Sensitive skin can be small fibre neuropathy: results from a case-control quantitative sensory testing study.

BACKGROUND: Sensitive skin syndrome (SSS) is defined as the occurrence of unpleasant sensations (itch, pain, burning, prickling) in response to stimuli that should not normally cause such sensations. Previous studies show that SSS could be a small fibre neuropathy, but quantitative sensory testing (QST) is lacking. OBJECTIVES: Using QST, to determine the presence or absence of tactile sensitivity disorder, mainly heat pain threshold (HPT), in patients with SSS. METHODS: This monocentric case-control study included 21 patients with SSS and 21 controls. The patients underwent QST. Neuropathic pain was assessed by two questionnaires: the Douleur Neuropathique 4 (DN4) and the Neuropathic Pain Symptom Inventory (NPSI). RESULTS: Forty-two patients were included in the study. The HPT was significantly lower in the cases (14·5 ± 2·8) than in the controls (17·8 ± 2·5) (P < 0·001). Intermediate pain (HPT 5·0) was also significantly decreased in patients with SSS. The DN4 and NPSI scores were significantly higher in the cases than in the controls. CONCLUSIONS: The decrease in HPT in patients with SSS compared with controls suggests the presence of hyperalgesia, probably due to the damage of C-fibres. These findings, as well as the increased DN4 and NPSI scores, strengthen the neuronal hypothesis of SSS and are new arguments for consideration of SSS as small fibre neuropathy.

Aggregate exposure to common fragrance compounds: Comparison of the contribution of essential oils and cosmetics using probabilistic methods and the example of limonene.

The knowledge of aggregate exposure to different types of products is paramount in the risk assessment. The aim of this study was to compare the relative contribution of essential oils compared to cosmetics on the daily dermal exposure to limonene, an ubiquitous fragrance compound that can be an allergen depending on its degree of oxidation. Aggregate daily exposure to limonene was calculated among a panel of French volunteers using both essential oils and cosmetics, for 4 different specific zones, i.e. face and neck, chest, upper limbs and lower limbs. Calculations were made using a probabilistic Monte Carlo method and sensitivity analysis. The main strength of this work was the inclusion of essential oils in addition to cosmetics in the model. For the first time, the generated data could be used to compare the contribution of these two products in dermal exposure. Essential oils appear to be significant contributors to exposure to limonene particularly for the face. This work is a first step that will permit to determine the exposure to other fragrance compounds with sensitizing potential. These data will be useful for risk managers to consider the inclusion of essential oils in the overall burden of this pathology.

Experience of multidisciplinary assessment of elderly patients with cancer in a French general hospital during 1 year: a new model care study.

OBJECTIVES: Our main aim was to describe and explore a multidisciplinary approach to the management of elderly patients with cancer, who constitute a heterogeneous population. MATERIALS AND METHODS: This descriptive study was performed between October 2009 and September 2010. Patients with cancer ≥ 70 years of age were included. Some underwent a simplified multidimensional geriatric assessment with a Charlson score administered by an oncologist, and the evaluation was submitted to a geriatrician who decided whether or not a complete a comprehensive geriatric assessment (CGA) (n=54) should be done. Another group of patients directly underwent a CGA (n=49), and a few patients included in a specific trial underwent a geriatric assessment (n=8). Each patient was classified as fit, vulnerable, or frail by a multidisciplinary team. RESULTS: 111 patients were included (median age: 81 years [range: 65-96]; 60 males). The most frequent types of cancer were lung (n=29), gastrointestinal (n=20) and head and neck (n=14). Median Charlson score was 2.1 [range: 0-9]. Standard therapy was given to 37/41 (90%) fit, 19/41 (42%) vulnerable, and 6/29 (21%) frail patients. Thirteen frail patients received best supportive care. A social worker was mobilized for 2/41 (5%) fit, 14/41 (34%) vulnerable, and 11/29 (38%) frail patients. CONCLUSIONS: Our study outlines the possibilities of cooperation between geriatricians and oncologists in a general hospital. This collaboration could modify therapeutic schedules especially in frail and vulnerable patients.

[Lymphocyte phenotyping in the cord blood of newborn infants]. / Phénotypage lymphocytaire dans les sangs de cordons de nouveau-nés.

Ontogeny and development of phenotypically defined T-cell subsets in humans, are the source of controversy. Cord blood represents a relevant model for the study of the normal T-cell differentiation pathway. We identified T lymphocytes subsets with monoclonal antibodies (Mab) in human cord blood and adults controls in an indirect immunofluorescence assay and B lymphocytes in a direct immunofluorescence assay. No difference was noted between the two populations with followed Mab: CD3-CD4-CD8-HLA class II-IL2 receptor, with a normal ratio CD4-CD8. The percentage of CD2+ cells was lower in neonatal blood. Double labeling studies characterized a lymphocyte population CD4-CD8 positive. This study revealed absence of immature T cells with CD1 monoclonal antibodies.

[Dysmyelopoiesis and T lymphoma. 2 cases]. / Dysmyélopoïèse et lymphome T. Deux observations.

The role played by T lymphocytes in myelopoiesis has been established in in vitro studies. Dysregulation of the lymphoid system results in quantitative and, more rarely, qualitative abnormalities of myelopoiesis. The authors report the clinical data of two cases of peripheral T cell lymphoma associated with an AREB type of dysmyelopoiesis. The fact that both conditions were diagnosed simultaneously and progressed in parallel is an indirect argument in favour of the regulation of myelopoiesis by the T lymphocytes.

[Detection of intracytoplasmic immunoglobulins by cytofluorography]. / Détection d'immunoglobulines intracytoplasmiques sur cytofluorographe.

In this report the authors describe a method of cell permeabilisation compatible with flow cytometry. To maintain cell integrity, lysolecithin is used. This method is simple, rapid, and reproducible. Control tests demonstrated no non-specific fluorescence due to lysolecithin treatment. This technique was used in several cases of chronic lymphocytic leukemia to detect intracytoplasmic immunoglobulins and monoclonality and in one case of multiple myeloma.