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Moderner Lichtschutz aus berufsdermatologischer Sicht

Modern light protection from the view of occupational dermatology

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Zusammenfassung

Die zunehmende Anerkennung UV-Licht-induzierter Hautkarzinome als Berufsdermatose in entsprechend exponierten beruflichen Tätigkeiten stellt auch neue Herausforderungen für die Prävention dar. Seit nahezu 100 Jahren wird ein aktiver Sonnenschutz durch Verwendung von UV-Licht-filternden topischen Präparaten entwickelt. Darüber hinaus wird angestrebt, durch Anwendung verschiedener antioxidativer Prinzipien wie Vitamin E, Vitamin C und pflanzlichen Antioxidantien eine zusätzliche Schutzwirkung zu erzielen. Die Evidenz für diese Präparate in ihrer zur Anwendung kommenden Formulierung ist aber sehr unterschiedlich wie auch die Verwendung von Tabletten zum Sonnenschutz. Die aktuellen Änderungen der berufsdermatologischen Einordnung von UV-Licht-bedingten Hauttumoren werden verstärkt auch derartige präventive Strategien fordern und in angemessenen klinischen Studien zu belegen sein.

Abstract

UV-light induced skin cancer is being more and more accepted in Germany as an occupational disease for several jobs with increased UV-light exposure. Over the past 100 years sunscreens with filters against UVB- and UVA-light have been developed. Another development is the use of antioxidants such as vitamin E, vitamin C and herbal agents for additional photoprotection. The evidence supporting these products in their topical and systemic formulation is very variable. The recent changes in the recognition of UV-induced skin cancers as occupational diseases increases the need for preventive strategies which are supported by appropriate clinical studies.

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Literatur

  1. Afaq F, Abu Zaid M, Khan N et al (2009) Protective effect of pomegranate-derived products on UVB-mediated damage in human reconstituted skin. Exp Dermatol 18:553–561

    Article  PubMed  CAS  Google Scholar 

  2. Afaq F, Katiyar SK (2011) Polyphenols: skin photoprotection and inhibition of photocarcinogenesis. Mini Rev Med Chem 11(14):1200–1215

    PubMed  CAS  Google Scholar 

  3. Ananthaswamy HN, Loughlin SM, Cox P et al (1997) Sunlight and skin cancer: Inhibition of p53 mutations in UV-irradiated mouse skin by sunscreens. Nat Med 3(5):510–514

    Article  PubMed  CAS  Google Scholar 

  4. Baur JA, Sinclair DA (2006) Therapeutic potential of resveratrol: the in vivo evidence. Nat Rev 5:493–506

    Article  CAS  Google Scholar 

  5. Bickers DR, Merk H (1986) The treatment of porphyria. Seminars Dermatol 5:186–197

    Google Scholar 

  6. Bimczok R, Gers-Barlag H, Mundt C et al (2007) Influence of applied quantity of sunscreen products on the sun protection factor—a multicenter study organized by the DGK task force sun protection. Skin Pharmacol Physiol 20:57–64

    Article  PubMed  CAS  Google Scholar 

  7. Bowden GT (2004) Prevention of non-melanoma skin cancer by targeting ultraviolet-B-light signalling. Nat Rev 4:23–35

    Article  CAS  Google Scholar 

  8. Chen L, Hu JY, Wang SQ (im Druck) The role of antioxidants in photoprotection: a critical review. J Am Acad Dermatol

  9. Dennis LK, Beane Freeman LE, Van Beek MJ (2003) Sunscreen use and the risk for melanoma: a quantitative review. Ann Intern Med 139:966–978

    PubMed  Google Scholar 

  10. Einspahr JG, Bowden GT, Alberts DS (2003) Skin cancer chemoprevention: strategies to save our skin. Recent Results Cancer Res 163:151–164

    Article  PubMed  CAS  Google Scholar 

  11. Elmets CA, Singh D, Tubesing K et al (2001) Cutaneous photoprotection from ultraviolet injury by green tea polyphenols. J Am Acad Dermtol 44:425–432

    Article  CAS  Google Scholar 

  12. Fischer TW, Slominski A, Zmijewski MA et al (2008) Melatonin as a major skin protectant: from free radical scavenging to DNA damage repair. Exp Dermatol 17(9):713–730

    Article  PubMed  CAS  Google Scholar 

  13. Fritsche E, Schäfer C, Calles C et al (2007) Lightening up the UV response by identification of the arylhydrocarbon receptor as a cytoplasmatic target for ultraviolet B radiation. PNAS 104(21):8851–8856

    Article  PubMed  CAS  Google Scholar 

  14. Gasparini G, Longo R, Sarmiento R, Morabito A (2003) Inhibitors of cyclo-oxygenase 2: a new class of anticancer agents? Lancet Oncol 4(10):605–610

