[Anterior lenticonus: diagnostic aid in Alport syndrome]. / Le lenticône antérieur: aide diagnostique au syndrome d'Alport.

Anterior lenticonus is a rare condition in which the lens presents a conical protrusion of its anterior cortex. Sometimes isolated, it may be an ocular manifestation of Alport syndrome, a hereditary nephritis accompanied by deafness and other ocular signs such as flecked retinopathy or posterior polymorphous corneal dystrophy. All these manifestations are a result of a genetic defect in type IV collagen, a major component of basal membranes in the human body. The clinical aspects and therapy of anterior lenticonus and Alport syndrome are described, as well as the exploration that must begin when anterior lenticonus is discovered. This exploration is essential so that this diagnosis can be made as soon as possible.

[Sneddon and Wilkinson's subcorneal pustulosis]. / La pustulose sous-cornée de Sneddon et Wilkinson.

The subcorneal pustular dermatosis of Sneddon and Wilkinson belongs to the heterogeneous group of neutrophilic dermatosis. This unique disorder is characterized by a superficial pustular eruption. The pustules are flaccid and aseptic. They develop predominantly on the trunk and in the groins, axillae and submammary areas. This disease is benign and chronic. However, it can be associated with some other conditions such as lymphoproliferative and myeloproliferative diseases. Dapsone is the treatment of choice to control the skin manifestations.

[Skin diseases and obesity]. / La peau et l'obésité.

Obesity is a chronic multifactorial disease representing a major health problem. Among its consequences, diverse facets of the cutaneous physiology are altered. Some dermatoses are also more prevalent. The most typical ones are acanthosis nigricans, skin tags, signs of hyperandrogeny, striae distensae, stasis acroangiodermatitis, leg ulcers, lymphoedema and intertrigo.

[How I investigate ... Alport's syndrome by skin biopsy. When the skin speaks for the kidney]. / Comment j'explore ... le syndrome d'Alport par la biopsie cutanée. Quand la peau parle pour le rein.

Alport's syndrome is a severe hereditary renal disease. Type IV collagen is abnormal in its molecular composition both in the kidneys and the skin. Immunohistochemistry performed on a conventional skin biopsy allows to prove the diagnosis in the affected subjects and in healthy women exhibiting the mutation on a single X chromosome.

[A conjugally exacerbated allergy: procuration dermatosis]. / Une allergie conjugale exacerbée: les dermatoses par procuration.

A young woman presented two distinct vesiculobullous dermatoses sharing in common her husband's imputability. She suffered from contact dermatitis due to colophony used by her husband who was violinist. During her second pregnancy, pemphigoid gestationis was diagnosed. This autoimmune disease is directed to the father's HLA class II present on the placenta. The same antibodies also interact with the dermo-epidermal junction in the mother where they induce blisters.

[Sports under the sun]. / Les sports sous le soleil.

The outdoor sports during summer and winter are often performed under uncontrolled exposure to ultraviolet irradiation from sunlight. Dangers are not small for the skin, the eyes and the immune system. Adequate sun protection is recommended. Caution is important in young children. The daily UV index represents a standardized assessment having a regional predictive value for the intensity of the ultraviolet irradiation reaching the biosphere.

[Skin betrayal, above athletic performance]. / Au-delà de la performance athlétique, la trahison de la peau.

Several compounds listed as illicit doping agents can express some effects on the skin. The cutaneous signs are diverse. The clue of the intake of such compounds can be supported by objective non-invasive biometrological assessments. However, such evaluations do not bring the irrefutable proof. The skin can also present unwanted reactions indicating intolerance to the doping agent. Such physiopathological manifestations are not limited to the sport competition, but can also affect some groups of the population searching for a look reminiscent of the ideal young and performing athlete.

[Liminal perception threshold of cutaneous distension]. / Seuil liminaire de la perception d'un étirement cutané

BACKGROUND: Cutaneous sensorial perception is complex and proves to be difficult to quantify. Skin sensitivity to mechanical distension is largely unexplored. We have developed an original method aimed at quantifiying these physiological parameters. VOLUNTEERS AND METHODS: The study was performed on 24 adult volunteers aged 20 to 50 years. A Cutometer SEM 474 equipped with 2 and 4 mm diameter probes was used to exert a progressive or a steep suction on the cheeks. The intensities of both the suction and the skin deformation observed at the earliest moment the traction was perceived by the volunteers were recorded. RESULTS: The liminar sensorial detection under progressive suction force was 1.5 times lower when using the 4 mm probe than the 2 mm probe. Suction necessary for liminar sensation was 7 times lower under steep suction than in response to the progressive mode. The skin deformation corresponding to the liminar sensorial perception was almost constant (C=0.5 p. 100) for each subject. By contrast, a large inter individual heterogeneity unrelated to age was present. COMMENTS: Sensitivity of facial skin to stretching can be explored using a precise suction method. Perception is more related to the rate of traction than to the surface area submitted to suction. Cutaneous deformation, nearly constant for each individual, appears to be the main parameter. Steep and progressive suctions appear to stimulate distinct types of mechanoreceptors. The presently described method can be applied in cosmetology and in functional investigation of various diseases such as diabetes, acromegaly and atopic dermatitis among others.

Unraveling the patterns of subclinical pheomelanin-enriched facial hyperpigmentation: effect of depigmenting agents.

