Aline Rodrigues da Silva Nagatomi

Reapplication improves the amount of sunscreen, not its regularity, under real life conditions.

The sun protection factor (SPF) of sunscreens is determined using samples applied with a thickness of 2 mg cm−2. Sunscreen users, however, typically apply sunscreen nonuniformly and in smaller amounts. The objective of our study was to verify whether sunscreen reapplication increases the amount and regularity of the product on the skin. Volunteers were asked to apply an SPF 6 sunscreen on their forearms and reapply it 30 min later on one forearm. Tape‐strips were used to collect five samples from two different sites on each forearm. The concentration of benzophenone‐3 in the samples was measured and the total amount of sunscreen was estimated using high‐performance liquid chromatography. The median amount of sunscreen film was 0.43 mg cm−2 (0.17–1.07) after one application and 0.95 mg cm−2 (0.18–1.91) after two applications (P = 0.002). No significant difference was found in the film uniformity. Though sunscreen reapplication increases the amount of product on the skin, levels are still lower than the recommended amount, confirming that the protection level is less than the product‐stated SPF. Our results are the first in the literature to support the recommendation for reapplying sunscreens. Based on our results, we recommend that sunscreens be labeled using qualitative measures.

Assessment of the quality of life of pediatric patients with the major chronic childhood skin diseases

BACKGROUND The skin is the primary interface of the human being with the external environment and the presence of skin diseases can have substantial effects on the quality of life. OBJECTIVE This study aims to make a comparative evaluation of the quality of life of pediatric patients with atopic dermatitis, psoriasis and vitiligo and correlate the findings with the total body surface and the areas with the disease exposed to view. METHODS The sample consisted of 118 patients with atopic dermatitis, vitiligo and psoriasis, aged between 5 and 16 years, who were asked to answer the Childrens Dermatology Life Quality Index (CDLQI) questionnaire. A dermatological examination for the measurement of total body surface affected by the disease was performed. RESULTS The three groups showed an impaired quality of life. Patients with atopic dermatitis and psoriasis showed a significantly greater impact on the QoL than the group with vitiligo. There is a trend towards impaired quality of life in patients from the three groups of dermatoses, which is related to increments in both the total affected area and affected area exposed to view (r = 0.428 and p <0.001, r = 0.381 and p <0.001, respectively). CONCLUSION The assessed children had impaired quality of life. However, there is a significantly greater impact in the groups with atopic dermatitis and psoriasis than in the group with vitiligo. This may be due to lack of symptoms in vitiligo and the fact this group presented a statistically smaller affected body surface than the other two groups.

Assessing depression and anxiety in the caregivers of pediatric patients with chronic skin disorders

BACKGROUND The literature has shown that the presence of emotional disturbances in caregivers of children with skin diseases affects the course and treatment of the disease. Anxiety and depression are among the most frequently reported psychiatric diagnoses related to this fact. OBJECTIVE To evaluate the presence of anxiety and depression in caregivers of pediatric patients with chronic skin disorders, exemplified by atopic dermatitis, psoriasis and vitiligo, and correlate them to the quality of life of the patients. METHODS The sample consisted of 118 patients with atopic dermatitis, vitiligo and psoriasis, monitored by their main caregiver. The levels of anxiety and depression in the caregivers were assessed using the Hamilton Anxiety Scale and the Beck Depression Inventory, respectively. The Childrens Dermatology Life Quality Index was applied. RESULTS Anxiety was observed in 36% of the caregivers of the patients with atopic dermatitis, in 36% of those of children affected by psoriasis, and in 42% of those responsible for pediatric patients with vitiligo. Depression occurred in 36% of the caregivers of patients with atopic dermatitis, in 36% of those of children affected by psoriasis and in 26% of those responsible for pediatric patients with vitiligo. There was a significant correlation between poor quality of life scores in patients with vitiligo and the presence of depression and anxiety in their caregivers. CONCLUSION Emotional disorders tend to be present among close family members of children with the chronic skin diseases studied and their prevention can help in controlling and treating these diseases.