Encyclopedia of Dermatology (6 Volume Set) by Columbus, Frank -- Read -- Imperial Library of Trantor

Index

ENCYCLOPEDIA OF DERMATOLOGY (6 VOLUME SET) ENCYCLOPEDIA OF DERMATOLOGY (6 VOLUME SET) CONTENTS PREFACE Chapter 1 CELLULAR AND HISTOLOGICAL CHANGES IN DERMIS AGING

ABSTRACT 1. INTRODUCTION 2. HISTOLOGY OF THE SKIN

2.1. Epidermal Layer 2.2. Dermal Layer

2.2.1. Extracellular Matrix of the Dermis 2.2.2. Cells in the Dermis 2.2.3. Structures Adnexal, Nerves and Vasculature 2.2.4. Papillary Dermis 2.2.5. Reticular Dermis

2.3. Hypodermis or Subcutaneous Tissue

3. HISTOLOGICAL VARIATIONS ACCORDING TO ANATOMICAL REGION 4. HISTOLOGICAL METHODS TO STUDY SKIN VARIATIONS

4.1. Histochemical Stains 4.2. Immunofluorescence 4.3. Immunohistochemistry

5. EMBRYOLOGICAL DEVELOPMENT 6. CELLULAR AND HISTOLOGICAL CHANGES IN THE DERMIS WITH AGING

6.1. Causes of the Cellular and Histological Alterations of the Dermis with Skin Aging

6.1.1. Sun-Protected Skin (Intrinsic Aging) 6.1.2. Sunlight-Exposed Skin (Photoaging)

6.2. Changes in the Extracellular Matrix of the Dermis Aging

6.2.1. Sun-Protected Skin (Intrinsic Aging)

6.2.1.1. Dermoepidermal Junction 6.2.1.2. Dermal Layer 6.2.1.3. Adnexal Structures, Nerves and Vasculature

6.2.2. Sunlight-Exposed Skin (Photoaging)

6.2.2.1. Dermoepidermal Junction 6.2.2.2. Dermal Layer

6.3. Cellular Changes

6.3.1. Sun-Protected Skin (Intrinsic Aging) 6.3.2. Sunlight-Exposed Skin (Photoaging)

6.5. Molecular Changes

7. CLINICAL MANIFESTATIONS OF THE CUTANEOUS AGING 8. HISTOLOGICAL CHANGES OF THE DERMIS WITH AESTHETIC TREATMENTS CONCLUSION REFERENCES

Chapter 2 NON-INVASIVE METHODS IN THE STUDY OF THE DERMAL STRUCTURE AND COMPOSITION

ABSTRACT 1. INTRODUCTION 2. MEASURING DERMAL FUNCTION: MECHANICAL PROPERTIES

2.1. The Cutometer 2.2. The Ballistometer

3. MEASURING DERMAL COMPOSITION

3.1. Fluorescence Spectroscopy 3.2. Near Infrared Spectroscopy 3.3. Raman Spectroscopy

4. MEASURING DERMAL STRUCTURE

4.1. Ultrasonography 4.2. Optical Coherence Tomography 4.3. Confocal Reflectance Microscopy 4.4. Higher Order Microscopy

4.4.1. Two Photon Fluorescence Microscopy 4.4.2. Second Harmonic Generation Microscopy

5. APPLICATIONS

5.1. Skin Aging 5.2. Skin Photoaging 5.3. Edema 5.4. Diabetes 5.5. Scars 5.6. Wounds

CONCLUSION REFERENCES

Chapter 3 DERMAL AND EPIDERMAL INTERACTION: A CRITICAL ROLE FOR SKIN HOMEOSTASIS

ABSTRACT 1. INTRODUCTION 2. EPITHELIAL-MESENCHYMAL INTERACTIONS

2.1. Regulation of Cell Growth and Differentiation 2.2. Tissue Repair and Healing

3. DISTURBANCES OF THE COMMUNICATION NETWORKS: SKIN AGING, MALFORMATION, SKIN TUMORS, AND OTHER RELATED DISEASES

3.1. Skin Aging 3.2. Malformation 3.3. Skin Tumors 3.4. Other Skin Diseases

4. MULTIPLE CO-REGULATION SYSTEM: CAPILLARY INDUCTION, GROWTH AND REGENERATION CONCLUSION REFERENCES

Chapter 4 MELANOGENESIS AND NATURAL HYPOPIGMENTATION AGENTS

ABSTRACT ABBREVIATIONS INTRODUCTION

Melanosynthesis Melanocytes and Melanosomes Melanin Biosynthesis Factors Regulating Melanin Biosynthesis Pigmentary Disorders Mechanisms of Depigmentation Natural Hypopigmentation Agents

EFFECT ON MELANOGENESIS ENHANCING TYROSINASE DEGRADATION INTERFERENCE WITH MELANOSOME MATURATION AND TRANSFER

Soybean Extract Centaureidin Methylophiopogonanone B (5,7-Dihydroxy-6,8-Dimethyl-3-(4-Methoxybenzyl)Chroman-4-One, MOPB) Niacinamide Lectins and Neoglycoproteins

INHIBITION OF INFLAMMATION-INDUCED MELANOGENESIS ACCELERATING SKIN DESQUAMATION

Chemical Exfoliants And Their Mode of Action

(1) α-Hydroxyacids (2) β-hydroxyacids (BHAs) (3) Retinol (4) Liquiritin

WHITENING AGENTS VERIFIED BY CLINICAL TRIALS

Arbutin and Its Derivatives Kojic Acid Ascorbic Acid and Its Derivatives Rucinol Potassium Methoxysalicylate Ellagic Acid Chamomilla Extract 5,5’-Dipropyl-Biphenyl-2,2’-Diol (Magnolignan®) Rhododendrol (4-(4-Hydroxyphenyl)-2-Butanol) Azelaic Acid Tranexamic Acid and Tranexamic Acid Cetyl Ester Hydrochloride Adenosine Monophosphate Disodium Salt N-Acetyl-4-S-Cysteaminylphenol Linoleic Acid AHAs and BHAs

CONCLUSION REFERENCES

Chapter 5 FUNGAL MELANINS: BIOSYNTHESIS AND BIOLOGICAL FUNCTIONS

ABSTRACT INTRODUCTION TYPES AND BIOSYNTHESIS OF FUNGAL MELANINS

Melanized Fungi

Cryptococcus Neoformans Members of the Order Chaetothyriales Fonsecaea Pedrosoi Exophiala Dermatitidis

Dimorphic Fungi

Sporothrix Schenckii Histoplasma Capsulatum Paracoccidioides Brasiliensis Other Dimorphic Fungi Candida Albicans and Other Yeasts Aspergillus Other Human Pathogenic Fungi Phytopathogenic Fungi

Implications for Human Health

CONCLUSION REFERENCES

Chapter 6 THE COAT COLOR GENES REGULATE EUMELANIN AND PHEOMELANIN SYNTHESIS IN MELANOCYTES

ABSTRACT INTRODUCTION REGULATION BY THE COAT COLOR GENES

Agouti, Mahogany, Mahoganoid and Subtle Grey Brown Albino Dilute, Leaden and Ashen Recessive Yellow and Lethal Yellow Pink-Eyed Dilution, Underwhite and Silver Slaty Ruby-Eye 2d, Beige and Mottled Sash

CONCLUSION ACKNOWLEDGMENTS REFERENCES

Chapter 7 THE ROLE OF MELANIN PRODUCTION IN GAEUMANNOMYCES GRAMINIS INFECTION OF CEREAL PLANTS

ABSTRACT INTRODUCTION MATERIALS AND METHODS

Fungal Isolates and Culturing Hyphal Morphology and Vegetative Growth Rate

MELANIN QUANTIFICATION

Purification of Melanin from Wild-type Hyphae Absorption of Azure A by Melanin Quantification of Melanin in Mycelia

PATHOGENICITY TESTS

Inoculation of Rice Using Conetainer Assay Inoculation of Rice Using a Petri-plate Assay Wax Embedment and Sectioning of Rice Roots Harvested from Conetainer Assay Agarose Embedment and Sectioning of Rice Roots Harvested from Petri-plate Assay

RESULTS

The Effect of Melanin Hyphal Width The Effect of Melanin on Hyphal Distance between Branches Fungal Vegetative Growth in Different Cultures Quantification of Melanin in Gaeumannomyces Graminis var. graminis Hypha Disease Severity and Ectotrophic Colonization of Rice in Conetainer Assay Histopathological Observations of Rice Inoculated in Conetainer Assay Disease Severity and Ectotrophic Colonization of Rice in Petri-plate Assay Histopathological Observation of Rice inoculated in Petri-plate Assay

DISCUSSION

Nature of Mutations Used (Pigmentation and Morphology) Effect of Melanin on Fungal Hyphal Morphology and Vegetative Growth Rate Melanin Quantification The Effect of Melanin on the Histopathology of Gaeumannomyces Graminis Effect of Melanin on Fungal Pathogenicity

