The task of the first sunscreens was to prevent the development of sunburn and, following the spirit of the 1950/1960s, to not impair the tanning of the skin. The need to quantify the protective performance soon arose. O...The task of the first sunscreens was to prevent the development of sunburn and, following the spirit of the 1950/1960s, to not impair the tanning of the skin. The need to quantify the protective performance soon arose. Originally with the help of natural-nowadays artificial-sunlight, a method was developed to determine a sun protection factor (SPF). It is formally defined as a ratio between minimum erythema-effective UV dose on sunscreen-protected skin and minimum erythema-effective UV dose on unprotected skin (ISO 24444:2019). Three observations question the suitability of the method. (1) Interlaboratory variability: Despite strict standardization, results of SPF determinations from different laboratories are subject to large variations. (2) Natural vs. artificial sunlight: The radiation spectrum of artificial sunlight differs from that of natural sunlight. SPFs determined with artificial sunlight (as depicted on all sunscreens currently on the market) are significantly too high compared to SPF determination with natural sunlight. (3) Erythema burden: When determining SPF, subjects are exposed to potentially harmful radiation. Against this background alternative methods-in vitro SPF, hybrid diffuse reflectance spectroscopy (HDRS) and in silico calculations-are presented. These have the potential to replace the current method. As an immediate measure, it is recommended to return to the comprehensible description of low, medium, high, and very high protection and in the future to take into account the spectrum of natural sunlight.
BACKGROUND: The internet is one of the most important sources for health-related information for the general population. Therefore, the analysis of internet search engines can help to capture the social interests and nee...BACKGROUND: The internet is one of the most important sources for health-related information for the general population. Therefore, the analysis of internet search engines can help to capture the social interests and needs regarding diseases. OBJECTIVES: The aim of this study was to investigate the search queries related to atopic dermatitis (AD) regarding frequency, focus of interest and temporal occurrence in the German federal states in order to identify possible regional differences. MATERIAL AND METHODS: Using the Google Ads Keyword Planner, AD relevant keywords including the monthly search volume between January 2017 and December 2020 were identified, which were then assigned to different categories. RESULTS: Overall, 1419 keywords were found that had a search volume of 14,817,610 queries. The category 'general' had the highest search volume (n = 5,970,840), but most keywords were assigned to the category 'location' (n = 348). About 60% of the keywords assigned to 'location' were related to AD on the face. On a national level, Bremen and Hamburg had the highest search volume per 100,000 inhabitants. With more than 70%, an enormous increase in search volume could be observed, which was especially high in 2020. DISCUSSION: With this internet search analysis, it was possible to clarify which aspects of AD were of particular importance for the German population, which can help to adapt information campaigns to the target population. In addition, the study underlines the increasing relevance of the internet as a source of information regarding health-related topics.
In the last two decades clinical rheumatological practice has been confronted with a steadily increasing number of autoinflammatory diseases, the immunological pathomechanisms of which have been elucidated and in part ca...In the last two decades clinical rheumatological practice has been confronted with a steadily increasing number of autoinflammatory diseases, the immunological pathomechanisms of which have been elucidated and in part can be clinically well classified. Whereas targeted genetic diagnostics previously served to confirm a clinically suspected diagnosis, genetic sequencing technology has much improved and enables a new diagnostic approach via high-throughput sequencing, e.g., panel sequencing, whole exome and whole genome sequencing. Thus, the decision to make a diagnosis clinically and/or genetically, has become a daily challenge. This article contrasts the clinical, immunological and genetic aspects of autoinflammatory diseases.
Sunscreens provide excellent protection against erythema and against chronic damage such as photoaging and skin cancer. Today's challenges concern safety of the products and improved methods for standardizing the evaluat...Sunscreens provide excellent protection against erythema and against chronic damage such as photoaging and skin cancer. Today's challenges concern safety of the products and improved methods for standardizing the evaluation of their efficacy. Other important topics are the further development of sunscreen products, as well as personalization of use. Personalized sun protection based on the phenotype, the genetic profiles and moreover the skin's microbiome - all linked to the identification of certain consumer susceptibility factors - is an exciting new area of research. In particular, the expansion with innovative topical agents such as DNA repair liposomes in improved galenic formulations with UV filters tailored to the skin phototype and new topical antioxidants could in future provide even more comprehensive sun protection. New antioxidants and other agents such as nicotinamide could increase systemic photoprevention. Sustainability will also be an important aspect to protect consumers, but also the environment (i.e. especially marine wildlife) from toxic effects of sunscreens.
BACKGROUND: The persistent global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can manifest on the skin in addition to the already known organ systems. Various clinical patterns of skin...BACKGROUND: The persistent global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can manifest on the skin in addition to the already known organ systems. Various clinical patterns of skin manifestations associated with coronavirus disease 2019 (COVID-19) have been described. In view of the associated morbidity and mortality, knowledge of cutaneous manifestations in the setting of COVID-19 may be helpful in early detection, risk stratification, diagnosis and treatment. Thus, we provide a summary of the various dermatologic findings associated with COVID-19, including clinical presentation, current pathophysiological concepts, and management, to support early diagnosis and treatment. GOAL: The current literature regarding skin lesions associated with COVID-19 and the most important aspects are analyzed. MATERIALS AND METHODS: A literature search was performed in PubMed and Medline databases until February 28, 2021. RESULTS AND CONCLUSION: The classification of skin manifestations in the context of SARS-CoV‑2 infection according to clinical dermatological patterns can help to identify patients with increased risk at an early stage and to treat them adequately to counteract a possibly more severe course of the disease as it occurs, e.g., in livedo. Thus, knowledge of the pathophysiological mechanisms can improve management of the disease and support possible countermeasures in coping with the disease.
