Unlike the pattern-reversal visual evoked potential, the flash visual evoked potential (FVEP) has had limited clinical use because of lower reproducibility and higher inter- and intra-individual variability. One potential explanation involves the time-locked nature of FVEP recordings, where activity such as unintentional suppression of eyes-closed alpha can lead to overlapping potentials that might obscure the FVEP-P2. The present investigation evaluated the reliability of the FVEP-P2 in young healthy controls across five sessions after applying narrow-band filtering (1-7 Hz) and additional notch filtering to remove alpha and beta activity. It was hypothesized that spectral entrainment would occur within the alpha and that correction for this entrainment would significantly improve the reliability of FVEP-P2. 27 younger, healthy participants aged 18-39 years (M = 24.48, SD = 5.26; 17 females) took part in the study, all reporting no history of photosensitivity or seizures, neurological disorders, or color deficiency. Each participant experienced five sessions of 100 strobe flashes with their eyes closed. The FVEP-P2 associated with each trial was identified using an automated algorithm. Narrow-band filtering (1-7 Hz) significantly improved FVEP-P2 latency reliability compared to the uncorrected condition. Notch filters targeting alpha and beta separately did not produce significant improvements, suggesting additive or overlapping contributions. FVEP-P2 amplitude reliability also improved with filtering, primarily because of attenuating alpha-band interference. Narrow-band and notch filtering mitigated alpha- and beta-band interference, enhancing the test-retest reliability of the FVEP-P2. These findings establish a clearer physiological basis for FVEP unreliability and demonstrate that spectral correction can elevate the FVEP-P2 to clinically acceptable reliability levels, supporting the continued clinical utility of the FVEP, particularly in patients for whom pattern-reversal stimuli are unsuitable (e.g., infants, comatose, or uncooperative individuals) and as a candidate biomarker in mild cognitive impairment and Alzheimer's disease (Arruda et al., 2020; Fix et al., 2014).

Australia has one of the world's highest melanoma incidences among youth. Adolescents often under-prioritise sun protection due to sociocultural factors, for example, the perceived attractiveness of tanned skin and a sense of invulnerability. This study reports on a curriculum-integrated sun safety intervention implemented in a single independent girls' secondary school, a context that provides important insights but also limits generalisability to mixed-gender and other school settings. High school students (aged 13-15) participated in sun safety workshops integrated into their Personal Development, Health, and Physical Education (PDHPE) curriculum. Sun protection knowledge, attitudes toward tanning, and self-reported protective behaviours were assessed via surveys administered pre-intervention, immediately post-intervention, and five months later. Students' sun safety knowledge increased significantly post-intervention (p < 0.001), and remained higher than baseline knowledge at 6 months, indicating substantial knowledge retention. Participants reported more frequent sunscreen use and protective behaviours after the program. The intervention also reduced the appeal of tanning, fewer students agreed that "a suntan looks good" after participating. Notably, all students regardless of ethnicity (Caucasian, Asian, Other), showed knowledge gains, but variations were observed. Students from historically underserved ethnic backgrounds started with lower baseline knowledge and exhibited slightly smaller improvements aligning with prior findings that sun awareness has differed across racial/ethnic group. These findings suggest that an engaging, curriculum-integrated sun safety program can produce immediate and sustained improvements in adolescents' sun protection knowledge and attitudes within a girls' secondary school context. While the single-site design limits broader generalisation, the results highlight the potential value of embedding sun safety education within school curricula. Future research should examine the effectiveness of this intervention across multiple school sites, including co-educational and diverse educational settings, to strengthen evidence for scalability and policy implementation aimed at long-term skin cancer prevention.

