Ka Ma'i 'ili a me ka UVB Phototherapy

He aha ka pilikia o ka maʻi maʻi ʻili me ka UVB phototherapy?

ʻAʻole like me ka radiation ultraviolet mai ka lā maoli a me nā kukui tanning cosmetic, he mau ʻumi makahiki o ka hoʻohana ʻana i ka dermatology ua hōʻike i ka UVB/UVB-Narrowband phototherapy (ʻo ia ka UVA i kāpae ʻia) ʻaʻole ia he pilikia nui no ka maʻi kanesa ʻili;
ʻo ia hoʻi ka maʻi maʻi maʻi maʻi basal cell (BCC), squamous cell carcinoma (SCC) a me ka melanoma malignant cutaneous (CMM).

No ke kākoʻo ʻana i kēia ʻōlelo, e noʻonoʻo
nā ʻōlelo aʻo aʻe, a me ke kūkākūkā e pili ana:

Ua kāhea ʻia kahi haʻawina cohort retrospective i paʻi ʻia ma Dekemaba 2023
ʻO ka hanana a me ka ʻike o nā maʻi maʻi ʻili i nā maʻi ma hope o ka phototherapy ultraviolet me ka ʻole o psoralens i hoʻopau ʻia:

 

 

"Ma ka huina, 3506 mau maʻi i mālama ʻia me ka broadband-ultraviolet-B, narrowband-UVB a / a i hui pū ʻia ʻo UVAB i loiloi ʻia me ka mean follow-up o 7.3 makahiki i hoʻoholo ʻia ʻaʻohe piʻi nui o ka maʻi melanoma a loaʻa ke kanesa keratinocyte me ka phototherapy"

Ua hōʻike ʻia kahi noiʻi hoihoi hou i paʻi ʻia ma ʻApelila 2023 "ʻO ka poʻe me ka vitiligo ka haʻahaʻa haʻahaʻa loa o ka maʻi maʻi melanoma a me ka maʻi ʻili non-melanoma i hoʻohālikelike ʻia i ka lehulehu."
Ua ʻōlelo pū kekahi "Ma muli o nā hopohopo e hiki i kekahi mau lāʻau lapaʻau no vitiligo, e like me ka phototherapy lōʻihi, ke hoʻonui i ka pilikia o ka maʻi maʻi ʻili, ʻo ka hōʻike ʻana o ka hōʻemi ʻana o ka maʻi maʻi ʻili e hōʻoluʻolu i nā poʻe ʻelua me ka vitiligo a me nā kauka e mālama ana i ke ʻano."

A kahi noiʻi hou i paʻi ʻia ma ʻAukake 2022 mai Wanekoua mai (Ka hopena o nā maʻi maʻi ʻili i nā poʻe maʻi me ka eczema i mālama ʻia me ka phototherapy ultraviolet) i hoʻoholo ai:

 

"Ma ka holoʻokoʻa, ʻokoʻa no nā poʻe maʻi me ka mōʻaukala o ka lawe ʻana i ka immunosuppressive therapy†, ʻaʻohe piʻi nui o ka melanoma, squamous cell carcinoma, a i ʻole basal cell carcinoma i nā maʻi e loaʻa ana i ka phototherapy ultraviolet, me ka UVB narrowband, broadband UVB, a me ka UVA hui pū me ka broadband. ʻO UVB, ke kākoʻo nei i kēia ma ke ʻano he lāʻau lapaʻau non-carcinogenic no nā maʻi me ka eczema atopic.

"ʻAʻole hōʻike nā loiloi o nā haʻawina e pili ana i ka UVB, nā narrowband a me ka broadband, i ka piʻi nui ʻana o ka maʻi maʻi ʻili nonmelanoma a i ʻole melanoma."

No ka heluhelu ʻana i ka haʻawina piha, e hahai i kēia loulou:

Nā lāʻau lapaʻau no psoriasis a me ka pilikia o ka maʻi maʻi.

Patel RV1, Clark LN, Lebwohl M, Weinberg JM.

"Ma kēia noiʻi nui, me ka hahai ʻana a hiki i 22 mau makahiki mai ka mālama mua ʻana me NB-UVB, ʻaʻole mākou i ʻike i kahi pilina paʻa ma waena o ka mālama ʻana i ka NB-UVB a me BCC, SCC a i ʻole ka maʻi ʻili melanoma." 

