Neonatal Blue Light Phototherapy Research Articles

Gyermekbőrgyógyászati kutatások a szegedi Bőrgyógyászati és Allergológiai Klinikán 2004-2023 között

The authors present their most relevant clinical investigations in the field of paediatric dermatology, performed in the Department of Dermatology and Allergology, University of Szeged, between 2004-2023. In their epidemiological surveys, wide spectrum of dermatological manifestations and disorders were consecutively recorded both in healthy, mature newborn infants and in premature infants referred to the Neonatal Intensive Care Unit. Different neonatal, maternal, diagnostic and other factors behind the skin symptoms were also investigated in detail. In their twin-studies, the authors investigated the effect of neonatal blue-light phototherapy on cutaneous and uveal naevus development, and the roles of different environmental and constitutional factors on naevus formation were also analysed in identical and non-identical twin pairs. The success of the treatment of chronic dermatological diseases considerably depends on the patient’s compliance. The main objectives of their study were to investigate the therapeutic compliance of patients diagnosed with acne vulgaris, in order to explore factors behind low compliance.

Neonatal Blue Light Phototherapy and Melanocytic Nevus Count in Children: A Systematic Review and Meta-Analysis of Observational Studies.

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. 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. 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. 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. 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.

Neonatal blue light phototherapy increases café-au-lait macules in preschool children.

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. 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.

Long-term hazards of neonatal blue-light phototherapy

Blue-light phototherapy has been an essential therapeutic tool in the management of neonatal jaundice for decades. Rarely, it is accompanied by acute dermatological and systemic side-effects, but fortunately these are reversible and can be adequately and promptly treated in routine neonatal practice. In contrast, much less is known about the potential long-term side-effects of neonatal blue-light phototherapy (NBLP). Many of the data that are currently available on how NBLP influences melanocytic naevus (MN) development are controversial. The results of recent well-designed epidemiological surveys suggest that NBLP could well be a risk factor for MN formation, and highlight the need for additional in vivo and in vitro studies. NBLP is at present the mainstay of treatment for neonatal jaundice, but in the future greater consideration should be given to its long-term side-effects when phototherapy is indicated. It is relevant to emphasize the importance of appropriately restricted and adequate clinical guidelines, and strict monitoring of the management of hyperbilirubinaemia, in order to avoid the unnecessary overtreatment of newborn infants.

Neonatal Blue Light Phototherapy and Melanocytic Nevi: A Twin Study

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. 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. 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. 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. 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.

Neonatal Phototherapy Increases Development of Pigmented Nevi

Neonatal blue light phototherapy (NBLP) is widely used to treat hyperbilirubinemia, effectively preventing kernicterus. Data regarding long-term safety of NBLP are few and conflicting. Investigators in Hungary performed a retrospective, cross-sectional, twin study to study the role of NBLP and other environmental factors in the development of pigmented nevi. The study included 58 pairs of twins …

Neonatal Blue-Light Phototherapy Does Not Increase Nevus Count in 9-Year-Old Children

One of the most important risk factors for melanoma is the number of acquired common and atypical nevi in childhood. The role played by neonatal blue-light phototherapy in the increasing incidence of common and atypical melanocytic nevi in childhood or adolescence has been discussed recently with discordant results. We designed a multicenter study to assess the effects of neonatal blue-light phototherapy on nevus count in a cohort of 9-year-old children. We counted back and arm nevi as a function of size in 828 children included in a French photoprotection educational campaign. History of neonatal phototherapy, phototype, skin, hair and eye color, and sunburn were assessed through questionnaires to which both parents and children responded, and a nevus count was performed by trained nurses blinded to phototherapy history. Mean nevus count was 16.7 per child. Twenty-two percent of the children had received neonatal blue-light phototherapy. Neonatal phototherapy had no effect on the nevus count irrespective of nevi location, nevi size, or phototype of the children. A light phototype, skin, and hair color; blue/green eyes; and history of sunburn were closely correlated with an increase in nevus count. This study found no evidence for a major role of blue-light phototherapy on nevus count in 9-year-old children. It underlines the dominant effect of phototype characteristics and history of sunburn in childhood on the early development of melanocytic nevi.

Neonatal blue-light phototherapy and melanocyte nevus count in children

9068 Background: One of the most important risk factor for melanoma is the number of acquired nevi in childhood. For a few years, the responsibility of neonatal blue-light phototherapy, a very effe...

Neonatal Blue-Light Phototherapy Could Increase the Risk of Dysplastic Nevus Development

To the Editor .— In their letter, Csoma et al1 described the possible concern that blue-light phototherapy would increase nevus development. They screened 747 school-aged children in their teens and reported that 44.6% of these children had received phototherapy. Although there were no differences in the prevalence of melanocytic nevi, the children exposed to blue-light phototherapy had higher numbers of moles and had a significantly higher prevalence of atypical nevi. Because atypical nevi are an important risk factor for the development of malignant melanoma, the authors raised the concern that phototherapy with blue …

Neonatal Blue-Light Phototherapy Could Increase the Risk of Dysplastic Nevus Development

To the Editor .— The number of individuals with large numbers of common and atypical melanocytic nevi has been continuously increasing in several white populations. Subjects with dysplastic nevi are at a substantially increased risk for the development of both uveal and cutaneous malignant melanoma.1,2 Numerous epidemiologic data have demonstrated that sunlight exposure is the major environmental factor involved in the development of melanoma, and it also exerts a considerable influence on the nevus count of an individual.3 Blue-light phototherapy …

Neonatal Blue-Light Phototherapy Could Increase the Risk of Dysplastic Nevus Development: In Reply

Neonatal Blue-Light Phototherapy Could Increase the Risk of Dysplastic Nevus Development: In Reply

Neonatal Blue-Light Phototherapy Could Increase the Risk of Dysplastic Nevus Development

To the Editor .— The number of individuals with large numbers of common and atypical melanocytic nevi has been continuously increasing in several white populations. Subjects with dysplastic nevi are at a substantially increased risk for the development of both uveal and cutaneous malignant melanoma.1,2 Numerous epidemiologic data have demonstrated that sunlight exposure is the major environmental factor involved in the development of melanoma, and it also exerts a considerable influence on the nevus count of an individual.3 Blue-light phototherapy …