Search PubMed⌕ Search

Biomedical subjects

A Dompmartin

Publications and source records attributed to A Dompmartin.

90 records · Page 5Linked to original sources
PubMed1989

[Malignant eccrine poroma. Apropos of 2 facial sites].

The authors report 2 cases of malignant eccrine poroma (M.E.P.) located on the face: one on the auricle which was treated by triangular shape resection, the other on the nasal tip which underwent a reconstruction with a Converse scalping flap after large surgical resection removed underlying skin and cartilages. A study reviewing the main features of M.E.P. is presented on the basis of these clinical cases. M.E.P. are skin appendage tumors originating from the intra epithelial portion of the eccrine sweat duct. Such denominations as malignant hidroancanthoma, eccrine porocarcinoma, poroepithelioma, correspond to the same tumor. They are very rare: 73 cases have been reported in the world literature with only 12 located on the face; the main localisations involve the lower extremities, but the palmo plantar areas are involved more frequently in benign tumors. Elderly people over 60 are concerned in almost all cases. Many of the patients have noticed a lesion for years before a diagnosis was made suggesting one of the etiopathogenic theories that M.E.P. may result from malignant transformation of a benign eccrine poroma. Their clinical appearance is non specific nevertheless their malignant nature is suspected and misdiagnosis with basal cell carcinoma is frequent. Microscopic findings demonstrate the diagnosis by showing the association of malignant features with eccrine poroma. These tumours invade both by superficial spead and by deep extension towards dermal and hypodermal structures. Their prognosis is marked by the rapid development, in approximately on half of cases, of cutaneous, lymp node and visceral metastases. Clinical and histological examination have no prognostic value exception the case of deep invasion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma, Sweat Gland↗
PubMed1986

[Course of the dermatophytic spectrum in tinea capitis. Apropos of 124 cases seen in Bordeaux].

The purpose of this study was to evaluate the epidemiology of tinea capitis in the Bordeaux area (Dermatology Unit of the Hôpital des Enfants, Bordeaux) during a 6-year period (January, 1979 to December, 1984). Dermatophytic infection of the hair was proven by culture in 124 patients, 21 of whom had a negative potassium hydroxide direct examination. Age and sex distribution are shown in figure 1. One case was observed in a 15 days old infant, and 4 cases in adult females (3 young black mothers of affected children, 1 elderly white woman). Table I indicates the geographical origin of the patients and the isolates identified. The incidence of anthropophilic dermatophytes has increased from 13 p. 100 to 50 p. 100 since our previous survey (1975-1978). M. langeronii (29 cases), T. soudanense (19 cases) and T. violaceum (10 cases) were isolated mostly among African immigrants from Western tropical Africa and the Maghreb. However, 4 children of French origin without any history of previous sojourn in endemic areas developed tinea capitis due to M. langeronii; the source of contamination could not be determined. Zoophilic dermatophyte infection was mainly caused by M. canis (50 cases), with cats being the most frequent source of contamination. Family cases were frequent: 64 corresponding to 28 families. This may be due to either interhuman contamination or the presence of a contact pet animal in the family. The discussion is focused on: the shift in dermatophytic isolates from tinea capitis toward anthropophilic species, notably M. langeronii, mainly caused by an increased immigration from West Africa; the relevant clinical and mycological correlations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Neutrophilic eccrine hidradenitis in a healthy patient].

BACKGROUND: Neutrophilic eccrine hidradenitis occurs mostly in patients receiving chemotherapy for acute myeloblastic leukemia, rarely in healthy patients. Histopathologic pattern is characteristic and includes selective necrosis of the eccrine glands with a local neutrophilic infiltrate. CASE REPORT: We report the case of a 41 year-old woman with no medical past-history who developed during 2 years successive papulous skin eruptions. The latter always resolved spontaneously. Skin biopsy led to the diagnosis showing typical features of neutrophilic eccrine hidradenitis. DISCUSSION: Our case is original because the neutrophilic eccrine hidradenitis had occurred in a healthy woman. Neither malignant hematologic disease nor visceral cancer was disclosed in this patient in the following 31 months.

