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Vol. 105. Issue 8.
Pages 780-788 (October 2014)
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Vol. 105. Issue 8.
Pages 780-788 (October 2014)
Original Article
DOI: 10.1016/j.adengl.2014.05.020
Determination of Minimal Erythema Dose and Anomalous Reactions to UVA Radiation by Skin Phototype
Determinación de la dosis eritemática mínima y reacciones anómalas a radiación ultravioleta A según fototipo
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A. Pérez Ferriolsa,
Corresponding author
perez_ampferr@gva.es

Corresponding author.
, J. Aguilerab, P. Aguilerac, D. de Argilad, M.A. Barnadase, X. de Cabof, J.M. Carrrascosag, M.V. de Gálvez Arandab, J. Gardeazábalh, A. Giménez-Arnaui, M. Lechac, J. Lorentef, J.A. Martínez-Lozanoj, M.T. Rodríguez Granadosk, Y. Solaf, M.P. Utrillasj, of the Spanish Photobiology Group (GEF)
a Servicio de Dermatología, Hospital General Universitario de Valencia, Valencia, Spain
b Unidad de Fotobiología Dermatológica y Oncología Cutánea, Departamento de Dermatología y Medicina, Universidad de Málaga, Málaga, Spain
c Servicio de Dermatología, Hospital Clínic de Barcelona, Barcelona, Spain
d Servicio de Dermatología, Hospital Universitario de La Princesa, Madrid, Spain
e Servicio de Dermatología, Hospital Sta. Creu i St. Pau, Barcelona, Spain
f Departamento de Astronomía y Meteorología, Universidad de Barcelona, Barcelona, Spain
g Servicio de Dermatología, Hospital Germans Trías i Pujol de Badalona, Barcelona, Spain
h Servicio de Dermatología, Hospital Universitario Cruces, Baracaldo, Spain
i Servicio de Dermatología, Hospital del Mar, Barcelona, Spain
j Grupo de Radiación Solar, Universidad de Valencia, Valencia, Spain
k Facultad de Medicina, Complejo Hospital Universitario, Santiago de Compostela, Spain
Article information
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Figures (4)
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Tables (4)
Table 1. Hospitals Participating in the Study and the Equipment Used for Phototesting and Calibration.
Table 2. UV Irradiation Dose Steps Used in the Phototesting Series, by Phototype and Light Source.
Table 3. Overall Mean MEDs, Reflecting Data From All Centers Testing With Solar Stimulators, and the Thresholds Indicating Photosensitivity for Each Phototype.
Table 4. Overall Mean MEDs, Reflecting Data From All Centers Testing With BBUVB Lamps, and the Thresholds Indicating Photosensitivity for Each Phototype.
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Abstract
Background

Phototesting is a technique that assesses the skin's sensitivity to UV radiation by determining the smallest dose of radiation capable of inducing erythema (minimal erythema dose [MED]) and anomalous responses to UV-A radiation. No phototesting protocol guidelines have been published to date.

Methodology

This was a multicenter prospective cohort study in which 232 healthy volunteers were recruited at 9 hospitals. Phototests were carried out with solar simulators or fluorescent broadband UV-B lamps. Each individual received a total of 5 or 6 incremental doses of erythemal radiation and 4 doses of UV-A radiation. The results were read at 24hours.

Results

At hospitals where solar simulators were used, the mean (SD) MED values were 23 (8), 28 (4), 35 (4), and 51 (6)mJ/cm2 for skin phototypes i to iv, respectively. At hospitals where broadband UV-B lamps were used, these values were 28 (5), 32 (3), and 34 (5)mJ/cm2 for phototypes ii to iv, respectively. MED values lower than 7, 19, 27, and 38mJ/cm2 obtained with solar simulators were considered to indicate a pathologic response for phototypes i to iv, respectively. MED values lower than 18, 24, and 24mJ/cm2 obtained with broadband UV-B lamps were considered to indicate a pathologic response for phototypes ii to iv, respectively. No anomalous responses were observed at UV-A radiation doses of up to 20J/cm2.

Conclusions

Results were homogeneous across centers, making it possible to standardize diagnostic phototesting for the various skin phototypes and establish threshold doses that define anomalous responses to UV radiation.

Keywords:
Phototesting
Minimal erythema dose
Solar simulator
Broadband ultraviolet-B lamps
Photodermatosis
Resumen
Antecedentes

La técnica del fototest evalúa la sensibilidad de la piel a la radiación ultravioleta (RUV) mediante la determinación de la mínima dosis de radiación capaz de producir eritema (dosis mínima eritemática [DEM]) y la respuesta anómala a UVA. No existen guías protocolizadas para la técnica del fototest.

Metodología

Estudio multicéntrico de cohortes prospectivo. Un total de 232 voluntarios sanos fueron reclutados en 9 centros hospitalarios. El fototest se realizó con simuladores solares (SS) o lámparas fluorescentes de UVB de banda ancha (UVBBA). Cada sujeto recibió un total de 5 o 6 dosis progresivas de radiación eritemática y 4 dosis de UVA. La lectura se realizó a las 24h.

Resultados

La DEM media por fototipo fue de 23±8, 28±4, 35±4 y 51±6mJ/cm2 (fototipos i a iv respectivamente) para los centros que utilizaron SS y de 28±5, 32±3 y 34±5mJ/cm2 cuando se utilizaron lámparas de UVBBA para fototipos del ii al iv. Se consideraron valores de DEM patológica 7, 19, 27 y 38mJ/cm2, para los fototipos i al iv respectivamente cuando se emplearon SS y de 18, 24 y 24mJ/cm2 para los fototipos ii-iv expuestos a lámparas de UVBBA. A dosis de hasta 20J/cm2 de UVA no se observaron respuestas anómalas.

Conclusiones

Existe homogeneidad de resultados en los diferentes centros participantes, lo que permite estandarizar el método del fotodiagnóstico para los diferentes fototipos cutáneos, así como establecer las dosis umbral que definen una respuesta anómala a la radiación ultravioleta.

Palabras clave:
Fototest
Dosis eritemática mínima
Simulador solar
Lámparas de luz ultravioleta B de banda ancha
Fotodermatosis

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