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J P Cesarini

Publications and source records attributed to J P Cesarini.

At least 19 recordsLinked to original sources
PubMed1998

Randomised trial of interferon alpha-2a as adjuvant therapy in resected primary melanoma thicker than 1.5 mm without clinically detectable node metastases. French Cooperative Group on Melanoma.

BACKGROUND: Owing to the limited efficacy of therapy on melanoma at the stage of distant metastases, a well-tolerated adjuvant therapy is needed for patients with high-risk primary melanoma. Our hypothesis was that an adjuvant treatment with low doses of interferon alpha could be effective in patients with localised melanoma. METHODS: After resection of a primary cutaneous melanoma thicker than 1.5 mm, patients without clinically detectable node metastases were randomly assigned to receive either 3x10(6) IU interferon alpha-2a, three-times weekly for 18 months, or no treatment. The primary endpoint was the relapse-free interval. FINDINGS: 499 patients were enrolled, of whom 489 were eligible. When used as part of a sequential procedure, interferon alpha-2a was of significant benefit for relapse-free interval (p=0.038). A long-term analysis, after a median follow-up of 5 years, showed a significant extension of relapse-free interval (p=0.035) and a clear trend towards an increase in overall survival (p=0.059) in interferon alpha-2a-treated patients compared with controls. There were 100 relapses and 59 deaths among the 244 interferon alpha-2a-treated patients compared with 119 relapses and 76 deaths among the 245 controls. The estimated 3-year-relapse rates were 32% in the interferon alpha-2a group and 44% in controls; the 3-year death rates were 15% and 21%, respectively. Only 10% of patients experienced WHO grade 3 or 4 adverse events. Treatment was compatible with normal daily life. INTERPRETATION: Adjuvant therapy of high-risk melanoma with low doses of interferon alpha-2a for 18 months is safe and is beneficial when started before clinically detectable node metastases develop.

Antineoplastic Agents↗
PubMed1997

Melanoma risk and residence in sunny areas. EORTC Melanoma Co-operative Group. European Organization for Research and Treatment of Cancer.

Melanoma risk among subjects from Germany, France and Belgium who had lived for 1 year or more in sunny climates was examined in a one-to-one unmatched case-control study conducted among white subjects 20 years old or more. A total of 412 consecutive patients with melanoma diagnosed from 1 January 1991 onwards, were derived from hospital registers; 445 controls were randomly chosen in the same municipality as the cases. After adjustment for host characteristics, melanoma risk associated with residence in a sunny area was 2.7 (95% CI: 1.4-5.2), increasing to 4.7 (95% CI: 1.4-13.5) if subjects sought a suntan when residing in sunny climates, and to 4.3 (95% CI: 1.7-11.1) if subjects arrived before the age of 10 years in the sunny area. Residence in sunny areas and recreational sun exposure seemed to combine their effects on melanoma risk. Increase in melanoma risk conveyed by deliberate sun exposure during adulthood was highest among subjects who had lived in sunny areas as a child or adolescent and lowest among subjects who had never resided in sunny areas. Our results support conclusions from migrant studies that indicated that childhood is a critical period of either vulnerability to solar radiation or more frequent exposures to melanoma risk factors. They also suggest that moderate sun exposure of an adult who was heavily sun exposed in childhood is associated with a higher melanoma risk than that of high sun exposure of an adult who was sun protected in childhood.

Adult↗
PubMed1995

Melanoma and use of sunscreens: an Eortc case-control study in Germany, Belgium and France. The EORTC Melanoma Cooperative Group.

Use of sunscreens is widely advocated as a preventive measure against sun-induced skin cancers. However, to date, no epidemiologic study has reported a decreased melanoma risk associated with sunscreen use. We have conducted a case-control study aimed at evaluating the influence of sunscreen use on the occurrence of cutaneous malignant melanoma. In 1991 and 1992, 418 melanoma cases and 438 healthy controls were interviewed in Germany, France and Belgium. The questionnaire used differentiated between regular sunscreens, psoralen sunscreen (prepared with 5-methoxypsoralen, a tanning activator and photocarcinogen), and self-tanning cosmetics (which produce a tan without ultraviolet radiation). After adjusting for age, sex, hair colour and holiday weeks spent each year in sunny resorts, the melanoma risk was of 1.50 (95% Cl:1.09-2.06) for regular sunscreens, and of 2.28 (95% Cl: 1.28-4.04) for psoralen sunscreens. No melanoma risk was associated with use of self-tanning cosmetics. Among subjects with a poor ability to tan, psoralen sunscreen users displayed a melanoma risk of 4.45 (95% Cl: 1.25-15.8) when compared with regular sunscreen users. There was a significant negative interaction between regular sunscreen use and sunburns experienced in adulthood. Use of sunscreens, especially psoralen sunscreen, was associated with higher density of pigmented lesions of the skin. Although we cannot exclude the presence of an unknown confounding factor, our results support the hypothesis that sunscreens do not protect against melanoma, probably because of their ability to delay or avoid sunburn episodes, which may allow prolonged exposure to unfiltered ultraviolet radiation. Serious doubts are raised regarding the safety of sunscreens containing psoralens.

