ⅲ、Ⅳ、Ⅴ型包括Ⅲα、顶Ⅲ、Ⅳα、Ⅴα 型病例 )。家族遗传史 :父系 15例 ,母系 3例 ,父母系 2例…     

银屑病患者血浆胆固醇和甘油三脂浓度改变问题

本文对150名各型银屑病患者血胆固醇和甘油三脂浓度作了检查.男性100名,女性50名.年龄16～59岁(平均男37±13岁,女36±13岁).包括局限型、泛发型、关节病型、渗出型、红皮病型.其中没有人患糖尿病、肥胖症以及用细胞抑制剂、皮质类固醇和亲脂药物治疗.高脂蛋白血症标准是采用高于Fredrickson等建议的所谓阈值水平浓度,胆固醇和甘油三脂分别相当于健康人群阈值上界的1O%及5%.对照组各年龄组数量与病例组相等.结果:患者的平均血胆固醇和甘油三脂浓度分别为194.8±2.33毫克及114.3±10.7毫克%,男女患者间无统计学差异.但两浓度指标在男女患者中随着年龄却有十分显著的正回归系数(胆固醇回归系数男为0.99,女为2.21;甘油三脂分别为1.26,2.84).在各型银屑病中,关节型年龄最高(45.3±9.8岁)、泛发型最低(34.7±12.4岁),但二指标在     

中国城市女性人群皮肤类型调查及相关研究

目的：调查中国女性群体的皮肤光型或日光反应性分型。方法：按照Fitzpatrick分型概念设计问卷,采用引导性答卷和自主性答卷两种方式进行调查;然后利用标准日光模拟器测定受试者的最小红斑量(MED)和最小持续黑化量(MPPD),比较分析这些参数在不同皮肤类型之间的变化。结果：接受调查的404名城市女性在引导性调查和自主性调查中．Ⅲ型皮肤分别占71．1％和74.3％,Ⅱ型分别占14．7％和25．6％,Ⅳ分别占14．2％和1．0％。未见Ⅰ、Ⅴ、Ⅵ型皮肤。上述皮肤类型和所测定的MED值和MPPD值有较好的对应变化关系,即从Ⅱ型到Ⅳ型皮肤,MED值逐渐增加,而MPPD值逐渐减小,在不同皮肤类型之间差异有显著性。结论：在所调查的中国女性人群中皮肤类型以Ⅲ型为主,其次是Ⅱ型和Ⅳ型。皮肤类型和所测的MED、MPPD值有良好的相关性。     

黄褐斑338例临床分析

目的分析黄褐斑的临床特点和发病诱因。方法用关于黄褐斑皮肤特点、光反应类型及发病诱因的问卷调查2011年9月-2012年6月天津市长征医院皮肤色素科门诊诊治的黄褐斑患者。结果共入选338例,男23例,女315例,男女比约为1∶14。平均发病年龄(34.84±5.54)岁。发病高峰年龄为30～40岁。270例(79.88%)暴露部位皮肤颜色为中等或偏深色,113例(33.43%)对光反应类型为Ⅳ型不易晒红中度晒黑,217例(64.20%)为干性或者混合性皮肤,138例(40.83%)为敏感性皮肤。明确由暴晒引起的有31例、日晒后加重者148例(43.79%),月经不调184例(占女性患者的58.41%),精神压力大且与病情相关的有73例(21.60%)。结论黄褐斑患者中半数以上为干性或混合性皮肤,对光反应类型为Ⅳ型的患者比例较一般人群大,日晒等物理因素、内分泌因素及精神压力是发病的主要诱因。     

曲靖市中学生对日晒危害认知及防晒行为的调查

目的了解曲靖市中学生对紫外线及日晒危害的认知、防晒措施、对防晒霜的认知及使用情况。方法采用问卷调查的方式,进行面对面交谈,填写调查问卷。结果大部分的中学生知道过度日晒可致皮肤损伤;其中女生及高中生对紫外线种类的认知、防晒意识及使用防晒霜的比例高于男生及初中生,(P0.01)。结论曲靖市中学生对有关日晒对皮肤健康的危害、防晒、防晒霜的认知和使用均有待提高,需要加强这方面知识的学习。     