REFERENCES

Chapter 8 SKIN ANATOMY AND PHYSIOLOGY RESEARCH DEVELOPMENTS IN MELANOCYTES

ABSTRACT 1. INTRODUCTION 2. THE DISORDERS IN ABERRANT MIGRATION OF MELANOBLASTS 3. THE DISORDERS IN BIOGENESIS OF MELANOSOMES IN MELANOCYTES 4. THE DISORDERS IN THE TRANSLOCATION OF MELANOSOMES IN MELANOCYTES 5. THE DISORDERS IN THE TRANSFER OF MELANOSOMES VIA INTERCELLULAR SPACES 6. THE DISORDERS IN THE TRANSLOCATION OF MELANOSOMES IN KERATINOCYTES 7. THE DISORDERS OF UNREGULATED MELANOGENESIS 7. THE DISORDERS OF NO OR DECREASED MELANOGENESIS 8. THE VARIANTS IN HAIR, EYES AND SKIN COLOR AND ASSOCIATED DISORDERS 9. OTHER DISORDERS

(1) Dyschromatosis Symmetrica Hereditaria (2) Reticulate Acropigmentation of Kitamura

10. FUNCTION AND HEALTH EFFECT CONCLUSION REFERENCES

Chapter 9 OPTICAL SPECTROSCOPY AND STRUCTURAL PROPERTIES OF SYNTHETIC AND NATURAL EUMELANIN

ABSTRACT INTRODUCTION EXPERIMENTAL

Materials Experimental Techniques

RESULTS AND DISCUSSION

Vibrational Spectroscopy: Raman and FTIR Absorption Spectroscopy Fluorescence Spectroscopy Macromolecular Structure: Dynamic Light Scattering Macromolecular Structure: X-Ray Diffraction Macromolecular Structure: Atomic Force Microscopy

CONCLUSION REFERENCES

Chapter 10 MELANIC PIGMENTATION IN ECTOTHERMIC VERTEBRATES: OCCURRENCE AND FUNCTION

ABSTRACT INTRODUCTION MELANOPHORES: COLOR CHANGES AND HORMONAL CONTROL

Melanossomes: An Organelle That Synthesizes and Stores Melanin

MELANIN IN ECTOTHERMIC VERTEBRATES

Visceral Pigmentation: Anatomical Patterns in Anurans

THE MELANIN IN HEMATOPOIETIC ORGANS THE FUNCTIONS OF MELANIN IN VISCERAL PIGMENTATION CONCLUSION ACKNOWLEDGMENTS REFERENCES

Chapter 11 FAIRNESS IN A NATURAL WAY -- NOVEL POLYHERBAL INGREDIENTS INHIBITING MELANIN SYNTHESIS AND TRANSFER

ABSTRACT INTRODUCTION

Decalepis hamiltonii Wight and Arn. (Asclepiadaceae) Hemidesmus indicus (L.) Schult. (Periplocaceae) Aloe vera (L.) Burm. F. (Liliaceae) Curcuma zedoria (Berg.) Rosc. (Zingiberaceae) Raphanus sativus Linn. (Brassicaceae) Cell Culture Melanin Measurement Tyrosinase Assay Dendrite Length and Number Measurement A New Breakthrough in Skin Lightening Benefit: Synergy of Poly Herbal Combination in Inhibiting Melanin Synthesis and Transfer

CONCLUSION REFERENCES

Chapter 12 THE MELANOCORTIN-1 RECEPTOR: A KEY MELANOMA RISK DETERMINANT AND A CRITICAL REGULATOR OF THE UV DNA DAMAGE REPAIR RESPONSE

ABSTRACT DESCRIPTIVE PARAGRAPH MELANOMA- A GROWING PROBLEM

Age and Melanoma Ultraviolet Radiation (UV) As a Carcinogen UV and Oxidative Damage UV and DNAPhotodamage UV and Geography Sun Tanning and Melanoma Risk UV and Vitamin D Sunburns Skin Complexion Inherited Determinants of Skin Color Melanocytes Melanocortin 1 Receptor (MC1R) MC1R and Adaptive Melanization α-MSH and POMC MC1R Antagonists Nucleotide Excision DNA Repair MC1R and NER MC1R and Double Strand Break Repair MC1R and Defense against Oxidative Damage Pharmacologic Manipulation of MC1R Signaling

REFERENCES

Chapter 13 MC1R, EDNRB AND KIT SIGNALING IN PIGMENTATION REGULATION AND RELATED DISORDERS

ABSTRACT INTRODUCTION

Pigment Production Pigment Cell Development

THE MELANOCORTIN 1 RECEPTOR PATHWAY

MC1R in Pigmentation Disruption of the MC1R Signaling Pathway in Mice and Humans

THE ENDOTHELIN RECEPTOR B PATHWAY

EDNRB in Melanocyte Development and Pigmentation Disruption of the EDNRB Pathway in Mice and Humans

THE KIT RECEPTOR PATHWAY

KIT Signaling in Melanocyte Development and Pigmentation Disruption of the KIT Signaling Pathway in Mice and Humans

INTERACTIONS AMONG SIGNALING PATHWAYS REFERENCES

Chapter 14 MULTIPLE GENES AND DIVERSE HIERARCHICAL PATHWAYS AFFECT HUMAN PIGMENTATION

ABSTRACT INTRODUCTION MAJOR PATHWAYS IN PIGMENTATION CYTOKINE REGULATION OF MELANOGENESIS GENES INFLUENCING NATURAL VARIATION IN HUMAN SKIN COLOUR HYPERPIGMENTATION OF SKIN MOSAIC HYPOPIGMENTATION OF SKIN CONCLUSION REFERENCES

Chapter 15 ACQUIRED SKIN PIGMENTATION

INTRODUCTION 1. MELASMA

Histopathology

Causation

(1) Hormonal Disturbances (2) Photohypersensitibity

Treatment Clinical Evaluation of Depigmenting Agents

2. PIGMENTATED CONTACT DERMATITIS

Treatment

3. PIGMENTED COSMETIC DERMATITIS

Causative Allergens Treatment

4. PIGMENTED PURPURIC LICHENOID DERMATITIS

Causation and Treatment

5. DIRTY NECK OF ATOPIC DERMATITIS REFERENCES

Chapter 16 THE PRO-OPIOMELANOCORTIN (POMC) AND MELANOCORTIN SYSTEM IN REGULATION OF HUMAN SKIN PIGMENTATION

ABSTRACT ABBREVIATIONS INTRODUCTION PRO-OPIOMELANOCORTIN (POMC) MELANOCORTIN RECEPTORS (MC-RS) ROLE OF THE MELANOCORTIN SYSTEM IN SKIN PIGMENTATION MUTATION OF POMC/MC-1R ON SKIN PIGMENTATION AND DISORDER CONCLUSION ACKNOWLEDGMENTS REFERENCES

Chapter 17 OVERVIEW ON THE MELANOCYTE PRECURSOR MIGRATION FROM THE NEURAL CREST

ABSTRACT INTRODUCTION MELANOBLAST-MIGRATION THROUGH BOTH ROUTES FROM THE NC HYPERPIGMENTATION IN SILKY CHICKEN FACTORS INVOLVED IN MELANOCYTE DIFFERENTIATION ACKNOWLEDGMENTS REFERENCES

Chapter 18 RADIATION TREATMENT AND ALOPECIA – PAST AND PRESENT CONCERNS

ABSTRACT THE USE OF X-RAYS TO INDUCE EPILATION

The Tinea Capitis (or Scalp Ringworm) Epilation Model The Beauty Shops Possible Side Effects Related to the Epilation Treatment

ALOPECIA AS A SEQUEL OF RADIOLOGICAL INTERVENTIONS

Diagnostic/Therapeutic Techniques and Accidents Can Cause Alopecia Radiation-Induced Alopecia – Clinical Features and Pathogenesis Prevention and Treatment of Radiation-Induced Alopecia

