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Biomedical subjects

B Sassolas

Publications and source records attributed to B Sassolas.

At least 55 records · Page 3Linked to original sources

[Methylprednisolone versus prednisolone methylsulfobenzoate in pemphigoid: a comparative multicenter study].

Bullous pemphigoid is a bullous skin disease associated with basal membrane antibodies. At present, the first treatment of these lesions is with corticosteroids. In this randomized study we compared the clinical results obtained with methylprednisolone (MePr) in 28 patients and with prednisolone methylsulfobenzoate (MsPr) in 29 patients. Both drugs were administered orally in daily doses of 1 to 1.5 mg/kg bodyweight. Three clinical data were examined: the number of bullous lesions, the intensity of pruritus and the extent of erythema after 5 then 10 days of treatment. After 10 days, the number of bullous lesions had decreased by 83 p. 100 with MePr and by 78 p. 100 with MsPr, and the decrease of pruritus had been significantly more pronounced in the MePr group than in the Ms group (p < 0.05). There had been no difference between treatments in the regression of erythema. Altogether, good results were obtained in 22/28 patients under MsPr (78.6 p. 100) and 18/29 patients under MePr (62.1 p. 100). This raises the question of the value of pharmacokinetic studies not only with these two corticosteroids, but also with prednisone which seems to be better absorbed.

Administration, Oral↗

Roxithromycin versus penicillin in the treatment of erysipelas in adults: a comparative study.

A prospective, randomized, multicentre trial was conducted to evaluate the efficacy and safety of roxithromycin (150 mg b.i.d. orally) and penicillin (2.5 MU x 8 daily intravenously, then 6 MU daily orally) in the treatment of hospitalized adult patients with erysipelas. Seventy-two patients entered the study. Thirty-one patients in the roxithromycin group and 38 patients in the penicillin group completed the trial. The overall efficacy rates (cure without additional antibiotics) were 84% (26/31) in the roxithromycin group and 76% (29/38) in the penicillin group (P = 0.43). No side-effects were observed in the roxithromycin-treated patients whereas rashes occurred in two cases in the penicillin group, leading to exclusion from the study. Oral roxithromycin can thus be considered an effective and well-tolerated treatment for erysipelas in adult hospitalized patients.

Acute Disease↗

Progressive macular hypomelanosis of the trunk: primary acquired hypopigmentation.

Dermatological practice in Martinique frequently encounters a bizarre skin condition presenting as a progressive and extensive hypomelanosis on the back. The course of this disorder is highly characteristic: it occurs mainly in females from 18-25 years of age, with a progressive development of round, pale, coalescent macules on the back and sometimes on the abdomen. This disease, which does not respond to therapy, spontaneously regresses within 3 to 4 years. Decreased epidermal melanin is the only histological feature. Ultrastructural examination of two cases found that the macular lesions were characterized by a switch from Stage IV single melanosomes (negroid) to small Type I-III aggregated melanosomes (caucasoid). It may thus be stated that the variation in skin coloration in these patients was due to a variation in melanosome size and distribution.

Adolescent↗

[Cutaneous allergic accidents caused by insulin. Current aspects apropos of 2 cases].

Current data concerning cutaneous allergy to insulin may be illustrated by the two cases reported here. One was a woman with gestational diabetes; she was treated with bovine insulin and developed generalized urticaria which subsided after switching to human insulin. The other was a woman who had pruritus localized to the site of injection with every type of insulin and in whom laboratory examinations showed an increase of specific IgE. Immunological reactions have been described since the time when exogenous insulin was introduced as a treatment of diabetes. The wide use of purified human insulin has considerably reduced their incidence but benign local and immediate systemic reactions are still being reported, their estimated frequency varying from 10 p. 100 to 50 p. 100 of the patients treated. In reality, allergy to insulin itself is extremely rare compared with allergic reactions to preservatives, such as metacresol, additives (protamine and zinc and contaminants present in insulin preparations: desamido-insulin. True allergic reactions to insulin may be localized or generalized and biphasic, and in most cases they are IgE-mediated. Some late local reactions, as well as atrophy, can be ascribed to delayed hypersensitivity. Treatment includes: (i) change in the type of insulin used; (ii) systemic or topical corticosteroid therapy; (iii) antihistamines and aspirin, and (iv) desensitization. The allergic complications of insulin therapy are benign; they usually do not require any particular treatment and often spontaneously regress.

Adult↗

Anti-Ro-positive lupus and hereditary angioneurotic edema. A 7-year follow-up with worsening of lupus under danazol treatment.

