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Biomedical subjects

B Guillot

Publications and source records attributed to B Guillot.

At least 199 records · Page 11Linked to original sources

Immunological aspects of psoriasis. IV. Presence of circulating immune complexes in patients before and after PUVA therapy; correlations with T-cell markers.

We investigated sixteen patients before and after 1 month of PUVA therapy (three times a week) for circulating immune complexes (CIC) and T-cell markers. CIC were detected by the PEG-C4 assay, using a laser nephelometry determination of polyethylene glycol (PEG, 3.5%) precipitated endogenous C4. T cells were evaluated by E rosettes, active E rosettes, anti-HTLA serum and ox EA gamma-rosettes. This latter method investigated mainly T cells bearing Fc receptors for IgG (Tgamma-cells). After 1 month of PUVA-therapy: (a) the cutaneous lesions markedly improved; (b) the mean percentages of E rosettes, active E rosettes, and HTLA bearing cells, depressed before treatment, returned to normal; (c) CIC were found in higher amounts; (d) T gamma-cell numbers decreased simultaneously. The improvement of T-cell levels assessed by E rosettes, active E rosettes and HTLA values was correlated with clearing of skin lesions, as previously reported by others. However, the increase of CIC during PUVA therapy, their correlation with T gamma-cell decrease, and their possible role in the pathogenic chain of psoriasis remains uncertain.

Adolescent↗

[Pathogenesis of psoriasis].

Psoriasis is basically an excessive proliferation of the epiderm. This state results mainly from an imbalance in the cyclical nucleotides linked mainly to anomalies of the keratinocyte membranes. The membrane change is due to antibodies whose production may be dependent upon a deficit of a T-lymphocyte sub-population. This deficit may be considered the result of the penetration of virus agent with the help of multiple genetic factors. The various link of this pathogenic chain may be modified by numerous external factors which, by causing a worsening in a pre-existing imbalance, brings about the appearance of lesions.

Antibody Formation↗

[Prevention of skin cancer programs: analysis of the impact of randomized trials].

INTRODUCTION: Exposure to ultraviolet sun rays is an important risk factor for the development of skin cancer. Confronted with the increase in the incidence of severe forms (melanoma), primary prevention plays a major part, together with the development of campaigns promoting individual and collective protection against ultraviolet rays. OBJECTIVE: The aim of this trial was to identify the factors of success or failure of skin cancer prevention programs and to analyze their impact. METHOD: Articles published in the literature from 1982 to 2002 were selected from the Medline databank using the following key words: "skin cancer, melanoma, evaluation, prevention and education, review, program, campaign and randomized controlled trial". For the final analysis, only the randomized trials with control group were retained. RESULTS: All the prevention programs increased short, median or long term knowledge. Conversely, the trials were sometimes contradicting with regard to the change in attitude. No methodologically correct trial clearly reported any change in behavior, the majority of them only collected intent behavior. CONCLUSION: Despite the methodological weaknesses of most of the trials published, this review of the literature underlined certain points. The most efficient programs appear to be those targeting children, the training sessions of which are long and/or repeated, with active individual participation. Programs based on the deleterious consequences of sun exposure on physical appearance appeared to produce better results in terms of any change in attitude and intent behavior.

Attitude to Health↗

[Sun exposure and sun protection behavior and attitudes among the French population].

