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1.
Photochem Photobiol ; 88(4): 1023-6, 2012.
Article in English | MEDLINE | ID: mdl-22332671

ABSTRACT

Many studies have been conducted showing that aminolevulinic acid (ALA)-photodynamic therapy (PDT) can be an alternative treatment for recalcitrant warts. Recently, we performed a study evaluating methyl-aminolevulinic acid (MAL)-PDT for the treatment of hand warts in a population of renal transplant patients. Two symmetrical targets were selected on each hand and randomly assigned to chemical keratolytic treatment followed by three cycles of ALA-PDT (75 J cm(-2) red light). Patients were evaluated after 3 months and a second run of PDT was performed if the total area and number of warts decreased less than 50%, with evaluation every 3 months for 1 year. Twenty patients were included and 16 were evaluable (9 M, 7 F). After 6 months the reduction of warts' area was 48.4% on the treated side versus 18.4% in the control area (P = 0.021). The decrease in the total number of warts was 41%versus 19.4% (P = NS). The global tolerance of the treatment was good with acceptable pain during irradiation. These results suggest that ALA-PDT is a safe and efficient treatment for transplanted patient warts. The improvement between treated and control zone is 20% due to the decrease in untreated warts' area and number.


Subject(s)
Aminolevulinic Acid/analogs & derivatives , Kidney Transplantation/immunology , Photochemotherapy , Photosensitizing Agents/administration & dosage , Warts/drug therapy , Adult , Aminolevulinic Acid/administration & dosage , Female , Hand/virology , Humans , Immunocompromised Host , Light , Male , Middle Aged , Prospective Studies , Treatment Outcome , Warts/immunology , Warts/virology
2.
Eur J Dermatol ; 20(4): 461-4, 2010.
Article in English | MEDLINE | ID: mdl-20507840

ABSTRACT

Fixed drug eruption (FDE) is one of the most typical cutaneous drug adverse reactions. This localized drug-induced reaction is characterized by its relapse at the same sites. Few large series of FDE are reported. The aim of this study was to retrospectively collect and analyse well informed cases observed in a hospital setting. This study involved 17 academic clinical centers. A French nation-wide retrospective multicentric study was carried out on a 3-year-period from 2005 to 2007 by collecting data in seventeen departments of dermatology in France. Diagnosis of FDE was based essentially on clinical findings, at times confirmed by pathological data and patch-testing. Records were reviewed for demographics, causative drugs, localization, severity, and patch-tests, when available. Fifty nine cases were analysed. Patients were 59-years-old on average, with a female predilection. The most common drug was paracetamol, followed by the non-steroidal anti inflammatory drugs. The time between drug intake and skin symptoms was, on average, two days. Beside these classical characteristics, some original findings were found including, a frequent non pigmentation course and a sex-dependent pattern of distribution. Women often had lesions on the hands and feet, and men on the genitalia. Given the fact that skin pigmentation is an inconstant feature of FDE, its French name (erythème pigmenté fixe) should be reconsidered. The sex-dependent distribution could help our understanding of the pathophysiology of fixed drug eruption.


Subject(s)
Adverse Drug Reaction Reporting Systems , Drug Eruptions/epidemiology , Acetaminophen/adverse effects , Adolescent , Adult , Aged , Aged, 80 and over , Analgesics/adverse effects , Analysis of Variance , Anti-Bacterial Agents/adverse effects , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Child , Drug Eruptions/diagnosis , Drug Eruptions/etiology , Female , France/epidemiology , Humans , Male , Middle Aged , Patch Tests , Retrospective Studies
3.
J Am Acad Dermatol ; 58(2): 217-23, 2008 Feb.
Article in English | MEDLINE | ID: mdl-18083273

