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Biomedical subjects

A Barbaud

Publications and source records attributed to A Barbaud.

At least 91 records · Page 5Linked to original sources
PubMed2000

[Cutaneous reactions to topical medications].

The management of patients who have developed a contact dermatitis due to topical drugs requires to stop the suspected drug application, to declare, if serious, the adverse drug reaction to the Pharmacovigilance network, to treat the patient with corticosteroid ointments, to perform dermatoallergological investigations e.g. drug patch tests to determine whether the adverse reaction was due to excipients or to the drug itself and at least to advise the patient concerning the avoidance of topical or systemic readministrations of the responsible molecule. An excipient responsible in inducing a contact sensitisation to an ointment can also be found in cosmetics. When a drug is responsible it is necessary to determine if cross-reactions with other drugs can occur and if the responsible molecule can induce systemic cutaneous adverse reaction if the drug is systemically readministered.

Administration, Topical↗
PubMed2000

[Ultra-late metastasis of melanoma with secondary dissemination along the venous stripping line].

BACKGROUND: A woman was cured of a melanoma of the leg. She presented an ultra late recurrence 17 years later, then rapid and extensive recurrence immediately after venous stripping. CASE REPORT: In 1977, a 38-year-old woman was operated for a SSM melanoma of the calf. She was then given chemotherapy and BCGtherapy for 2 years. In 1994, she presented a nodular recurrence which was treated surgically. In March 1997, she underwent a stripping of the leg. One month later, a nodular recurrence was discovered along the stripping line. DISCUSSION: The ultra late recurrence (> 15 years) in this case is highly exceptional and, to our knowledge, this is the first case of a recurrence along a vascular course. We discuss metastatic dissemination of SSM melanoma and the role played by stripping in this case of recurrence.

Adult↗
PubMed2000

[Polyclonal T lymphocyte proliferation in drug lymphocyte activation test].

BACKGROUND: We examined the clonality of the specific T cell reaction activated with specific drug antigens in patients with a positive lymphocyte activation test. PATIENTS AND METHODS: Ten patients were investigated. Their clinical features suggested drug allergy. Six weeks after a skin reaction, skin tests and lymphocyte activation tests were run. For each lymphocyte activation test, we explored the clonality of the T cell proliferation by examining the VJ rearrangement of the TCR gamma locus using polymerase chain reaction and denaturing gradient gel electrophoresis. RESULTS: All samples gave positive lymphocyte activation tests proving in vitro polyclonal T cell proliferation in reaction to a drug. There was no difference in clonality between the pilot lymphocyte activation test and the lymphocyte activation test after stimulation with phytohemagglutinin or with the drug antigen. DISCUSSION: Our findings show that in vitro T cell proliferation induced by a specific drug antigen as disclosed by the lymphocyte activation test is a polyclonal or oligoclonal cell proliferation. This lack of production of a preferential T clone in a T cell-mediated immune drug reaction implies that many T lymphocytes can recognize the antigen and be stimulated by the same drug.

Adult↗
PubMed2000

[Contact dermatitis due to ethyl alcohol: how to perform patch tests?].

INTRODUCTION: Ethyl alcohol sensitization is rare and can induce immediate contact urticaria or delayed eczema. Patch tests performed with ethanol can provoke an irritative reaction and are not well codified. CASE-REPORTS: We report on 4 cases of contact dermatitis due to alcohol in 4 women. Eczema was due to alcohol contained in the reservoir of a transdermal transfer system with estrogens in 2 cases and related to the application of alcoholized antiseptic lotions in the other 2 cases. In 2/4 cases we observed a co-sensitization with corticosteroids. METHODS: Patch tests were performed with alcohol at 95 degrees diluted at 70 p. 100 and at 10 p. 100 in water and read after 20 minutes then on day 2 and day 4. RESULTS: Positive results were obtained in 4/4 cases when alcohol was tested diluted at 70 p. 100 in water and in 3/4 cases when diluted at 10 p. 100 in water. No irritant reaction was observed in 140 negative controls. DISCUSSION: Immediate after 20 minutes and delayed readings of patch tests performed with ethyl alcohol diluted at 70 p. 100 seem to be convenient in diagnosing cutaneous delayed hypersensitivity to alcohol. Co-sensitization between corticosteroids and alcohol could be due to an aldehyde deshydrogenase deficiency.