    Article  PubMed  CAS  Google Scholar 

  15. Gilchrest BA (1993) Sunscreens—a public health opportunity. N Engl J Med 329:1193–1194

    Article  PubMed  CAS  Google Scholar 

  16. Green A, Williams G, Neale R et al (1999) Daily sunscreen application and betacarotene supplementation in prevention of basal-cell and squamous-cell carcinomas of the skin: a randomised controlled trial. Lancet 354:723–729

    Article  PubMed  CAS  Google Scholar 

  17. Hayden CGJ, Roberts MS, Benson HAE (1997) Systemic absorption of sunscreen after topical application. Lancet 350:863–864

    Article  PubMed  CAS  Google Scholar 

  18. Hexsel CI, Bangert SD, Hebert AA, Lim HW (2008) Current sunscreen issues: 2007 food and drug administration sunscreen labelling recommendations and combination sunscreen/insect repellent products. J Am Acad Dermatol 59(2):316–323

    Article  PubMed  Google Scholar 

  19. Hill D (1999) Efficacy of sunscreens in protection against skin cancer. Lancet 354:699–700

    Article  PubMed  CAS  Google Scholar 

  20. Jang M, Cai L, Udeani GO et al (1997) Cancer chemopreventive activity of resveratrol, a natural product derived from grapes. Science 275:218–220

    Article  PubMed  CAS  Google Scholar 

  21. Junkins-Hopkins JM (2010) Antioxidants and their chemopreventive properties in dermatology. J Am Acad Dermatol 62(4):663–665

    Article  PubMed  Google Scholar 

  22. Kim KH, Back JH, Zhu Y et al (2011) Resveratrol targets transforming growth factor-β2 signaling to block UVB-induced tumor progression. J Invest Dermatol 131(1):195–202

    Article  PubMed  CAS  Google Scholar 

  23. Krutmann J, Schroeder P (2009) Role of mitochondria in photoaging of human skin: the defective powerhouse model. J Invest Dermatol Symp Proc 14(1):44–48

    Article  CAS  Google Scholar 

  24. Krutmann J (2009) Actives – Zentraler Bestandteil des modernen Lichtschutzes. Hautarzt 60:294–300

    Article  PubMed  CAS  Google Scholar 

  25. Kullavanijaya P, Lim HW (2005) Photoprotection. J Am Acad Dermatol 52:937–958

    Article  PubMed  Google Scholar 

  26. Lademann J, Meinke M, Sterry W, Patzelt A (2009) Wie sicher sind Nanopartikel? Hautarzt 60:305–309

    Article  PubMed  CAS  Google Scholar 

  27. Lambert JD, Sang S, Yang CS (2007) Possible controversy over dietary polyphenols: benefits vs risks. Chem Res Toxicol 20:583–585

    Article  PubMed  CAS  Google Scholar 

  28. Lautenschlager S, Wulf HC, Pittelkow MR (2007) Photoprotection. Lancet 307:528–537

    Article  Google Scholar 

  29. Liby KT, Yore MM, Sporn MB (2007) Triterpenoids and rexinoids as multifunctional agents for the prevention and treatment of cancer. Nat Rev 7:357–369

    Article  CAS  Google Scholar 

  30. Lim HW, Hönigsmann H (2007) Photoprotection. In: Lim HW, Hönigsmann H, Hawk JLM (Hrsg) Photodermatology. Informa Healthcare, New York, S 267–278

  31. Lin FH, Lin JY, Gupta RD et al (2005) Ferulic acid stabilizes a solution of vitamin C and E and doubles its photoprotection of skin. J Invest Dermatol 125:826–832

    Article  PubMed  CAS  Google Scholar 

  32. Lin JY, Selim MA, Shea CR et al (2003) UV photoprotection by combination topical antioxidants vitamin C and E. J Am Acad Dermatol 48:866–874

    Article  PubMed  Google Scholar 

  33. Lodén M, Beitner H, Gonzalez H et al (2011) Sunscreen use: controversies, challenges and regulatory aspects. BJD 165:255–262

    Article  Google Scholar 

  34. Maier T, Korting HC (2005) Sunscreens—which and what for? Skin Pharmacol Physiol 18:253–262

    Article  PubMed  CAS  Google Scholar 

  35. Marks R, Rennie G (1988) Malignant transformation of solar keratoses to squamous cell carcinoma. Lancet 4:795–797

    Article  Google Scholar 

  36. Merk HF, Baron JM, Heise R et al (2006) Concepts in molecular dermatotoxicology. Exp Dermatol 15:692–704

    Article  PubMed  CAS  Google Scholar 

  37. Merk HF (2007) Topical diclofenac in the treatment of actinic keratoses. Int J Dermatol 46(1):12–18

    Article  PubMed  CAS  Google Scholar 

  38. Moseley H (2006) Photoprotection. In: Ferguson J, Dover JS (Hrsg) Photodermatology. Manson Publishing, London, S 21–28

