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Biomedical subjects

B L Diffey

Publications and source records attributed to B L Diffey.

At least 19 recordsLinked to original sources
PubMed1992

Stratospheric ozone depletion and the risk of non-melanoma skin cancer in a British population.

Quantitative estimation of the increased risk of non-melanoma skin cancer (NMSC) in British people that may result from depletion of the stratospheric ozone layer is given for the present generation of British people. For adults alive today continuing ozone depletion at current rates is predicted to result in a relatively small additional lifetime risk (< 5%) of NMSC, assuming no changes in climate, time spent outdoors, behaviour or clothing habits. The lifetime risk incurred by today's children, however, is 10%-15% greater than expected in the absence of ozone depletion. However, if the production and use of substances which deplete ozone are reduced, as expected under the current provisions of the Montreal Protocol, the increased lifetime risk of skin cancer is likely to be less than this estimate. These predicted increases in risk, resulting from greater solar ultraviolet exposure, can be offset by adopting changes to behaviour during the summer months which may involve spending less time outdoors, wearing appropriate clothing including wide-brimmed hats, applying topical sunscreens, or a combination of these.

Adult↗
PubMed1992

The relationship between chronological age and the erythemal response to ultraviolet B radiation.

To investigate whether erythemal responses to ultraviolet radiation alter with age, we have reviewed the results of monochromator phototesting in adults and children, and have measured the dose-response curves for UVB erythema in a further 38 subjects. There was no significant difference between adults and children in minimal erythema dose (MED) at 300 nm; the median MED in 254 adults was 34 mJ/cm2 (range 14-80 mJ/cm2) and in 24 children aged less than 15 years was 30 mJ/cm2 (range 10-80 mJ/cm2). Objective measurements of UVB-induced erythema were performed in 15 subjects aged below 25 years and 23 subjects aged above 60 years. A dose-response curve for UVB erythema was constructed for each subject and the slope of the steepest part of each curve calculated by logit regression; the values in the young subjects were greater than in the older group (P less than 0.02). However, there was no difference between the two groups in either the visually assessed MED or the calculated UVB dose required to produce a constant degree of mild erythema.

Adult↗
PubMed1992

Sun protection with hats.

The degree of sun protection provided by various styles of hat at different anatomical sites on the head was measured using model headforms and ultraviolet-sensitive film badges. It was found that hats with a small brim, such as the flat cap favoured by elderly male photosensitive patients, provided negligible protection at all sites apart from the vertex and forehead. Peaked baseball-style caps offer good protection to the nose but are relatively ineffective at other sites on the face. Hats with a wide (greater than 7.5 cm) brim are necessary in order to provide reasonable protection factors (greater than 3) around the nose and cheeks.

Face↗
PubMed1992

The influence of pigmentation and illumination on the perception of erythema.

The visual assessment of erythema induced by ultraviolet radiation (UVR) involves a comparison of the irradiated site with surrounding nonirradiated skin. By viewing the skin through plastic filters of varying shades of brown to simulate different degrees of pigmentation and under either incandescent or fluorescent lighting, we were able to examine the influence of pigmentation and illumination on the perception of erythema. Illuminating the skin with either light source at the same illuminance did not affect the determination of the minimal erythema dose (MED). Likewise, the range of pigmentation that may occur in Caucasian skin had little or no effect on the perception of the MED compared with white, untanned skin. However, when the skin was viewed through dark brown filters that approximate the absorbance of Negro skin, erythema was only perceived at sites that had been irradiated with more than about twice the MED.

Erythema↗
PubMed1991

Sunscreen protection against UVB, UVA and blue light: an in vivo and in vitro comparison.

The photoprotection against UVB, UVA and blue light provided by a widely prescribed sunscreen (RoC 15+ A+B) was compared with two new products containing microfine titanium dioxide (Sun E45 lotion SPF 15 and Sun E45 cream SPF 25) [corrected]. Comparisons were made in vivo using photosensitive patients with either chronic actinic dermatitis or erythropoietic protoporphyria, and in vitro using a newly developed spectrophotometric assay. Good agreement was obtained between the in-vivo and in-vitro methods at each waveband. All products showed high protection against UVB radiation, but the products containing microfine titanium dioxide showed significantly higher protection against both UVA and blue light than RoC 15+ A+B. Products containing microfine titanium dioxide are likely to offer superior photoprotection in those patients who are abnormally sensitive to long wavelength ultraviolet radiation than products which are currently available on prescription.

Adult↗
PubMed1991

PUVA treatment of psoriasis in the United Kingdom.

Information concerning the operation of 134 PUVA units in 96 dermatology centres in the U.K. was collected by a postal questionnaire. The most common protocol was to give PUVA three times weekly in the treatment of psoriasis, and to choose the initial dose of UVA according to skin type. However, the initial UVA dose encompassed a range of five or more within each skin type.

Clinical Protocols↗
PubMed1991

The action spectrum between 320 and 400 nm for clearance of psoriasis by psoralen photochemotherapy.

We have compared the effectiveness of oral 8-methoxypsoralen photochemotherapy (PUVA) using ultraviolet fluorescent lamps with peak emission at either 325, 352 or 370 nm in the treatment of 24 patients with psoriasis. The forearms of each patient were treated three times weekly with two of the three lamps. The erythemal sensitivity of each patient was tested before the first treatment to ensure that equally erythemal doses of radiation were given from each of the lamps. A side-to-side comparison was used to assess response to treatment at weekly intervals for the 6 weeks of the trial. The lamp with peak emission at 325 nm was shown to be significantly superior to either of the other lamps in terms of response assessed at weekly intervals, and time to clearance of psoriasis. An action spectrum, constructed from the median doses required for clearance of psoriasis using each of the lamps, showed that the effectiveness of the radiation decreased exponentially with increasing wavelength throughout the UVA waveband, such that radiation at 320 nm was an order of magnitude more effective than at 360 nm. This suggests that lamps with peak emission around 325 nm will be more effective than those conventionally used in PUVA units with a peak emission at 352 nm. Lamps with peak emission around 325 nm are also highly effective in the treatment of psoriasis with phototherapy alone. Thus a single treatment unit containing these lamps could be used either for PUVA or ultraviolet phototherapy of psoriasis, avoiding duplication or irradiation equipment.

Adolescent↗
PubMed1991

The relationship between plasma psoralen concentration and psoralen-UVA erythema.

The plasma 8-methoxypsoralen (8-MOP) concentration was measured in 60 patients commencing psoralen photochemotherapy (PUVA). At the time of blood sampling each patient was phototested using a series of 10 exposures to UVA. The resulting erythema was measured objectively 72 h after irradiation and dose-response curves for psoralen-UVA erythema were constructed. Although the dose of 8-MOP was calculated according to body weight, patients receiving 30 mg of 8-MOP had a significantly lower mean plasma concentration than those receiving higher doses. There was no significant correlation between plasma 8-MOP concentration and minimal phototoxic dose, either estimated visually or calculated from the dose-response curves. However the slope of the dose-response curve showed significant correlation with plasma 8-MOP concentration. The variation between patients in the rate of increase of the erythemal response, but not the variation in threshold sensitivity, can be explained by difference in plasma psoralen concentration.

Adolescent↗