No ka heluhelu ʻana i ka haʻawina piha, e hahai i kēia loulou:
ʻO ka nui o nā maʻi maʻi ʻili ma 3867 mau maʻi i mālama ʻia me Narrow-Band UVB Phototherapy
Lohe RMKerr ACRahim KFʻO Ferguson JʻO Dawe RS.

"ʻAʻole i ʻike ʻia ka piʻi nui ʻana o ka maʻi kanesa ʻili i loko o nā haʻawina ʻehā e loiloi pono ana i ka hopena carcinogenic o NB-UVB."

No ka heluhelu ʻana i ka haʻawina piha, e hahai i kēia loulou:
ʻO nā pilikia carcinogenic o ka psoralen UV-A therapy a me ka narrowband UV-B therapy i ka psoriasis plaque maʻi: kahi loiloi palapala ʻōnaehana.

Archier E1, Devaux S, Castela E, Gallini A, Aubin F, Le Maître M, Aractingi S, Bachelez H, Cribier B, Joly P, Jullien D, Misery L, Paul C, Ortonne JP, Richard MA.

"ʻAʻohe ʻokoʻa koʻikoʻi ma waena o ka nbUVB a me nā pūʻulu mana. No laila, ʻo ka nbUVB phototherapy e hoʻohana ana i nā kukui TL-01 me he mea lā he ʻano lapaʻau palekana palekana no nā maʻi me nā kiʻi kiʻi ʻili III-V.

No ka heluhelu ʻana i ka haʻawina piha, e hahai i kēia loulou:
ʻAʻohe mea hōʻike no ka piʻi ʻana o ka maʻi kanesa ʻili i nā Korea me nā kiʻi kiʻi ʻili III-V i mālama ʻia me ka phototherapy UVB narrowband.

Jo SJ1, Kwon HH, Choi MR, Youn JI.

“Ua haʻi aku ʻo Dr. Wahi a Lebwohl. "Ma ka liʻiliʻi loa i kēia manawa, ʻike ʻia ʻaʻole kōkua ka UVB narrowband i ka maʻi maʻi ʻili. Eia nō naʻe, i nā maʻi maʻi maʻi maʻi, makaʻala mākou i ka hoʻohana ʻana i ka phototherapy.

No ka heluhelu ʻana i ka haʻawina piha, e hahai i kēia loulou:
Nā lāʻau lapaʻau psoriasis maʻamau
keiki nā manawa o nā maʻi e ulu ana i ka maʻi maʻi ʻili Dermatology Times Mei-2017

"No laila, ʻaʻole hāʻawi ka haʻawina i kēia manawa i nā hōʻike no ka piʻi ʻana o ka maʻi maʻi maʻi ʻili no nā poʻe maʻi i mālama ʻia me ka broadband a i ʻole ka narrowband UVB phototherapy" 


No ka heluhelu ʻana i ka haʻawina piha, e hahai i kēia loulou:
ʻAʻohe mea hōʻike no ka piʻi ʻana o ka maʻi kanesa ʻili i nā poʻe maʻi psoriasis i mālama ʻia me ka broadband a i ʻole narrowband UVB phototherapy: kahi haʻawina retrospective mua.

Weischer M1, Blum A, Eberhard F, Röcken M, Berneburg M.

"(UVB-Narrowband) Palekana a maʻalahi ka Phototherapy. ʻOiai hiki i nā pilikia ke komo i ka sunburn, ʻaʻole mākou e ʻike i nā maʻi maʻi ʻili, melanoma a i ʻole melanoma. ʻO Vitiligo paha ka pale no ka melanoma. 

Nā manaʻo hou, nā lāʻau lapaʻau no vitiligo - Pearl Grimes - Dermatology Times Aug-2016

"ʻOiai nā hopohopo e pili ana i ka hiki ke make o ka radiation ultraviolet, ʻaʻole i ʻike ka hapa nui o nā haʻawina i ka piʻi ʻana o ka maʻi ʻili non-melanoma a i ʻole melanoma i nā maʻi i mālama ʻia me ka ultraviolet B (broadband and narrowband) a me ultraviolet A1 phototherapy."

No ka heluhelu ʻana i ka haʻawina piha, e hahai i kēia loulou:
ʻO ka ʻaoʻao ʻeleʻele o ka mālamalama: Nā hopena ʻino o ka Phototherapy.

