Ultraviolet radiation exposure among recreational and competitive
cyclists in Utah
(Poster reference number 5647)
Julia Curtis, University of Utah School of Medicine, Salt Lake City, UT, United
States; Christopher Hull, MD, University of Utah, Salt Lake City, UT, United States;
Michael Hadley, MD, University of Utah, Salt Lake City, UT, United States
Purpose: UV radiation exposure is an important environmental risk factor for many
types of skin cancer. Individuals who spend time outdoors are particularly
susceptible to the damaging effects of UV rays. Previous small studies have
documented high exposures to UV radiation among cyclists and triathletes.
Objective: To measure the UV exposure among cyclists during the summer in Utah
and correlate these exposure levels with measurements of serum vitamin D and
information obtained from questionnaires on UV protection.
Methods: UV exposure was quantified for professional and amateur cyclists during
the summer months of 2009 and 2010 using the Viospor (Bacillus subtilis spore) UV
dosimeter worn on the top of the helmet and on the shoulder under the cycling
jersey. Some of these participants had measurements of serum vitamin D. Each
cyclist answered a questionnaire on UV protection habits.
Results: Twenty-two cyclists were enrolled and completed the study. The mean
cumulative minimal erythema dose (MED) was 11.35 (range, 2.3-30.4). The cycling
jerseys partially reduced (but did not completely block) the detectable UV radiation
compared to the helmet. There were no significant differences among a jersey
labeled as UV protective and jersey with no UV label. The mean serum vitamin D
level was 38.01 ng/mL (range, 28.3-55.9). The vitamin D reference range is 30 to
80 ng/mL. Two cyclists were mildly deficient, with levels of 28.6 and 28.3 ng/mL.
Seventeen cyclists completed the questionnaire. The average frequency of using
sunscreen on the body was 56% of the time (range, 0-100%). Many of the cyclists
noted that they did not need to worry about photoaging or exposure to high UV
levels.
Conclusion: Recreational and competitive cyclists in Utah are exposed to very high
UV radiation levels during summer months. The cyclists in this study considerably
exceeded recommended limits of exposure. Cyclists and other outdoor athletes
should be educated about these high recreational UV exposures and made aware of
the hazards of UV radiation. Photoprotective measures including sunscreen,
photoprotective clothing, and avoiding the mid-day sun should be recommended
to these athletes.
Commercial support: None identified.
PIGMENTARY DISORDERS & VITILIGO
A study to assess the safety and tolerability of salicylic acid peels for
melasma in dark skinned patients
(Poster reference number 5174)
Rashmi Sarkar, MD, Maulana Azad Medical College and Lok Nayak Hospital, New
Delhi, India; Poonam Puri, MD, Safdarjung Hospital and Vardhman Mahavir
Medical College, New Delhi, India
Background: Melasma, a common disorder of hyperpigmentation, is rather chal-
lenging to treat. Besides treating any etiologic factor if identified, broad-spectrum
sunscreens, topical therapy with or without combination with chemical peels
remains the mainstay of treatment. Although salicylic acid peels have been tried for
melasma, there is a dearth of studies in dark skinned patients. This prompted us to
take up this study to evaluate the efficacy and tolerance of salicylic acid peels in
melasma in dark skinned patients.
Methods: 20 Indian patients of melasma were taken up for the study. Only patients
who had epidermal and mixed melasma according to Wood’s light examination were
taken up for the study. They were primed with broad spectrum sunscreens and 2%
hydroquinonone/0.025% tretinoin in combination for 2 weeks before treatment.
Three consecutive 20% and 30% salicylic acid peels each were done 2 weekly
followed by the 2% hydroquinone/0.025% tretinoin in between peels. A subjective
assessment was carried by the patient and the results were graded as excellent
(66-100% lightening), good (33-66% lightening), fair (10-33% lightening), and poor
(\ 10% lightening). MASI index and photographic evaluation were done by the
investigators both before and after treatment. A follow-up was done for 8 weeks
during which the patients were only on broad spectrum sunscreens.
Results: Subjectively, the result was graded as good (33-66%) by 7 patients. There
was a decrease in the MASI index after treatment which was found to be significant
(P \.05). Even photographic evaluation revealed a lightening in the pigmentation.
