Search PubMed⌕ Search

Biomedical subjects

A Barbaud

Publications and source records attributed to A Barbaud.

At least 145 records · Page 8Linked to original sources

Acyclovir-resistant chronic cutaneous herpes simplex in Wiskott-Aldrich syndrome.

A 28-year-old man with Wiskott-Aldrich syndrome presented with ulcerative-proliferative lesions on his face from which herpes simplex type 1 (HSV-1) was isolated. He was initially treated with 10 mg/kg of acyclovir (Zovirax) intravenously every 8 h, but his skin lesions worsened. Clinical resistance to acyclovir was suspected, and therapy with this drug was intensified. The dosage of acyclovir was increased to 45 mg/kg, administered by continuous infusion, and the lesions subsequently resolved. The strain of HSV recovered from the patient showed acyclovir-resistance in vitro, using the colorimetric method with neutral red. Herpes simplex virus resistance to acyclovir is rare. It is more common in immunocompromised patients if subtherapeutic doses are administered in the treatment of chronic persistent forms of infection. Whenever clinical resistance to acyclovir is suspected, the dosage should be increased to 2 mg/kg per h administered via an infusion pump. If no improvement is observed in the patient's condition with this regimen, a phosphorylated medication whose mechanism of action is not dependent on viral thymidine kinase, such as foscarnet (phosphonoformic acid), should be substituted.

Acyclovir↗

Cushing's disease and cutaneous alternariosis.

Alternaria species are common plant pathogens, but a rare cause of human infection. We present a patient with cutaneous alternariosis that revealed a relapse of an old case of Cushing's disease. Immunosuppression following the excessive glucocorticoid production seemed to contribute to the development of dermatosis. We also present a review of the literature on the association of Cushing's disease and cutaneous alternariosis. Our case is unique because the ketoconazole therapy that we used was successful in the treatment of both diseases.

Aged↗

[Bullous amyloidosis].

The patient, a 75-year old man, was admitted in May, 1986 for separation of the epidermis and extensive ecchymotic patches. Physical examination showed numerous haemorrhagic erosions on the extensor aspect of the limbs, feet and hands, and wide patches of epidermal separation in the axillary and dorsal regions. Ecchymotic purpura was present on the limbs, abdominal wall, neck and right orbital region. Nikolsky's sign was positive at the periphery of the lesions. Epidermal cysts, 1 to 5 mm in diameter, were visible on the back of the hands and on the upper part of the neck. There was no macroglossia. Several biopsies were performed in both diseased and healthy skin. Light microscopy of the diseased skin showed, at the junction of the papillary and middle dermis, a band of eosinophilic deposit in which were true intradermal bullae containing red cells. Congo red and thioflavine T stainings were positive, forming a dermal band. At direct immunofluorescence IgG, IgA, IgM as well as the C3 and C9 components of complement were absent. At electron microscopy there was no bullous separation at the dermoepidermal junction; the dermal deposits had a dense amyloid-like fibrillar structure without ramifications. Laboratory examinations showed lambda-2 monoclonal gammopathy with normal levels of IgG and IgA and slightly decreased IgM. Bence-Jones protein was found in the ruin. Bone marrow examination showed 8 p. 100 plasmocytes. The diagnosis was: non myelomatous lambda-2 monoclonal dysglobulinaemia. Amyloid deposits were found in biopsies of the gums and rectum. Other investigations gave negative results. Bullous lesions have been reported in about 20 cases of primary amyloidosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

[Keratosis lichenoides chronica and prolonged exposure to infrared radiation].

BACKGROUND: We report a case of keratosis lichenoides chronica and prolonged exposure to a source of heat (infrared radiation). CASE REPORT: A 35 year-old man was examined for a symmetric and reticulate dermatosis on the abdomen, the interior of arms and lower extremities. The lesions had progressed over several months. They were characterized by hyperpigmentation, erythematous, bullous and squamous papules. These lesions were associated with those of the scalp, evoking seborrheic dermatitis. The patient was exposed to a source of heat with an electric radiator on his bare chest everyday. The skin biopsy showed a lichenoid reaction. All these elements allowed to put the diagnosis of keratosis lichenoides chronica, probably actived by the infrared light. DISCUSSION: Keratosis lichenoides chronica is a rare acquired dermatosis of the young adult. Its physiopathology remains elusive. This dermatosis is characterized by keratosic violaceous lichenoid papules distributed symmetrically. The eruption is usually asymptomatic. The histological examination indicates a lichenoid reaction. The progression is chronic and the disease is very resistant to therapy. Keratosis lichenoides chronica has never been described as being able to be induced by Koebner's phenomenon. In the literature, two cases of erythema ab igne were associated with lichen planus. For some authors, keratosis lichenoides chronica is an entity itself, for others it would be related to lichen planus. These arguments enabled us to diagnose keratosis lichenoides chronica probably activated by the infrared light.

Adult↗