  39. Mukhtar H, Merk HF (1989) Skin chemocarcinogenesis. Clin Dermatol 7:1–10

    Article  PubMed  CAS  Google Scholar 

  40. Ong CS (1998) Percutaneous absorption of sunscreens. Lancet 351:139–140

    Article  PubMed  CAS  Google Scholar 

  41. Osterwalder U, Herzog B (2009) Sun protection factors: world wide confusion. Br J Dermatol 161(Suppl. 3):13–24

    Google Scholar 

  42. Osterwalder U, Lim HW (2007) Novel developments in photoprotection: part I. In: Lim HW, Hönigsmann H, Hawk JLM (Hrsg) Photodermatology. Informa Healthcare, New York, S 279–296

  43. Pinell SR (2003) Cutaneous photodamage, oxidative stress, and topical antioxidant protection. J Am Acad Dermatol 48(1):1–19

    Article  Google Scholar 

  44. Rohr M, Klette E, Ruppert S et al (2010) In vitro sun protection factor: still a challenge with no final answer. Skin Pharmacol Physiol 23:201–212

    Article  PubMed  CAS  Google Scholar 

  45. Rougier A, Seite S, Lim HW (2007) Novel developments in photoprotection: part II. In: Lim HW, Hönigsmann H, Hawk JLM (Hrsg) Photodermatology. Informa Healthcare, New York, S 298–309

  46. Sambandan DR, Ratner D (2011) Sunscreens: an overview and update. J Am Acad Dermatol 64:748–758

    Article  PubMed  CAS  Google Scholar 

  47. Schauber J, Gallo RL (2008) The vitamin D pathway: a new target for control of the skin’s immune response? Exp Dermatol 17:633–639

    Article  PubMed  CAS  Google Scholar 

  48. Schroeder P, Krutmann J (2009) IRA-Schutz – Notwendigkeit und Möglichkeiten. Hautarzt 60:301–304

    Article  PubMed  CAS  Google Scholar 

  49. Schwarz A, Navid F, Sparwasser T et al (2012) 1,25-Dihydroxyvitamin D exerts similar immunosuppressive effects as UVR but is dispensable for local UVR-induced immunosuppression. J Invest Dermatol [Epub ahead of print]

  50. Schwarz T (2010) The dark and the sunny sides of UVR-induced immunosuppression: photoimmunology revisited. J Invest Dermatol 130:49–54

    Article  PubMed  CAS  Google Scholar 

  51. Shapira N (2010) Nutritional approach to sun protection: a suggested complement to external strategies. Nutr Rev 68(2):75–86

    Article  PubMed  Google Scholar 

  52. Sorg O, Antille C, Saurat JH (2004) Retinoids, other topical vitamins, and antioxidants. In: Rigel DS, Weiss RA, Lim HW, Dover JS (Hrsg) Photoaging. Marcel Dekker, New York, S 89–113

  53. Stahl W, Krutmann J (2006) Systemische Photoprotektion durch Karotinoide. Hautarzt 57:281–285

    Article  PubMed  CAS  Google Scholar 

  54. Stege H, Mang R (2006) Lichtschutz – Grundlagen der UV-Protektion. Hautarzt 57:459–470

    Article  PubMed  CAS  Google Scholar 

  55. Surh YJ (2003) Cancer chemoprevention with dietary phytochemicals. Nature 3:768–780

    CAS  Google Scholar 

  56. Thompson SC, Jolley D, Marks R (1993) Reduction of solar keratoses by regular sunscreen use. N Engl J Med 329:1147–1151

    Article  PubMed  CAS  Google Scholar 

  57. Trémezaygues L, Reichrath J (2010) Zur Bedeutung des Vitamin D-Stoffwechsels in der humanen Haut. Hautarzt 61:478–486

    Article  PubMed  Google Scholar 

  58. Von Felbert V, Schumann H, Mercer JB et al (2007) Therapy of chronic wounds with water-filtered infrared-A (wIRA). GMS Krankenhaushygiene Interdisziplinär 2(2):1–12

    Article  Google Scholar 

  59. Wolf P (2009) UV-Filter, State of the Art. Hautarzt 60:285–293

    Article  PubMed  CAS  Google Scholar 

  60. Yang CS, Wang X, Lu G, Picinich SC (2009) Cancer prevention by tea: animal studies, molecular mechanisms and human relevance. Nat Rev 9 429–439

    Google Scholar 

  61. Young AR, Wikonkal NM (2007) The chronic effects of ultraviolet radiation on the skin: photocarcinogenesis. In: Lim HW, Hönigsmann H, Hawk JLM (Hrsg) Photodermatology. Informa Healthcare, New York, S 107–117

  62. Zussman J, Ahdout J, Kim J (2010) Vitamins and photoaging: Do scientific data support their use? J Am Acad Dermatol 63(3):507–525

    Article  PubMed  CAS  Google Scholar 

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Merk, H., Baratli, J. Moderner Lichtschutz aus berufsdermatologischer Sicht. Hautarzt 63, 796–800 (2012). https://doi.org/10.1007/s00105-012-2462-4

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