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Abdellatif M, Tawfik GM, Makram AM, Abdelsattar MK, Dobs M, Papadopoulos DN, Hoang-Trong BL, Mostafa EM, Duong PDT, Huy NT. Association between neonatal phototherapy and future cancer: an updated systematic review and meta-analysis. Eur J Pediatr 2023; 182:329-341. [PMID: 36352244 DOI: 10.1007/s00431-022-04675-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/11/2022] [Accepted: 10/22/2022] [Indexed: 11/11/2022]
Abstract
Phototherapy is the main treatment of neonatal hyperbilirubinemia to prevent encephalopathy. It is generally believed to be safe; however, some studies have shown it might be associated with cancer development. In this systematic review and meta-analysis, we aimed to assess the effect of neonatal phototherapy on future cancer risk. A systematic search in 13 databases was conducted in December 2018 and updated in August 2022 to identify studies that report cancer development after exposure to phototherapy. Throughout the study period, regular manual searches were also conducted to include new studies. A meta-analysis using R programming language was done in which the odds ratios (ORs) with 95% confidence intervals (CIs) were estimated and pooled using the reported adjusted and unadjusted data. Fifteen studies were included. A statistically significant association was detected between neonatal phototherapy and any type of cancer (OR 1.24; 95% CI 1.1, 1.4), any hematopoietic cancer (OR 1.49; 95% CI 1.17, 1.91), any leukemia (OR 1.35; 95% CI 1.08, 1.67), and myeloid leukemia (OR 2.86; 95% CI 1.4, 5.84). The other investigated cancers (lymphoid leukemia, Hodgkin's lymphoma, kidney cancer, nervous system cancer, and skin cancer) were not associated with phototherapy. Conclusions: Phototherapy may carry a possible risk of future cancers. Future research is needed to quantify the magnitude of the cancer risk. These future studies should consider predictors of preterm birth or exclude premature babies from their analysis. What is Known • There were various reports about the possible association between phototherapy in neonates and the increased risk of cancer in the future. What is New • A statistically significant association between phototherapy and various hematopoietic cancers (especially myeloid leukemia) was recorded. • The effect of the duration of phototherapy on the increased risk of hematopoietic cancers is yet unclear.
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Affiliation(s)
| | - Gehad Mohamed Tawfik
- Online Research Club, Nagasaki, Japan.,.,Department of Otorhinolaryngology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Abdelrahman M Makram
- Online Research Club, Nagasaki, Japan.,.,Faculty of Medicine, October 6 University, Giza, Egypt.,School of Public Health, Imperial College London, London, UK
| | | | - Monica Dobs
- Online Research Club, Nagasaki, Japan.,.,Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Dimitrios N Papadopoulos
- Online Research Club, Nagasaki, Japan.,.,Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Bao-Long Hoang-Trong
- Online Research Club, Nagasaki, Japan.,.,Faculty of Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Esraa Mahmoud Mostafa
- Online Research Club, Nagasaki, Japan.,.,Faculty of Medicine, Port Said University, Port Said, Egypt
| | - Pham Diep Thuy Duong
- Pediatric Department, Faculty of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Nguyen Tien Huy
- Online Research Club, Nagasaki, Japan. .,, . .,School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
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2
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Ahmadipour S, Baharvand P, Rahmani P, Hasanvand A, Mohsenzadeh A. Effect of Synbiotic on the Treatment of Jaundice in Full Term Neonates: A Randomized Clinical Trial. Pediatr Gastroenterol Hepatol Nutr 2019; 22:453-459. [PMID: 31555570 PMCID: PMC6751109 DOI: 10.5223/pghn.2019.22.5.453] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 03/28/2019] [Accepted: 04/08/2019] [Indexed: 12/22/2022] Open
Abstract
PURPOSE Jaundice accounts for most hospital admissions in the neonatal period. Nowadays, in addition to phototherapy, other auxiliary methods are used to reduce jaundice and the length of hospitalization. This study aimed to investigate the effect of probiotics on the treatment of hyper-bilirubinemia in full-term neonates. METHODS In this randomized clinical trial, 83 full-term neonates, who were admitted to the hospital to receive phototherapy in the first 6 months of 2015, were randomly divided into two groups: synbiotic (SG, n=40) and control (CG, n=43). Both groups received phototherapy but the SG also received 5 drops/day of synbiotics. Serum bilirubin, urine, stool, feeding frequency, and weight were measured daily until hospital discharge. A p-value<0.05 was considered statistically significant. RESULTS The mean total serum bilirubin in the SG was lower than that in the CG (9.38±2.37 and 11.17±2.60 mg/dL, respectively). The urine and stool frequency in the SG was significantly higher than that in the CG (p<0.05). The duration of hospitalization in the SG was shorter than that in the CG. CONCLUSION Use of synbiotics as an adjuvant therapy had a significant treatment effect on jaundice in full-term neonates. Further studies including larger samples with long follow-up periods are essential to confirm the benefits of routine use of synbiotics in neonatal patients with jaundice.
