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C Beylot

Publications and source records attributed to C Beylot.

At least 37 records · Page 2Linked to original sources
PubMed2002

[Bullous localization of a lupus erythematosus induced by radiotherapy].

INTRODUCTION: Connective diseases induced or exacerbated by radiotherapy are not frequent. We report a particular erosive erythematosus lupus with lesions in the precise distribution of radiation therapy given for a breast cancer. OBSERVATION: An 80 year-old woman presented with painful erosive skin lesions of her breast which had been treated by irradiation 9 years before. The patient also had rheumatoid arthritis. A skin biopsy showed keratinocyte necrosis, acantholysis and a dermal lymphocytic infiltrate under the basal cell layer. Direct immunofluorescence showed granular deposition of IgG, IgM and C3 along the basal cell layer. Antinuclear antibodies were positive at a titre of 1: 1,000. Erythematosus lupus diagnosis was established and annular lesions secondarily appeared on her neck, back, and arms. A treatment with hydroxychloroquine and topical corticosteroïds was effective in 3 months. DISCUSSION: The unusual erosive lesions and their localization on a previously irradiated site suggest the role of X-rays in our observation, despite their late appearance after radiotherapy. Radiotherapy and erythematosus lupus affect the same target structures (basal cells and small dermal capillaries) and could have additive effects. The presence of rheumatoid arthritis in the past medical history may have exaggerated this complication.

Adrenal Cortex Hormones↗
PubMed2002

[Exanthema].

Explore the source record for details and available documents.

Diagnosis, Differential↗
PubMed2001

Evidence that an identical T cell clone in skin and peripheral blood lymphocytes is an independent prognostic factor in primary cutaneous T cell lymphomas.

The monoclonality of the T cell receptor gamma-chain gene was analyzed by polymerase chain reaction in skin and blood specimens of 85 patients with cutaneous T cell lymphomas including 67 mycosis fungoides, seven Sézary syndromes, and 11 CD30- nonepidermotropic cutaneous T cell lymphomas. A cutaneous T cell clone was detected in 69% of mycosis fungoides and 100% of Sézary syndromes. This frequency varied according to the clinical stage: 57% in early stages (Ia-IIa) to 96% in advanced stages (IIb-IV, Sézary syndrome). A peripheral blood T cell clone was detected in 42% of early stages and in 74% of late stages but was identical to the cutaneous one in 15% and in 63%, respectively. A significant association between initial clinical stage and T cell monoclonality was observed. In nonepidermotropic cutaneous T cell lymphomas, T cell monoclonality was detected in 55% of skin and 36% of blood samples. Univariate and multivariate analyses showed that, besides the initial clinical stage, an identical cutaneous and blood T cell clone was an independent prognostic factor for disease progression of mycosis fungoides/Sézary syndrome (hazard ratio 3.4, 95% confidence interval 1.4-9.9). Parallel polymerase chain reaction study of skin and blood specimens may therefore provide an initial prognostic marker that could help to monitor therapeutic strategies. A fully prospective study, with simultaneous therapeutic trials, needs to be done to confirm our findings and to include treatment variables in the statistical analysis.

Adult↗
PubMed2001

Sodium valproate-induced cutaneous pseudolymphoma followed by recurrence with carbamazepine.

We report a patient with a sodium valproate-induced cutaneous pseudolymphoma, presenting with an erythematous papule, histologically mimicking a non-epidermotropic T-cell lymphoma. Polymerase chain reaction study of the skin biopsy revealed monoclonal rearrangement of the T-cell receptor gamma gene. Withdrawal of sodium valproate was followed by regression of the lesion, but 5 months after substitution by carbamazepine, two further papules appeared, with similar histological features and a T-cell clone identical to the initial one. Carbamazepine was stopped and the lesions disappeared without relapse over a 4-year follow-up. Sodium valproate is very rarely responsible for a hypersensitivity syndrome, and our case is the first report of sodium valproate-induced cutaneous pseudolymphoma. The recurrence with carbamazepine may be due to a common effect on T-cell lymphocyte function. The return of the same monoclonal population shows that the recurrence of monoclonal T cells may be observed in benign conditions and is not an exclusive hallmark of cutaneous lymphoma.