INTRODUCTION: The number of new skin cancers has constantly increased in France over the past two decades. The role of sun exposure can partly explain this phenomenon and justifies the development of information and prevention campaigns to change peoples' attitude towards sun bathing. To be effective, we need to know how much information and what attitudes the population currently has with regard to the sun. Although several studies in France have targeted children, little data is available regarding adults. This trial was aimed at pinpointing the knowledge, attitude and behavior of adults regarding sun exposure. MATERIAL AND METHODS: Data were collected during a randomized multicenter study on the prevention and early diagnosis of cutaneous tumors, conducted in 26 Health Centers from 1998 to 2000. Standardized questionnaires were handed to those consulting to assess their knowledge, attitudes and behavior towards sun bathing. The population was composed of 41 143 adults aged over 30, consulting one of the 26 Health Check-up units. Analysis of the data was made using SAS v 6.12 and STATA 7.0 software. Logistic regression identified the explicative factors of knowledge and behavior. All the statistical analyses were considered significant above a threshold of alpha<5%. RESULTS: A total of 33 021 persons filled-in the self-questionnaire. Forty-nine percent were women and 51% were men, with a mean age of 50 years. Geographically, 25% lived in the North-East, 16% in the North-West, 25 p.cent in the South-East and 34% in the South-West. Thirty percent claimed that they tanned without burning and 2% of the population studied had often suffered from sun burn, generally when they were adult. The risks related to sun burn were known, because 92% knew that the sun increased the risk of skin aging and 89% knew that it increased the risk of skin cancer. Regarding sun screens, knowledge was not so good; 42% thought that all products were the same and 53% that they allowed one to sun bathe longer. This knowledge was better in those with fair skins, in those who had a history of sun burn, in women and in those who lived in the northern areas of France. Conversely, knowledge decreased with age and was limited in those aged over 60. Regarding behavior, those with fair skin and who reddened under the sun without tanning, protected themselves more. The women declared they protected themselves more than the men, but they used less sun protective measures (clothing, hats...), other than sun screens, than men. Subjects aged over 60 protected themselves more than younger subjects. Lastly, a personal cutaneous history increased protective behavior, and those from northern France protected themselves more than those from the South. DISCUSSION: This analysis of 33 021 adults aged over 30 shows the good global knowledge of the consequences of sun bathing, but also the lack of knowledge on the interest of using external sun protection and the role of physical means of protection. Attitudes varied depending on gender, age and phototype and also depending on the area where they lived. Despite good knowledge, the most frequent behavior of adults aged over 30 is still not appropriate with differences depending on age, gender and area, which must prompt more appropriate targeting of prevention campaigns according to the populations concerned.

Adult↗

[Huriez syndrome].

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Adult↗

Immunity in psoriasis.

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Antibodies, Anti-Idiotypic↗

Skin reactions to inhaled corticosteroids. Clinical aspects, incidence, avoidance, and management.

Inhaled corticosteroids are considered by many to be the therapy of choice in the treatment of asthma and allergic rhinitis. Systemic adverse effects are well known and are mainly dose dependent. Adverse cutaneous effects have also been characterized. Some of them are frequent and dose dependent, for example thinning of the skin and easy bruising. These adverse effects are probably present in about half of the patients treated with inhaled corticosteroids. The risk of these adverse effects is more important among elderly people and increases with the duration of the treatment and the daily dosage. Thinning of the skin and easy bruising are probably dependent on collagen synthesis modifications. Among rare or underestimated reactions, several adverse effects have been described such as angina bullosa hemorrhagica, acne and allergy. In this latter case, the attention should be paid to relevant clinical signs such as eczematous lesions of the face and aggravation of the nasal symptoms. Mucocutaneous infections related to inhaled corticosteroid use have also been reported, the most frequent being candidiasis. However, the frequency of symptomatic clinical infection is very rare. The risk of viral infection, especially with a herpes virus, has never been described. As cutaneous complications of corticosteroids are mainly dose dependent, these adverse effects could be prevented by attention to the daily dosage. Infection could be prevented by rising the mouth after inhalation and the use of a spacer device. If cutaneous adverse effects occur despite proper use of the inhaled corticosteroids and became unpleasant for the patient, discussion with a pneumologist or otorhinolaryngologist may be required but temporary halting therapy is rarely useful.

Administration, Inhalation↗

Peristomal subepidermal autoimmune blistering disease.