Valejo Coelho MM1, Apetato M2.

kūkākūkā

ʻO ka hoʻoheheʻe Ultraviolet (UVR) mai ka lā maoli
"Ua manaʻo ʻia ʻo ia ke kumu kumu nui
i ka hoʻokomo ʻana i ka maʻi maʻi ʻili"

Ua māhele ʻia ʻo UVR i:

UVA
320-400nm
ʻO nā lōʻihi nalu tanning

UVB
280-320nm
ʻO nā hawewe wela

UVC
100-280nm
Kānana ʻia e ka lewa o ka honua

UVB UVA
No laila, no ke kumu o kēia kūkākūkā, UVR=UVA+UVB.

ʻO kēlā me kēia nalu nalu o ka māmā e hoʻoulu i nā ʻano hopena olaola like ʻole i ka ʻili kanaka. ʻO nā hawewe lōʻihi o UVA e komo i loko o ka dermis, aʻo UVB e komo wale i ka epidermis.

ʻEkolu ʻano nui o nā maʻi maʻi ʻili:

BCC

kinikō basal cell

SCC

ka pūkinoma pūkole pūʻokoʻa

CMM

melanoma kino kino

Hoʻohui pū ʻia ʻo BCC a me SCC ma ke ʻano he maʻi maʻi maʻi ʻili non-melanoma (NMSC), a ua hilinaʻi ʻia ka maʻi maʻi UVB kumulative ola. ʻO nā wahi ʻili i loaʻa i ka nui o ke ola o ka UVR ka mea maʻalahi, e like me ke poʻo, ka ʻāʻī, ka umauma, a me nā lima. Hiki ke mālama ʻia ka NMSC inā ʻike mua ʻia.
Ka ma'i 'ili a me ka UVB Phototherapy
ʻOiai ʻo UVB ke kuleana no ka ʻā ʻana o ka ʻili (erythema) a me ka NMSC, ʻo ia hoʻi ke ʻano o ka waveband e hana ai i ka Vitamin D i loko o ka ʻili a ʻo ia ka mea maikaʻi loa no ka mālama ʻana i nā ʻano maʻi ʻili.

No ka hōʻemi ʻana i ka erythema a me ka NMSC ʻoiai e hāʻawi mau ana i ka mālama ʻana i ka maʻi maʻi ʻili, ua hoʻomohala ʻia ʻo UVB-Narrowband (311nm peak, /01) e Philips Lighting i nā makahiki 1980 a ke hoʻomalu nei i ka phototherapy olakino ma ka honua holoʻokoʻa. No ka ʻike hou aku e ʻike: Ka hoʻomaopopo ʻana i ka Narrowband UVB Phototherapy.

ʻO ka Melanoma ka maʻi maʻi ʻili weliweli loa no ka mea hiki ke hoʻolaha i ka maʻi kanesa i nā wahi ʻē aʻe o ke kino. "Malia paha ʻo ka hui pū ʻana o nā kumu, e komo pū ana me nā kumu kūlohelohe a me nā genetic, ke kumu o ka melanoma. Eia nō naʻe, manaʻo nā kauka i ka ʻike ʻana i ka radiation ultraviolet (UV) mai ka lā a me nā kukui tanning a me nā moena ke kumu nui o ka melanoma.17

ʻAʻole hiki i ka kukui UV ke kumu i nā melanoma a pau, ʻoi aku ka nui o nā mea i loaʻa ma nā wahi o kou kino i ʻike ʻole ʻia i ka lā. Hōʻike kēia i nā kumu ʻē aʻe ke kōkua i kou pilikia o ka melanoma. Hiki ke kumu mai ka melanoma e ka UVA a me ka UVB, akā aia kekahi mau hōʻike e hiki ke hoʻokani ʻo UVA i kahi kuleana nui.3

ʻO nā kumu pilikia o ka melanoma: nā mole (melanocytic nevi), ʻano ʻili (ʻoi aku ka nui o ka pilikia ma mua o ka poʻe me nā ʻili ʻeleʻele), a me ka puhi ʻana i ka lā, ʻoi aku ka nui o ka wā kamaliʻi. “ʻOi aku ka ikaika o ka ʻike ʻana i ka lā ikaika i ka ulu ʻana o ka melanoma ma mua o ka hoʻomau ʻana o ka lā i kēlā me kēia lā. " 6

Eia naʻe e wehewehe ʻia ka ʻoiaʻiʻo "ʻOi aku ka pinepine o ka Melanoma ma waena o ka poʻe me nā hana i loko o ka hale ma mua o ka poʻe e loaʻa ana i nā hōʻike UV kaiapuni nui (ka mahiʻai, lawaiʻa, etc.)."