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Affiliation(s)
- Shokoufeh Ahmadipour
- Razi Herbal Medicine Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.,Department of Pediatrics, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Parastoo Baharvand
- Department of Social Medicine, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Parisa Rahmani
- Pediatric Gastroenterology and Hepatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Hasanvand
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Azam Mohsenzadeh
- Department of Pediatrics, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
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3
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De Luca D, Dell'Orto V. Patched Skin Bilirubin Assay to Monitor Neonates Born Extremely Preterm Undergoing Phototherapy. J Pediatr 2017; 188:122-127. [PMID: 28662949 DOI: 10.1016/j.jpeds.2017.05.080] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 05/08/2017] [Accepted: 05/31/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To verify the reliability and safety of transcutaneous bilirubin (TcB) measurements in patched skin areas in neonates born extremely preterm under phototherapy. STUDY DESIGN Sixty neonates (<30 weeks' gestation) receiving phototherapy were enrolled and TcB was measured via a second-generation transcutaneous bilirubinometer in patched skin areas (of at least 2.5 cm diameter). Total serum bilirubin (TSB), lactate, pH, hemoglobin, and skin temperature were measured within 10 minutes of the TcB assay. Clinicians were blinded to TcB values, and clinical decisions about phototherapy were made with the TSB measurement only. RESULTS TcB and TSB significantly were correlated (r = 0.84; P <.001), even after adjustment for hemoglobin, pH, lactate, gestational and postnatal age (standardized β = 0.8; P <.001; adjusted R2 = 0.75), or treatment duration (standardized β = 0.8; P <.001; adjusted R2 = 0.7). When the Bland-Altman analysis was used, TcB overestimated TSB at high values (mean difference TSB - TcB: -2.8 [2.4] mg/dL). If clinicians used the TcB only, no neonate would have had phototherapy stopped prematurely, and 21 (35%) would have continued phototherapy when it could have been stopped. CONCLUSIONS The correlation between TSB and TcB (measured in patched skin areas) was comparable with that obtained in more mature neonates, and it was not influenced by clinical variables or factors affecting skin bilirubin passage. TcB overestimated TSB, and this may expose infants born preterm to unnecessary phototherapy, although it could spare approximately 65% of TSB assays.
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Affiliation(s)
- Daniele De Luca
- Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, South Paris University Hospitals, AP-HP and South Paris-Saclay University, Paris, France.
| | - Valentina Dell'Orto
- Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, South Paris University Hospitals, AP-HP and South Paris-Saclay University, Paris, France
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4
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Crall CS, Rork JF, Delano S, Huang JT. Phototherapy in children: Considerations and indications. Clin Dermatol 2016; 34:633-9. [PMID: 27638444 DOI: 10.1016/j.clindermatol.2016.05.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Phototherapy can be a safe and effective treatment for various skin diseases in children. Special considerations governing the use of this treatment modality in pediatric populations include patient, family, and facility-based factors that are oriented around heightened concerns with regard to safety and tolerability of treatment. Although phototherapy has been found to be effective in a wide range of dermatologic conditions affecting pediatric populations, including psoriasis, atopic dermatitis, pityriasis lichenoides, cutaneous T-cell lymphoma, and vitiligo, there is need for additional research on other conditions in which phototherapy has shown promise.
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Affiliation(s)
- Cary S Crall
- Harvard Medical School, Dermatology Program, Division of Allergy and Immunology, Department of Medicine, Boston Children's Hospital, Boston, MA
| | - Jillian F Rork
- Department of Dermatology, University of Massachusetts School of Medicine, Worcester, MA
| | - Sophia Delano
- Harvard Medical School, Dermatology Program, Division of Allergy and Immunology, Department of Medicine, Boston Children's Hospital, Boston, MA
| | - Jennifer T Huang
- Harvard Medical School, Dermatology Program, Division of Allergy and Immunology, Department of Medicine, Boston Children's Hospital, Boston, MA.