CONCLUSION ACKNOWLEDGMENTS REFERENCES

Chapter 19 PSYCHOSOCIAL ASPECTS IN ALOPECIA AREATA: STUDIES ON STRESS INVOLVEMENT IN ADULTS AND CHILDREN

1. INTRODUCTION 2. STUDIES OF STRESS INVOLVEMENT IN ALOPECIA AREATA IN CHILDREN, ADULTS AND DIFFUSE ALOPECIA IN CHILDREN

2.1. Study on Adults

2.1.1. Demographics 2.1.2. Stress Involvement

2.2. Study on Children/Adolescents

2.2.1. Demographics 2.2.2. Stress Involvement

3. DISCUSSION

3.1. Stress Involvement 3.2. Psychiatric Symptomatology 3.3. Quality of Life

CONCLUSION AND LIMITATIONS REFERENCES

Chapter 20 THE POWER OF THE GENE: THE ORIGIN AND IMPACT OF GENETIC DISORDERS ALOPECIA: CAUSES, DIAGNOSIS AND TREATMENT

ABSTRACT 1. INTRODUCTION 2. EPIDEMIOLOGY 3. CLASSIFICATION 4. ASSOCIATED DISORDERS

Nail Change Autoimmune Diseases Atopic Dermatitis Psychiatric disorders

5. GENETIC FACTORS 6. PATHOGENESIS 8. TREATMENT CONCLUSION REFERENCES

Chapter 21 ALOPECIA AREATA: TREATMENT OPTIONS

ABSTRACT INTRODUCTION TREATMENT OF ALOPECIA AREATA

Corticosteroid Therapy

Topical Corticosteroids Intralesional Corticosteroids Systemic Corticosteroids

Photochemotherapy (PUVA) Topical Sensitizers Anthralin Minoxidil New Immunomodulatory Therapies Topical Tacrolimus (Protopic) Topical Pimecrolimus (Elidel) Topical Cyclosporine A (Psorban) New Biologic Therapies Liposomes Miscellaneous Agents

Sulfasalazine Inhibition of the Fas-Fasl System Imiquimod Bexarotene

Nonpharmacologic Methods

Laser Therapy Cosmetic Treatments

CONCLUSION REFERENCES

Chapter 22 THE GENETIC BASIS OF ALOPECIA AREATA

ABSTRACT INTRODUCTION ALOPECIA AREATA AND HLA GENES ALOPECIA AREATA AND NON-HLA GENES CONCLUSION REFERENCES

Chapter 23 OCULAR ROSACEA: RECENT ADVANCES IN PATHOGENESIS AND THERAPY

ABSTRACT DEFINITION HISTORY EPIDEMIOLOGY CLINICAL MANIFESTATIONS CLINICAL COURSE, STAGES AND GRADING PATHOPHYSIOLOGY DIAGNOSIS HISTOPATHOLOGY DIFFERENTIAL DIAGNOSIS TREATMENT REFERENCES

Chapter 24 INVASIVE CANDIDIASIS EPIDEMIOLOGY, DIAGNOSIS AND TREATMENT

ABSTRACT 1. INTRODUCTION 2. EPIDEMIOLOGY OF IC. DIFFERENCES IN THE DISTRIBUTION AND PATHOGENICITY BETWEEN THE SPECIES IN NEONATES, CHILDREN AND ADULTS: CANDIDA ALBICANS, CANDIDA GLABRATA, CANDIDA KRUSEI, CANDIDA PARAPSILOSIS, AND CANDIDA TROPICALIS 3. RISK FACTORS FOR INVASIVE CANDIDIASIS 4. MECHANISMS OF CANDIDA DISSEMINATION 5. CLINICAL PRESENTATIONS OF INVASIVE CANDIDIASIS 6. DIAGNOSTIC METHODS: FROM THE IDENTIFICATION OF CANDIDA TO THE NUCLEIC ACID DETECTION 7. CARE AND TREATMENT OF PATIENTS. CONCERNS ON ANTIFUNGAL RESISTANCE AND NEW THERAPEUTIC APPROACHES REFERENCES

Chapter 25 CANDIDA PARAPSILOSIS COMPLEX

ABSTRACT I. HISTORY II. ECOLOGY AND EPIDEMIOLOGY III. VIRULENCE FACTORS

1. Adherence 2. Biofilm Formation 3. Secreted Enzymes

A. Aspartic Proteinases B. Phospholipases C. Lipases D. Hemolysin

IV. MYCOLOGY

1. Colony Morphology and Dimorphism 2. Genetics

V. ANTIFUNGAL SUSCEPTIBILITY

Amphotericin B Fluconazole Voriconazole Echinocandins

VI. CLINICAL MANIFESTATIONS AND TREATMENT

1. Candidemia 2. Endocarditis 3. Meningitis 4. Onychomycosis 5. Endophthalmitis 6. Peritonitis 7. Arthritis 8. Otomycosis 9. Vulvovaginitis 10. Urinary Tract Infection

REFERENCES

Chapter 26 ORAL CANDIDIASIS: CONVENTIONAL AND ALTERNATIVE TREATMENT OPTIONS

ABSTRACT ORAL CANDIDAL INFECTION: PREVALENCE, SYMPTOMS, AND ETIOLOGICAL FACTORS CONVENTIONAL AND ALTERNATIVE TREATMENT OPTIONS FOR ORAL CANDIDIASIS

Conventional Treatments for Oral Candidiasis

Antifungal Agents Denture Hygiene

Alternative Treatment Options for Oral Candidiasis

Microwave Irradiation for Denture Disinfection and Oral Candidiasis Treatment Photodynamic Therapy for Denture Disinfection and Oral Candidiasis Treatment Adjunctive Modalities for Oral Candidiasis Treatment

REFERENCES

Chapter 27 CANDIDA SPP. IN ORAL CAVITY OF CHILDREN WITH IMMUNODEFICIENCIES

ABSTRACT INTRODUCTION 1. FACTORS INFLUENCING HOST-FUNGUS INTERACTIONS 2. CLINICAL SYMPTOMS OF ORAL CANDIDIASIS 3. ORAL CANDIDIASIS DIAGNOSIS

Use of D-Arabinitol Fungal Metabolite in Diagnosing Fungal Infections

4. YEAST INFECTIONS IN IMMUNODEFICIENCIES

4.1. Study Synopsis 4.2. Primary Immunodeficiencies

4.2.1. Phagocyte Impairment 4.2.2. Decreased Count of Impaired Function T Lymphocytes

4.3. Secondary Immunodeficiencies

4.3.1. Pharmacological Immunosuppression Cytostatics Used in Neoplasms

Immunosupressants in Glomerulonephritis and Transplantology

CANDIDA SPECIES AND INS

Material and Method Results

CANDIDA SPECIES AND DIABETES

Material and Method Results

REFERENCES

Chapter 28 OXIDATIVE STRESS AND THE DEVELOPMENT OF ANTIFUNGAL AGENTS FOR THE TREATMENT OF CANDIDIASIS

ABSTRACT INTRODUCTION CANDIDA SPP. AND OXIDATIVE STRESS THE OXIDATIVE STRESS AND THE DEVELOPMENT OFANTI-CANDIDA DRUGS CONCLUSION REFERENCES

Chapter 29 INHALATION AND TOPICAL STEROID THERAPY AND ORAL CANDIDIASIS: A BRIEF OVERVIEW

ABSTRACT INTRODUCTION THE EFFECT OF CORTICOSTEROIDS IN THE INFLAMMATORY AND IMMUNE RESPONSE STEROID INHALATION THERAPY TOPICAL CORTICOSTEROID THERAPY STEROID INDUCED ORAL CANDIDIASIS WITH INHALED CORTICOSTEROIDS STEROID INDUCED ORAL CANDIDIASIS WITH TOPICAL STEROIDS MANAGEMENT OF STEROID INDUCED ORAL CANDIDIASIS ANIMAL MODELS: EXPERIMENTALLY INDUCED ORAL CANDIDIASIS WITH STEROID TREATMENT MECHANISMS OF PATHOGENESIS OF STEROID INDUCED ORAL CANDIDIASIS PREVENTIVE MEASURES CONCLUSION AND FUTURE DIRECTIONS REFERENCES

Chapter 30 FLUORESCENT STAINING FOR THE DIAGNOSIS OF ORAL ERYTHEMATOUS CANDIDIASIS

ABSTRACT 1. INTRODUCTION 2. EXAMINATION OF CANDIDA IN THE DIAGNOSIS OF ORAL CANDIDIASIS

2.1. Culture Examinations 2.2. Microscopic Examinations

2.2.1. Conventional staining 2.2.2. Fluorescent Staining 2.2.3. The Staining Method Using Fungiflora Y

3. DIFFERENCES IN THE CYTOLOGICAL FINDINGS BETWEEN PSUEDOMEMBRANOUS AND ERYTHEMATOUS CANDIDIASIS 4. COMPARISON OF FUNGIFLORA Y WITH MODIFIED GIEMSA STAINING IN ERYTHEMATOUS CANDIASIS

4.1. Comparison of the Reliability of Staining with Fungiflora Y and Modified Giemsa Staining 4.2. Comparison of the Accuracy of Fungiflora Y with Modified Giemsa Staining

5. QUANTITATIVE EVALUATION OF CANDIDA BY MICROSCOPY IN ERYTHEMATOUS CANDIDIASIS

5.1. Subjects and Methods

5.1.1. Subjects 5.1.2. Methods for Microscopic Examination

5.2. Relationship between the Microscopic and Cultural Examinations of Candida

CONCLUSION REFERENCES

Chapter 31 CYANOSIS: CAUSES, SYMPTOMS AND TREATMENT

ABSTRACT INTRODUCTION CAUSES OF CYANOSIS

Central Cyanosis Peripheral Cyanosis Mixed Cyanosis Differential Cyanosis Cyanosis Due to Abnormal Pigmentation