BACKGROUND: During photoaging, the density of melanin chromatophores is heterogeneous in the epidermis. AIMS: To define the patterns of pheomelanin-enriched melanotic hypermelanosis of the face in phototype II subjects and to assess the effect of depigmenting agents. Azelaic acid and glycolic acid were tested as well as a soy extract, reported to reduce pigmentation through interaction with the protease-activated receptor 2 (PAR-2) of keratinocytes. METHOD: Evaluations were made by image analysis of high magnification pictures obtained by a video camera equipped with an internal ultraviolet-emitting unit (Visioscan((R))). RESULTS: Three patterns of subclinical facial hypermelanosis were recognized including the spotty perifollicular type, the accretive globular type and the elongated type of the sunny side of wrinkles. Azelaic acid and the soy extract led to significant skin lightening after a 3-week treatment. By contrast, glycolic acid showed an inconsistent effect. CONCLUSION: Sensitive fluorescence video recording combined with image analysis represents an advance in the noninvasive assessment of the mottled subclinical skin pigmentation. The depigmenting effect observed with the soy extract indicates that the inhibition of PAR-2 may be a novel way to approach certain pigmentary disorders of the skin.

[Bites by terrestrial vertebrates]. / Morsures par des vertébrés terrestres.

Bites by terrestrial vertebrates, reptiles or mammals, represent a special risk in tropical regions. Envenomation is possible by a few lizards and many snakes. For mammals, tissular destructions due to the bite can be severe. Whatever is the offending animal, bites can further become infected by transmitted viruses or bacteria.

[Cutaneous larva migrans syndrome]. / Syndrome larva migrans cutané.

The presence of an erythematous serpiginous cord migrating inside the skin must evoke one of several parasitoses. Such a type of lesion is encountered in distinct diseases including larva migrans, gnathostoma dermatitis, larva currens, Loa-Loa filariosis, dirofilariasis and creeping myiasis.

[Relativity of the management of skin cancers. A plea for synergy between general practitioners and the dermatologist-oncologist]. / Relativité de la prise en charge des cancers cutanés. Plaidoyer pour la synergie entre le médecin généraliste et le dermatologue-oncologue.

The clinical diagnosis and treatment of cutaneous cancers represent a frequent situation in cancerology. About one third of all human cancers take their origin from the skin. The general practitioner and the dermatologist-oncologist play the key role in that field of health care.

[Malacoplakia associated with a myelodysplastic syndrome]. / Malacoplasie associée à un syndrome myélodysplasique.

Malakoplakia is a rare chronic disease with pleomorphic presentations. It involves many organs, particularly the urinary and gastro-intestinal tracts. It is less common on the skin. Lesions result from impaired phagocytosis of bacteria by macrophages. Malakoplakia is sometimes related to immunodeficiencies. The diagnosis is usually made by histological examination. We report a case associated with a myelodysplastic syndrome.

[Towards obsolete senescence. Everything wanes ... Old age no longer exists!]. / Vers l'obsolescence de la sénescence. Tout se déglingue ... Il n'y a plus de vieillesse!

Skin ageing is the global result of the influence of numerous factors. Oxidative stress through the intervention of free radicals is one of the most important biological mechanisms solicited by ageing promotors. Prevention of skin senescence relies on several approaches. The main ones are sun protection, tobacco avoidance and limitation of sustained mechanical stress to the skin. Free radical scavengers in adequate combinations might slow down the ageing process. In cosmetology, retinol fulfills its claims. Vitamins E and C, as well as selenium and some plant extracts also show some interest. In the search for increased efficacy, tretinoin is the single topical drug available. Its biologic activity boosts the epidermal growth and the collagen synthesis while inhibiting some metalloproteinases responsible for dermal degradation. Clinical proofs of its efficacy are beyond doubt.

[Urban and rural mycozoonoses]. / Les mycozoonoses urbaines et rurales.

The main mycozoonoses are due to specific dermatophytes which are pathogens for man and animals. Contamination occurs most often after close contact with the animal showing clinical lesions or with inapparent carriage only. The contaminated environment also participates to the mycozoonotic epidemics. Interhuman transmission is more rarely encountered. Young children before puberty are most receptive to the disease. The main urban mycozoonosis is due to Microsporum canis transmitted by dogs and cats. Rural mycozoonoses due to Trichophyton ochraceum can be contracted from bovines. Zoophilic dermatophytes induce lesions which are most often quite inflammatory in humans.

Sebum rheology evaluated by two methods in vivo. Split-face study of the effect of a cosmetic formulation.

Modulation of the rheological characteristics of sebum at the surface of the skin might represent a valuable strategy for the treatment of seborrhea. In this field, only a small number of studies have addressed sebum diffusion within the stratum corneum. In an open, split-face study conducted on 20 men, we measured the sebosuppressive effect of Effidrate cream which is based on a glycerol alkyl-ether. Measurements were made in the morning at three-week intervals for a total period of 3 months. Sebum casual levels and sebum excretion rates were measured using a SM810 Sebumeter. Lipid-absorbent Sebutape was also used to collect all the sebum released from infundibular reservoirs over a four-hour period. Clinical assessments were relatively uninformative but the photometric measurements showed that Effidrate cream had a sebosuppressive action. The underlying biological mechanism remains unclear but a hypothesis based on enhanced sebum absorption by the stratum corneum is discussed.

[Airborne dermatoses]. / Dermatoses aéroportées.

Airborne dermatoses are due to various gas and particles in suspension in air. They have irritative, toxic or allergic origins. They may be associated with ocular and respiratory complaints. Such diseases are likely underestimated in both their prevalence and practical considerations dealing with their prevention.