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5
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Lai YC, Yew YW. Neonatal Blue Light Phototherapy and Melanocytic Nevus Count in Children: A Systematic Review and Meta-Analysis of Observational Studies. Pediatr Dermatol 2016; 33:62-8. [PMID: 26645992 DOI: 10.1111/pde.12730] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Neonatal blue light phototherapy (NBLP) is an established method of managing neonatal hyperbilirubinemia. Approximately 5% of newborns are exposed to NBLP. Evidence of whether NBLP predisposes to the development of melanocytic nevi later in life has been conflicting. OBJECTIVES The goal of the current study was to conduct a systematic review and meta-analysis to quantitatively assess the effect of NBLP on melanocytic nevus count. METHODS We searched for observational studies in Medline, EMBASE, and the Cochrane Central Register from their inception to April 15, 2015. Meta-analysis of Observational Studies in Epidemiology guidelines were followed. DerSimonian and Laird random-effects models were used to calculate the weighted mean difference (WMD). Publication bias was assessed using a funnel plot and the Egger's test. RESULTS Five studies with a total of 2,921 subjects were included, of whom 642 underwent NBLP. With random-effects modeling, those who had previous NBLP did not have a significantly higher mean number of melanocytic nevi (WMD = 0.32 [95% confidence interval -0.67, 1.31], p = 0.53). Visual inspection of the funnel plot suggested potential publication bias, although the Egger's test (p = 0.09) indicated no small-study effect. CONCLUSION There was no evidence that prior NBLP exposure significantly increased the number of melanocytic nevi. Available evidence has not revealed any cause for major concern for NBLP. Other risk factors such as exposure to sunlight, childhood history of sunburn, and fair skin complexion might play a greater role in the development of melanocytic nevi in childhood.
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Affiliation(s)
- Yi Chun Lai
- T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Yik Weng Yew
- T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.,National Skin Centre, Singapore City, Singapore
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6
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Pfaff S, Liebmann J, Born M, Merk HF, von Felbert V. Prospective Randomized Long-Term Study on the Efficacy and Safety of UV-Free Blue Light for Treating Mild Psoriasis Vulgaris. Dermatology 2015; 231:24-34. [PMID: 26044167 DOI: 10.1159/000430495] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 03/30/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Blue light irradiation reduces the proliferation of keratinocytes and modulates T-cell immune response in vitro and has been shown to reduce the severity of psoriasis vulgaris (Pv) in two clinical trials. OBJECTIVE Evaluation of safety and efficacy of long-term UV-free blue light treatment at home for mild Pv. METHODS Forty-seven patients with mild Pv were randomized for receiving high-intensity blue light treatment (HI: 453 nm LED, 200 mW/cm(2), n = 24) and low-intensity treatment (LI: 453 nm LED, 100 mW/cm(2), n = 23) of one Pv plaque for 12 weeks. A contralateral control plaque remained untreated. RESULTS Patient compliance and satisfaction were high. The primary endpoint, change from baseline (CfB) of the Local Psoriasis Severity Index, revealed a significant improvement of the target compared to the control plaques (ΔCfB for the HI group: -0.92 ± 1.10, p = 0.0005; for the LI group: -0.74 ± 1.18, p = 0.0064). CONCLUSION UV-free blue light home treatment is safe and improves Pv plaques.
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Affiliation(s)
- Stephanie Pfaff
- Department of Dermatology and Allergology, University Hospital, RWTH Aachen University, Aachen, Germany
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7
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Neonatal blue light phototherapy increases café-au-lait macules in preschool children. Eur J Pediatr 2014; 173:1519-25. [PMID: 24942237 DOI: 10.1007/s00431-014-2349-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 05/24/2014] [Accepted: 05/26/2014] [Indexed: 10/25/2022]
Abstract
UNLABELLED Neonatal blue light phototherapy (NBLP) is an effective treatment for hyperbilirubinaemia. Concerning the influence on melanocytic nevi, conflicting studies have been published. To assess the role of NBLP according to the incidence of melanocytic nevi in preschool children, a cohort of 104 5- to 6-year-old children were included. The case group consisted of 52 NBLP-exposed children, while the control group (n = 52) never had NBLP and was matched regarding age, gender, gestational age and skin phototype. Six dizygotic twins were included with one twin having received NBLP, respectively. The following parameters were recorded: nevi count, presence of freckles, café-au-lait macules, skin phototype and previous history of sun exposure. There was no significant association between nevi count and exposure to NBLP (median nevi count 17.0 compared to 18.5 in controls). No significant difference was also found in the dizygotic twin pairs with a median nevi count of 10.0 (with NBLP) compared to 14.5 (without NBLP). However, a significantly higher prevalence of café-au-lait macules was found in children with NBLP (mean count 0.5) than in children without NBLP (mean count 0.2; p = 0.001). Significant predictors for the number of melanocytic nevi included skin phototype, sun exposure and vacations in the South. CONCLUSION In this study, NBLP had no significant influence on the development of melanocytic nevi, but on café-au-lait macules which was a new finding. Differences with comparable studies regarding age, differentiation between nevi and other pigmented lesions as well as dose and type of NBLP need to be taken into account for further investigations.