北京和上海部分人群对紫外线的认知和防护

目的:调查中国城市人群对紫外线的认知和防护情况.方法:在北京和上海两城市以问卷调查的形式,了解部分人群对紫外线的基本特性、紫外线对人类健康的影响、防护紫外线的措施、防晒化妆品的认知和使用情况以及获得紫外线和防护知识的渠道.结果:共有1 171人完成问卷调查,其中仅有少部分人掌握了紫外线的基本特性;大部分被访者知道紫外线可以引起皮肤晒伤、老化和皮肤肿瘤,少部分(35%)人知道紫外线与白内障的形成有关.对于紫外线的防护,女性首选防晒化妆品,而男性首选太阳镜.对于防晒化妆品的调杏结果,尤其对于长波紫外线的防护(protection of UVA,PA),有45%的人不知道其含义;只有小部分人认为在高原和海滨需要使用防晒化妆品;影响选购防晒化妆品的首要影响因素为品牌知名度.获取紫外线和防护知识的首要渠道为电视广告.结论:北京和上海两城市的人群对于紫外线的认知及防护知识不尽满意,需要利用公共媒体加强这方面的宣传和教育.     

煤矿工人足癣的流行病学分析

作者等于1985年在徐州矿务局权台煤矿共调查井下工人2059人,均为男性,17-51岁(平均29±7.9),以30-50岁壮年组较高(64.64%P<0.01),工龄0.5-28年,平均工龄7.9±6.6年,以井下工人足癣患病率较高(P<0.01),0-4年工龄的患病率为54.33%,20年以上工龄患病率为77.24%,高20%左右.患者1179人,平均年龄29.9±8岁,平均工龄8.5±7.1,患病率为57.26%,真菌镜检阳性者928人,镜检阳性率78.71%.1179例的临床类型以鳞屑型(24.77%)、趾间型(37.15%)和上述两型的馄合型(35.28%)居多,三型共占97.2%鳞屑型与趾间型及两者混合型之间镜检阳性率差弃有显著性(x²=24.12,P<0.01),以趾间型阳性率最高,达85.16%.     

维族和汉族女性对紫外线危害的认知水平和皮肤防护现状调查

目的了解乌鲁木齐地区女性对紫外线危害的认知水平和自我皮肤防护的现状,使皮肤科医护人员更有针对性地进行个体化健康教育。方法随机抽取新疆维吾尔自治区人民医院皮肤科门诊维吾尔族和汉族女性就诊者494例进行问卷调查,采用SPSS17．0软件进行统计分析。结果知道紫外线会致光老化者占61．97％,知道防晒系数（SPF）和UVA防护等级（PA）含意的分别占46．96％（250／494）和17．21％（85／494）,认为日光弱的冬天和室内需要防晒的分别占50．69％和30．56％,汉族女性比维吾尔族女性该方面知晓率高（P〈0．01）;13岁以后开始有护肤意识的占6％,维吾尔族在13～15岁开始的占9．03％,汉族占4．08％;维吾尔族中有87．74%的女性经常使用天然物品护肤,有使用护肤品习惯的占58．0％,比汉族女性（分别占44．24％和48．37％）人数更多;维吾尔族女性不熬夜者占22．58％,汉族女性为55．21％;维吾尔族女性经常在室外活动的占6．45％,汉族女性为9．73％。结论494例受检者对紫外线的危害认知水平低,自我皮肤防护意识弱,且存在错误认知,需要加强并纠正该地区人群的皮肤防晒护肤知识宣传和自我护肤的健康教育。     