Adult↗
PubMed2001

Multicenter randomized comparative double-blind controlled clinical trial of the safety and efficacy of zinc gluconate versus minocycline hydrochloride in the treatment of inflammatory acne vulgaris.

BACKGROUND: In addition to tetracyclines, zinc may constitute an alternative treatment in inflammatory lesions of acne. OBJECTIVE: To evaluate the place of zinc gluconate in relation to antibiotics in the treatment of acne vulgaris. METHODS: Zinc was compared to minocycline in a multicenter randomized double-blind trial. 332 patients received either 30 mg elemental zinc or 100 mg minocycline over 3 months. The primary endpoint was defined as the percentage of the clinical success rate on day 90 (i.e. more than 2/3 decrease in inflammatory lesions, i.e. papules and pustules). RESULTS: This clinical success rate was 31.2% for zinc and 63.4% for minocycline. Minocycline nevertheless showed a 9% superiority in action at 1 month and one of 17% at 3 months, with respect to the mean change in lesion count. Regarding safety, the majority of the adverse effects of zinc gluconate and of minocycline concerned the gastrointestinal system and were moderate (5 dropouts with zinc gluconate and 4 with minocycline). CONCLUSION: Minocycline and zinc gluconate are both effective in the treatment of inflammatory acne, but minocycline has a superior effect evaluated to be 17% in our study.

Abdominal Pain↗
PubMed2001

[Cutaneous pyoderma gangrenosum with hepatosplenic localization and monoclonal gammapathy. A case report].

Pyoderma gangrenosum is an ulcerative disease of the skin. The histopathological lesions are nonspecific, characterized by a diffuse neutrophilic infiltrate in the dermis. Pyoderma gangrenosum is associated with inflammatory, digestive or articular disease, or acute or chronic hemotology disorders in 50% of the cases, more rarely with monoclonal gammapathy. A visceral localization of pyoderma gangrenosum is rare, simulating a systemic disease or an underlying neoplasia. We report a case of cutaneous pyoderma gangrenosum with splenic and hepatic localizatios associated with an IgG monoclonal gammapathy. We emphasize the efficacy of immunosuppressor treatment and the importance of long-term monitoring of these patients.

Drug Monitoring↗
PubMed2000

[Subacute cutaneous lupus. Evolutive and therapeutic features of a series of 24 cases].

OBJECTIVE: Subacute cutaneous lupus is a clinical entity defined in 1979 by Sontheimer. Anti-malaria drugs are used as standard treatment for flare-ups, but in case of failure, less well-known alternative therapies may be used. The aim of this work was to determine how patients with subacute cutaneous lupus respond to these other treatments. PATIENTS AND METHODS: Twenty-four cases of subacute cutaneous lupus diagnosed between 1980 and 1998 and followed for 5 years (mean, range 3 months to 16 years) were reviewed retrospectively. Anti-malaria drugs were used as first line treatment in 23 cases and thalidomide alone or in combination in 13 cases. RESULTS: Prognosis of subacute cutaneous lupus was good in our series. There was no renal involvement and none of the patients presented neurological involvement of the psychiatric type. Anti-malaria drugs were insufficient in 13 cases. Thalidomide, either alone or in combination, was then used and was successful in 11 out of 13. Tolerance to treatment was good. Treatment withdrawal was required because of adverse effects in 4 out of 24 patients given anti-malaria drugs and in 3 out of 13 given thalidomide. DISCUSSION: Besides the good prognosis of subacute cutaneous lupus, our series emphasizes the important contribution of thalidomide to second line treatment.

Adult↗
PubMed2000

[Subacute cutaneous lupus erythematosus].