Adult↗
PubMed1994

Cutaneous malignant melanoma and exposure to sunlamps or sunbeds: an EORTC multicenter case-control study in Belgium, France and Germany. EORTC Melanoma Cooperative Group.

The study objective was to assess whether exposure to sunlamps and sunbeds represents a risk factor for cutaneous malignant melanoma (CMM). A 1-to-1 unmatched case-control study was conducted among subjects 20 years old or more with naturally non-pigmented skin in Germany, France and Belgium. A total of 420 consecutive patients with CMM diagnosed from 1 January 1991 onward were derived from hospital registers; 447 controls with no history of skin cancer were chosen at random in the same municipality as the cases. Exposure to sunlamps or sunbeds starting before 1980 is associated with a crude estimated risk of CMM of 2.71 (95% CI: 1.06-7.78) for at least 10 hr of accumulated exposure. This risk is of 2.12 (95% CI: 0.84-5.37) after adjustment for age, sex, hair colour and average number of holiday weeks each year in sunny resorts. Subjects who experienced skin-burn due to sunlamps or sunbeds, and who had accumulated at least 10 hr of exposure, displayed a crude estimated CMM risk of 4.47 (95% CI: 1.45-13.7), which rose to 8.97 (95% CI: 2.10-38.6) for those who exposed their skin for tanning purposes. The risk associated with skin-burn is only marginally modified after multiple adjustments for host characteristics and recreational exposure to sunlight. Apparently, sunlamps and sunbeds share the increased risk of CMM, which seems to concentrate in subjects exhibiting hazardous behaviour towards ultraviolet radiation sources. However, although it is reasonable to believe that high doses of pure ultraviolet A radiation can be dangerous, this is not firmly established by this study. Most exposures to ultraviolet A tanning devices began after 1980; therefore, epidemiologic studies have difficulty in revealing any increase in risk of CMM starting after 1980 because of the latent period between exposure and occurrence of melanoma. Public health authorities should have a cautious approach towards the rapidly developing fashion of tanning under sunlamps or sunbeds.

Adult↗
PubMed1994

Recreational exposure to sunlight and lack of information as risk factors for cutaneous malignant melanoma. Results of an European Organization for Research and Treatment of Cancer (EORTC) case-control study in Belgium, France and Germany. The EORTC Malignant Melanoma Cooperative Group.

This study addressed the impact of exposure to ultraviolet radiation on the risk of cutaneous malignant melanoma (CMM), as well as the behavioral components at stake in its occurrence. We performed a one-to-one unmatched case-control study among subjects aged 20 years or more with naturally non-pigmented skin in Germany, France and Belgium. Four-hundred and twenty consecutive patients with CMM diagnosed from 1 January 1991 on were derived from hospital registries; 447 controls were chosen randomly in the same municipality as cases. Subjects unaware of the dangers of exaggerated exposure to sunlight display an estimated CMM risk of 3.72% (95% confidence interval 2.63-5.26). The number of holiday weeks spent annually in sunny resorts and sunbathing during the hot hours of the day are strong risk factors in the three countries, but not the number of years spent outdoors, as farmers or building workers. Multiple logistic adjustments on the host characteristics increases the CMM risk associated with recreational exposure to sunlight, as well as the adjustment on the unawareness of the dangers of exaggerated exposure to sunlight. Recreational exposure to sunlight and sunburn early in life seem capable of fostering the proliferation of pigmented lesions of the skin. Our data support the hypothesis that most CMM develop from pigmented lesions of the skin containing initiated melanocytes, and that the cell proliferation due to brutal, intermittent exposures to solar radiation amplifies the likelihood of a melanocyte entering into a malignant process.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Validity of the histopathological criteria used for diagnosing dysplastic naevi. An interobserver study by the pathology subgroup of the EORTC Malignant Melanoma Cooperative Group.