APPROACH TO A PATIENT WITH CYANOSIS MANAGEMENT OF PATIENT WITH CYANOSIS REFERENCES

Chapter 32 PERINATAL CYANOSIS: NEUROPSYCHOLOGICAL FUNCTIONING

ABSTRACT COMMON CYANOTIC POPULATIONS

Cardiac Etiologies Respiratory Etiologies Prenatal Etiologies Related to Low Birth Weight and Nenonatal Prematurity Hypoxic-Ischemic Brain Injury Neurocognitive Implications Intelligence Language Motor Memory Attention and Executive Function Academic Psychosocial Functioning

INTERVENTIONS CONCLUSION REFERENCES

Chapter 33 LARYNGOMALACIA: A CAUSE OF CYANOSIS IN PEDIATRIC AGE

ABSTRACT INTRODUCTION TERMINOLOGY AND INCIDENCE PATHOLOGICAL MECHANISM SYMPTOMATOLOGY SYNCHRONOUS AIRWAY LESIONS COMORBIDITIES DIAGNOSIS TREATMENT NON-INVASIVE VENTILATION CONCLUSION REFERENCES

Chapter 34 THE VISUAL RECOGNITION OF CYANOSIS AND THE INFLUENCE OF LIGHTING AND COLOR VISION

ABSTRACT INTRODUCTION 1. THE SPECTRAL REFLECTION CHARACTERISTICS OF THE OBJECT VIEWED 2. THE SPECTRAL CHARACTERISTICS OF THE LIGHTING 3. THE SPECTRAL CHARACTERISTICS OF THE OBSERVER

Influences on Perception

CONCLUSION REFERENCES

Chapter 35 KERATINOCYTES IN PSORIASIS: KEY PLAYERS IN THE DISEASE PROCESS

ABSTRACT I. SKIN HOMEOSTASIS AND REGULATION OF FUNCTION II. PSORIASIS

1. Epidemiology 2. Clinical Features 3. Psoriasis and the Quality of Life 4. Psoriasis-Associated Co-Morbidities 5. Histologic Features 6. Psoriasis Phenotypes

CLASSIFICATION OF PSORIASIS ACCORDING TO THE CLINICAL PHENOTYPE

I. Chronic Plaque Psoriasis II. Inverse Psoriasis III. Guttate Psoriasis IV. Erythrodermic Psoriasis V. Childhood Psoriasis VI. Pustular Psoriasis VII. Nail disease (Psoriatic Onychodystrophy) VIII. Psoriatic Arthritis (PsA) 7. Therapeutic Armamentarium

i. Topical Therapy ii. Phototherapy

ULTRAVIOLET B RADIATION (UVB)

Acute Chronic

iii. Systemic Therapy Etanercept is Discussed Below as A Representative of this Class of Biologic Therapies

8. The Mystery of the Disease Origin 9. Emerging Drugs

THE CONTROVERSIAL ROLE OF DMF CONCLUSION REFERENCES

Chapter 36 TYPES, TRIGGERS AND TREATMENT STRATEGIES OF PSORIASIS

ABSTRACT INTRODUCTION TRIGGERING FACTORS

Infections Drugs Cutaneous Traumas Stress and Psychosomatic Factors Alcohol Smoking

CLINICAL VARIANTS

Psoriasis Vulgaris-Chronic Plaque Psoriasis Guttate Psoriasis Small Plaque Psoriasis Inverse Psoriasis Seborrhoeic Psoriasis Scalp Psoriasis Palmoplantar (Non Pustular) Psoriasis Nail Psoriasis Mucous Membranes Pustular Psoriasis Erythrodermic Psoriasis

TREATMENT

General Considerations Topical Treatments

Corticosteroids Vitamin D Analogues Tazarotene Salicylic Acid Topical Calcineurin Inhibitors Anthralin Coal Tar

Phototherapy

UVB Phototherapy Photochemotherapy

Systemic Oral Agents

Methotrexate Acitretin Cyclosporine Other Systemic Drugs

Biologics

Alefacept Efalizumab Adalimumab

Etanercept

Infliximab Ustekinumab

CONCLUSION REFERENCES

Chapter 37 A NEW STRATEGY FOR THE TREATMENT OF PSORIASIS— KERATIN 17 (K17)-TARGETING THERAPY

ABSTRACT INTRODUCTION 1. KERATIN 17

1.1. Expression and Location of Keratin 17 1.2. Functions of Keratin 17 1.3. Keratin 17 As an Immune Regulator

2. KERATIN 17 AND PSORIASIS

2.1. Expression of K17 in Psoriasis 2.2. K17 and Psoriasis-Associated Cytokines

2.2.1. Regulation of K17 Expression by IFN- 2.2.2. Regulation of K17 Expression by IL-17 and IL-22 2.2.3. Signal-Regulated Kinase Pathway of K17 Expression

2.3. Impact of K17 on Psoriatic Autoreactive T Cells

2.3.1. Classic Antigens of Psoriatic T Cells in Different Types of Psoriasis 2.3.2. Sequences in K17 Serving As Psoriatic T Cell-Epitopes

2.3. K17 and Autoimmune Positive Feedback Loops in Psoriasis

3. K17 AND TREATMENT OF PSORIASIS

3.1. Treatments in Psoriasis 3.2. K17 in the Treatments of Psoriasis 3.3. K17 As a Therapeutic Target for Psoriasis

4. FUTURE PERSPECTIVES CONCLUSION ACKNOWLEDGMENTS REFERENCES

Chapter 38 NARROW-BAND ULTRAVIOLET LIGHT B (UVB) AND PSORALEN PLUS UVA EFFECT IN THE CIRCULATING LEVELS OF BIOLOGICAL MARKERS IN PSORIASIS

ABSTRACT INTRODUCTION PHOTOTHERAPY – A BRIEF HISTORIC APPROACH UVB THERAPY PUVA THERAPY NB-UVB VERSUS PUVA PUVA AND NB-UVB EFFECTS ON BIOMARKERS CONCLUDING REMARKS REFERENCES

Chapter 39 PSORIASIS VULGARIS INVESTIGATED BY ELECTRON PARAMAGNETIC RESONANCE

ABSTRACT INTRODUCTION APPARATUS

Stratum Corneum Cyanoacrylate Glue Stripping Preparation of SC Sheets for EPR Measurements Spin Probes EPR Line-Shapes due to Spin Probe Motion Qualitative Mobility Parameter (S) Quantitative Mobility Parameter (S0) by Slow-Tumbling Spectral Simulation

RESULTS AND ANALYSES

Qualitative Mobility Parameter (S) and Quantitative Mobility Parameter (S0) of SC Lipids Quantitative Mobility Parameter (S0) Related to SC Lipid Structure Other Applications of the EPR Method

Effects of Mild Surfactants on SC Lipids Effects of Skin Penetration Enhancers on SC Lipids SC with Psoriasis Vulgaris Psoriatic Nails

CONCLUSION REFERENCES

Chapter 40 PSORIASIS AND COMORBIDITIES

ABSTRACT INTRODUCTION

Psoriasis and Cardiovascular Risk Psoriasis and Metabolic Disease Psoriatic Arthritis (PsA) Non-Alcoholic Fatty Liver Disease (NAFLD) Crohn’s Disease (CD) Erectile Dysfunction Uveitis Cancer

Lymphoma Cutaneous Non-Melanoma Cancer (CNMC)

Psoriasis and Psychological and Psychiatric Comorbidities

REFERENCES

Chapter 41 NUTRITION AND THE TREATMENT OF PSORIASIS

ABSTRACT DISCUSSION

Vitamin A Vitamin D Low Calorie Diet Gluten-Free Diet Metabolic Syndrome Supplements Alcohol Pharmacologic Drugs

CONCLUSION REFERENCES

Chapter 42 PSORIASIS AND CARDIOVASCULAR DISEASE - UPDATE

ABSTRACT LINK BETWEEN PSORIASIS AND ATHEROSCLEROSIS PSORIASIS IS STRONGLY ASSOCIATED WITH CLINICAL MANIFESTATIONS OF ATHEROSCLEROSIS BIOLOGIC THERAPIES IN LATE STAGE CLINICAL DEVELOPMENT FOR PSORIASIS BIOLOGIC THERAPIES IN EARLY CLINICAL DEVELOPMENT FOR PSORIASIS CONCLUSION

Conflict of Interests

REFERENCES

Chapter 43 BULLOUS PEMPHIGOID: AN OVERVIEW

ABSTRACT INTRODUCTION EPIDEMIOLOGY CLINICAL ASPECTS TRIGGER FACTORS DIAGNOSIS DIFFERENCIAL DIAGNOSIS MANAGEMENT OF BULLOUS PEMPHIGOID REFERENCES