SKIN LESIONS: The concept that patients with subacute cutaneous lupus erythematosus (SCLE) skin lesions represent a distinct lupus erythematosus subset was proposed in 1979 by Sontheimer and supported by many studies. Skin lesions are papulo-squamous, psoriasiform or annular. Photosensitivity is a common complaint and photo-reproduction is significantly frequent in these patients. They persist for weeks or months and typically heal without atrophy or scarring with hyperpigmentation or more often hypopigmentation. SYSTEMIC INVOLVEMENT: Systemic disease is generally quite mild and the prognostic is usually favourable. High-titer, precipitating antibodies to Ro/SSA and HLA DR2 and/or HLA DR3 are strongly associated with SCLE. In some observations, the relation-ship between SCLE and drugs has been recognized. TREATMENT: Antimalarial agents are first line systemic treatment. Other therapies, including Thalidomide are helpful for patients with resistant disease. The pathomechanisms of photosensitive SCLE involved antigens Ro/SSA, epidermal and dermal cytokines, intercellular adhesion molecules, mononuclear cells.

Acute Disease↗
PubMed2000

[Descriptive epidemiological study of acne on scholar pupils in France during autumn 1996].

BACKGROUND: Acne is the most common symptom prompting patients to consult a dermatologist. No previous study has been conducted in France to determine the prevalence of acne and describe the main epidemiological features. SUBJECTS AND METHODS: A cross sectional study was conducted in November 1996 and included 913 school children aged 11 to 18 years. This sample was statistically representative of the entire secondary school population in France during the 1996-1997 school year. The subjects were stratified by 5 criteria: age, sex, rural or urban residence, sun exposure, type of school. RESULTS: Taking the clinical diagnosis made by the dermatologist investigator as the main criteria, the overall prevalence of acne was 72 p. 100. It was 76.1 p. 100 using the new ECLA grading system previously described. The prevalence of acne was sex and age dependent: highest scores were found for girls aged 14-16 years and for boys aged 16-17 years. Genetic factors were very important for the outcome of acne. Finally, 41 p. 100 of the acneic subjects were following a treatment, prescribed by a dermatologist in two-third of the cases. DISCUSSION: These results are in agreement with those previously published in the literature although some differences were disclosed. It would appear important to distinguish between minimal acne with a few retentional pimples occuring during adolescence and severe acne (more than 20 pimples on the face) requiring early medical care to avoid scarring.

Acne Vulgaris↗
PubMed2000

[Successful treatment of corticoid-resistant pemphigus with high-dose intravenous immunoglobulins].

INTRODUCTION: Pemphigus vulgaris is a serious autoimmune bullous disease, that may be difficult to control. Although corticosteroids have dramatically improved the outcome of the disease, this treatment may be complicated by unresponsiveness or serious side-effects. We report the case of a patient with pemphigus vulgaris refractory to corticosteroids who responded rapidly to the addition of high-dose intravenous immunoglobulins. CASE REPORT: A 38-year-old man presented with a 1-month history of widespread bullous lesions of the skin and oral mucosa. The diagnosis of pemphigus vulgaris was made on the results of histology and direct immunofluorescence of perilesional skin. Systemic corticosteroids were initially started, but cutaneous and mucosal lesions poorly responded after 6 weeks. Mensual cycled of intravenous immunoglobulins were then begun and led to a complete disappearance of the lesions after three cycles. Four courses of high-dose intravenous were administered, that allowed to reduce doses of steroids. The patient was in complete remission without treatment after a two-year follow-up. DISCUSSION: Pulse therapy with high-dose intravenous immunoglobulins has been occasionally used for the treatment of pemphigus vulgaris, especially in an attempt to reduce side-effects of immunosuppressive agents or when these therapies are ineffective. We report an additional case, suggesting in addition of recent data of literature, that immunoglobulins may be useful as an alternative treatment in pemphigus vulgaris.

Adrenal Cortex Hormones↗
PubMed2000

[Chronic lymphocytic leukemia revealed by atypic pemphigus].

