Knowledge and behavior of Lebanese parents regarding melanoma prevention in public and private school children

Aim: Assess the knowledge and behavior of Lebanese parents when it comes to melanoma and its prevention in children. Methods: A survey, to be completed by parents, was sent through children from three schools. Results: During sun exposure only 23.5% of 1012 respondents were always covering enough areas of their children's skin and 74.1% did not always apply sunscreen to their children. Parents of private school children were three times more likely to apply sunscreen to their children when exposed to sun, four times more likely to reapply sunscreen every 2–3 h and 21 times more likely to use a higher sun protection factor. Conclusion: Sun protection in children is insufficient and sunburns are frequent, illustrating the need for melanoma awareness campaigns.

Characteristics of the ageing skin, xerosis cutis and its complications

People in the developed countries are living longer. Geriatric dermatology is playing an increasingly important role as chances of developing skin-related problems increase with their ageing. Skin ageing is induced by two main processes: intrinsic and extrinsic. Extrinsic ageing is caused by environmental factors such as sun exposure, smoking, alcohol consumption, air pollution, and poor nutrition. Intrinsic ageing reflects the genetic background and depends on time. The aged skin is characterised by the appearance of dryness, atrophy, wrinkles, pigmented lesions, patchy hypopigmentation, and elastosis. This article provides an overview of skin ageing processes and common conditions found in the elderly persons such as xerosis, pruritus, and eczema.

On the Nose: Anti-MDA-5 Dermatomyositis Manifesting as Perinasal Swelling

The clinical presentation of dermatomyositis (DM) is diverse, with varied phenotypes that may be correlated with specific autoantibodies. The anti-melanoma differentiation-associated gene 5 (MDA5) antibody in DM is associated with an amyopathic phenotype of DM, with several unusual cutaneous manifestation and increased risk for rapidly progressive interstitial lung disease. Initial presentation may be subtle, but early diagnosis is key to initiation of proper immunosuppressive therapy. In this report, we describe perinasal edema and erythema as a presenting complaint of anti-MDA5 DM in an otherwise healthy 40-year-old woman. The edema began shortly after heavy sun exposure and was followed by painful papules in her hands and arthritis within a few weeks. She was found to have high titer of anti-CCP and anti-MDA5, and thus was diagnosed with DM and rheumatoid arthritis overlap. A CT chest, abdomen, and pelvis showed patchy ground-glass and interstitial opacities in bilateral lower lobes consistent with mild interstitial lung disease without evidence of malignancy. Perinasal cutaneous findings and arthralgias improved with initiation of prednisone. To our knowledge, this is the first report of perinasal edema as a presenting symptom for DM and should raise suspicion for MDA-5 disease.

Influence of environmental factors on the spread of COVID-19 in Saudi Arabia

Background Coronavirus disease 2019 (COVID-19) has affected millions of people worldwide. The infection is mostly spread through the inhalation of infected droplets. Saudi Arabia is a vast country having different climatic conditions. Methods The study evaluated the influence of environmental factors on the spread of COVID-19. Six zones (A to F) were classified depending on the climatic conditions. The study was conducted by retrospective analysis of COVID-19 records from the ministry of health between the months of September 2020 and August 2021. The environmental data such as average temperature (°C), humidity (%), wind speed (m/s) and sun exposure (kwh/m2) were retrieved from official sites. The data was analyzed to determine the effect of these factors on the spread of COVID-19. SPSS IBM 25 software was used to conduct the analysis and p < 0.05 was considered to indicate the significance of the results. Results According to the findings, the rate of infection was greater between April and July 2021. Six climatic zones experienced high temperatures, little humidity, consistent wind flow, and intense sun exposure throughout this time. The correlation study revealed a significant (p < 0.05) relationship between the environmental factors and the spread of COVID-19. The data suggested that during summer condition when the weather is hot, less humid, and steady wind flow with lots of sun exposure, the COVID-19 infection rate got augmented in Saudi Arabia. Poor ventilation and closed-door habitats in an air-conditioned atmosphere during this period could have played a role in human transmission. More research on air quality, population mobility and diseased condition is essential, so that precise proactive measures can be designed to limit the spread of infection in specific climatic seasons.

