WNL we never looked: vulvar carcinoma incidence after screening cutoff

The incidence of vulvar carcinoma increases with age, though elderly women receive less aggressive cancer therapies and fewer strategies aimed at cancer prevention. Furthermore, elderly women dual enrolled in Medicaid-Medicare experience poor survival rates for vulvar carcinoma. Herein, we provide recommendations for the prevention of and guidelines for the multidisciplinary care of vulvar carcinoma. Prevention of vulvar carcinoma can be categorized into primary, secondary, and tertiary prevention. Primary prevention consists of vaccination, secondary prevention consists of screening, and tertiary prevention is aimed at the management of premalignant and early-stage lesions

Visible Light Part II. Photoprotection against visible and ultraviolet light

Cutaneous photobiology studies have focused primarily on the UV portion of the solar spectrum. However, VL comprises 50% of EMR that reaches the earth\u27s surface, and, as discussed in Part I of this CME, VL has cutaneous biologic effects such as pigment darkening and erythema. Photoprotection against VL includes sun avoidance, seeking shade, and the use of photoprotective clothing. Organic and inorganic UV filters used in sunscreens do not protect against VL; only tinted sunscreens do. In the US, these filters are regulated by the FDA as an over-the-counter drug and are subjected to more stringent regulations than in Europe, Asia, and Australia. There are no established guidelines regarding VL photoprotection. Alternative measures to confer VL photoprotection are being explored. These novel methods include topical, oral, and subcutaneous agents. Further development should focus on better protection in the range of UVA1 (340-400nm) and VL while enhancing the cosmesis of the final products

Visible Light Part I. Properties and Cutaneous Effects of Visible Light

Approximately fifty percent of sunlight reaching the Earth\u27s surface is visible light (400-700 nm). Other sources of visible light include lasers, light-emitting diodes (LEDs), and flash lamps. Photons from visible light are absorbed by photoreceptive chromophores (e.g., melanin, heme, and opsins), altering skin function by activating and imparting energy to chromophores. Additionally, visible light can penetrate the full thickness of the skin and induce pigmentation and erythema. Clinically, lasers and light devices are used to treat skin conditions by utilizing specific wavelengths and treatment parameters. Red and blue light from LEDs and intense pulsed light (IPL) have been studied as anti-microbial and anti-inflammatory treatments for acne. Pulsed dye lasers are used to treat vascular lesions in adults and infants. Further research is necessary to determine the functional significance of visible light on skin health and wellness without confounding the influence of ultraviolet and infrared wavelengths