Quantity of sunscreen used by European students

BACKGROUND: The ability of sunscreen products to delay sun-induced skin erythema is indicated by the sun protection factor (SPF), which is measured using an internationally agreed sunscreen thickness of 2 mg cm(-2). OBJECTIVES: To determine the thickness of sunscreen used under practical conditions. METHODS: In two double-blind randomized trials performed in five different places in Europe in 1997 and 1998, 148 18--24-year-old students received either an SPF 10 or an SPF 30 sunscreen to be used during their summer holidays. RESULTS: Complete, detailed data on quantities of sunscreen used and skin areas on to which sunscreen was applied were available for 124 students. The median thickness of sunscreen applied was 0.39 mg cm(-2). We found no variation in sunscreen thickness according to sex, skin phototype, study place or SPF. CONCLUSIONS: Our results indicate that most consumers do not benefit from the SPF indicated on sunscreen bottles, and do not support the idea that thickness of sunscreen applied would be greater if these products were cheaper. We suggest that information on ability of a sunscreen product to prevent sunburn should be adapted in order to reflect actual usage patterns.     

Sun‐exposure knowledge and protection behavior in a North Chinese population: a questionnaire‐based study

Background: Sun exposure can cause a range of skin disorders. Skin damage can be prevented by following certain sun‐protection measures. However, the majority of reported studies regarding sun‐exposure knowledge and behavior have involved Caucasian populations. Methods: A self‐administered multiple‐choice questionnaire was administered. The questionnaire consisted of 13 questions aimed at evaluating people's knowledge, awareness, and protection behavior regarding sun exposure, and their knowledge of sunscreens and sunscreen use. Results: A total of 623 volunteers were enrolled, including 238 men (38.2%) and 385 women (61.8%). The percentages of correct answers regarding sun‐exposure knowledge and awareness ranged from 50% to 80%. Overall, 58.8% used sunscreen as a sun‐protection measure in daily life, followed by use of protective clothes (49.3%), sun umbrella (45.4%), sunglasses (45.3%), and hat (42.2%). Fifty‐two percent thought that suntan was harmful or not attractive. The mean sun‐protection factor (SPF) of the sunscreens used was 27.7 ± 9.2 and the mean UVA protection grade (PA) was 2.3 ± 0.6. Conclusions: Knowledge and awareness concerning the harmful effects of sun exposure are widespread among the Chinese population. Sunscreens with high SPF and PA are the most commonly used among Chinese people. Clear sex differences were observed. There is a significant difference in the attitude toward suntan between Chinese and Caucasian populations.     

Sunscreen applied at ≥ 2 mg cm−2 during a sunny holiday prevents erythema,a biomarker of ultraviolet radiation-induced DNA damage and suppression of acquired immunity

Rates of skin cancer are increasing more rapidly in the UK than any other form of cancer. The deadliest form of the disease is melanoma skin cancer, which affects 128% more people now than it did 28 years ago. Sun protection factors (SPFs) are known to protect the skin from sunburn when sunscreen is applied at 2 mg per cm^-2. However, whilst on holiday, people typically apply just 0.8 mg cm^-2 of sunscreen. This study aimed to identify if typical sunscreen application during a holiday with daily sun exposure results in skin cancer risk factors such as sunburn. Participants spent one week in Tenerife, a country with a very high ultraviolet index. 22 participants applied their own sunscreen without instruction and 40 participants were given SPF 15 sunscreen and guidance on effective application (three times daily at 2 mg cm^-2). It was found that participants who followed typical sunscreen application displayed significantly greater levels of sunburn and other risk factors associated with skin cancer compared to those who followed optimal application guidelines to achieve SPF 15. Individuals who followed the effective application guidelines with SPF 15 sunscreen had no sunburn on five exposed body sites. The results of this study highlight how typical sunscreen use is not providing sufficient protection from the sun in the majority of people. As well as this, it is demonstrated that sunburn is associated with an increased risk of developing skin cancer. Therefore, achieving an adequate SPF by teaching the general public how to properly apply sunscreen may be an important step in preventing skin cancer.     