Adult↗
PubMedDate not supplied

[Evaluation of the diagnosis of pigmented tumors of the skin and factors leading to a decision to excise. Dermatologists of the Postgraduate Association of Haute-Normandie].

INTRODUCTION: The necessity of excising melanomas characterized by a slight thickness at an early stage, leads dermatologists to remove pigmented lesions which do not correspond to melanomas. The aims of this study were: a) to prospectively assess the accuracy of melanoma diagnosis, b) to quantify the number of excisions performed according to the degree of melanoma suspicion, c) to determine the specific clinical sign or signs of relevant diagnostic value. PATIENTS AND METHODS: This study was conducted prospectively from January 1996 to August 1997 by dermatologists in private practice and dermatologists from a University Hospital staff. When it was decided to excise a pigmented lesion, a form was filled out choosing the most appropriate clinical diagnosis, the degree of melanoma suspicion, and clinical signs which lead to surgery. Based on histological findings as the reference, the sensitivity, specificity, accuracy of melanoma diagnosis and the kappa test that evaluates the concordance between clinical and histological diagnosis, were performed. The diagnostic value of clinical signs was assessed by variance analysis. RESULTS: Of the 353 excised lesions, 38 (10.7 p. 100) were identified as melanoma on histologic examination. The sensitivity, the specificity and diagnostic accuracy were: 79 p. 100, 94 p. 100 and 53 p. 100 respectively. The kappa test concordance between clinical and histological diagnosis was 0.66. Two hundred and two lesions (57 p. 100) were excised even though the clinical suspicion of melanoma was poorly considered. Only one of these 202 lesions was identified histologically as a true melanoma. Thirty seven (24.5 p. 100) of the 151 remaining excised lesions with an "average" or "strong" suspicion were true melanomas. The clinical signs considered, alone or associated, had a poor predictive positive value (< 38 p. 100). An analytical approach performed with a logistic model permitted the identification of two associated signs suggesting a best diagnostic value. DISCUSSION: This is the only study, to our knowledge, reported in the literature which prospectively assesses the sensitivity, specificity and concordance between clinical and histological diagnosis of melanoma. Results were considered from average to good. The originality of this study was to assess the number of pigmented lesions excised according to the degree of melanoma suspicion, suggesting the possibility of reducing the number of nevi removed when the melanoma risk was considered clinically poor. Finally, this study emphasizes the limits of clinical semiology and the need for future diagnostic methods in the assessment of melanoma.

Adult↗
PubMedDate not supplied

[Does benign summer light eruption exist?].

BACKGROUND: Contrary to other countries, in which a unique entity is recognized, two sub-groups of light eruption, benign summer light eruption and polymorphous light eruption, are identified in France. Benign summer light eruption was individualized with a few criteria: age at onset between 25-35 years old, female predominance, onset within 12 hours after an intensive exposure to sun, presence of lesions on areas which have not been regularly exposed to sunlight such as the upper chest, absence of lesions on the face, improvement during the summer period and negativity of the polychromatic phototest. In fact patients usually presenting with benign summer light eruption do not have all the criteria and they gradually develop a polymorphous light eruption. The aim of this study was to quantify, among the patients presenting with a light eruption, the population with three main criteria of benign summer light eruption. PATIENTS AND METHOD: Eighty-seven patients presenting with a light eruption, a polymorphous light eruption or a benign summer light eruption, were selected by a dermatologist. For each patient the presence or absence of the 3 main criteria were noted: a) no lesion of the face, b) improvement of the eruption during the summer period, c) negative polychromatic phototest. RESULTS: Among the 87 patients, 9 of them (10 p. 100) had the three main criteria of benign summer light eruption. DISCUSSION: Benign summer light eruption is either rare or defined with wrong criteria. The polychromatic phototest was gradually replaced by the UVA phototest. In fact, provocation UVA phototests do not individualize benign summer light eruption from polymorphous light eruption. Individualization of the benign summer light eruption is not justified because there is a continuous spectrum of light eruptions, ranging from the benign eruption which improves during the summer period and the chronic eruption with a high photosensitivy and lesions of the face.

