(2) Male expatriates reported more frequent intensive sun exposures and more skin exposures during nautical and mountain sports than male nonexpatriates. Ezzedine and colleagues have registered a large cohort of French adults to observe for sun exposure

and protection behaviors in tropical and high UV-index countries for short and prolonged stays, and their results have repeatedly demonstrated that travelers would benefit from more pre-travel advice regarding sun exposures and sun protective behaviors.[20, 21] Observational studies have demonstrated that the public often misuses sunscreens for intentional UV overexposures and knows little about proper sunscreen protection, selection, AZD1208 supplier and use. In 2001,

Wright and colleagues evaluated attitudes toward sunscreen effectiveness and found that 47% of study subjects reported staying out longer in the sun after applying sunscreen.[22] Later, Autier defined this behavior as sunscreen abuse or the misuse of sunscreens by sun-sensitive subjects engaging in intentional sun exposure to increase their duration of exposure without decreasing sunburn occurrence.[23] In 2008, Ezzedine and colleagues reported the results of a cross-sectional BMN-673 study on artificial and natural tanning behaviors in a French national cohort of 7,200 adults.[24] The investigators determined that indoor tanners were also regular sunbathers unconcerned about the risks of combined indoor and outdoor UV exposures.[24] In a 2009 survey assessment of sunscreen knowledge, Wang observed that only 48.2% of survey

respondents knew that “SPF” was the acronym for “sun protection factor.”[25] The confusing measurement systems for UV protection afforded by sunscreens and photoprotective clothing are compared in Table 1.[18, 26, 27] The quantity and frequency of sunscreen use are the most important factors determining sunscreen efficacy. The international standard quantity of sunscreen application used to determine SPF is 2 mg/cm2.[28, 29] However, Diffey observed that most people apply only 0.5 to 1.5 mg/cm2 Tacrolimus (FK506) of sunscreen and do not reapply sunscreens after swimming or excessive sweating.[29] Drug-induced photosensitivity reactions occur commonly and are characterized by cutaneous eruptions in sun-exposed areas and result from either toxic or allergic reactions between drugs and UV radiation, primarily UVA.[30-33] Phototoxic reactions are more common than photoallergic reactions, which occur when drug haptens combine with skin proteins producing an immune cellular reaction.[31] Chronic therapy with certain photosensitizing drugs has been associated with the subsequent development of skin cancers, such as PUVA therapy for psoriasis which increases risks of SCC and CMM.