Administration, Topical↗
PubMed2000

[Skin tests in the study of drug eruptions with suspected immuno-allergic mechanism].

Skin testing (patch tests, prick test and intradermal tests) with the suspected compound has been reported to be helpful in determining the cause of cutaneous adverse drug reactions (ADRs), but the value and specificity of these tests need to be determined. In a previously published study involving 72 patients, we observed positive results in 72% of the cases, in 43%, 24% and 67% in patch, prick and intradermal skin tests, respectively. The results of skin tests varied with the clinical type of cutaneous ADR, as a significantly higher number of positive patch tests was observed in maculopapular rashes (59%) than in urticarial reactions (13%) or in eythrodermic ADR (80%). The results of patch tests varied with the drug tested as frequent positive results were obtained with amoxicillin, pristinamycin, carbamazepine, pseudoephedrine, heparinoids... This study and the analysis of the literature support the value of careful sequential drug skin testing in establishing the cause of cutaneous ADR. Guidelines are proposed for performing these tests, and these include the use of appropriate negative control patients to avoid false-positive results, the determination of the relevance of positive patch tests, a contact sensitization to drug being able to elicite a positive result on patch tests with a preserved oral tolerance to the same drug. These tests have to be performed with a strict medical survey as they can induce a relapse of the cutaneous ADR.

Drug Eruptions↗
PubMed2000

[Endoscopic sympathectomy for palmar and plantar hyperhidrosis: results in 107 patients].

INTRODUCTION: Transthoracic endoscopic sympathectomy for palmar hyperhidrosis is a safe and effective method. However, no radical and definite treatment exists for plantar hyperhidrosis. We report our experience, immediate post-operative and mid-term results after transthoracic and lumbar endoscopic sympathectomy for palmar and plantar hyperhidrosis. PATIENTS AND METHODS: One hundred and seven of 117 patients cured between January 94 and December 98, answered a questionnaire regarding their past history, the early post-operative results, side effects and complications caused by the operation and mid-term results with particular emphasis on patient satisfaction. RESULTS: Seventy-eight thoracic and lumbar endoscopic sympathectomies and 125 thoracic endoscopic sympathectomies were performed. The patients were 30 men (median age 30 years) and 77 women (median age 26 years). Only women underwent lumbar endoscopic sympathectomy because of risk of retrograde ejaculation. No severe complications were noted. The success rate was 96 p. 100 for palmar hyperhidrosis and 98,5 p. 100 for plantar hyperhidrosis. No recurrences were noted in 97 p. 100 of the patients with median follow-up of 28 months. The main side effect was compensatory sweating which was the reason for dissatisfaction for 5 p. 100 of the patients. Cutaneous dryness and gustatory sweating were also described. However, 95 p. 100 of the patients were "satisfied" or "very satisfied". CONCLUSION: Our experience proved that lumbar endoscopic sympathectomy is as safe and effective for treatment of plantar hyperhidrosis, as thoracic endoscopic sympathectomy for palmar hyperhidrosis.

Adolescent↗
PubMed1999

[Radiodermatitis afer heart catheterization].

INCREASING INCIDENCE: The development of new interventional techniques in radiology, particularly angioplasty of the coronary arteries, has lead to a rise in the incidence of radioderimitis. Clinical presentations vary from skin rash to necrosis and chronic ulceration. Telangiectasic atrophy and poikilodermitis are also observed. CASE REPORTS IN THE LITERATURE: Twenty-three cases of radiodermitis after cardiac catheterism have been reported in the literature. Mean delay to onset after the first radiology examination varies from 15 days to 10 years. TO REDUCE THE RISK: The main risk factor is a long duration of scopy using the same incidence. Use of older non-digitalized radiology machines also increases the risk. Physicians performing endovascular procedures should be aware of the risk of radiodermitis after angioplasy and implement radioprotective measures. RETROSPECTIVE DIAGNOSIS: Patients who develop localized pigmentation disorders and/or telangiectasies should be questioned concerning prior, often forgotten, radiology examinations.

Cardiac Catheterization↗