Ten (dermato)pathologists studied 50 cutaneous melanocytic lesions including common naevocellular naevi, dysplastic naevi (DN), melanomas in situ and invasive primary melanomas, with emphasis on the histological criteria of DN. Using a standardised form, 20 defined histopathological features were scored (semi)quantitatively. Concordance of diagnosis, efficacy and reproducibility of features were investigated. DN were distinguished well from the other entities (mean Po 0.87). Agreement on the degree of atypia of DN was low. The reproducibility of the scoring was best for the following features: irregular nests, lymphohistiocytic infiltrate, marked junctional proliferation and large nuclei. The overall values of these features to discriminate between DN and non-DN were better than for the other features studied. Using the presence of at least three of the four features as a condition for the diagnosis of DN, values for sensitivity, specificity and positive and negative predictive values were 0.86, 0.91, 0.96 and 0.73, respectively. On the basis of the results these features seem best suited as histological criteria for the diagnosis of DN.

Diagnosis, Differential↗
PubMed1992

[Biological effects of solar radiations].

Main biological effects of ultra-violet radiations are discussed. At a dermatological point of view, most of these effects are harmful: actinic erythema, cutaneous cancerogenesis (basal and spinous cell carcinomas, malignant cutaneous melanomas). Photo-immunosuppression and photoaging of the skin are discussed. Two benefic actions of sunlight are reviewed: synthesis of vitamin D3 and positive action of visible radiations on human psychism.

Cholecalciferol↗
PubMed1992

[Histology and physiology of black skin].

The aim of this article is to review the experimental knowledge concerning black skin. We point out its histological and physiological features without discussing here the specific pathology of black patients. Under the microscope skin structure is roughly the same in all races, but morphological differences exist, particularly within the epidermis, with potential practical consequences. In comparison with white skin, the black skin stratum corneum is equal in thickness but more compact: about twenty cell layers are observed in blacks versus sixteen layers in whites. The lipid content of black epidermis is also somewhat higher, and this perhaps explains the greater cellular cohesion, hence the difficulty in stripping off the black horny layer. These findings could also explain a slightly inferior permeability of black skin to certain chemicals. The hair of blacks in naturally more brittle and more susceptible to breakage and spontaneous knotting than that of whites. The kinky or wooly form of black hair, the weak intercellular cohesion between cortical cells and the specific hair grooming practices among black people account for these effects. The higher electrical resistance of black skin suggests that the black epidermis would be less hydrated than white epidermis. Anatomically, the amount of sweat glands in black and white skins is identical and varies with climatic changes but not with racial factors. Likewise, sweating is thought to be similar in both races, taking into account the contradictory results from studies, but black subjects withstand humid heat better while whites cope better with dry heat.(ABSTRACT TRUNCATED AT 250 WORDS)

Black People↗
PubMed1992

[Dermatologic risks of quartz-halogen lamps].

Halogene sources are used increasingly in general illumination. Their quartz envelop is technically necessary, but presents the disadvantage of to letting the emitted UVA, UVB and UVC go through. Originally used as in indirect lighting, they have been introduced as desk-top lamps, without filter. We have proceeded to the verification of their output with a spectrophotometer calibrated by actinometry and we have calculated their relative erythemal efficacy according to the Parrish's action spectrum for human erythema. We found that, at 10 cm from the human skin, the irradiance was able to induce a minimal erythema in about 10 minutes on clear back skin. At working distance (50 cm), a barely perceptible erythema could be observed on the back of the hands after 8 consecutive hours working. We also found that sunburn cells were present in the skin sensitized with a potent phototoxic agent (8-methoxypsoralen) applied 15 minutes before a 4-6 minutes irradiation with the halogen source (at 20 cm), thus, indicating a potential risk for local phototoxicity and photoallergy. The cumulative doses per year, for 4 hours exposure per day, five days a week, reaches 125 minimal erythemal doses, equivalent to the average yearly exposure of individuals for work and leisure. If one assumes that this regimen is maintained for 30 years, the risk for induction of skin cancers on the dorsal aspect of the hands and the forearms, may be increased by a 3.4 factor, according to the widely accepted previsional models.(ABSTRACT TRUNCATED AT 250 WORDS)

Erythema↗
PubMed1989

Erythema induced by quartz-halogen sources.

The erythemal effect of 100-W quartz-halogen sources, previously predicted from radiation measurements, was directly measured on humans at a distance of 10 cm. Minimal erythema was produced in 15 min for skin type I. These data show that normal use of a desktop lamp should not usually lead to erythema in one day, but that long-term effects cannot be ignored, because for lifetime use at work, the relative risk for squamous cell carcinoma on the back of the hands is 3.4.

Carcinoma, Squamous Cell↗
PubMed1989

[Solaria].

Explore the source record for details and available documents.

Adolescent↗
PubMed1988

Photo-induced events in the human melanocytic system: photoaggression and photoprotection.