ʻO ka hapa nui o nā palapala ʻepekema maʻi ʻili e pili ana i nā hopena o ka lā maoli (UVR, ʻo ia ka hapa nui o UVA, me ka emi ʻana o ka pākēneka o UVB i ka piʻi ʻana o ka latitu),

Akā pehea ke hoʻohana ʻia ʻo UVB wale nō (me ka UVA i kāpae ʻia), e like me ka lāʻau lapaʻau UVB / UVB-Narrowband phototherapy?

ʻOiai ʻo ke ʻano o ka spectrum hana no NMSC ua aneane pau loa i ka laulā UVB, ua hōʻike ʻia nā haʻawina ma luna nei he UVB/UVB-Narrowband phototherapy. ʻaʻole ia he kumu pilikia nui no ka maʻi maʻi ʻili; ʻo ia hoʻi ka maʻi maʻi maʻi maʻi basal cell (BCC), squamous cell carcinoma (SCC) a me ka melanoma malignant cutaneous (CMM).

ʻO ka loaʻa ʻole o ka UVA hiki ke hoʻopilikia i kahi hana, a "Ma ka holoʻokoʻa, aia kekahi mau hōʻike e pili ana ka huaora D i ka maʻi maʻi ʻili nonmelanoma (NMSC) a me ka pale ʻana i ka melanoma, ʻoiai ʻaʻohe hōʻike pololei e hōʻike i kahi hopena pale." 14,15 "Ua hōʻike ʻia kekahi mau noiʻi ʻana he hana pale ka vitamin D i nā ʻano maʻi ʻino kūloko. E pili ana i ka maʻi maʻi ʻili, hōʻike ʻia nā noiʻi epidemiologic a me nā noiʻi hoʻokolohua e loaʻa i ka huaora D a me kāna mau metabolites ka hopena pale like.. " 13

No ka hoʻoponopono ʻana i ka hopohopo me ka NMSC i hoʻokomo ʻia i ka UVB, no ka mea, pili ia i ka nui o ka nui o ke ola, ʻoi aku ka maikaʻi o ka poʻe ʻili maikaʻi, pono ke kāpae ʻia mai ka mālama ʻana i nā wahi o ka ʻili i pono ʻole ka lāʻau lapaʻau a ua loaʻa iā UVR nui i ke ola o ka mea maʻi. a no ka pale ʻana i kēlā mau wahi mai ka UVR hou mai ka lā maoli. ʻO ka poʻe me ka mōʻaukala a/a i ʻole ka mōʻaukala ʻohana o ka maʻi maʻi ʻili e nīnau i kā lākou kauka ma mua o ka lawe ʻana i ka phototherapy UV. Pono e loaʻa iā lākou kahi "ʻili ʻili" ma ka liʻiliʻi i kēlā me kēia makahiki e ʻike ai i ka maʻi kanesa ʻili; e like me ka mea e ʻike ʻia i ke kukui ultraviolet, no ka lāʻau lapaʻau UV phototherapy, nā mea hoʻonaninani hoʻonaninani, a i ʻole ka lā maoli.

Eia kekahi, loaʻa ka UVR mai ka lā maoli mai luna mai o ke kanaka (no ka laʻana, e ʻā ana ka lā mai luna ma ka lae, nā pepeiao a me nā poʻohiwi). kino piha ʻO ka UVB phototherapy ʻaneʻane e hoʻopuka ʻia mai ka ʻaoʻao (kū mau nā maʻi no ka mālama ʻana mai kahi hāmeʻa i kau ʻia i luna), no laila aia kekahi hōʻemi ʻike geometric i nā wahi ʻili pilikia loa. ʻO ka hana "hoʻomaʻemaʻe" mua o ka UVB e pili ana i ka nui o ka nui o ka UVB phototherapy i nā mahina he nui, a ukali ʻia e nā mālama "mālama" lōʻihi i ka hoʻemi ʻia a me ka pinepine.