Giant squamous cell carcinoma of the scalp

We report the case of a 43-year-old male with a history of pulmonary tuberculosis cured one year previously and a 25-year-old history of smoking. The patient presented with a tumor of the scalp that had been evolving since the age of thirteen years, gradually increasing in size, neglected by the patient. An examination revealed a giant tumor of the occipital area (Fig. 1), 15 × 8 cm in size, which was protruded and ulcerated, with thick, hard edges. On biological assessment, a hemogram revealed microcytic hypochromic anemia at 2.9 g/dL. Ferritin was at 4 ng/mL. HIV serology was negative. A skin biopsy revealed a mature, well-differentiated, infiltrating squamous cell carcinoma (Fig. 2). A CT scan of the brain revealed a poorly limited subgalactic parietooccipital lesion process, with bone lysis and endocranial extension and invasion of the upper longitudinal sinus. Ultrasonography of the lymph node area revealed bilateral axillary and inguinal adenopathies with an infracentimetric fatty hilum. The immediate management was to transfuse the patient with three red blood cells. Control hemoglobin was 7.7 g/dl. The patient, then, received external radiotherapy but was lost to follow-up. Squamous cell carcinoma is the second most common skin cancer [1], occurring in elderly patients with a clear phototype on sun-exposed areas. Its frequency is increasing and correlates with sun exposure [1]. It may reach enormous sizes if neglected and not treated in its early stages. The most common causes of a delayed diagnosis are low socioeconomic status, poor personal hygiene, and fear of the diagnosis and of its possible consequences [2]. Giant carcinomas are defined by a diameter exceeding 5 cm [3]. They pose a higher risk of complication and mortality. The invasiveness of these tumors depends on the size, anatomical location, and histological subtype. Their treatment is difficult because, even with extensive surgical removal, recurrence and metastasis are frequent [3].

A Randomized Clinical Trial of Precision Prevention Materials Incorporating MC1R Genetic Risk to Improve Skin Cancer Prevention Activities Among Hispanics

Purpose: Skin cancer incidence is increasing among Hispanics, who experience worse outcomes than non-Hispanic Whites. Precision prevention incorporating genetic testing for (melanocortin-1 receptor) MC1R, a skin cancer susceptibility marker, may improve prevention behavior. Experimental Design: Hispanic participants (n = 920) from Tampa, FL and Ponce, PR, were block-randomized within MC1R higher- and average-risk groups to precision prevention or generic prevention arms. We collected baseline information on demographics, family history of cancer, phenotypic characteristics, health literacy, health numeracy, and psychosocial measures. Participants reported weekday and weekend sun exposure (in hours), number of sunburns, frequency of five sun protection behaviors, intentional outdoor and indoor tanning, and skin examinations at baseline, 3 months, and 9 months. Participants also reported these outcomes for their eldest child ≤10 years old. Results: Among MC1R higher-risk participants, precision prevention increased sunscreen use (OR = 1.74, P = 0.03) and receipt of a clinical skin exam (OR = 6.51, P = 0.0006); and it decreased weekday sun exposure hours (β = −0.94, P = 0.005) and improved sun protection behaviors (β = 0.93, P = 0.02) in their children. There were no significant intervention effects among MC1R average-risk participants. The intervention did not elevate participant cancer worry. We also identified moderators of the intervention effect among both average- and higher-risk participants. Conclusions: Receipt of MC1R precision prevention materials improved some skin cancer prevention behaviors among higher-risk participants and their children and did not result in reduced prevention activities among average-risk participants. Despite these encouraging findings, levels of sun protection behaviors remained suboptimal among participants, warranting more awareness and prevention campaigns targeted to Hispanics Significance: Our results support a precision public health approach to reducing skin cancers among Hispanics, an underserved population in precision medicine, and may additionally improve preventive behaviors among their children.