This study aimed to assess the risks associated with ultraviolet radiation (UVR) exposure among military outdoor workers at Lohatla Military Base, South Africa, and to inform targeted risk reduction strategies. A quantitative, cross-sectional design was employed, using a questionnaire survey with 161 participants (81% completion rate; 58.39% male; the largest age group was 19-25 years) and five days of objective environmental monitoring. Environmental data confirmed the presence of elevated solar ultraviolet radiation conditions, with peak irradiance levels recorded between 12:00 PM and 1:00 PM, while temperature highs frequently exceeded 35 °C (peaking at 39 °C). Statistical analysis using Spearman's rank-order correlation revealed strong positive associations among sun protection behaviours, including wearing protective clothing, hat use, sunscreen use, and avoidance of peak sun exposure hours (ρ values up to 0.764, p < 0.001), indicating the clustered and interdependent nature of effective sun safety practices. Furthermore, engagement in protective behaviours was significantly associated with improved health outcomes, including a lower incidence of sunburn (ρ = 0.407, p < 0.001) and reduced hyperpigmentation (ρ = 0.438, p < 0.001). These findings indicate that combined protective strategies are associated with reduced self-reported dermatological outcomes. Despite the benefits of individual behaviours, military personnel remain exposed to high levels of environmental ultraviolet radiation, underscoring the need for institutional, evidence-based policy interventions to mitigate occupational exposure risks. The study concludes that military organisations should implement mandatory administrative controls (e.g., schedule adjustments), standardise high-ultraviolet-protection-factor protective gear, and enhance targeted health literacy training to mitigate long-term UV-related health risks and improve the operational effectiveness of their workers.

Sunbeds emitting ultraviolet radiation (UVR) are an established carcinogen, but little attention has been given to the adverse photosensitivity reactions the UVR exposure can cause. We addressed this information gap through systematic review of the literature on photosensitivity reactions reported following community sunbed use. A systematic search of Medline (via PubMed), CINAHL and Embase identified studies published in English (inception to May 2025). The protocol was registered in Prospero (CRD420251048551). We included all study designs. Quality was assessed using JBI Critical Appraisal Checklists (Case-Reports, Case-Series) and Downes Appraisal (Cross-Sectional Studies), and narrative synthesis performed. Of 413 articles screened, 34 met inclusion criteria (26 case-reports, 6 case-series, 2 cross-sectional studies; 28 high quality for their study design). There were 67 photosensitivity reactions, including 33 cases of photodermatoses (29 pseudoporphyria; 4 solar urticaria, 3 as first presentations), and 3 cases of photoaggravated disorders (one first presentation and two exacerbations of known SLE). There were 31 photosensitivity reactions induced by exogenous substances including 11 to systemic drugs (10 skin, one retinal). Phototoxic reactions occurred to celery, parsnip and lime juice (14 via contact, one ingested), and 5 photocontact reactions to other topical agents including a well-being product. Severe systemic reactions occurred, and 6 cases hospitalised. Findings reveal wide-ranging and severe photosensitivity reactions and indicate attention should be given to providing effective information about the risks and triggers of photosensitivity reactions from sunbeds. This includes to sunbed-outlet staff, sunbed-users, patients with disorders that can be UVR-triggered or aggravated, and people taking potentially photosensitising medication.

BACKGROUND Photo recall dermatitis (PRD) is a phototoxic eruption that occurs in areas of previous ultraviolet-damaged skin following systemic administration of a drug, most commonly chemotherapeutic medications. Although generally considered a self-limited dermatologic phenomenon, its implications in immunocompromised patients have not been well characterized. Secondary infection complicating PRD has not been previously established in the literature. This case is unique because the patient had an unusual rash while neutropenic, then developed a bloodstream infection (BSI), with the skin as her most likely source. CASE REPORT We describe a case of a woman in her 80s with metastatic pancreatic adenocarcinoma enrolled in a clinical trial of a DNA methyltransferase-inhibiting nucleoside analog who presented with fever, neutropenia, and an erythematous rash localized precisely to areas of a recent sunburn. Dermatologic evaluation supported a diagnosis of photo recall dermatitis. Peripheral blood cultures grew Staphylococcus hominis in 1 of 4 bottles, while concurrent port cultures were negative. She developed clinical signs of a true BSI rather than culture contamination, with the presentation consistent with a skin source as the most likely route of entry rather than a central-line-associated BSI (CLABSI) usually observed with S. hominis infections. CONCLUSIONS This case is, to the best of our knowledge, the first reported instance of photo recall dermatitis complicated by bloodstream infection. It highlights the potential for inflammatory skin barrier disruption to serve as a portal of entry in neutropenic patients. Clinicians should be aware that photo recall dermatitis can lead to infections, including BSIs, in immunocompromised hosts.

