The Risks and Benefits of Cutaneous Sunlight Exposure

UoM administered thesis: Doctor of Medicine

  • Authors:
  • Sarah Felton

Abstract

The University of ManchesterSarah Jane Felton, Doctor of MedicineThe Risks and Benefits of Cutaneous Sunlight Exposure, 2016Background: Recommendations to restrict summer sunlight exposure to prevent skin cancer apparently conflict with requirements to protect bone health through adequate 25-hydroxyvitamin D (25[OH]D) levels, as provided by cutaneous ultraviolet (UV)B exposure. Furthermore, sunlight exposure promotes a feeling of euphoria that is felt to drive further sun-seeking behaviour.Objectives: My principal objective was to examine health risk (DNA damage) and health benefits (25[OH]D gain, and potential cutaneous photoprotection) following low-level summer sunlight exposures in people of light (phototype II) and darker (phototype V) skin. A further objective was to evaluate serum endocannabinoid levels, potential drivers of mood elevation, following these exposures, and to assess for evidence of tanning addiction in a cross-section of psoriasis patients who had received similar low dose UV exposures, as medical phototherapy.Methods: During wintertime, 10 white Caucasians and 6 South Asians aged 18 to 60 years, from Greater Manchester, UK, received a simulated summer's sunlight exposures, specifically 1.3 standard erythemal dose, thrice weekly for 6 weeks, whilst casually dressed. Serum and urine samples and skin colour measurements were taken at baseline, Monday, Wednesday and Friday of week 1 and then weekly, and buttock skin that had received differential UVR exposures was biopsied for immunohistochemical analysis. Phototype II individuals, who are at higher risk of sunburn, were subsequently challenged with 2X minimal erythema dose (MED) UVB on small areas of simulated summer-exposed and photoprotected skin. Separately, a link to an online tanning questionnaire survey was sent to all members of the National Psoriasis Foundation (USA) during my USA field trip.Results: The simulated summer resulted in 50% gain in 25(OH)D for both phototype groups, but significantly more cutaneous DNA damage (cyclobutane pyrimidine dimers, CPD) in phototype II than V (p

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Original languageEnglish
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Award date31 Dec 2016