Genetic, sociodemographic and lifestyle factors associated with serum 25-hydroxyvitamin D concentrations in Brazilian adults: the Pró-Saúde Study

This study aims to investigate factors associated with serum 25-hydroxyvitamin D [25(OH)D] concentration in Brazilian adults considering sociodemographic and lifestyle factors, as well as vitamin D-related single nucleotide polymorphisms (SNPs). This is a cross-sectional study (n = 491; 34-79y; 251 women), nested within a prospective cohort (Pró-Saúde Study). Associations between serum 25(OH)D and sociodemographic characteristics, diet, use of supplement, physical activity, season of blood collection, body fat, skin type, sun exposure index, and SNPs CYP2R1-rs10741657 and GC-rs2282679 were explored by multiple linear regression. The prevalence of serum 25(OH)D < 50nmol/L was 55%. Serum 25(OH)D was lower among women (β = -4.38; 95%CI: -8.02; -0.74), those with higher visceral fat (β = -4.02; 95%CI: -5.92; -2.12), and those with AC and CC genotypes for GC-rs2282679 (β = -6.84; 95%CI: -10.09; -3.59; β = -10.63; 95%CI: -17.52; -3.74, respectively). Factors directly associated with serum 25(OH)D included summer (β = 20.14; 95%CI: 14.38; 25.90), intermediate skin type (β = 6.16; 95%CI: 2.52; 9.80), higher sun exposure (β = 0.49; 95%CI: 0.22; 0.75), vitamin D intake (β = 0.48; 95%CI: 0.03; 0.93), and physical activity (β = 4.65; 95%CI: 1.54; 7.76). Besides physical activity, diet, and sun exposure, non-modifiable factors, such as GC genotypes must be considered when evaluating vitamin D insufficiency in mixed-race populations. Moreover, high visceral fat in association with poorer vitamin D status deserve attention given that both conditions are unfavorably related with chronic and acute health outcomes.

Coexistence of Neonatal Lupus Erythematous and Sturge–Weber Syndrome

Neonatal lupus erythematous (NLE) is a rare condition presented by lupus dermatitis shortly after birth or later following sun exposure. Sturge–Weber syndrome (SWS) is also an uncommon congenital condition characterized by extensive capillary malformation and ophthalmic and/or neurologic involvement. Here, we describe the first case of coexistence of NLE and SWS which posed a significant diagnostic challenge to clinicians.

Characterization and Evolution of Volatile Compounds of Cabernet Sauvignon Wines from Two Different Clones during Oak Barrel Aging

Xinjiang is a major wine-making region in China, but its hot climate in summer and intense sun exposure negatively affect the aroma quality of Cabernet Sauvignon wine. The aim of this study was to characterize and differentiate the volatile composition of Cabernet Sauvignon wines from two clones (169 and 191) in Xinjiang, and to study their aromatic profile evolution during 12-month oak barrel aging period. Results showed that before aging, clone 169 wine contained higher concentrations of several alcohols and ethyl esters, while acetate esters and furanic compounds were higher in clone 191 wine. After aging, levels of many terpenes, norisoprenoids, volatile phenols and phenolic aldehydes were significantly higher in clone 169 wine than 191 wine. Aroma series analysis revealed that clone 169 wine exhibited higher floral and roasty aromas after aging, while clone 191 wine had stronger chemical aroma. Principal component analysis indicated that aging process played a primary role in the alteration of volatile profile in these wines. Clone played a secondary role and oak barrel had a tertiary contribution to the variation. The present work indicates that clone 169 is a better choice for producing high-quality aged Cabernet Sauvignon wine with intense and elegant aroma in Xinjiang.