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8
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Clarkson DM, Nicol R, Chapman P. Neonatal phototherapy radiometers: Current performance characteristics and future requirements. Med Eng Phys 2014; 36:522-9. [DOI: 10.1016/j.medengphy.2013.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 10/24/2013] [Accepted: 11/03/2013] [Indexed: 11/15/2022]
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9
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Affiliation(s)
- Michael Jeffrey Maisels
- Department of Pediatrics, Oakland University William Beaumont School of Medicine, Beaumont Children's Hospital, Royal Oak, Michigan
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10
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Oláh J, Tóth-Molnár E, Kemény L, Csoma Z. Long-term hazards of neonatal blue-light phototherapy. Br J Dermatol 2013; 169:243-9. [DOI: 10.1111/bjd.12335] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2013] [Indexed: 01/24/2023]
Affiliation(s)
- J. Oláh
- Department of Dermatology and Allergology; University of Szeged; Szeged Hungary
| | - E. Tóth-Molnár
- Department of Ophthalmology; University of Szeged; Szeged Hungary
| | - L. Kemény
- Department of Dermatology and Allergology; University of Szeged; Szeged Hungary
- Dermatological Research Group of the Hungarian Academy of Sciences; University of Szeged; Szeged Hungary
| | - Z. Csoma
- Department of Dermatology and Allergology; University of Szeged; Szeged Hungary
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11
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de Maleissye MF, Beauchet A, Saiag P, Corrêa M, Godin-Beeckmann S, Haeffelin M, Mahé E. Sunscreen use and melanocytic nevi in children: a systematic review. Pediatr Dermatol 2013; 30:51-9. [PMID: 22994908 DOI: 10.1111/j.1525-1470.2012.01847.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We conducted a systematic review of the association between melanocytic nevi (MN) in childhood and sunscreen use. A bibliographic search was conducted between November 2008 and January 2009 using the following key words on MEDLINE and EMBASE: child*, in combination with naevi, nevi, naevus, nevus and sunscreen, sun protection. We also used Medical Subject Headings [sunscreening agents], or [radiation protection] with [nevus, pigmented]. A first screening was done on title and abstract reading. Randomized trials and cohort and cross-sectional studies analyzing the relationship between the use of sunscreen and MN in children were selected. Three reviewers abstracted data from each article. The three sets of results were compared for concordance and rereviewed if necessary. Fifteen articles were included (20,743 children). The studies were not consistent in terms of the ages of the children, MN count methods, or sunscreen use assessment. Owing to this heterogeneity, we were unable to pool the studies and conduct a meta-analysis. Twelve studies did not report that the use of sunscreen had a protective effect against MN development. Three studies reported a lower MN count when sunscreen was applied. This systematic review underlines the methodologic differences between studies. Eight of 15 studies reported a positive association between sunscreen application and MN count. Differences in MN counts, overexposure to sun, and inadequate sunscreen application on fair-skinned children could explain the disparity in the results. There is still no evidence of a protective effect of sunscreen against MN development in children.