Chapter 44 BULLOUS PEMPHIGOID DUE TO ANTI-TNFΑLPHA

ABSTRACT INTRODUCTION REFERENCES

Chapter 45 DESQUAMATIVE GINGIVITIS AS AN ORAL MANIFESTATION OF MUCOUS MEMBRANE PEMPHIGOID: DIAGNOSIS AND TREATMENT

ABSTRACT INTRODUCTION DESQUAMATIVE GINGIVITIS SPECIFIC SITE CONSIDERATION MANAGING PATIENTS WITH DESQUAMATIVE GINGIVITIS PERIODONTAL CONSIDERATIONS CONCLUSION REFERENCES

Chapter 46 ASSOCIATIONS BETWEEN BULLOUS PEMPHIGOID AND INTERNAL MALIGNANCIES: A LITERATURE REVIEW

ABSTRACT INTRODUCTION HISTORICAL PERSPECTIVE INCIDENCE OF INTERNAL MALIGNACIES AMONG BP PATIENTS INCIDENCE OF BP IN PATIENTS WITH INTERNAL MALIGNANCY DISCUSSION AND SUMMARY REFERENCES

Chapter 47 NEW THERAPEUTIC ADVANCES IN THE MANAGEMENT OF ACNE

ABSTRACT INTRODUCTION OXIDATIVE STRESS

Fullerene Taurine Bromamine

ANTI-MICROBIAL MOLECULES

Picolinic Acid Calcipotriene Vaccines Thiazolidinedione Derivatives Antimicrobial Peptides ProOxy Povidone-Iodine

ANTI-INFLAMMATORY

Zileuton Afamelanotide Apremilast Gevokizumab Ectopeptidase Inhibitors

OTHER

Talarozole Cortexolone 17α-Propionate Epigallocatechin-3-Gallate Oligonucleotides

NATURAL PRODUCTS - HOMOEOPATIC MEDICINE

Resveratrol Curcumin Ethanolic Rosemary Extract Essential Oil and Aromatherapy Marine-Derived Ingredients Homoeopatic Medicine

INSTRUMENTAL TREATMENT

Headheld Heat Device Acleara Needle Insert Clear Device KLOX Biophotonic System PhotoPneumatic System Photodimanic Therapy Botulin Ultrasound Device Plasma Treatment System Silk'n Blue Device Low-Level Laser Therapy (Erchonia EML)

CONCLUSION REFERENCES

Chapter 48 A LARGE-SCALE EUROPEAN OBSERVATIONAL STUDY TO DESCRIBE THE MANAGEMENT OF ACNE IN CLINICAL PRACTICE

ABSTRACT BACKGROUND QUESTIONS ADDRESSED EXPERIMENTAL DESIGN RESULTS PRESCRIPTION THERAPY SECOND VISIT (58 ± 17 DAYS AFTER) DISCUSSION AND CONCLUSION ACKNOWLEDGMENTS REFERENCES

Chapter 49 SKIN AGING

ABSTRACT INTRODUCTION SKIN AGING: MORPHOLOGICAL AND PHYSIOLOGICAL ALTERATIONS OF THE SKIN INTRINSIC AND EXTRINSIC SKIN AGING MECHANISMS INVOLVED IN INTRINSIC AND/OR EXTRINSIC SKIN AGING

1. Telomere Shortening 2. Production of Free Radicals 3. Solar Radiation 4. Hormonal Factors 5. DNA Errors or Mutations 6. Smoking

CLINICAL FEATURES THERAPEUTIC APPROACH ANTIOXIDANTS

Vitamin C Vitamin E Vitamin A Alpha Hydroxy Acids Tea Polyphenols Soy Isoflavones

CONCLUSION REFERENCES

Chapter 50 A PROCEDURE FOR THE ASSESSMENT OF SKIN AGING

ABSTRACT INTRODUCTION COMPUTER ANALYSIS OF DIGITAL CAMERA-CAPTURED PHOTOGRAPHIC IMAGES

Analysis of Facial Pores Analysis of Facial Pigmentation Analysis of Facial Skin Texture

ASSESSMENT OF SKIN AGING USING THE ROBO SKIN ANALYZER® REFERENCES

Chapter 51 AGED SKIN AND STRENUOUS EXERCISE: CAN THE SKIN HANDLE THE HEAT?

ABSTRACT INTRODUCTION HEAT LOSS MECHANISMS IN THE SKIN AGE AND SKIN BLOOD FLOW DURING EXERCISE-HEAT STRESS AGE AND SWEATING RESPONSE DURING EXERCISE-HEAT STRESS AGED SKIN AND HEAT ACCLIMATISATION SUMMARY AND FUTURE RESEARCH CONCLUSION REFERENCES

Chapter 52 NEW INSIGHTS ON THE REGULATION OF EXTRACELLULAR MATRIX PROTEINS DURING SKIN AGING

ABSTRACT 1. INTRODUCTION 2. CLINICAL FEATURES OF AGED SKIN 3. DERMAL STRUCTURAL AND FUNCTIONAL CHANGES OF AGED SKIN

3.1. Composition of Dermal Extracellular Matrix 3.2. Structural and Functional Changes of Extracellular Matrix in Aged Skin 3.3. Roles of Matrix Metalloproteinases in Extracellular Matrix Degradation in Aged Skin

4. MOLECULAR MECHANISM OF SKIN AGING: IMPLICATION OF NF-B AND TGF- IN DERMAL AGING

4.1. Overview 4.2. Implication of NF-B in the Regulation of Extracellular Matrix in Aged Skin

4.2.1. Signal Transduction of NF- B 4.2.2. Role of NF-B in the Regulation of Extracellular Matrix Protein Degradation 4.2.3. Role of NF-B in Regulation of Extracellular Matrix Protein Expression

4.3. Implication of TGF- in the Regulation of Extracellular Matrix in Aged Skin

4.3.1. TGF- Signaling Pathway and Regulation 4.3.2. Physiological Significance of TGF- in the Regulation of ECM 4.3.3. TGF- Signaling Pathway in Aged Skin

CONCLUSION REFERENCES

Chapter 53 IMPROVED CELL METABOLISM AND STRENGTHENING OF THE EXTRACELLULAR MATRIX BY NICOTINAMIDE, AND COPPER FOR ANTI-SKIN AGING

ABSTRACT INTRODUCTION I. SKIN AGING: OXIDATIVE STRESS AND INFLAMMATION II. SKIN AGING: EXTRACELLULAR MATRIX (ECM)

II.a. Matrixmetalloproteinases/Elastases II.b. Collagen II.c. Elastin

III. SKIN AGING: SIGNAL TRANSDUCTION PATHWAYS IV. ANTI-SKIN AGING: NICOTINAMIDE AND COPPER

IV.a. Nicotinamide IV.B. Copper

CONCLUSION REFERENCES

Chapter 54 SKIN MORPHOLOGY OF CAUCASIAN WOMEN DURING AGING

ABSTRACT 1. INTRODUCTION

1.1. Skin Lines Network 1.2. Skin Tension and Anisotropy of Skin Lines Network 1.3. Identification of Langer’s Lines

2. MORPHOLOGICAL EVOLUTION OF SKIN LINES NETWORK OF CAUCASIAN FRENCH WOMEN DURING AGING

2.1. Multi-Scale Analysis of Skin Lines Network Morphology 2.2. Changing the Orientation of Lines and Anisotropy during Aging 2.3. Dynamic Rotation of Skin Line Network during Aging 2.4. Anisotropy Index of Skin Lines Network during Aging 2.5. 3D Reconstruction of Skin Line Network: Volumetric Anisotropy and Tree of Skin Tension Network [27, 28, 29, 30] 2.6. Morphological Tree of Skin Line Network [28, 29, 30, 11]

3. PLATES AREA: INDICATOR OF THE LOSS OF ELASTICITY

3.1. Model of Skin Line and Plates Network as Indicators of Aging 3.2. Dynamic Change of Plate Area: Aging Speed of Caucasian Women [33]

CONCLUSION REFERENCES

Chapter 55 MOLECULAR UNDERSTANDING OF THE DEVELOPMENT OF “AGE SPOTS”

ABSTRACT I. INTRODUCTION II. Clinical Observations and Treatments of Solar Lentigines III. Histological Manifestation of Solar Lentigines IV. MOLECULAR CLUES TO THE PATHOLOGY OF SOLAR LENTIGINES

A. Overview B. Hyperplasia and Hyperactivity of Melanocytes in Solar Lentigines C. Molecular Mechanism of Hyperpigmentation: The Expression of Pigmentary Proteins during Solar Lentigines Development D. Molecular Mechanism of Deep Rete Ridges Formation: Dynamic Changes in Genes Involved in Keratinocyte Proliferation and Differentiation within the Solar Lentigines