A 24-year-old woman, having familial hereditary angioneurotic edema (HAE) treated with danazol, developed an anti-Ro-positive lupus featured by a mild erythematous eruption that seemed initially to decrease and then worsened under danazol, and dramatically improved after danazol was withdrawn. The relationship between lupus and HAE is discussed with special reference to the hormonal sensitivity of autoimmune diseases. It is possible that the responsibility of danazol as well as the immunogenetic background can explain the clinical course of this association.

Adult↗

[Papulo-erythematous eruption of neonatal lupus].

INTRODUCTION: Neonatal lupus is rare and cutaneous lesions are usually suggestive of the diagnosis. We describe the case an infant with atypical clinical and histological aspects. CASE REPORT: A female newborn, 6 weeks of life, presented since 3 weeks a papulo-erythematous eruption involving the trunk and the 4 limbs. Cutaneous biopsy showed a dermal infiltrate of mononuclear cells, which corresponded morphologically to lymphocytes. But myelo-monocytic origin was proved by immunostaining. This result could be seen in hematodermia and macrophagic activation syndrome, but we had no clinical sign for these diagnosis. Later, she presented an erythema of the eyelids and erythematous papules of the face leading to suspicion of neonatal lupus. Questioning the mother revealed that she had Raynaud's syndrome since 1995. Antinuclear factors were positive in the patient and her mother, corresponding to antiSSA and antiSSB antibodies. She exhibited cytolytic hepatitis but no congenital heart block. Direct immunofluorescence was negative. The clinical evolution was good with complete clearing of the eruption at the age of 3 months. At 10 months, clinical and biological examinations were normal, with no arguments for haematological disease. DISCUSSION: This observation is original because of the initial papulo-erythematous eruption which is rare in neonatal lupus. Diagnosis was confirmed when specific secondary cutaneous lesions appeared. The biopsy of the first eruption showed a myelo-monocytic infiltrate which has never been described in neonatal lupus. However cutaneous biopsies are rarely performed in neonatal lupus and immunostaining is lacking in the literature.

Age Factors↗

[Subcutaneous mycosis due to Scopulariopsis brevicaulis in an aplasic patient].

INTRODUCTION: Among the filamentous fungi of the Hyphomycete class, Annellospore group, the Scopulariopsis genera presently includes 16 species considered as opportunist pathogens. We report some unusual cutaneous manifestations due to Scopulariopsis brevicaulis in an immunodepressed patient. OBSERVATION: A 67 year-old man presented with a lymphomatous form of Waldenström's macroglobulinemia. During chemotherapy with medullar aplasia, inflammatory cutaneous nodules appeared on the forearm and leg. Microbiological and histological examinations identified Scopulariopsis brevicaulis. The patient improved with rapid remission from aplasia using hematopoietic growth factors and treatment with itraconazole. COMMENTS: In a patient in medullar aplasia, the rapid onset of an extra-ungual cutaneous localization (forearm and leg) of a Scopulariopsis brevicaulis infection, without systemic involvement, suggests that the cutaneous inoculation occurred through scratching (from the nails) or from another cutaneous origin. Prolonged neutropenia enhanced the pathogenicity of this mycosis. The mycological and histological examinations are fundamental to confirm the diagnosis.

Aged↗

[Variations of the skin permeability in premature newborn infants. Value of the skin vasoconstriction test with neosynephrine].

BACKGROUND: The skin of preterm infants is defective as a barrier and does not function like that of mature until about 2 weeks of age. METHODS: Percutaneous drug absorption was studied by observing the blanching response to aqueous solutions of 10% Neosynephrin applied to a small area of skin on the internal surface of the thigh. The subjects, 10 preterm infants born at gestational ages 29 to 32 weeks (mean: 31 weeks 2 days), were tested when they were aged from day 0 to 7. The controls were 8 normal newborns aged 2 days. All preterm infants were tested a second time at the age 7 to 17 days (mean: 10 days). The blanching response was measured after 5 minutes, and graded on a scale of 0 to 4. RESULTS: The first test was positive grade 2 to 4 in all the preterm babies, while it was negative in the normal newborns. The second test was negative in 7 of the 10 preterm infants; in other 3, the grade was at least 50% lower. Infants nursed under radiant heaters were not different from the other infants. CONCLUSION: Skin permeability is increased in immature infants, but falls steadily until about the age of 10 days. The results of the Neosynephrin test could be useful in predicting the response to topically administered drug.

Drug Evaluation↗