Revisión del tema Fotoprotección en los niños

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Abstract

Resumen El cáncer de piel es el tipo de cáncer cuya tasa de incidencia ha aumentado más en el mundo. La exposición a la radiación ultravioleta (RUV) durante la infancia y la adolescencia juega un papel trascendente en el desarrollo futuro del cáncer de piel, ya que los niños protegidos correctamente de las RUV tienen 78% menos riesgo de desarrollar cáncer de piel en su vida adulta. Las medidas de fotoprotección son recomendables en todas las edades, pero en la población infantil y juvenil deben ser más intensas, ya que los niños son más susceptibles que los adultos a las radiaciones UV

Translated abstract

Summary Skin cancer is the type of cancer whose incidence rate has increased the most in the world. Exposure to ultraviolet radiation (UVR) during childhood and adolescence plays an important role in the future development of skin cancer, since children properly protected from UVR have 78% lower risk of developing skin cancer in their adult lives. Sun protection measures are recommended for all ages, but in children and young people it should be more intense since children are more susceptible than adults to UV radiation

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Addressing the health benefits and risks, involving vitamin D or skin cancer, of increased sun exposure.

Alina Carmen Porojnicu, Arne Dahlback, Johan Moan … (2008)

Solar radiation is the main cause of skin cancers. However, it also is a main source of vitamin D for humans. Because the optimal status of vitamin D protects against internal cancers and a number of other diseases, a controversy exists: Will increased sun exposure lead to net health benefits or risks? We calculated the relative yield of vitamin D photosynthesis as a function of latitude with a radiative transfer model and cylinder geometry for the human skin surface. The annual yield of vitamin D is 3.4 and 4.8 times larger below the equator than in the U.K. and Scandinavia, respectively. In populations with similar skin types, there are clear latitude gradients of all major forms of skin cancer, indicating a north-south gradient in real sun exposure. Surprisingly, the incidence rates of major internal cancers also increase from north to south. However, the survival prognosis also improves significantly from north to south. Reasons for these findings are discussed in view of the role of vitamin D. In Norway, melanoma rates increased by a factor of 6 from 1960 to 1990, while the prognosis improved in the same period. After 1990, melanoma rates have remained constant or even decreased in age groups <50 years, whereas the prognosis has not improved further. These data, together with those for internal cancers and the beneficial effects of an optimal vitamin D status, indicate that increased sun exposure may lead to improved cancer prognosis and, possibly, give more positive than adverse health effects.

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Sun exposure and melanoma risk at different latitudes: a pooled analysis of 5700 cases and 7216 controls

Yu-mei Chang, Jennifer H. Barrett, D. Bishop … (2009)

Background Melanoma risk is related to sun exposure; we have investigated risk variation by tumour site and latitude. Methods We performed a pooled analysis of 15 case–control studies (5700 melanoma cases and 7216 controls), correlating patterns of sun exposure, sunburn and solar keratoses (three studies) with melanoma risk. Pooled odds ratios (pORs) and 95% Bayesian confidence intervals (CIs) were estimated using Bayesian unconditional polytomous logistic random-coefficients models. Results Recreational sun exposure was a risk factor for melanoma on the trunk (pOR = 1.7; 95% CI: 1.4–2.2) and limbs (pOR = 1.4; 95% CI: 1.1–1.7), but not head and neck (pOR = 1.1; 95% CI: 0.8–1.4), across latitudes. Occupational sun exposure was associated with risk of melanoma on the head and neck at low latitudes (pOR = 1.7; 95% CI: 1.0–3.0). Total sun exposure was associated with increased risk of melanoma on the limbs at low latitudes (pOR = 1.5; 95% CI: 1.0–2.2), but not at other body sites or other latitudes. The pORs for sunburn in childhood were 1.5 (95% CI: 1.3–1.7), 1.5 (95% CI: 1.3–1.7) and 1.4 (95% CI: 1.1–1.7) for melanoma on the trunk, limbs, and head and neck, respectively, showing little variation across latitudes. The presence of head and neck solar keratoses was associated with increased risk of melanoma on the head and neck (pOR = 4.0; 95% CI: 1.7–9.1) and limbs (pOR = 4.0; 95% CI: 1.9–8.4). Conclusion Melanoma risk at different body sites is associated with different amounts and patterns of sun exposure. Recreational sun exposure and sunburn are strong predictors of melanoma at all latitudes, whereas measures of occupational and total sun exposure appear to predict melanoma predominately at low latitudes.

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UV radiation-induced immunosuppression is greater in men and prevented by topical nicotinamide.

Diona L. Damian, Clare R.S. Patterson, Michael Stapelberg … (2008)

UV radiation-induced immunosuppression augments cutaneous carcinogenesis. The incidence of skin cancer continues to increase despite increased use of sunscreens, which are less effective at preventing immunosuppression than sunburn. Using the Mantoux reaction as a model of skin immunity, we investigated the effects of solar-simulated (ss) UV and its component UVA and UVB wavebands and tested the ability of topical nicotinamide to protect from UV-induced immunosuppression. Healthy, Mantoux-positive volunteers were UV-irradiated on their backs, with 5% nicotinamide or vehicle applied to different sites in a randomized, double-blinded manner. Subsequent Mantoux testing at irradiated and adjacent unirradiated sites enabled measurement of UV-induced immunosuppression with and without nicotinamide. Suberythemal ssUV caused significant immunosuppression, although component UVB and UVA doses delivered independently did not. Men were immunosuppressed by ssUV doses three times lower than those required to immunosuppress women. This may be an important cause of the higher skin cancer incidence and mortality observed in men. Topical nicotinamide prevented immunosuppression, with gene chip microarrays suggesting that the mechanisms of protection may include alterations in complement, energy metabolism and apoptosis pathways. Nicotinamide is a safe and inexpensive compound that could be added to sunscreens or after-sun lotions to improve protection from immunosuppression. immunosuppression.JID JOURNAL CLUB ARTICLE: For questions, answers, and open discussion about this article, please go to http://network.nature.com/group/jidclub

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Author and article information

Contributors

Julio Magliano: Role: ND

Mariela Álvarez: Role: ND

Marina Salmentón: Role: ND

Alejandra Larre Borges: Role: ND

Miguel Martínez: Role: ND

Journal

Journal ID (publisher): adp

Title: Archivos de Pediatría del Uruguay

Abbreviated Title: Arch. Pediatr. Urug.

Publisher: Sociedad Uruguaya de Pediatría (Montevideo )

ISSN: 1688-1249

Publication date (Print): 2011

Volume: 82

Issue: 2

Pages: 98-103

Article

Publisher ID: S1688-12492011000200007

SO-VID: 45bee66d-5e2b-4af7-8256-1cf7bb64c0b2

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http://creativecommons.org/licenses/by/4.0/

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SciELO Uruguay

Self URI (journal page): http://www.scielo.edu.uy/scielo.php?script=sci_serial&pid=1688-1249&lng=en

Revisión del tema Fotoprotección en los niños

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Most cited references 38

Addressing the health benefits and risks, involving vitamin D or skin cancer, of increased sun exposure.

Sun exposure and melanoma risk at different latitudes: a pooled analysis of 5700 cases and 7216 controls

UV radiation-induced immunosuppression is greater in men and prevented by topical nicotinamide.

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