Sunscreen products containing inorganic micronized titanium dioxide (TiO) and zinc oxide (ZnO) have been available since the 1950s. Their cosmetic acceptance remained limited as they persist as a white paste on the skin....Sunscreen products containing inorganic micronized titanium dioxide (TiO) and zinc oxide (ZnO) have been available since the 1950s. Their cosmetic acceptance remained limited as they persist as a white paste on the skin. By reducing the size of the particles into the nano-range below 100 nm, their optical property of reflecting visible light is reduced. After the year 2000, organic filters of this size range were developed. The enthusiasm for nanotechnology that prevailed at the time did not transfer to sunscreen products with nanoparticulate filters. Consumers suspect that the particles permeate the skin, are absorbed by the blood, and spread throughout the body causing illness. Not least due to public pressure, cosmetics-which include sunscreen products-became the first product segment in which accordingly manufactured substances were subjected to strict regulations. Despite advanced regulation and strict approval procedures for nanoparticulate filters, public reservations remained. Possible reasons for this are lack of knowledge or mistrust of the applicable legislation, unclear perception of the behavior of nanoparticles in sunscreen products and as a result unclear perceptions of hazard, risk, and exposure. Against this background, the nature and behavior of nanoparticulate filters in sunscreens on the skin and potentially in the skin, as well as the regulatory framework that ensure that nanoparticulate filters and the products containing them are safe to use are discussed.
In this article, the current recommendations from the recently updated S2k guideline on the management of immunoglobulin E (IgE)-mediated food allergy are presented. These include information on the frequency of food all...In this article, the current recommendations from the recently updated S2k guideline on the management of immunoglobulin E (IgE)-mediated food allergy are presented. These include information on the frequency of food allergies, food allergy prevention, clinical pictures and differential diagnostics, as well as food allergy diagnostics including in vivo and in vitro diagnostics, and finally aspects of the course and therapy of food allergy.
We describe the case of a man who developed an acute allergic reaction for the first time in his life directly after drinking a protein shake after a workout session. Allergy diagnostics, including skin prick testing and...We describe the case of a man who developed an acute allergic reaction for the first time in his life directly after drinking a protein shake after a workout session. Allergy diagnostics, including skin prick testing and the determination of specific IgE antibodies revealed sensitizations to cow's milk and hen's egg. Due to the association between the onset of symptoms after ingestion of a milk protein shake, a type-1-allergic reaction to milk protein was suggested. The patient denied a provocation test, although this could have been an opportunity to elucidate the role of physical exercise in this case. We suspect in the present case a loss of tolerance of early childhood sensitization due to repetitive high protein exposure in the context of physical activity. The patient was provided information regarding dietary and emergency management.
Solar radiation contains about 6.8% ultraviolet (UV) radiation. UV radiation is still regarded as one of the most important risk factors for both nonmelanoma skin cancer (NMSC; predominantly basal cell carcinoma and squa...Solar radiation contains about 6.8% ultraviolet (UV) radiation. UV radiation is still regarded as one of the most important risk factors for both nonmelanoma skin cancer (NMSC; predominantly basal cell carcinoma and squamous cell carcinoma) and malignant melanoma (MM). To avoid induction and persistence of UV-induced mutations, our skin is armed with an arsenal of endogenous protective mechanisms such as induction of cell cycle arrest, repair mechanisms, immunosurveillance and the initiation of various types of cell death. Exogenous sun protection includes a range of behaviors such as avoiding extensive sun exposure, wearing UV-proof clothing and appropriate application of topical sunscreens.
We report about a 28-year-old woman with an anaphylactic reaction to falafel. The diagnosis of type 1 allergy to peas was made based on the detailed medical history, the sensitization profile and an oral food challenge....We report about a 28-year-old woman with an anaphylactic reaction to falafel. The diagnosis of type 1 allergy to peas was made based on the detailed medical history, the sensitization profile and an oral food challenge. Pea (Pisum sativum) is a legume that is increasing used, for example, as protein flour in vegetarian and vegan food products. In addition to the case report, we discuss the anaphylaxis risk of food used in the vegan diet.
In the world of allergology, alpha-gal syndrome remains one of the most fascinating discoveries over the last 15 years as it is triggered by specific IgE directed against the immunogenic sugar galactose-α‑1,3‑galactose (...In the world of allergology, alpha-gal syndrome remains one of the most fascinating discoveries over the last 15 years as it is triggered by specific IgE directed against the immunogenic sugar galactose-α‑1,3‑galactose (alpha-gal), found foremost in mammalian meat, milk and products derived thereof, potentially resulting in anaphylaxis. Also, mammalian-derived drugs and medical products have been identified as possible culprits. Nonetheless, tick bites remain the major cause of specific alpha-gal-sIgE. Herein, we summarize the current clinical knowledge and pathophysiology of alpha-gal syndrome in order to better understand this disease.