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Affiliation(s)
- Marie-Florence de Maleissye
- Research Unit EA 4339 Skin, environment, and cancer, Ambroise Paré University Hospital, University of Versailles-Saint Quentin en Yvelines, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, Paris, France
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12
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13
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Tella E, Beauchet A, Vouldoukis I, Séi JF, Beaulieu P, Sigal ML, Mahé E. French teenagers and artificial tanning. J Eur Acad Dermatol Venereol 2012; 27:e428-32. [PMID: 23078037 DOI: 10.1111/jdv.12015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Exposure to solar and artificial ultraviolet (UV) radiations is a major risk factor for skin cancers. France has enacted one of the strictest laws that, notably, restrict tanning-bed access to adults ≥18 years old. OBJECTIVE We evaluated artificial tanning behaviours of French teenagers (11-17 years old): sunless-tanning products, sunlamps and artificial tanning beds. METHODS An anonymous questionnaire evaluating sunburn history, skin phototype, behaviours with sunless-tanning products and indoor tanning, and parents' behaviours was distributed to students enrolled in two middle and high schools in Antony, a typical city of the middle class French population, located in the Paris suburbs. RESULTS Among 713 teenagers (mean age: 13.5 years: male/female: 1.1) responding, more than half declared that it was important to be tanned during the summer, 1% reported having already used tanning pills, 9.9% tanning creams and 1.4% indoor tanning. Female teenagers significantly more frequently resorted to indoor tanning (P = 0.02), cited the importance of being tanned all year long (P < 0.0001), used tanning pills (P < 0.0001) or tanning creams (P < 0.006), and their parents relied on indoor tanning (P < 0.0001). Profiles of tanning-pill and -cream users were similar. Mean ages for the two groups were comparable. CONCLUSION French regulations for indoor tanning seem quite effective. Our analyses revealed a typical teenager profile with sun-exposure risk behaviours, for example, indoor tanning, and use of tanning pills or creams. They could be a selective target for sun-protection information campaigns.
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Affiliation(s)
- E Tella
- Department of Dermatology, Victor-Dupouy Hospital, Argenteuil, France Public Health Department, Ambroise-Paré University Hospital, University of Versailles-Saint-Quentin-en-Yvelines, Boulogne- Billancourt Cedex, France INSERM/UPMC-UMRS 945, Pitié-Salpêtrière University Hospital, Paris, France Department of Dermatology, Saint-Germain-en-Laye, France Department of Dermatology, Pontoise, France
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14
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Mahé E, Beauchet A, de Paula Corrêa M, Godin-Beekmann S, Haeffelin M, Bruant S, Fay-Chatelard F, Jégou F, Saiag P, Aegerter P. Outdoor sports and risk of ultraviolet radiation-related skin lesions in children: evaluation of risks and prevention. Br J Dermatol 2011; 165:360-7. [PMID: 21574980 DOI: 10.1111/j.1365-2133.2011.10415.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Excessive ultraviolet (UV) radiation exposure can cause skin cancers, skin photoageing and cataracts. Children are targeted by sun-protection campaigns because high sun exposure and sunburn in childhood increase the risk of melanoma in adulthood. Little information is available about UV radiation risk and exposure in children who take part in outdoor sports. OBJECTIVE To evaluate the risk of developing UV radiation-induced skin lesions run by children who practise outdoor sports, and UV radiation exposure and sun-protection measures during a soccer tournament. METHODS Firstly, we evaluated the relationship between melanocytic naevus - a skin lesion linked with exposure to UV radiation - and outdoor sports in 660 11-year-old children. Secondly, we used the occasion of a 1-day soccer tournament held in the spring to evaluate UV radiation-protective measures used by soccer players and the public. We also evaluated the UV radiation index and cloud cover during the tournament, and calculated the UV radiation dose and minimal erythema dose depending on skin phototype. RESULTS The naevus count and acquired naevus count measured over the 2 years of the study were higher in the 344 children who practised outdoor sports. Sun-protective measures were insufficient for soccer players and the public. CONCLUSIONS This study shows that outdoor sports increase the risk of developing UV radiation-induced skin lesions in childhood. During a 1-day soccer tournament held in the spring, children and their parents were inadequately protected against the sun. These results suggest that sun-protection campaigns should be aimed at children who practise popular outdoor sports.
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Affiliation(s)
- E Mahé
- Department of Dermatology, Ambroise Paré University Hospital, University of Versailles-Saint Quentin en Yvelines, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, France.