Peristomal subepidermal autoimmune blistering disease has rarely been reported in the literature [1-3]. We report a new case of this entity. In the three reported cases, the diagnosis of bullous pemphigoid was retained. In our case, clinical and immunological patterns rather favour a cicatricial pemphigoid.

Autoimmune Diseases↗

[Eosinophilic ulceration of the tongue].

BACKGROUND: Eosinophilic ulceration of the tongue is a classic condition little reported in the literature. We describe a case in a patient taking nicorandil. CASE REPORT: An 84-year-old patient consulted for an ulceration of the tongue which had progressed for 5 months. The ulcer was very painful and the patient had lost 2.5 kg. The patient had been taking nicorandil at the dose of 10 mg/d for a year. Biopsies of the tongue ulcer confirmed the diagnosis of eosinophilic ulceration. Immunohistochemistry determined predominantly T-cell infiltration. Search for Epstein-Barr virus was negative. The ulcer completely regressed within one month without withdrawal of nicorandil. DISCUSSION: This was a typical case of eosinophilic ulceration of the tongue, both from the point of view of the clinical expression and the histological findings. A nicorandil-induced ulcer was ruled out on clinical (low daily dose, delay to onset) and histological arguments as well as the spontaneous regression without drug withdrawal. Nicorandil may have played a role in the abnormally long duration of the ulceration.

Aged↗

Unlikely role of Epstein-Barr virus in the pathogenesis of primary cutaneous CD30+ anaplastic large cell lymphoma.

BACKGROUND: Primary cutaneous CD30+ anaplastic large cell lymphoma (ALCL) is a rare subset of cutaneous lymphoma, with a much better prognosis than its nodal counterpart. The pathogenesis of both nodal and primary cutaneous CD30+ ALCL is largely unknown but experimental data support the hypothesis that the Epstein-Barr virus could play a role in the nodal subset. OBJECTIVE: To evaluate the involvement of Epstein-Barr Virus (EBV) in primary cutaneous CD30+ ALCL by searching for both nucleic acids and EBV proteins in cutaneous lesions. SETTING: Two University Hospitals in Southern France (secondary referral hospitals). PATIENTS: Eight consecutive patients with typical primary cutaneous CD30+ anaplastic large cell lymphoma were studied. METHODS: Search for the presence of DNA, RNA and EBV proteins in cutaneous lesions by PCR, in situ hybridization and immunohistochemistry. RESULTS: EBV DNA and RNA was identified in only one lesion of primary cutaneous CD30+ ALCL and in none of the normal adjacent skin samples. In situ hybridization and immunohistological studies were consistently negative in all samples. CONCLUSION: These results do not support an early role of EBV in the oncogenetic pathogenesis of primary cutaneous CD30+ ALCL.

Adaptor Proteins, Signal Transducing↗

[Is fibrositis an immuno-rheumatologic disease?].

An attempt was made to test the hypothesis that immunological dysfunction occurs in primary polyenthesopathy (PP) by studying skin immunofluorescence, capillary microscopy, photoplethysmography and the lymphocyte populations in PP patients defined according to the usual criteria of Yunus. Skin immunofluorescence in 15 PP patients (14 women, 1 man, average age 50.9 years) failed to reveal any deposit of IgG, A, M, Clq, or C3c either at the dermoepidermal junction or in the vessels. 26 patients (24 women, 2 men, average age 50.5 years) were studied using capillary microscopy and 12 using digital photoplethysmography. The microvascularization abnormalities observed were mild and non specific. A study of the lymphocyte populations using Coulter flux cytometry in 35 PP patients (32 women, 3 men, average age 46 years) did not show any modification in the number of CD4 and CD8 lymphocytes by comparison with the controls. These results do not agree with the data given in the literature and this is probably due to the heterogeneity of the patients studied, with some studies showing a low concentration of antinuclear factors and an abnormal frequency of dry symptoms which, in the opinion of the authors, is considered as an exclusion criterion in the diagnosis of PP. In the author's view, polyenthesopathy is not an immune disease.

Adult↗