1. The Expression Pattern of Ki76, a Keratinocyte Proliferation Marker, during Solar Lentigines Development 2. Increased Expression of Keratin 15, a Hair Follicle Stem Cell Marker, in Solar Lentigines 3. Increased KGF/KGFR Expression in the Early-Mid Stages of SLs

V. THE ROLE OF KGF/KGFR IN THE INITIATION OF SOLAR LENTIGINES

A. KGF Increases Hyperpigmentation In Vitro B. KGF Induces Both Hyperpigmentation and Elongated Rete Ridges In Vivo

CONCLUSION REFERENCES

Chapter 56 SKIN REJUVENATION – ULTRASTRUCTURAL STUDY

ABSTRACT INTRODUCTION MORPHOLOGICAL ASSESSMENT

Chemical peeling Pulsed Dye Laser (PDL) LED IPL Type Fractional CO2 Laser

CONCLUSION REFERENCES

Chapter 57 THE ROLE OF SUN EXPOSURE IN SKIN AGING

ABSTRACT INTRODUCTION MECHANISMS OF SKIN PHOTOAGING

Skin Exposure to UVR Ozone Depletion and UVR

FACTORS AFFECTING TERRESTRIAL UVR UVR AND ITS PENETRATION TO THE SKIN DAMAGING EFFECT OF UVR

Skin Response to Acute and Chronic UV Radiation Skin Antioxidant Defense DNA Damage Damage to Elastin and Collagen and Wrinkle Formation Why UV Radiation Accelerates the Aging Process?

UVR AND ROS FORMATION MOLECULAR MECHANISMS BY WHICH UVR CAUSES PHOTOAGING INTERMITTENT EXPOSURE HYPOTHESIS

Sunburn Tanning

BENEFICIAL EFFECTS OF UV HARMFUL EFFECTS OF SUNSCREENS TREATMENT OF PHOTOAGING CONCLUSION REFERENCES

Chapter 58 PHOTOPROTECTION PRACTICES

ABSTRACT INTRODUCTION ENVIRONMENTAL PROTECTIONS

Atmosphere and Geography Time of Day and Season Clouds, Particulates, and Reflections Shade Solar Ultraviolet Index

INTRINSIC PHOTOPROTECTIVE PROPERTIES OF THE SKIN PHYSICAL PHOTOPROTECTIVE AGENTS

Glass

Automobile and Airplane Glass Architectural Glass for Buildings

Sunglasses Other Eye Protection Photoprotective Clothing Hats

TOPICAL PHOTOPROTECTIVE AGENTS

Makeup Sunscreens

Organic Sunscreen Agents Inorganic Agents

SYSTEMIC PHOTOPROTECTIVE AGENTS

Polypodium Leucotomos Carotenoids Afamelanotide Polyphenols Other Antioxidants

CONCLUSION REFERENCES

Chapter 59 RISK FACTORS FOR SUN EXPOSURE DURING SPRING BREAK AMONG COLLEGE STUDENTS

ABSTRACT INTRODUCTION METHODS RESULTS

Artificial Tanning Reasons for Tanning Sun Safety

DISCUSSION

Artificial Tanning Reasons for Tanning Sun Safety Strengths and Limitations

CONCLUSION ACKNOWLEDGMENTS REFERENCES

Chapter 60 SUN EXPOSURE AND PROTECTION HABITS AND VITAMIN D LEVELS IN CHILDREN AND ADOLESCENTS WITH A HISTORY OF MALIGNANCY

ABSTRACT ABBREVIATIONS SUN EXPOSURE AND SKIN CANCER RECOMMENDATIONS OF SUN PROTECTION BEHAVIORS SOURCES OF VITAMIN D

Sun Exposure Food Daily Vitamin D Requirements Recommendations for 25OHD Levels Prevalence of Vitamin D Deficiency

VITAMIN D ROLES

Skeletal Extra-Skeletal Sun Exposure and Non-Skin Cancer

VITAMIN D AND CANCER RISK, MORBIDITY AND MORTALITY VITAMIN D LEVELS IN PEDIATRIC PATIENTS WITH MALIGNANCY CHILDHOOD CANCER SURVIVORS AND SUN EXPOSURE CONCLUSION - BALANCING RISKS AND BENEFITS OF SUN EXPOSURE REFERENCES

Chapter 61 THE SURGEON GENERAL’S CALL TO ACTION TO PREVENT SKIN CANCER: FACTS FOR CONSUMERS*

SKIN CANCER IS COMMON AND COSTLY UV (ULTRAVIOLET) EXPOSURE IS A MAJOR CAUSE OF SKIN CANCER—AND THE MOST PREVENTABLE INDOOR TANNING INCREASES THE RISK IF SKIN CANCER, INCLUDING MELANOMA

Myths about Tanning Everyone Can Play a Part in Preventing Skin Cancer

What can policymakers do? What can businesses and employers do? What can health care systems, insurers, and clinicians do? What can early learning centers, schools, colleges, and universities do? What can community, non-profit, and faith-based organizations do? What can individuals and families do?

Chapter 62 THE SURGEON GENERAL’S CALL TO ACTION TO PREVENT SKIN CANCER*

SKIN CANCER AS A MAJOR PUBLIC HEALTH PROBLEM

Why We Must Act Now Why a Focus on UV Radiation? Sources of UV Radiation Addressed in This Document

UV Exposure and Overexposure

Skin Cancer Incidence and Mortality

Nonmelanoma Skin Cancers

Basal Cell Carcinomas Squamous Cell Carcinomas

Melanoma

Variation by Sex Variation by Anatomic Site Variation by State Survival

Economic Burden of Skin Cancer Risk Factors for Skin Cancer

Genetic Factors

Skin Type

Race and Ethnicity Exposure to UV Radiation

Types of UV Radiation U.S. Environmental Protection Agency’s UV Index UV Exposure and Skin Cancer Chronic versus Intermittent UV Exposure Outdoor Workers Indoor Tanning Other Harms Caused by Excessive UV Exposure Complex Relationship between Outdoor UV Exposure, Vitamin D, and Human Health

Vitamin D Medical Uses of UV Exposure

Benefits of Being Outdoors Risks of Indoor Tanning Outweigh Any Potential Benefits

Current Trends in Sun Protection, Sunburn, and Indoor Tanning

Indoor Tanning

REDUCING THE RISK OF SKIN CANCER

For Individuals

Sun Protection Strategies

Wear Protective Clothing Wear a Hat and Sunglasses Seek Shade Avoid Times of Peak Sunlight Use Sunscreen Avoid Indoor Tanning and Sunbathing

Barriers to Using Sun Protection Barriers to Reducing Intentional Tanning Social Norms Regarding Tanned Skin

For Clinicians For Communities and Schools

Current Evidence on Effective Community-Level Interventions Prevention Policies in Schools Barriers to Interventions in Schools and Communities

For Outdoor Work Settings State and Local Policies, Legislation, and Regulation

Sun Protection Policies and Legislation

Sun Protection Education and Awareness

Indoor Tanning Policies and Legislation

Federal Policies, Legislation, and Regulation

Sun Protection Policies and Legislation Indoor Tanning Regulations

Barriers to Addressing Indoor Tanning Through Policies, Legislation, and Regulation

Ubiquity of Indoor Tanning Devices Enforcement Compliance Marketing Lack of a Comprehensive Approach

International Efforts to Prevent Skin Cancer

GAPS IN RESEARCH AND SURVEILLANCE

Individuals Parents Clinicians Schools Outdoor Workers Communities and Social Networks Indoor Tanning Legislation and Multilevel Influence Surveillance

Cancer Surveillance Behavioral Surveillance Surveillance of Environmental Exposure

Vitamin D and Sun Protection Economic Analysis Potential Unintended Consequences of Interventions

CALLS TO ACTION

Goal 1. Increase Opportunities for Sun Protection in Outdoor Settings

Strategy 1A. Increase Shade in Outdoor Recreational Settings Strategy 1B. Support Sun-Protective Behaviors in Outdoor Settings Strategy 1C. Increase Availability of Sun Protection in Educational Settings Strategy 1D. Increase Availability of Sun Protection for Outdoor Workers

Goal 2: Provide Individuals with the Information They Need to Make Informed, Healthy Choices about UV Exposure

Strategy 2A. Develop Effective Messages and Interventions for Specific Audiences Strategy 2B. Support Skin Cancer Prevention Education in Schools Strategy 2C. Integrate Sun Safety into Workplace Health Education and Promotion Programs Strategy 2D. Partner with Health Care Systems and Providers to Implement and Monitor Use of Recommended Preventive Services for Provider Counseling on Skin Cancer Prevention Strategy 2E. Establish Partnerships between Public and Private Sectors to Disseminate Effective Messages About Skin Cancer Prevention Strategy 2F. Enhance Ongoing Engagement of Federal Partners to Advance Our Nation’s Skin Cancer Prevention Efforts

Goal 3: Promote Policies That Advance the National Goal of Preventing Skin Cancer