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15
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Csoma Z, Tóth-Molnár E, Balogh K, Polyánka H, Orvos H, Ocsai H, Kemény L, Széll M, Oláh J. Neonatal blue light phototherapy and melanocytic nevi: a twin study. Pediatrics 2011; 128:e856-64. [PMID: 21930537 DOI: 10.1542/peds.2011-0292] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Neonatal blue light phototherapy (NBLP) has been widely and successfully used for the treatment of neonatal jaundice to reduce the plasma concentration of bilirubin and, hence, to prevent kernicterus. Only a few and controversial data are available in the literature as to how NBLP influences melanocytic nevus development. OBJECTIVE Our goal was to conduct a twin study with the aim of better understanding the role of NBLP in melanocytic nevus development. We also investigated the roles of other environmental and constitutional factors in nevus formation. METHODS Fifty-nine monozygotic and dizygotic twins were included in this cross-sectional study. One of the twin members received NBLP, and the other did not. A whole-body skin examination was performed to determine the density of melanocytic skin lesions. The prevalence of benign pigmented uveal lesions was evaluated during a detailed ophthalmologic examination. A standardized questionnaire was used to assess data relating to constitutional, sun-exposure, and other variables. To search for possible gene-environmental interactions involved in the appearance of pigmented lesions, the melanocortin 1 receptor variants and the I439V polymorphism of histidine ammonia-lyase genes were also determined in the enrolled twins. RESULTS NBLP was associated with a significantly higher prevalence of both cutaneous and uveal melanocytic lesions. No association was found between the examined gene polymorphisms and the number of pigmented alterations in the examined study group. CONCLUSIONS Our data suggest that NBLP could well be a risk factor for melanocytic nevus development. Phototherapy with blue-light lamps is a standard and essential therapeutic modality in neonatal care; therefore, additional in vivo and in vitro studies are necessary to establish its potential long-term adverse effects.
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Affiliation(s)
- Zsanett Csoma
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary.
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16
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Echographic measurement of skin thickness in sites suitable for intradermal vaccine injection in infants and children. Vaccine 2011; 29:8438-42. [PMID: 21821081 DOI: 10.1016/j.vaccine.2011.07.111] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Revised: 07/20/2011] [Accepted: 07/25/2011] [Indexed: 12/26/2022]
Abstract
Whereas the knowledge of skin thickness is essential to determine microneedle length and ensure proper administration of and better responses to intradermal vaccines, very few figures are available, especially in infants and children. Using ultrasound echography, we investigated skin thickness in 384 children aged 4-7, 12-18, and 54-66 months at potential body sites for intradermal vaccine delivery: deltoid, suprascapular, upper back, and lumbar area. The mean epidermis plus dermis thickness was significantly higher at the suprascapular than at the deltoid site (1.29mm vs. 1.22mm) and remained relatively unchanged whatever the BMI, age, sex, and skin phototype. In the 43 children aged 54-66 months, the mean skin thickness was significantly higher in the upper than in the lumbar area (1.39mm vs. 1.31mm). In this study setting, the heterogeneity in skin thickness cannot be considered sufficient to indicate various microneedle lengths for various ages or injection sites.
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17
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Abstract
Sun exposure, fair phototype, and a high common melanocytic nevus (MN) count have been identified as the most important risk factors for melanoma. MN are mainly acquired during childhood, and their relationship to sun exposure, sunburn, and light skin complexion is well documented. The purpose of this study was to investigate how the sun protection attitudes of parents and their offspring affect MN development in children. We designed a cross-sectional study in 828 9-year-old school children. Trained nurses counted the MN on each child's back and arms, depending on their size. Questionnaires filled by children and parents provided information about sun exposure, attitude towards the sun, and sun-protection behaviors. Multivariate analysis showed that the childhood MN count was linked to fair phenotype--fair skin: rate ratio (RR)=3.80, 95% confidence interval (CI)=2.25-6.41; blue/green eyes: RR=1.2, 95% CI=1.11-1.34; blond hair: RR=1.25, 95% CI=1.10-1.41; history of sunburn: RR=1.13, 95% CI=1.03-1.23, seaside sun exposure--RR=1.14, 95% CI=1.01-1.28, and to their parents' behaviors during exposure to the sun--increase in the number of MN when parents used sunscreen: RR=1.23, 95% CI=1.08-1.40; decrease in MN count when parents wore a tee-shirt: RR=0.86, 95% CI=0.79-0.93. In conclusion, fair phenotype and sun exposure are known major risk factors for MN. Parents' behaviors influence their children and appeared in our analysis as another determinant predictor of MN count, being protective against (wearing a tee-shirt when exposed to sun) or increasing the risk (sunscreen use, reflecting higher sun exposure) for childhood MN development.
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Mahé E, de Maleyssie MF, Fay-Chatelard F, Beauchet A. Nævus de l’enfant : marqueur d’exposition solaire et outil de mesure des campagnes de prévention solaire. Arch Pediatr 2010; 17:912-3. [DOI: 10.1016/s0929-693x(10)70175-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Mazereeuw-Hautier J. Quoi de neuf en dermatologie pédiatrique ? Ann Dermatol Venereol 2009; 136 Suppl 7:S426-35. [DOI: 10.1016/s0151-9638(09)73384-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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