Factors influencing skin ageing in a Mediterranean population from Turkey

Background. Skin ageing is a continuous process, with intrinsic factors determining which extrinsic factors (chronic sun exposure and other environmental factors, particularly smoking) have the greatest effect. Aim. To investigate the effects of lifestyle and environmental factors on skin ageing in a Mediterranean population from Ankara, Turkey. Methods. In total, 574 (337 women, 237 men; age range 18–89 years) were enrolled into the study. Data were collected on age, gender, weight, height, body mass index (BMI), skin phototype, smoking status, consumption of alcohol (> 3 units/week) and coffee (> 1 cup/day), sun exposure, use of sunscreen and sunglasses, and involvement in sports and physical activities. The Daniell skin‐wrinkling grading system was used as a marker of skin ageing. Results. We found that male gender, chronic sun exposure and number of pack‐years of cigarette smoking significantly contributed to the formation of facial wrinkles. There was a negative correlation between facial wrinkling and the use of sunscreen and sunglasses and facial wrinkling (P < 0.001 for both). We did not find any significant association between wrinkling score and alcohol consumption, coffee consumption, sports participation or d skin phototype. Moreover, wrinkling score was significantly higher in patients with a BMI < 25 kg/m² than in patients with a BMI > 25 kg/m² (P < 0.018). Multiple logistic regression analysis was conducted after adjusting for age, gender, smoking status, alcohol consumption, skin phototype, sun exposure, and use of sunglasses and topical sun protection. We found that gender and age were significantly associated with skin ageing (P < 0.014 and < 0.001, respectively). Conclusion. In this study, older age, male gender, low BMI, smoking and chronic sun exposure had a negative influence on skin ageing in a Turkish population.     

Decreased p53 expression in chronically sun-exposed human skin after topical photoprotection

UV-induced DNA damage appears to play an essential role in skin car-cinogenesis. Following acute UV irradiation, there is an overexpression of normal p53 protein in epidermal keratinocytes, representing a physiological response to DNA damage. Sun protection through topical sunscreens or clothing is believed to reduce the hazardous effects of UV irradiation and subsequently the risk of skin cancer. We have examined the effect of an SPF 15 topical sunscreen and blue denim fabric (SPF 1700) in chronically sun-exposed human skin after sun exposure during a normal summer. Skin biopsies from sun-protected and sun-exposed skin were compared with respect to immunohistochemically detectable p53. This method provides a model for assessing the significance of different degrees of UV protection under physiological conditions. Our results show a significant reduction of p53-positive cells in sun-protected skin as compared with sun-exposed skin. The reduction of p53-positive keratinocytes differed between topical sunscreen (33% reduction) and blue denim fabric (66% reduction). Interindividual variations were large, possibly because of variations in sun exposure. These variations also suggest that mechanisms determining UV damage at the cellular level are complex. The role of residual p53-positive keratinocytes after 2 months of total sun-protection (i.e., SPF 1700) is discussed.     

Photoprotection by Sunscreens

Ultraviolet (UV) radiation is an etiologic factor for the development of nonmelanoma skin cancers and also possibly melanoma. The American Academy of Dermatology currently recommends the daily use of sunscreens with a sun protection factor (SPF) of 15 or above. The SPF numerical rating is an in vivo, standardized measure of sunscreen efficacy. SPF assessment predominantly reflects the ability of a product to screen UVB radiation. The physical and biologic properties of UVA radiation are relevant as UVA contributes to photoimmunosuppression and photocarcinogenesis. An ideal sunscreen assessment system would address both UVB and UVA protection. However, the SPF rating should continue to serve as the major determinant of sunscreen efficacy.     

北京市小学生日晒危害认知和防晒行为的调查

目的调查北京市小学生对日晒危害的认知及其防晒措施。方法以问卷调查形式,了解北京市部分小学生对有关日晒引起皮肤损害、采取的防晒措施,以及获得日晒危害和防护知识的渠道。结果共有560人完成问卷调查,平均年龄(10±1)岁。大部分小学生知道过度日晒可以引起皮肤灼伤、晒黑,50%的学生知道过度日晒可致皮肤老化、皮肤肿瘤。大部分小学生在进行户外活动时采取防晒措施,但仅有18.5%的小学生外用防晒化妆品。电视传媒是北京市小学生获得日晒对皮肤危害及其防护知识的主要来源。结论北京市小学生对有关日晒引起皮肤危害的认知及防护知识还不太满意,需要加强这方面的宣传和教育,以获取相关信息。     

Sun exposure behavior and protection practices in a Mediterranean population: a questionnaire-based study