Strategy 3A. Support Inclusion of Sun Protection in School Policies, Construction of School Facilities, and School Curricula Strategy 3B. Promote Electronic Reporting of Reportable Skin Cancers and Encourage Health Care Systems and Providers to Use Such Systems Strategy 3C. Incorporate Sun Safety into Workplace Policies and Safety Trainings Strategy 3D. Support Shade Planning in Land Use Development

Goal 4: Reduce Harms from Indoor Tanning

Strategy 4A. Monitor Indoor Tanning Attitudes, Beliefs, and Behaviors in the U.S. Population, Especially among Indoor Tanners, Youth, and Parents Strategy 4B. Continue to Develop, Disseminate, and Evaluate Tailored Messages to Reduce Indoor Tanning among Populations at High Risk Strategy 4C. Support Organizational Policies That Discourage Indoor Tanning by Adolescents and Young Adults Strategy 4D. Enforce Existing Indoor Tanning Laws and Consider Adopting Additional Restrictions Strategy 4E. Address the Risks of Indoor Tanning with Improved Warning Labels and Updated Performance Standards

Goal 5: Strengthen Research, Surveillance, Monitoring, and Evaluation Related to Skin Cancer Prevention

Strategy 5A. Enhance Understanding of the Burden of Skin Cancer and Its Relationship with UV Radiation Strategy 5B. Evaluate the Effect of Interventions and Policies on Behavioral and Health Outcomes Strategy 5C. Build on Behavioral Research and Surveillance Related to UV Exposure Strategy 5D. Quantify the Prevalence of Tanning in Unsupervised Locations

CONCLUSION APPENDIX 1: SCOPE AND DEFINITIONS

Types of Skin Cancer

Basal Cell Carcinomas Squamous Cell Carcinomas Melanomas

Types of Ultraviolet Exposure

Overexposure Limited Exposure

APPENDIX 2: SIGNS AND SYMPTOMS OF SKIN CANCER APPENDIX 3: SKIN CANCER SCREENING APPENDIX 4: SUCCESS STORIES IN SKIN CANCER PREVENTION

Federal Resources for Skin Cancer Prevention in Schools RAYS Skin Cancer Prevention Program Shines Bright for New Mexico Schoolchildren City of Toronto Shade Policy

APPENDIX5: FEDERAL DEPARTMENTS, AGENCIES, AND POLICIES

U.S. Department of Health and Human Services: Healthy People National Cancer Institute Centers for Disease Control and Prevention Comprehensive Cancer Control Programs and Coalitions Agency for Healthcare Research and Quality U.S. Food and Drug Administration Federal Trade Commission U.S. Environmental Protection Agency National Park Service Occupational Safety and Health Administration Affordable Care Act

APPENDIX 6: ABBREVIATIONS AND ACRONYMS REFERENCES End Notes

Chapter 63 FALSE AND MISLEADING HEALTH INFORMATION PROVIDED TO TEENS BY THE INDOOR TANNING INDUSTRY: INVESTIGATIVE REPORT *

I. EXECUTIVE SUMMARY II. BACKGROUND

A. The Growing Popularity of Indoor Tanning B. Cancer and Other Health Risks C. Federal and State Regulation

III. PURPOSE AND METHODOLOGY IV. FINDINGS

A. Tanning Salons Provided False Information about the Health Risks of Indoor Tanning B. Tanning Salons Provided Inaccurate or Misleading Information about Health Benefits of Indoor Tanning C. Tanning Salons Regularly Disregarded FDA Safety Recommendations D. Tanning Salons Targeted the Teen Market in Advertisements E. Tanning Industry Websites Provide Misleading Information

CONCLUSION End Notes

Chapter 64 METABOLOMIC ASSESSMENT OF SUNSCREEN EFFICACY

ABSTRACT INTRODUCTION METABOLOMICS A TOOL TO MEASURE UV INDUCED ENDPOINTS METABOLOME ANALYSIS OF SUN EXPOSED SKIN UROCANIC ACID AS A MARKER OF UV EXPOSURE INCREASED OXIDATIVE STRESS AS A RESULT OF ADENOSINE DEGRADATION ALTERED HOMOCYSTEINE PATHWAY LEADING TO ALTERED RATIO OF GLUTATIONE NICOTINAMIDE PATHWAY SUGGESTS PATHWAY SUGGESTS SKIN IS USING SALVAGE PATHWAY AS COMPARED TO DE NOVO PRODUCTION TO CONSUME THE DAMAGED NICOTINAMIDES SYSTEM BIOLOGY A NEW APPROACH TO INVESTIGATE THE EFFICACY OF SUNSCREEN SUNSCREEN APPLICATION PREVENTS IRRADIATION INDUCED ISOMERIZATION OF UROCANIC ACID SUNSCREEN APPLICATION PREVENTS INFLAMMATION PRODUCED AS A RESULT OF ADENOSINE CATABOLISM INDUCED BY UV RADIATION CONCLUSION ACKNOWLEDGMENTS REFERENCES

Chapter 65 THE HISTORY AND EVOLUTION OF SUNSCREEN

ABSTRACT. SUNSCREENS: PROPERTIES, ROLE IN SKIN CANCER PREVENTION AND HEALTH EFFECTS REFERENCES INTRODUCTION THE MILLENNIA OF PALLOR BEGINNING OF THE “HEALTHY TAN” THE INDUSTRIAL REVOLUTION AND THE GROWTH OF OUTDOOR LEISURE MAKING TAN CHIC GROWING KNOWLEDGE OF THE DANGERS OF UV RADIATION THE HISTORY OF SUNSCREEN EVOLUTION OF SUNSCREEN: AESTHETICS EVOLUTION OF SUNSCREEN: EFFICACY EVOLUTION OF SUNSCREEN: BREADTH OF COVERAGE CHANGING ATTITUDES OF SUN PROTECTION THE MULTI-MILLION DOLLAR INDUSTRY HISTORY OF REGULATION 2013 FDA SUNSCREEN REGULATION MANDATE [25] FUTURE OF SUNSCREEN TIMELINE REFERENCES

Chapter 66 PSYCHOLOGY BEHIND THE USE OF SUNSCREENS, TANNING AND SKIN CANCER PREVENTION

ABSTRACT SUNSCREEN AND SKIN CANCER PREVENTION BEHAVIORAL AND SOCIAL PSYCHOLOGY OF SUNSCREEN USE TANNING AND SKIN CANCER PSYCHOLOGICAL ASPECTS OF TANNING SKIN CANCER PSYCHOLOGY CONCLUSION REFERENCES

Chapter 67 THE ROLE OF ANTIOXIDANTS IN SUNSCREENS: THE CASE OF MELATONIN

ABSTRACT 1. HUMAN SKIN

1.1. Epidermis 1.2. Dermis 1.3. Hypodermis

2. SOLAR RADIATION

2.1. UVB 2.2. UVA 2.3. Vis Light 2.4. NIR

3. SUN EXPOSURE EFFECTS

3.1. Short Time Effects

Erythema Free radical formation

3.2. Long Time Effects

Photoaging Immunosuppression Photocarcinogenesis Photodermatoses

4. SUN PROTECTION

4.1. Chemical Filters 4.2. Physical Filters 4.3. Antioxidants 4.4. DNA Repair Agents 4.5. Cyclooxygenase-2 Inhibitors 4.6. Iron Chelators 4.7. Osmolytes

5. MELATONIN

5.1. Endogenous Synthesis 5.2. Skin Metabolism

6-hydroxymelatonin 2-hydroxymelatonin Cyclic 3-hydroxymelatonin AFMK AMK

5.3. Melatonin Effects

Immunomodulation Antioxidant

Free Radical Scavenger Endogenous Antioxidant Defense Capacity Improvement

Melatonin As an Adjuvant in the Treatment of Cancer

5.4. Melatonin As a Photoprotective Agent

Erythema Apoptosis Generation of ROS Cell Viability Gene Expression Mitochondrial Membrane Potential DNA Synthesis DNA Damage

5.5. Melatonin in Sunscreens

REFERENCES

Chapter 68 UV FILTERS, THEIR DEGRADATION REACTIONS AND ECO-TOXICOLOGICAL EFFECTS

ABSTRACT INTRODUCTION

UV Filter Degradation Reactions Photo-Degradation of UV Filters

Photolysis Photo-Isomerization

Degradation Induced by Disinfecting Agents Eco-Toxicological Effects of UV Filters and Their Degradation by-Products