Xeroderma pigmentosum (XP) is a rare recessive autosomal genodermatosis caused by defects in nucleotide excision repair (NER). Patients with XP are extremely sensitive to ultraviolet-light, resulting in an increased incidence of skin cancers in sun-exposed areas. Thanks to improved photoprotection and therapeutic education, the life expectancy of patients with XP has increased substantially. Recently, however, it has been observed that some XP patients are also at very high risk of developing internal tumors. Notably, 50% of these tumors correspond to severe myelodysplastic syndrome (MDS) and/or acute myeloid leukemia (AML) occurring in XP-C patients younger than 25 years, almost 50 years earlier than for the general population. To explain this striking susceptibility, we hypothesize that two distinct but complementary mechanisms contribute to the high risk of hematologic malignancies in XP-C patients. First, preserved transcription-coupled repair combined with defective global-genome repair in XP-C cells, in the presence of as-yet-uncharacterized endogenous bulky DNA lesions, results in a more than 25-fold increase in mutation frequency in XP-C-associated hematologic malignancies compared with corresponding tumors in the general population. Whole-genome sequencing of XP-C hematologic malignancies reveals a COSMIC SBS8 mutational signature characteristic of NER deficiency. Second, the XPC protein has been identified as a co-factor of RNA polymerase II regulating hundreds of genes. Loss of full-length XPC leads to dysregulation of multiple gene pathways, including those involved in hematopoietic, immunologic, and oncogenic processes. We propose that together, the accumulation of driver-gene mutations and the disruption of hematopoietic regulatory pathways may account for the exceptionally high incidence and severity of MDS/AML observed in young XP-C patients.

Lupus erythematosus is an autoimmune disease that frequently presents with dermatologic manifestations. When it is limited to the facial area, it is difficult to distinguish from other inflammatory diseases. Among the differential diagnoses of facial erythema, lupus erythematosus tumidus (LET) is an uncommon entity that represents a subtype of lupus erythematosus. It is characterized as a photosensitive dermatosis with a favorable clinical course and prognosis. A 32-year-old female patient presented with dermatosis localized to the face, specifically in the frontal and maxillary regions, characterized by persistent facial erythema with papular eruptions over a two-year period. Initially diagnosed as rosacea, she received multiple treatments without clinical improvement. Subsequently, histopathological findings led to the diagnosis of LET, a form of intermittent cutaneous lupus erythematosus that occurs much less frequently than other forms of cutaneous lupus. It presents with a relapsing course associated with sun exposure, histopathologically characterized by superficial and deep perivascular and periadnexal lymphocytic infiltrates with dermal mucin deposition. It may clinically mimic other skin disorders. Therefore, skin biopsies are indicated in various clinical scenarios when histopathologic information is required to make a diagnosis and establish the definitive treatment plan.

Porphyrias are rare metabolic disorders caused by inherited or acquired enzymatic defects in the heme biosynthesis pathway, resulting in the accumulation of heme precursors or toxic porphyrin intermediates. The cutaneous porphyrias arise from enzymatic defects in later steps of the heme biosynthesis pathway, which lead to the build-up of photoactive porphyrins in the skin and liver, such as coproporphyrins, protoporphyrins, and uroporphyrins. These photoactive porphyrins generate reactive oxygen species that drive the characteristic cutaneous manifestations, including painful photosensitivity, skin fragility, and blistering. The cutaneous porphyrias encompass both blistering and non-blistering subtypes, which include erythropoietic protoporphyria, X-linked protoporphyria, congenital erythropoietic porphyria, porphyria cutanea tarda, and hepatoerythropoietic porphyria, each distinguished by specific biochemical patterns and clinical features. Acute hepatic porphyrias, which include acute intermittent porphyria, variegate porphyria, hereditary coproporphyria, and aminolevulinic acid dehydratase deficiency porphyria, result in the accumulation of neurotoxic precursors, such as δ-aminolevulinic acid and porphobilinogen. While acute neurovisceral attacks predominate in acute hepatic porphyrias, certain subtypes, such as variegate porphyria and hereditary coproporphyria, may present with blistering photosensitivity, creating a significant diagnostic overlap between cutaneous porphyrias and other photodermatoses. This overlap underscores the importance of awareness of acute hepatic porphyrias among dermatologists, who may be the first clinicians to encounter patients with these disorders. In addition, recent treatment breakthroughs will likely bring patients with porphyrias to pursue care, changing the likely underestimated disease prevalence rates. This narrative review provides a comprehensive overview of the pathobiology, clinical features, diagnostic strategies, and management approaches for the cutaneous and acute hepatic porphyrias.

