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      The therapeutic dental challenge of xeroderma pigmentosum patients: case report

      case-report

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          Abstract

          Xeroderma pigmentosum (XP) is a rare genetic disease characterized by a hypersensitivity to ultraviolet (UV) radiation leading to defective deoxyribonucleic acid (DNA) repair and predisposing to skin tumorigenesis. This paper reports the safe approaches used for the dental treatment of XP patients, controlling the ultraviolet (UV) sources at the dental office. An XP 29-year-old woman was referred for oral pain and sensitivity at the service of periodontology, UV rays were checked with a UV-meter. During the examination, the patient kept her sunglasses while the practitioner was dressed in dark colors using an anti-UV filter over the surgical light. Facial dark brown pigmentations, limited mouth opening, tumor resection scar on the tongue, moderate periodontitis, and dental caries were noticed. Moderate periodontitis and dental caries were diagnosed. Treatment was planned in collaboration with the dermatologist. Soft scaling and root planning were performed in short sessions and self-curing material was used for coronary fillings after caries removal. In taking care of XP patients, particular attention should be given by dental professionals to: i) the office management for a UV-safe environment; ii) the adoption of suitable dental care and safe biomaterials with short sessions and regular controls; and iii) the adoption of personal protections by patients and practitioners.

          Most cited references9

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          An evaluation of UV protection imparted by cotton fabrics dyed with natural colorants

          Background The ultraviolet properties of textiles dyed with synthetic dyes have been widely reported in literature. However, no study has investigated the ultraviolet properties of natural fabrics dyed with natural colorants. This study reports the Ultraviolet Protection Factor (UPF) of cotton fabrics dyed with colorants of plant and insect origins. Methods Three cotton fabrics were dyed with three natural colorants. Fabrics were characterized with respect to fabric construction, weight, thickness and thread count. Influence of fabric characteristics on Ultraviolet Protection Factor was studied. Role of colorant concentration on the ultraviolet protection factor was examined via color strength analysis. Results A positive correlation was observed between the weight of the fabric and their UPF values. Similarly, thicker fabrics offered more protection from ultraviolet rays. Thread count appears to negatively correlate with UPF. Dyeing with natural colorants dramatically increased the protective abilities of all three fabric constructions. Additionally, within the same fabric type UPF values increased with higher depths of shade. Conclusion Dyeing cotton fabrics with natural colorants increases the ultraviolet protective abilities of the fabrics and can be considered as an effective protection against ultraviolet rays. The UPF is further enhanced with colorant of dark hues and with high concentration of the colorant in the fabric.
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            Xeroderma Pigmentosum: General Aspects and Management.

            Xeroderma Pigmentosum (XP) is a rare genetic syndrome with a defective DNA nucleotide excision repair. It is characterized by (i) an extreme sensitivity to ultraviolet (UV)-induced damages in the skin and eyes; (ii) high risk to develop multiple skin tumours; and (iii) neurologic alterations in the most severe form. To date, the management of XP patients consists of (i) early diagnosis; (ii) a long-life protection from ultraviolet radiation, including avoidance of unnecessary UV exposure, wearing UV blocking clothing, and use of topical sunscreens; and (iii) surgical resections of skin cancers. No curative treatment is available at present. Thus, in the last decade, in order to prevent or delay the progression of the clinical signs of XP, numerous strategies have been proposed and tested, in some cases, with adverse effects. The present review provides an overview of the molecular mechanisms featuring the development of XP and highlights both advantages and disadvantages of the clinical approaches developed throughout the years. The intention of the authors is to sensitize scientists to the crucial aspects of the pathology that could be differently targeted. In this context, the exploration of the process underlining the conception of liposomal nanocarriers is reported to focus the attention on the potentialities of liposomal technology to optimize the administration of chemoprotective agents in XP patients.
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              Strategic Task and Break Timing to Reduce Ultraviolet Radiation Exposure in Outdoor Workers

              Objectives: Public health messaging about sun avoidance strategies is often not practical for outdoor workers. The objective of this study was to use personal monitoring data to determine when peak UVR exposure occurs for outdoor workers, estimate how much UVR could be reduced by altering the timing of shady tasks or breaks during peak exposure times, and descriptively compare these to peak periods of ambient UVR. Ultimately, we aim to provide evidence-based sun avoidance recommendations for outdoor workers in British Columbia, Canada. Methods: UVR exposure data [standard erythemal dose (SED)] were collected during the 2013 summer months in Vancouver, using personal electronic dosimeters that sampled once per minute for an average of 4.4 working days (range: 1–7 days). Mixed-effect models were used to estimate the 60-, 30-, and 15-min time intervals at which maximum exposure occurred for the months of July and August. Using these time intervals, UVR exposure during peak periods was summarized as SED and as a percentage of the total daily exposure. Ambient UVR was also collected using data from the nearest Brewer spectrophotometer station and parallel analyses were conducted. Results: There were 73 workers and 321 participant-days available for analysis. Models indicated that periods of maximum exposure for 15-, 30-, and 60-min intervals began at 12:28, 12:17 pm, and 11:52 am, respectively, for sunny days in July. These periods were similar in August. The median exposure during these time periods and the potential for reducing UVR was 0.03 SED (2.8% potential daily exposure reduction), 0.09 SED (7.1%), and 0.18 SED (15.9%), respectively. However, there was a large range in exposure estimates as some workers experienced up to 84.8% of their exposure in the peak 60-min interval. Conclusion: Skin cancer prevention messaging does not include practical messages for outdoor workers and providing times of peak UVR help to identify times when the greatest reductions in exposure can occur. Prevention measures including shady breaks, increased sun protection, and task reorganization during these peak times are recommended during these peak times to reduce UVR exposure among those at highest risk.
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                Author and article information

                Contributors
                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                04 April 2023
                2023
                : 44
                : 159
                Affiliations
                [1 ]International University of Rabat, College of Health Sciences, International Faculty of Dental Medicine, BioMed Unit, Technopolis Parc, Rocade of Rabat-Salé, Sala-Al Jadida, Morocco,
                [2 ]Department of Periodontology, Faculty of Dental Medicine, Mohammed V University in Rabat, Rabat, Morocco
                Author notes
                [& ] Corresponding author: Yasmine Hanine, International University of Rabat, College of Health Sciences, International Faculty of Dental Medicine, BioMed Unit, Technopolis Parc, Rocade of Rabat-Salé, Sala-Al Jadida, Morocco. yasmine-hanine@ 123456uir.ac.ma
                Article
                PAMJ-44-159
                10.11604/pamj.2023.44.159.34950
                10349632
                334e2964-d299-4e41-903d-c4ad8f9ed099
                Copyright: Yasmine Hanine et al.

                The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 April 2022
                : 05 March 2023
                Categories
                Case Report

                Medicine
                xeroderma pigmentosum,dental care,ultraviolet rays,case report
                Medicine
                xeroderma pigmentosum, dental care, ultraviolet rays, case report

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