BACKGROUND: Bullous diseases are occasionally reported during chronic lymphocytic leukemia. We report the case of a woman in which a bullous disease of difficult nosologic classification has revealed chronic lymphocytic leukemia. CASE REPORT: A 57-year-old woman, well-known for a rheumatoid arthritis, developed a bullous eruption. It was associated with voluminous lymphadenopathies, and laboratory investigations revealed a chronic lymphocytic leukemia. Clinicopathological aspect and immunofluorescence studies argued for a paraneoplastic pemphigus but immunoblot showed only antibodies against desmoglein 1. DISCUSSION: Paraneoplastic pemphigus is an autoimmune bullous disease defined by the criteria of Anhalt, including autoantibodies mostly directed against cytoplasmic proteins of the plakin family. Our case is unusual for the absence of these antibodies and for the presence of antibodies directed against a cell surface target, desmoglein 1. Such a case confirms the overlapping auto-immune responses in pemphigus.

Arthritis, Rheumatoid↗
PubMed1999

Leg ulcers and hydroxyurea: forty-one cases.

BACKGROUND: Hydroxyurea is an antitumor agent used to treat chronic myeloproliferative disorders. Leg ulcerations have been reported in patients undergoing long-term hydroxyurea therapy for myeloproliferative diseases. To better define this dermatological adverse effect of hydroxyurea therapy and to try to understand the pathophysiological process of this disease, we collected medical information for such patients in a multicenter retrospective study. OBSERVATIONS: Forty-one patients (mean age, 67 years) developed leg ulcerations while undergoing hydroxyurea therapy (mean therapy duration, 5 years). The sex ratio was 1, and there was no underlying vascular disease. Hematologic abnormalities were identified. Complete recovery from the ulcerations occurred quickly after withdrawal of treatment in 33 (80%) of the cases. CONCLUSIONS: This longest-reported series of patients confirms the role of hydroxyurea therapy in the onset of leg ulcerations. Healing or improvement requires cessation of treatment. Cutaneous atrophy and impaired wound healing may explain the relationship between hydroxyurea and leg ulcers. In addition, the megaloblastic erythrocytes resulting from the presence of hydroxyurea may circulate poorly through the capillary network. A prospective study in hematologic centers would be valuable.

Adult↗
PubMed1999

[Acrodystrophic neuropathy of Bureau and Barrière].

INTRODUCTION: The acrodystrophic neuropathy described by Bureau and Barrière in the 1950s is a rare trophic complication of chronic, analgesic neuropathy due to alcohol abuse, which is at the origin of perforating ulcers of the foot, vasomotor disorders with dysautonomia, and leads to mutilating arthropathy of the lower limb. This neuroacropathy, also termed vagabonds' or vagrants' disease, usually occurs in subjects with a debilitated condition, chronic alcoholism, and unfavourable socioeconomic conditions. EXEGESIS: We report four cases of Bureau-Barrière disease which occurred in male subjects who were on average 55 years of age. The clinical presentation was close to that reported in the literature. Indeed, all four patients were alcoholic, nondiabetic and lived under conditions of precarious hygiene. Therapeutic management of the patients was difficult due to bad compliance with the treatment and persistence of alcohol abuse. Immobilization of the foot is considered to be the primary treatment. Local care including baths and bandages with hydrocolloids must be continued during several months, and associated with antibiotic therapy, administered by infusion when necessary. The outcome is often chronic, with poor prognosis. Given the limited therapeutic possibilities, acrodystrophic neuropathy is an invalidating disease with high morbidity. CONCLUSION: Bureau-Barrière disease is a rare, serious invalidating disease. The clinical symptomatology is usually based on the diagnostic triad: analgesia of the foot, perforating ulcers of the foot, and deforming and mutilating arthropathy of the lower limb. Treatment is often hampered due to poor compliance with local care and persistence of alcohol abuse.

Alcoholism↗