Using 2023 national Youth Risk Behavior Survey data, we estimated the prevalence of any sunburn and frequent sunburn (≥5 times in the past year) among US high school students and examined associations with demographic and behavioral characteristics. Overall, 54.7% of students reported any sunburn, and 22.9% of students with any sunburn reported frequent sunburn. After adjustment for sex, race and ethnicity, and grade, any sunburn prevalence differed by sex, race and ethnicity, body mass index, several substance use and activity measures, diet, and social media use; factors associated with frequent sunburn partially overlapped but also differed. Persistently high adolescent sunburn prevalence supports continued youth skin cancer prevention efforts.

Chronic relapsing inflammatory optic neuropathy (CRION) is a rare cause of recurrent optic neuritis characterized by steroid responsiveness and relapse upon treatment withdrawal. Because no definitive diagnostic test exists, the diagnosis is clinical and requires exclusion of more common demyelinating and antibody-mediated disorders. We describe a 45 year-old woman with a history of psoriasis, photodermatitis, and Hashimoto thyroiditis who presented with four episodes of severe left retro-orbital pain and progressive visual blurring over a three-year period, with the right eye remaining unaffected throughout. Each episode demonstrated left optic nerve enhancement on magnetic resonance imaging and responded promptly to intravenous corticosteroids. Extensive evaluation for multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein (MOG) antibody disease was consistently negative. A diagnosis of seronegative CRION was established based on the recurrent steroid-responsive clinical pattern. Long-term immunosuppressive therapy with mycophenolate mofetil, later transitioned to mycophenolic acid due to gastrointestinal intolerance, resulted in clinical stability during follow-up. One additional relapse occurred following a brief three-day interruption of mycophenolate for treatment of cellulitis. CRION should be considered in patients with recurrent optic neuritis when workup for demyelinating and antibody-mediated conditions is negative. Early recognition and initiation of long-term immunosuppressive therapy are important to reduce relapse frequency and prevent cumulative optic nerve damage.

Sunburn is an important risk factor for skin cancer. Understanding sunburn prevalence and the contexts in which sunburn commonly occurs might help guide the development and implementation of sun safety interventions. Data from the 2024 National Health Interview Survey sample adult questionnaire were analyzed to describe the prevalence of one or more and four or more sunburns among U.S. adults during the previous 12 months and the percentages of U.S. adults who experienced their most recent sunburn while they were working at their job; intentionally tanning; exercising; spending time in, on, or near water; using sunscreen; or drinking alcohol. Overall, an estimated 88.1 million (35.1%) U.S. adults had at least one sunburn during the previous 12 months, and 18.8 million (7.5%) had four or more sunburns. Among adults who experienced sunburn during the previous year, spending time in, on, or near the water was the most frequently reported context of their most recent sunburn (60.6%); followed by exercising (24.7%); drinking alcohol (17.6%); intentionally tanning (15.9%); and working at their job (12.9%). Approximately one half (55.1%) of respondents reported that their most recent sunburn occurred despite using sunscreen. These findings can help guide research and activities to adapt, tailor, and expand evidence-based interventions to improve use of sun protection, prevent sunburn, and reduce skin cancer risk.