Lā kino piha
Mea kino kino piha
ʻAʻole koi ʻo UVB phototherapy i ka mea maʻi e loaʻa i ka lā, a ʻoi aku ka maikaʻi o nā dosis UVB ma mua o ka nui no ka mālama lōʻihi "He koho kūpono anei nā ʻāpana ʻāpana ʻo Ultraviolet B Home no ka lāʻau lapaʻau hoʻomau a mālama ʻia paha o nā maʻi ʻili kiʻi?” ,18 a e mālama i ka lawa o ka Vitamin D. 09,11,12

ʻO nā polokalamu SolRx UVB-Narrowband āpau he Health Canada e hoʻokō nei no ka "Vitamin-D Deficiency" ma ke ʻano he "hōʻailona no ka hoʻohana", ʻo ia hoʻi ua hoʻoholo lākou e palekana a maikaʻi hoʻi, a no laila hiki ke kūʻai ʻia ma ke kānāwai no ia kumu ma Kanada. 10

No ka Home phototherapy, ke kaʻina hana ʻoluʻolu o ka lawe ʻana i nā lāʻau lapaʻau a me ke ʻano kanaka e alakaʻi i ka mea maʻi e lawe wale i ka nui o ka UVB e pono ai e mālama i ka ʻili a i ʻole a kokoke. ʻO ka poʻe maʻi phototherapy home e lilo i mea akamai loa i ka nui o ka UVB e lawe ai a i ka manawa, me ka liʻiliʻi, ʻoi aku ka nui o nā kau i makemake ʻia e nā mea he nui.

ʻO ka home phototherapy hoʻi e hōʻemi iki i ka hala ʻana o nā lāʻau lapaʻau a loaʻa i nā lāʻau lapaʻau ma hope o ka lā i makemake ʻole ʻia. ʻO ia hoʻi, "He like ka maikaʻi o ka phototherapy Ultraviolet B ma ka home no ka mālama ʻana i ka psoriasis e like me ka phototherapy ultraviolet B ma kahi hoʻonohonoho maʻi ma waho a ʻaʻole ia e hōʻike i nā pōʻino palekana hou aʻe i kahi hoʻonohonoho e pale ana i nā irradiations hiki ʻole ke kuhikuhi ʻia. Eia kekahi, ʻoi aku ka haʻahaʻa o ka mālama home, ʻoi aku ka maikaʻi o ka mahalo, a hāʻawi i nā hoʻomaikaʻi like i ka maikaʻi o ke ola. ʻO ka hapa nui o nā mea maʻi i ʻōlelo e makemake lākou i ka mālama ʻana i ka ultraviolet B i ka wā e hiki mai ana ma ka home ma mua o ka phototherapy i kahi hoʻonohonoho maʻi ma waho. 16

Hoʻokipa ʻo Solarc Systems i nā manaʻo e hoʻomaikaʻi i kēia ʻatikala ʻike lehulehu.

KA MANAʻO

He mea nui ʻaʻole huikau ka UVB a me UVB-Narrowband phototherapy me PUVA (psoralen + UVA kukui), no ka mea, "ua hōʻike maopopo ʻia ke kuleana o ka PUVA therapy i ka carcinogenesis ʻili i nā kānaka me psoriasis" [Nā pilikia kino o ka PUVA a me ka nbUVB i loko o ka psoriasis plaque maʻi maʻi _ kahi loiloi palapala ʻōnaehana 2012] PNo laila ua kaupalena pinepine ʻia ʻo UVA i 200 a 300 mau lāʻau lapaʻau, a no nā hihia koʻikoʻi loa i hāʻule i ka UVB a i ʻole UVB-Narrowband phototherapy.   

E hoʻomaopopo ':

1 Brenner, Michaela, and Vincent J. Hearing. “ʻO ke kuleana pale o ka Melanin e kūʻē i ka pōʻino o UV i ka ʻili kanaka. " Photochemistry a me Photobiology, vol. 84, aole. 3, 2007, pp. 539–549., doi:10.1111/j.1751-1097.2007.00226.x.

2 "ʻO ka maʻi maʻi ʻili / Melanoma Center: nā hōʻailona, ​​​​nā lapaʻau, nā hōʻailona, ​​​​nā ʻano, nā kumu, a me nā hoʻāʻo. WebMD

3 Setlow, RB, et al. “ʻO nā lōʻihi hawewe kūpono i ka hoʻokomo ʻana i ka Melanoma Malignant.Nā papahana o ka National Academy of Sciences, vol. 90, aole. 14, 1993, pp. 6666–6670., doi:10.1073/pnas.90.14.6666.

