Photoprotective habits in children with systemic lupus erythematosus

Abstract

Background Systemic lupus erythematosus (SLE) is a complex autoimmune disease that can involve multiple organ systems. Exposure to ultraviolet radiation (UVR) can exacerbate pre-existing SLE, and can even induce systemic manifestations. This study aimed to investigate the photoprotective habits of children with SLE and the factors that significantly influence those photoprotective habits. Methods This questionnaire-based cross-sectional study included paediatric SLE patients being treated at the Department of Paediatrics at Siriraj Hospital, Mahidol University, between September 2018 and September 2019. Data were obtained from medical records and a face-to-face interview. Results Ninety-six patients were enrolled, with a female-to-male ratio of 8:1. The mean age of patients at enrollment was 13.7 ± 2.4 years. Of the 96 patients, 70 (72.9%) reported being directly exposed to sunlight for less than two hours per day, but 39% of patients spent time in the sun during the peak hours of UVR. Up to 95% of patients used sunscreen. However, only 64% of patients applied it every day, and only 35% of patients used an adequate amount of sunscreen. Girls were significantly more likely to apply sunscreen every day than boys were ( p = 0.041). SLE patients with a shorter disease duration had significantly greater exposure to sunlight than patients with a disease duration of more than four years ( p = 0.040). Conclusion Sunscreen was the most common photoprotective method. However, most patients used sunscreen inappropriately. A shorter disease duration was significantly associated with more sunlight exposure. Regular evaluation and emphasis of the importance of photoprotection should be encouraged among paediatric SLE.

Accuracy and adequacy of photoprotection in pediatric systemic lupus erythematosus patients, and the effect of education on photoprotection: a prospective study

“…As a result, a fingertip unit or teaspoon unit has been recommended [ 23 , 27 ]. We found that at the first assessment, a majority of the patients applied sunscreen less than the recommended amount, which is in line with previous studies in SLE patients [ 7 , 26 ] and in the general population [ 28 , 29 ]. An inadequate amount of applied sunscreen significantly decreases its efficacy [ 30 ].…”

“…The rate of sunscreen use is higher compared to the adult studies from Abdul Kadir et. al (52.3%) [ 7 ] and Chanprapaph et al(63.5%) [ 25 ] but is approximately close to another study in children in Thailand (95.8%) [ 26 ]. This may be because Thai families place value on family connections and close parent–child relationships.…”

“…This indicates that education could not improve behaviors around wearing sunglasses if the family could still not afford them. This socioeconomic reason was confirmed by another study from Thailand which found that sunglasses were more frequently used in patients with a higher family income [ 26 ].…”

Accuracy and adequacy of photoprotection in pediatric systemic lupus erythematosus patients, and the effect of education on photoprotection: a prospective study

“…As a result, a ngertip unit or teaspoon unit has been recommended. 21,25 We found that at the rst assessment, a majority of the patients applied sunscreen less than the recommended amount, which is in line with previous studies in SLE patients 5,24 and in the general population. 26 , 27 An inadequate amount of applied sunscreen signi cantly decreases its e cacy.…”

“…al (52.3%) 5 and Chanprapaph et al (63.5%) 23 but is approximately close to another study in children in Thailand (95.8%). 24 This may be because Thai families place value on family connections and close parent-child relationships. Children tend to be more dependent on parents, especially for health and self-care.…”