On 8 weeks follow-up, only 4 patients still graded their results as good, 14 as fair, and
2 as poor.
Conclusion: Salicylic acid appears promising as an adjuvant in the management of
melasma in dark skinned patients, but is effective only in combination with topical
agents. More long-term studies with larger number of patients is required to
evaluate.
Commercial support: None identified.
AB178 J AM ACAD DERMATOL
Assessment of a new skin brightening emulgel containing glycolic acid,
lactic acid, kojic acid, arbutin, and UVA/UVB filters in females with
melasma
(Poster reference number 4700)
Un Sun Park, MD, Theraskin, Sao Bernardo do Campo, Brazil; Antonio Gomes-
Neto, MD, Theraskin, Sao Bernardo do Campo, Brazil; Carlos Machado-Filho, MD,
CEPAD, Santo Andre, Brazil; Luiz Henrique Paschoal, MD, CEPAD, Santo Andre,
Brazil
Background: There has been an increase in researches focusing on obtaining
alternatives to hydroquinone regarding its skin brightening effect. The objective of
this study is to assess the efficacy, tolerability and safety of a new hydroquinone-free
emulgel containing a combination of acids (glycolic, lactic, and kojic), arbutin and
UVA/UVB filters amongst a population of women with melasma.
Methods: Thirty-five women ranging from 25 to 40 years of age, phototypes I-IV, with
stable epidermic or mixed melasma were included in the study. The volunteers
applied the product on the face daily during the morning for 30 days. Dermatologic
(clinical and MASI score) and instrumental evaluations (Visioface) were performed
at baseline and at the end of the study (day 30).
Results: Results showed a decrease in the mean MASI score of 42% (from 2.9 at the
baseline to 1.69 at the end of the study). Instrumental analysis with Visioface showed
a reduction of 11% of brown spots and 32.7% of UV spots. The product was well
tolerated by the volunteers. No severe adverse events were reported. Few transitory
episodes of skin discomfort, irritation and burning were reported, all of mild
intensity, which is a common side effect related with the topical use of alpha-
hydroxy acids (AHAs).
Conclusion: The emulgel containing glycolic acid, lactic acid, kojic acid, arbutin, and
UVA/UVB filters reduced brown and UV spots in women with melasma, resulting in
a decrease of MASI score in the volunteers and can be considered a useful
hydroquinone-free option regarding the treatment of patients with melasma.
Commercial support: 100% sponsored by Theraskin.
Combined use of topical corticosteroids and calcineurin inhibitors in the
treatment of vitiligo
(Poster reference number 4922)
Juliano Breunig, MD, PhD, University of Santa Cruz do Sul, Santa Cruz do Sul,
Brazil; Hiram Almeida Jr, MD, PhD, Federal University of Pelotas, Catholic
University of Pelotas, Pelotas, Brazil; Rodrigo Duquia, MD, MHS, Federal
University of Pelotas, Pelotas, Brazil
Background: There are studies demonstrating the clear benefit of topical cortico-
steroids (TC) and topical calcineurin inhibitors (TCI) in the repigmentation of
vitiligo. TCI have a safer profile, especially because they do not induce skin atrophy,
the main concern of the long-term of TC use.
Methods: We assessed the use of betametasone valerate 0.1% ointment and
tacrolimus 0.1% ointment (on alternating weeks, only at night), during three
months. One male and two female patients with localized vitiligo were treated
during the summer in south Brazil. The patient’s age varied between 20 and 40 years,
and the vitiligo was recent in all cases (\1 year of evolution).
Results: All patients achieved more than 75% of repigmentation. The only side effect
observed was burning sensation in the axillas in one subject. One patient achieved
total repigmentation in a lesion on the left forearm, and the second best
repigmentation was of 90% in the dorsum of the left hand. The third patient
achieved 75% repigmentation in the axillas.
Discussion: The few participants of our study and the sun exposition are the main
limitations of this study, although high protective sunscreens were prescribed.
These preliminary results show a good repigmentation rate.
Commercial support: None identified.
APRIL 2012