The human skin is submitted to solar, essentially ultraviolet radiation (UVR), aggressions, and develops, for sufficient doses, erythema and pigmentation. The individual sun-sensitivity depends on the nature and the quantity of melanins present in the epidermis. These parameters are inherited as genetic traits which account for the large variations of the constitutive and adaptive pigmentation encountered in the caucasian populations. From red-haired skin-sensitive individuals, to dark-haired sun-resistant individuals, phaeomelanins (red) and eumelanins (black) are mixed in variable proportions. Pure melanins extracted from red hairs and black hairs behave differently when submitted to ultraviolet radiations: phaeomelanins develop aggressive species of molecules responsible for DNA damages, mutations, and cell death. On the contrary, eumelanins are less toxic for the major cellular metabolisms. The sun-sensitive populations suffer from more skin cancer of all types than the dark ones. In particular, they are exposed significantly to higher risk of melanoma and to the risk of bearing more nevi following large solar exposures early in the life.

Humans↗
PubMed1987

[Clinical and mycological study of 11 cases of genitopubic trichosporosis nodosa (white piedra)].

Piedra (stone in Spanish) is the name given to a trichomycosis characterized by the formation of nodules resembling small stones. There are two varieties of the disease, depending on the colour of the nodules: white piedra and black piedra. Black piedra sharply differs from white piedra on three main scores: a) the causative agent is a black filamentous and sexed dematicious fungus, Piedraia hortai; b) the disease exclusively affects the scalp, and c) the geographical distribution of human black piedra is limited to tropical and subtropical areas (South America, South-East Asia). White piedra has a different aetiology, being caused by an asexual fungus, Trichosporon beigeli. The genus Trichosporon (Behrend, 1890) and the species T. beigeli (Vuillemin, 1902) were created from a case of piedra of the moustache. White piedra may involve hairy regions other than the scalp, such as the beard and moustache, less frequently the armpits, eyebrows, eyelashes and pubic hair. The disease has been observed in all continents, except Africa, and under all climates, although it is exceptionally found in cold areas (two indigenous cases in Finland). The observatio princeps of white piedra (on a false chignon) was published in 1865 by Beigel, in London. In France, only three cases, all concerning the moustache, were reported at the very beginning of this century No other case has been published in that country in the east 80 years. T. beigeli is a common saprophyte in nature. It has been found in soil, water, fruit, rotten vegetables, sawdust, as well as in man (skin, skin appendages, mucosae) and in animals (mammals, insects, mussels).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

[Haber's syndrome. First French family (2 cases)].

Haber's syndrome is a genodermatosis first described by Sanderson and Wilson (17) in 1965. Pursuing Dr. Haber's work, these authors reported three cases from one single family presenting with the dermatosis. A second family was reported by Seiji and Otaki (17) in 1971; Izaka described two cases (pedigree unknown, 13) and two more by Kikuchi (10, 13) in 1981 and 1983. We report here two new cases (brother and sister) discovered in 1984 (7) and representing the first French family. The dermatosis is characterized by clinical, genetic and histological criteria. It is transmitted as an autosomal dominant trait (fig. 1 and 2). Clinically, the face is affected by a rosacea-like dermatitis beginning in childhood and proceeding with pustular flare-ups. The facial lesions are frequently aggravated by exposure to the sun. The patients have pigmented keratotic lesions of the trunk resembling seborrhoeic warts. These lesions are very numerous and begin, on average, during the second decade of life. Some patients present with lesions that are diagnosed as Bowen's disease at histological examination (7, 17). Xerosis cutis is also present. Microscopically, the facial lesions consist of a necklace of basaloid cells around the hair and sebaceous follicles. The keratotic lesions have been reported as either intra-epidermal epitheliomas (17), or seborrheic warts without signs of malignancy (7, 10, 13), or equivalents of the facial lesions (19).

Adult↗
PubMed1986

[Intraepidermal melanocytic proliferation. A practical guide to the classification of ambiguous melanotic skin lesions and of possible precursors of malignant melanomas].

A group of senior Pathologists engaged in review work on international randomized trials for the W.H.O and/or the E.O.R.T.C., propose a new simplified classification of melanocytic lesions with an intra-epidermal component, applicable in routine. This classification attempts to introduce standards to permit morphological identification of a large group of intra-epidermal melanocytic proliferations with three classes of atypia (slight, mild, severe) and group of malignant melanomas especially those without dermal invasion. The new definitions and objective criteria (at cytological and architectural level) of diagnosis are given with examples of equivalence between some established entities and this new universal terminology.

Cell Transformation, Neoplastic↗