Objective: Skin cancer campaigns have only recently been implemented in a wide scale in Greece. In order to better target those individuals at risk, we aimed to explore sun exposure behaviors in a sample of the Greek population.
Methods: A total of 802 subjects, randomly selected among the residents of the two largest Greek cities, underwent a questionnaire-based telephone interview, assessing the degree of sun exposure patterns and knowledge of skin cancer risk factors.
Results: Females more commonly (90%) used sunscreens compared with males (67.5%), and among sunscreen users, only 8% used products with SPF <10. Almost half of the participants (48%) preferred going to the beach during the midday hours. Over exposure to the sun was mostly reported by individuals with phototypes III/IV and of younger age (18–35 years). Most participants were aware of sun exposure as a cause of skin cancer, but among those who did not, 41% were younger than 34 years of age.
Conclusions: In our survey, significant differences in age, sex and phototypes were observed with regard to sun exposure patterns and sunscreen use. Educational campaigns should focus more on younger age groups, encouraging a more complete set of photoprotective measures. However, potential trial limitations inherent in self-reported measures should be taken into account.     

Sunscreen use and sun protection practices in students and personnel of Celal Bayar University

BACKGROUND/PURPOSE: The steady increase in the incidence of melanoma, non-melanoma cutaneous neoplasia and preneoplastic disorders has contributed to the demand for more effective protection from the sun. In this study, we aimed to determine the prevalence of sunscreen use and other sun protection behaviors in a large sample of students and personnel of Celal Bayar University, Manisa, Turkey. METHODS: The study group included 1018 participants of whom 607 work in the Celal Bayar University Hospital and 411 are students from the Medical Faculty and School for Health Professionals. All participants completed a questionnaire composed of 45 items about sun protection and other health behaviors, such as sports activity, use of cigarettes, alcohol and seat-belts. Sun protection factor (SPF) of sunscreen, avoiding sun exposure during peak hours, wearing clothing, a hat and sunglasses were studied. RESULTS: Of the 1018, 403 participants were male and 615 were female. While avoiding sun exposure during peak hours was the most popular preventive behavior for men (42.5%), wearing sunglasses was the most popular one for women (50.7%). Avoiding exposure was the second preventive behavior for women (42.1%). Use of sunscreen with SPF 15+ was the second popular protective measure for men (19.4%) and the third one for women (39.2%). There were no significant relationships between sun protection behaviors and obesity, use of cigarettes and alcohol. We also investigated behavioral changes with sunburn experience in the participants who had sunburn history. Among these behavioral changes, increased use of sunscreen and decreased sun exposure during peak hours with sunburn experience were significant. CONCLUSION: Our study demonstrated that the risk of sun exposure is largely unrecognized in Manisa, Turkey, and we have very incomplete information about protective measures. An efficient policy of education on the effective use of sun protection methods should be developed to prevent skin cancer.     

Skin cancer prevention in the primary care setting: assessment using a standardized patient

Our objective was to utilize the standardized patient technique in assessing the ability of primary care physicians to identify and counsel primary prevention for patients at high risk for skin cancer. A secondary goal was to test the feasibility of this technique as a measure of actual physician behaviors in the outpatient setting. We used a convenience sample of 15 primary care physicians. The standardized patient was an 18-year-old woman with skin phototype I. She presented to physicians as needing a general physical examination for a summer lifeguard job at a beach. She stated a family history of skin cancer. Physician performances were rated using a standard checklist completed by the standardized patient following each visit. We found that none of the physicians asked questions specifically related to skin phototype or sun exposure habits such as childhood sunburns. Only 13% asked about mole changes. For counseling, 67% of physicians recommended sunscreen use; only 7% discussed sunscreen types or procedures for effective use. Only 13% counseled other skin protective behaviors. No significant differences by physician gender were found in these areas; however, female physicians counseled more global health behaviors than male physicians (p < or = 0.01). Our pilot data suggest that little skin cancer primary prevention counseling is performed for high-risk patients. The standardized patient technique worked well in obtaining outcome data for physicians' preventive practices.