4 Berneburg, Mark, a me Lena Krieger. "Ke Kumu o 1000 Evaluation for Melanoma Induction e Ultraviolet A akā ʻaʻole ʻo Ultraviolet B Radiation e koi i ka Melanin Pigment." F1000 – Hoʻopuka Paʻi ʻana i nā hoa o ka Palapala Biomedical, 2012, doi:10.3410/f.717952967.793458514.

5 Brenner, Michaela, and Vincent J. Hearing. “ʻO ke kuleana pale o ka Melanin e kūʻē i ka pōʻino o UV i ka ʻili kanaka. " Photochemistry a me Photobiology, vol. 84, aole. 3, 2007, pp. 539–549., doi:10.1111/j.1751-1097.2007.00226.x.

6 Rodos, A.Nā Kūlana Melanoma. " AIM ma Melanoma, Fitzpatrick's Dermatology in General Medicine

7 ʻO Iuzeniene, ʻo ʻAsta, a ʻo Johan Moan. “Nā hopena maikaʻi o ka hoʻoheheʻe ʻana o UV ma mua o ka huaora D Production. " Dermato-Endocrinology, vol. 4, aole. 2, 2012, pp. 109–117., doi:10.4161/derm.20013.

8 Maverakis, Emanual, et al. “Māmā, me Ultraviolet. " ʻO ka National Institute of Health, Mei 2010, doi:10.1016/j.jaut.2009.11.011.

9 United States, Congress, National Toxicology Program. “Pāhaʻi-SpectrumUltraviolet (UV) Radiation a me UVA, a me UVB, a me UVC.ʻO ka ʻōuli ākeaUltraviolet (UV) Radiation a me UVA, a me UVB, a me UVC, Hui Hoʻolālā ʻenehana a hoʻokele, 2000.

10 "ʻIke Hoʻoponopono." ʻO Solarc Systems Inc.,

11 Bogh, Mkb, et al. “ʻOi aku ka maikaʻi o ka Narrowband Ultraviolet B ʻEkolu manawa i kēlā me kēia pule i ka mālama ʻana i ka hemahema o ka Vitamin D ma mua o 1600IU Oral Vitamin D3 i kēlā me kēia lā.. " ʻO ka Pelekane Pelekane o Dermatology, vol. 167, aole. 3, 2012, pp. 625–630., doi:10.1111/j.1365-2133.2012.11069.x.

12 Ala-Houhala, Mj, et al. “Hoʻohālikelike o ka Narrowband Ultraviolet B Exposure a me ka Oral Vitamin D Substitution on Serum 25-Hydroxyvitamin D Concentration.ʻO ka Pelekane Pelekane o Dermatology, vol. 167, aole. 1, 2012, pp. 160–164., doi:10.1111/j.1365-2133.2012.10990.x

13 Tang, Jean Y., et al. “ʻO ka Vitamin D i ka Carcinogenesis Cutaneous: Māhele I.ʻO ka National Institute of Health, Nov. 2012, doi:10.1016/j.jaad.2012.05.044.

14 Tang, Jean Y., et al. “ʻO ka Vitamin D i ka Carcinogenesis Cutaneous: Māhele II.ʻO ka National Institute of Health, Nov. 2012, doi:10.1016/j.jaad.2012.05.044.

15 Navarrete-Dechent, Cristián, et al. “Kaapuni ana i ka Vitamin-D Binding Protein a me Free 25-Hydroxyvitamin D Concentrations i na ma'i me ka Melanoma: A Case-Control Study."Ka Buke o ka American Academy of Dermatology, vol. 77, aole. 3, 2017, pp. 575–577., doi:10.1016/j.jaad.2017.03.035.

16 Koek, M. BG, et al. “ʻO ka Home versus Outpatient Ultraviolet B Phototherapy no ka Psoriasis ʻAʻole i Koʻikoʻi: Pragmatic Multicentre Randomized Controlled Non-Inferiority Trial (PLUTO Study).” Bmj, vol. 338, aole. Mei07 2, Iulai 2009, doi:10.1136/bmj.b1542.

17 https://www.mayoclinic.org/diseases-conditions/melanoma/symptoms-causes/syc-20374884

18 He koho kūpono anei nā ʻāpana ʻāpana ʻo Ultraviolet B Home no ka lāʻau lapaʻau hoʻomau a mālama ʻia paha o nā maʻi ʻili kiʻi?"