UV-Radiation, Apoptosis and Skin

Apoptosis or programmed cell death is a key function in regulating skin development, homeostasis and tumorigenesis. The epidermis is exposed to various external stimuli and one of the most important is UV radiation. The UVA and UVB spectra differ in their biological effects and in their depth of penetration through the skin layers. UVB rays are absorbed directly by DNA which results in its damage. UVA can also cause DNA damage but primarily by the generation of reactive oxygen species. By eliminating photodamaged cells, apoptosis has an important function in the prevention of epidermal carcinogenesis. UV-induced apoptosis is a complex event involving different pathways. These include: 1. activation of the tumour suppressor gene p53; 2. triggering of cell death receptors directly by UV or by autocrine release of death ligands; 3. mitochondrial damage and cytochrome C release. The extrinsic pathway through death receptors such as fibroblast-associated, tumour necrosis factor receptor and TNF related apoptosis inducing ligand receptor activate caspase cascade. The intrinsic or mitochondrial pathway of apoptosis is regulated by the Bcl-2 family of proteins, anti-apoptotic (Bcl-2, Bcl-xl, Bcl-w) and the pro-apoptotic (Bax, Bak, Bid). The balance between the pro-apoptotic and anti-apoptotic proteins determines cell survival or death. We discuss recent findings in the molecular mechanisms of UV induced apoptosis

Utjecaj strukturirane edukacije na klinički tijek atopijskoga dermatitisa u dječjoj dobi [The impact of structured education on the clinical course of atopic dermatitis]

Background: Atopic dermatitis (AD) is a common childhood disease of increasing prevalence that not only changes the life of the affected children but also affects the social and emotional functioning of their families. Objectives: The aim of the study was to determine the effects of the structured educational program for parents of AD children, aged 3 months to 7 years, according to AD clinical course, family quality of life, anxiety and perceived stress of parents. Methods: One hundred thirty four parents AD children attending the Outpatient Unit of Pediatric dermatology in Children's Hospital Zagreb participated in the study; the interventional group (structured educational program together with normal management regiment); the control group (routine education, medical consultation and management). The severity of AD was estimated using Scoring AD (SCORAD) index. Parents were asked to complete the Croatian version of Family dermatology life quality index (FDLQI), Patient oriented (PO) SCORAD, Percieved stress scale (PSS), State trait anxiety inventory (STAI) and general questionnaire. Results: Results of the study showed that the intervention group had a significant improvement in the scoring AD (SCORAD, PO SCORAD), family quality of life, percieved stress and anxiety when compared to the control group. Conclusion: Our structured educational program had positive effect on AD severity, family quality of life, parental stress and anxiety and have to be part of AD management

»Halo Nevi« and UV Radiation

Halo nevi, also termed Sutton nevi, are defined as benign melanocytic nevi that are surrounded by an area of depigmentation resembling a halo. Halo nevi are common in children and young adults, with a mean age at onset of 15 years. The incidence in the population is estimated to be approximately 1%. Affected individuals frequently have multiple lesions which are usually localized on the back. A familial tendency for halo nevi has been reported. The etiology of halo nevi is unknown. It is an autoimmune response and T lymphocytes are considered to play a key role in the progressive destruction of nevus cells. Halo nevi may be associated with autoimmune disorders such as vitiligo, Hashimoto thyroiditis, alopecia areata, celiac disease, atopic dermatitis and others. It has been proved that halo nevi are detected after an intense sun exposure especially after sunburns. The etiology of halo nevi, association with malignant melanoma and the role of sun exposure in the development of halo nevi are discussed

Treatment of Anogenital Warts in an 18-month-old Girl with 5% Imiquimod Cream

Possible modes of transmission of human papilloma virus (HPV) in children include perinatal transmission, sexual transmission or extragenital contact. Conventional treatment options with chemical and physical destruction methods can be difficult and painful and often require general anesthesia. Imiquimod is topically active immunomodulatory agent and it\u27s use for pediatric anogenital warts has been reported with good results. We report a case of extensive anogenital warts in a 18-months-old girl who was successfully treated with topical 5% imiquimod cream.</p

Acute Skin Sun Damage in Children and Its Consequences in Adults

Children spend more time outdoors than adults and there is compelling evidence that childhood is a particularly vulnerable time for the photocarcinogenic effects of the sun. The negative effects of solar radiation are accumulated during the entire lifetime; however 80% of total lifetime sun exposure is taking place before the age of 18 years. Child skin is more sensitive than adult skin because natural defense mechanisms are not fully developed. A short exposure to midday sun will result in sunburns. Epidemiologic studies show a higher incidence of malignant melanoma in persons with a history of sunburns during childhood and adolescence. Sun exposure among infants and pre-school children is largely dependent on the discretion of adult care providers. Sun protective habits of mothers may predict the level of sun exposure in children. It is very important to transfer the knowledge and positive habits of proper sun protection to children. The purpose of sun-safety behavior is not to avoid outdoor activities, but rather to protect the skin from detrimental sun effects. Proper sun protection of children includes protection from excessive sun exposure, sunburns and other forms of skin damage caused by sun, which may lead to the future development of skin cancers. This paper reviews acute skin reactivity to sun in childhood and adolescence that causes damage in skin structure and function and produces undesirable chronic changes in adults