Adult↗
PubMedDate not supplied

[Polychromatic phototest sensibility is superior to UVA phototest in polymorphic light eruptions].

BACKGROUND: The phototest is used to confirm the diagnosis of polymorphous light eruption and to evaluate the different treatments. The different light sources in the different countries explains the lack of standardization. In France, we use a polychromatic source emitting a radiation close to the solar spectrum. The study compared the efficacy of a polychromatic source with a UVA source in the photo-induction of lesions. PATIENTS AND METHOD: Sixty-four patients presenting with a polymorphous light eruption were selected by a dermatologist. Polychromatic and UVA phototests were performed on each patient. At day 8, the phototest was considered positive if there were papules. RESULTS: Polychromatic and UVA phototests were positive in respectively 56 p. 100 and 23 p. 100 of the patients. Forty-one per cent of the patients had both polychromatic and UVA negative phototests. DISCUSSION: Polychromatic phototest seems to be more sensitive than UVA phototest. Induction of the lesions with a polychromatic source is so easy that it proves the significant role for UVB in the genesis of polymorphous light eruption. The percentage of negative phototests is identical to those published in the literature. Negative phototests are not necessarily secondary a bad methodology, they can individualize patients with those lower photosensitivity who present with a polymorphous light eruption that may resolve spontaneously.

Diagnosis, Differential↗
PubMedDate not supplied

[An association of paraneoplastic syndromes in a patient].

BACKGROUND: Erythema gyratum repens is a rare cutaneous marker for internal malignancy and the association with other paraneoplastic syndromes is not unusual. CASE REPORT: We report the case of a 54 year-old man with a three-month history of erythroderma which evolved into erythema gyratum repens; a bronchial carcinoma was discovered. Erythema gyratum repens was associated with acquired ichthyosis, hyperkeratosis of the ears and eosinophilia. Improvement of the paraneoplastic dermatosis was achieved by treatment of the underlying carcinoma with chemotherapy, surgery and radiation. However, the lesions relapsed when metastases appeared. Another regimen of chemotherapy improved the carcinoma and the dermatosis. DISCUSSION: The parallel course of the carcinoma and the cutaneous eruption strongly supports the diagnosis of a cutaneous paraneoplastic syndrome. Three months prior to erythema gyratum repens, the patient developed a scaling erythroderma. This unusual early manifestation is misleading. Our case highlights the possible association of different paraneoplastic syndromes: initially scaling erythroderma, followed by erythema gyratum repens associated with acquired ichthyosis, hyperkeratosis of the ears and eosinophilia.

Adenocarcinoma↗
PubMedDate not supplied

Treatment of an infantile acne with oral isotretinoin.

We report the case of a little girl who presented with a nodulocystic acne which had its onset at the age of 20 months. She had no clinical or biological features of endocrinopathy. The lesions did not respond to conventional antibiotics so she was started on oral isotretinoin. A seven-month treatment period was necessary to achieve remission. The onset of infantile acne is usually around 6 to 16 months and there is a male predominance. The onset is later in females. Oral erythromycin is the first line treatment when topical therapies are inefficacious. Some cystic lesions do not respond to oral antibiotics. In these cases, oral isotretinoin may be effective and the treatment is similar to that of an adult. Clinical and biological tolerance is good with no growth retardation. Lesions may relapse after the withdrawal of isotretinoin but they are less important and easily controlled with topical treatments. Isotretinoin can be used for nodulocystic acne to reduce the risk of scarring.

Acne Vulgaris↗