In Vitro Studies In Vivo Studies

FUTURE PERSPECTIVES ACKNOWLEDGMENTS REFERENCES

Chapter 69 ASSESSMENT OF SUNSCREEN SAFETY BY SKIN PERMEATION STUDIES: AN UPDATE

ABSTRACT INTRODUCTION THE PROCESS OF PERCUTANEOUS ABSORPTION SKIN PERMEATION OF UV-FILTERS

Human Studies Animal Studies

NOAEL AND RISK ASSESSMENT OF UV-FILTERS CONCLUSION REFERENCES

Chapter 70 UV PROTECTION BY WOOLEN FABRIC DYED WITH NATURAL DYESTUFF

ABSTRACT INTRODUCTION EXPERIMENTAL

Materials

Fabric Plant Selection Mordants

Procedure

Extraction of Dyestuff Mordanting Procedure of mordating Dyeing

Measurements

RESULTS AND DISCUSSION CONCLUSION REFERENCES

Chapter 71 LIGHT CONVERSION FOR UV PROTECTION BY TEXTILE FINISHING AND CARE

ABSTRACT INTRODUCTION EXPERIMENTAL

Materials Procedure

Textile Finishing Textile Care - Laundering

Methods

RESULTS AND DISCUSSION CONCLUSION ACKNOWLEDGMENTS REFERENCES

Chapter 72 THE POTENTIAL OF MYCOSPORINE-LIKE AMINO ACIDS AS UV-SUNSCREENS

ABSTRACT 1. INTRODUCTION 2. SOLAR ULTRAVIOLET RADIATION AND BIOLOGICAL EFFECTS 3. UV-ABSORBING COMPOUNDS

3.1. Mycosporine-like Amino Acids 3.2. Occurrence and Distribution of MAAs 3.3. Regulation of MAAs Biosynthesis 3.4. MAA Biosynthesis under Different Abiotic Factors

4. MAAS AS SUNSCREENS: DOMINANT ROLE IN PHOTOPROTECTION CONCLUSION ACKNOWLEDGMENTS REFERENCES

Chapter 73 GUIDELINES FOR SCHOOL PROGRAMS TO PREVENT SKIN CANCER*

SUMMARY INTRODUCTION

Burden of Skin Cancer Risk Factors for Skin Cancer

Excessive Exposure to UV Radiation Childhood and Adolescent UV Exposure Skin Color and Ethnicity Moles Family History Age Environmental Factors Affecting UV Radiation Artificial UV Radiation

Protective Behaviors

Avoiding the Sun and Wearing Proper Clothing and Sunglasses Sunscreens Prevalence of Behavioral Risk Factors, Sun-Safe Behaviors, and Attitudes Related to Sun Safety

Concerns Regarding Promoting Protection from UV Radiation

GUIDELINES FOR SCHOOL PROGRAMS TO PREVENT SKIN CANCER

Schools as Settings for Skin Cancer Prevention Efforts

SKIN CANCER PREVENTION GUIDELINES

Guideline 1: Policy — Establish Policies that Reduce Exposure to UV Radiation

Developing the Policy or Policies Policy Options

Guideline 2: Environmental Change — Provide and Maintain Physical and Social Environments that Support Sun Safety and that are Consistent with the Development of Other Healthful Habits

Physical Environments Social Environments

Guideline 3: Education — Provide Health Education to Teach Students the Knowledge, Attitudes, and Behavioral Skills They Need To Prevent Skin Cancer. The Education Should be Age-Appropriate and Linked to Opportunities for Practicing Sun-Safety Behavior

Scope and Sequence Active Learning and Behavioral Focus School Programs in a Broader Context

Guideline 4. Family Involvement — Involve Family Members in Skin Cancer Prevention Efforts Guideline 5: Professional Development — Include Skin Cancer Prevention Knowledge and Skills in Preservice and In-service Education for School Administrators, Teachers, Physical Education Teachers and Coaches, School Nurses, and Others Who Work with Students Guideline 6: Health Services — Complement and Support Skin Cancer Prevention Education and Sun-Safety Environments and Policies with School Health Services. Guideline 7: Evaluation — Periodically Evaluate Whether Schools are Implementing the Guidelines on Policies, Environmental Change, Education, Families, Professional Development, and Health Services

CONCLUSION APPENDIX A. PUBLIC HEALTH ACTION STEPS FROM THE INTERNATIONAL AGENCY FOR RESEARCH ON CANCER APPENDIX B. SUNSCREEN: HOW TO SELECT, APPLY, AND USE IT CORRECTLY

When to Apply Sunscreen How to Apply Sunscreen What to Look for When You Buy Sunscreen

APPENDIX C. SKIN CANCER EDUCATION RESOURCES REFERENCES

Chapter 74 SHADE PLANNING FOR AMERICA’S SCHOOLS*

WHAT IS THE PURPOSE OF THIS MANUAL?

Why Should Schools Care About Skin Cancer? Why Shade? What Are the Additional Benefits of Shade?

Extending the Classroom Extended Periods of Physical Activity School Grounds Aesthetics

Who Should Read This Manual? How Can This Manual Be Used?

SECTION 1. WHAT IS UV RADIATION?

What Are the Factors That Affect UV Radiation Levels?

Time of Day Time of Year Geographical Latitude Altitude Weather Conditions Atmospheric Ozone

What Are Direct and Indirect UV Radiation? How is UV Radiation Measured? What Are the Health Effects of Exposure to UV Radiation?

Sunburn Tanning Photosynthesis of Vitamin D3 Photoaging of the Skin Eye Damage Basal Cell Cancer Squamous Cell Cancer preventing the disease. Melanoma

Where Can I Find More Information?

SECTION 2. STRATEGIES FOR PROVIDING SHADE

Solid Roof Structures

Advantages Disadvantages Considerations

Shade Cloth Structures Sun Protection Factor (SPF)

Advantages Disadvantages Considerations

Natural Shade

Advantages Disadvantages Considerations

Where Can I Find More Information?

WILDLIFE HABITAT CREATION RESOURCES FOR NATURAL SHADE SOLUTIONS SECTION 3. PLANNING FOR SHADE

The Shade Planning Team The Shade Audit

Interviews Behavioral Observations Environmental Observations Assessing the Findings

Shade Design Funding Where Can I Find More Information?

SECTION 4. CASE STUDIES

Collier County, Florida

Getting Started Approval and Building Costs Maintenance Continued Efforts

Pinellas County, Florida

Getting Started Building Costs Maintenance Continued Efforts

SHADE Foundation of America and the U.S. Environmental Protection Agency’s SunWise School Program

SHADE Foundation of America The U.S. Environmental Protection Agency’s SunWise School Program Creating a Collaboration How the Program Works Building Costs Continued Efforts

SECTION 5. THE EARTH-SUN RELATIONSHIP

The Sun’s Annual Path and the Creation of Shade The Sun’s Daily Path and the Creation of Shade The Earth’s Rotation and Revolution Axis Tilt and Solar Radiation Putting It All Together

Visual Sun Chart webShade

Where Can I Find More Information?

SECTION 6. HOW TO CONDUCT A SHADE AUDIT

Stakeholder Interviews Interview Guides Sample Questions for School Principals Sample Questions for School Teachers Sample Questions for Students Sample Questions for Building Maintenance Engineers Sample Questions for Neighbors Behavioral Observations Environmental Observations

Creating a Tree Inventory Estimating the Height and Trunk and Canopy Diameters of a Tree Describing a Tree’s Canopy Density Measuring Existing Shade

Considering Potential Shade Strategies The Shade Planning Matrix Making Recommendations

The Rationale Statement of Goals Strategies for Achieving the Goals Approaches for Achieving the Goals

End Notes

Chapter 75 SUN SAFETY FOR AMERICA’S YOUTH TOOLKIT*

1. ABOUT THE SUN SAFETY FOR AMERICA’S YOUTH TOOLKIT 2. WHY IS SUN SAFETY IMPORTANT FOR YOUNG PEOPLE?

Why Is It Important to Work with Schools?

3. STEP I: IDENTIFY AND RECRUIT SUN SAFETY PARTNERS

Develop Partnerships to Facilitate Sun Safety Planning and Implementation Identify Other State/Tribe/Territory/Jurisdiction Partners to Engage in Sun Safety Planning Identify Local Partners to Engage in Sun Safety Planning

4. STEP II. UNDERSTAND SUN SAFETY NEEDS AND RESOURCES IN YOUR STATE/TRIBE/ TERRITORY/JURISDICTION

Assess and Understand the Skin Cancer Burden in Your State/ Tribe/Territory/Jurisdiction Conduct a Sun Safety Inventory: What Do We Already Know about the Available Resources around Sun Safety in our State/ Tribe/Territory/Jurisdiction? Understand Your State/Tribe/Territory/Jurisdiction’s Legal and/or Policy Issues Related to Sun Safety

5. STEP III: PLAN AND IMPLEMENT SUN SAFETY ACTIVITIES

Conduct a SWOT Analysis

Internal Factors: Strengths and Weaknesses External Factors: Opportunities and Threats What Do You Do with the SWOT Results?

Select and Implement Sun Safety Activities Guideline 1: Policy – Establish Policies that Reduce Exposure to UV Radiation

Why Is Sun Safety Policy Important? Sample Activities