ABSTRACT

OBJECTIVE: We sought to identify criteria able to distinguish between Jessner's lymphocytic infiltration of the skin (JLIS) and lupus erythematosus tumidus (LET). METHODS: The following characteristics were recorded in a retrospective, multicenter analysis of patients with JLIS and LET: clinical features (number, size, type, and localization of lesions; photosensitivity; extracutaneous signs), histologic findings, phototesting, lupus serology, treatment, and outcome. Available histologic slides were reviewed blinded to the initial diagnosis using a pre-established grid. RESULTS: Univariate analysis of data from patients with JLIS (15 women, 17 men; mean age: 35 years) and LET (13 women, one man; mean age: 31 years) showed the following significant (P < .05) differences: more frequent back involvement and annular lesions in JLIS, as opposed to female predominance, more frequent face involvement, and plaques in LET. Phototesting, especially ultraviolet B, induced lesions in 18 of 26 patients with JLIS and all 4 with LET. The blinded histologic review (33 samples) only found slight epidermal atrophy and focal thickened dermoepidermal junction more frequent and perivascular lymphocyte infiltrations less dense in LET. The two groups of patients reclassified according histopathologic features (18 LET and 11 JLIS) showed only slight clinical differences (more frequent nasal bridge lesions in LET and annular lesions in JLIS). LIMITATION: The retrospective nature of the study is a limitation. CONCLUSION: JLIS and LET in this population showed more similarities than differences, supporting a continuous spectrum covering these two entities.


Subject(s)
Lupus Erythematosus, Discoid/pathology , Lymphocytes/pathology , Photosensitivity Disorders/pathology , Skin Diseases/pathology , Adult , Antimalarials/therapeutic use , Female , Humans , Lupus Erythematosus, Discoid/drug therapy , Male , Photosensitivity Disorders/drug therapy , Retrospective Studies , Skin/pathology , Skin Diseases/drug therapy , Ultraviolet Rays/adverse effects
4.
J Plast Reconstr Aesthet Surg ; 60(10): 1097-102, 2007.
Article in English | MEDLINE | ID: mdl-17825775

ABSTRACT

Haemangiomas are common benign vascular tumours but extensive ones are rare. Such large haemangiomas require treatment but important sequelae persist even after complete regression. We report the case of a young girl who presented with cosmetically disturbing sequelae after complete regression of a large haemangioma of the face. She referred to our multidisciplinary team to improve her facial appearance.


Subject(s)
Facial Neoplasms/surgery , Hemangioma/surgery , Plastic Surgery Procedures/methods , Skin Neoplasms/surgery , Adolescent , Facial Neoplasms/pathology , Female , Hemangioma/pathology , Humans , Laser Therapy , Lip/surgery , Lipectomy/methods , Magnetic Resonance Imaging , Skin Neoplasms/pathology
6.
Eur J Dermatol ; 13(2): 161-5, 2003.
Article in English | MEDLINE | ID: mdl-12695132

ABSTRACT

CD4+ CD56+ hematologic neoplasms were recently individualized. We report three cases of CD4+ CD56+ malignancies with cutaneous lesions in three cases and also bone marrow involvement in two cases. Two patients relapsed 2 and 3 months after polychemotherapy. Two patients died within 3-10 months. A constant immunophenotype was observed with the co-expression of CD4 and CD56, the absence of B and T-cell markers. The salient fact of this report is the presence of T-cell clonal rearrangement. The clinical and pathological features closely resemble the specific cutaneous manifestations in acute leukemia with monocytic differentiation, especially the granulocytic sarcoma. Because of the positivity of the CD56, natural killer cell proliferations were discussed. Since 1994, 50 cases of CD4+, CD56+ cutaneous neoplasms have been reported with specific clinical, cytologic and immunohistochemical features. The diagnosis is more difficult when the cutaneous location is exclusive; on the contrary, the cytological features of the blood and medullar cells with cytoplasmic vacuoles and pseudopodia are characteristic of this hematologic neoplasm. The presence of CD123 antigen in most of the cases is an argument for a plasmacytoid dendritic cell proliferation and it is also a good marker for primary cutaneous lesions.


Subject(s)
CD4-Positive T-Lymphocytes/immunology , CD56 Antigen/immunology , Hematologic Neoplasms/immunology , Hematologic Neoplasms/pathology , Skin Neoplasms/immunology , Skin Neoplasms/pathology , Aged , Aged, 80 and over , Diagnosis, Differential , Female , Hematologic Neoplasms/diagnosis , Hematologic Neoplasms/therapy , Humans , Interleukin-3 Receptor alpha Subunit , Male , Middle Aged , Receptors, Interleukin-3/immunology , Skin Neoplasms/diagnosis , Skin Neoplasms/therapy
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