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British Photodermatology Group

PD01 A re-evaluation of teenage sunbed use following the introduction of legislation banning use for under 18 year olds S. Menzies, S. Daly, M. Fitzgerald and D. McKenna Sligo University Hospital, Sligo, Ireland Indoor tanning is associated with an increased risk of skin cancer. The risk is higher in frequent users and in those using sunbeds at a younger age. In a previous study of Irish teenagers, we showed that 7.5% of respondents had used a sunbed, with a higher rate in Dublin (11.2%) [Fitzgerald M, Daly S, McKenna D et al. Ambient and sunbed ultraviolet radiation exposure: exposure rates, protection habits and attitudes of Irish teenagers aged 14–18 years before introduction of national sunbed legislation. Br J Dermatol 2015; 173 (Suppl. S1): 6]. In 2014, legislation was introduced in Ireland to ban the use of sunbeds in teenagers (age < 18 years). The purpose of the present study was to reassess sunbed usage among teenagers aged 14–18 years, 2 years after the introduction of the ban. We assessed (i) sunbed usage rates, (ii) sunburn history, (iii) sun-protection habits and (iv) attitudes towards sun and sunbed exposure. The same secondary schools as before were visited and the teenagers completed an anonymous questionnaire. The numbers completing the questionnaire, age and male-to-female ratio were similar to those in the original study. The results showed that more teenagers are using sunbeds following the ban (9%). Teenagers in Dublin continue to have a higher rate of sunbed use (12.3%) compared with other regions. After the ban there was an increase in sunbed usage in tanning shops (before 21%, after 50%) and at home (before 18%, after 42%). More teenagers were consented prior to treatment (before 9%, after 18%). The majority did not wear eye protection (63%), resulting in eye problems in 8%. In the present study, 50% had experienced burning due to sunbed use, most frequently occurring on the face (34%) and chest (26%). A minority (2%) of teenagers used Melanotan. Sunburn due to ambient exposure was reported by 90% of teenagers, with 39% experiencing at least five burns. Sunscreen was seldom used at home (30%) compared with when holidaying abroad (86%). The majority of teenagers believe that a tan looks healthy (64%) and makes you look more attractive (68%). Conversely, the majority also acknowledged that tanning is harmful (82%), dangerous (71%) and associated with wrinkles (75%). Our findings show that there has been no reduction of sunbed use in teenagers following the introduction of legislation banning its use in those aged < 18 years. This may be due to a lack of enforcement of the legislation, in addition to an increasing trend for sunbed use at home. PD02 Does the extent of psoriasis clearance following ultraviolet B predict duration of remission? N.H. Watson, N. Reynolds and S.C. Weatherhead The Royal Victoria Infirmary, Newcastle upon Tyne, U.K. Narrowband ultraviolet B (NB-UVB) is a well-established, highly effective psoriasis treatment. However, remission duration is highly variable and factors that determine this are not understood. Psoriasis clearance is usually measured as ≥ 75% or ≥ 90% improvement in Psoriasis Area and Severity Index (PASI 75 or 90); however, our clinical observations suggested that patients notice relapse initiating from resistant plaques that did not clear during phototherapy. We therefore hypothesized that complete clearance of psoriasis (PASI 100) might be important in inducing prolonged remission. Our pilot study, Predicting Remission of Psoriasis after Phototherapy (PROPAP) recruited 100 patients with psoriasis routinely prescribed NBUVB. PASI scores were recorded before, at weekly intervals during, and after phototherapy. Recurrence was defined as a relapse of > 50% from pretreatment PASI. After completing NB-UVB, patients were telephoned monthly for up to 18 months and attended for PASI evaluations if they had any recurrence. Of 100 patients, 89 completed the treatment phase of the study. They were subdivided into four groups according to final PASI response: 15% achieved PASI 100, 29% achieved PASI 90–99, 40% achieved PASI 75–89 and 16% did not achieve PASI 75. Fifty-nine patients completed the followup phase of the study. There was no statistical difference in remission duration between the groups (medians 5, 6, 4 and 4 months, respectively; P = 0.29) with a median overall time of 4 months. The latter is comparable with the findings from other studies (Ryan C, Renfro L, Collins P et al. Clinical and genetic predictors of response to narrowband ultraviolet B for the treatment of chronic plaque psoriasis. Br J Dermatol 2010; 163: 1056–63). Patients in the PASI 100 group had lower baseline median PASI scores (6.3; P = 0.06) and treatment duration (18 treatments; P = 0.006) compared with the PASI 90–99 and 75–89 groups. Those in the PASI < 75 group had similar baseline median PASI scores to the PASI 100 group (5; P = 0.82) but, as expected, received significantly more UVB exposures (27 treatments; P = 0.048). Patients with short remission duration (< 2 months) were younger (median age 38 years; n = 13) than those with remission durations of 12–18 months (median age 60 years; n = 12; P = 0.039), and the age of onset of psoriasis was similar between these two groups (21 vs. 27 years; P = 0.25). There was no other significant difference between these groups including joint, nail or scalp involvement; smoking status; family history; skin type or body mass index (P > 0.05). To our knowledge, this is the