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C Derancourt

Publications and source records attributed to C Derancourt.

At least 37 records · Page 2Linked to original sources
PubMed2000

[Acute generalized exanthematous pustulosis in hypercalcemia].

BACKGROUND: We report a case of typical exanthematous pustulosis rash that was particularly severe both clinically and biologically. Laboratory tests led to the diagnosis of acute parvovirus B19 infection. CASE REPORT: A 23-year-old man with no past medical history developed fever with an erythematous pustulosis rash predominantly involving the folds. Blood cell count revealed hyperleukocytosis. There was no previous drug intake. This skin reaction was associated with severe systemic manifestations including hypovolemic shock, and hematologic and metabolic disturbances. Virology tests revealed acute parvovirus B19 infection. The hospital physician caring for this patient also presented evidence of acute parvovirus B19 infection. DISCUSSION: The clinical features and the course of this skin eruption were typical of generalized exanthematous pustulosis. We discuss the rare viral causes of acute generalized exanthematous pustulosis and compare our case with a previously reported case of acute generalized exanthematous pustulosis with mononucleosic syndrome in a patient with no prior drug intake. The clinical and biological manifestations of this case were similar to drug hypersensitivity syndrome.

Acute Disease↗
PubMed1999

[Papillomavirus-induced anogenital lesions in 121 HIV seropositive men. Clinical, histological, viral study, and evolution].

OBJECTIVE: To determine the prevalence of the Human Papillomavirus (HPV) in Human Immunodeficiency Virus (HIV) infected men, using clinical examination and molecular hybridization in situ. PATIENTS AND METHODS: From May 1995 to May 1997 we studied the prevalence, clinical and histological characteristics, the types and the evolution of the HPV lesions among 121 HIV-infected men. The HPV DNA was determined by molecular hybridization in situ, using biotinylated probes which recognized HPV types 6/11, 16/18 and 31/33/35 in 79 p. 100 (5/19) of the patients (17 biopsies). RESULTS: Sixteen per cent (19/121) of the patients are HPV infected: genital warts in 37 p. 100 (7/19), anal warts in 37 p. 100 (7/19), and ano-genital warts in 26 p. 100 (5/19) of the patients. In every case of anal codyloma, intracanalar lesions were found. In 47 p. 100 (9/19) of the cases, histological exam showed an intra-epithelial neoplasia. The HPV types 6/11, 16/18 and 31/33/51 were positive in 53 p. 100 (9/17), 35 p. 100 (6/17) and 35 p. 100 (6/17) biopsies respectively. High-risk types of HPV have been noted in 71 p. 100 (12/17) of the biopsies. The evolution of the clinical lesions was: recovering in 47 p. 100 (9/19) of the patients (after 3 months of treatment), recurrence in 16 p. 100 (3/19) of the anal warts (after 1 to 3 months of treatment), stabilization in 16 p. 100 (3/19) of the genital warts (after 6 months of treatment) and extension in 11 p. 100 (2/19) of the anogenital warts (after 3 months of treatment). CONCLUSION: The high prevalence of condyloma and dysplasia emphasizes the importance of the anogenital exam in HIV-positive patients. In case of anal lesions, anuscopy and biopsy are required. We insist on the need to closely follow these patients with HPV lesions in order to adapt treatment. Anal cytology and HPV-DNA detection by Hybrid Capture Assay, should be developed for screening and prevention of the malignant transformation of HPV lesions in this population.

AIDS-Related Opportunistic Infections↗
PubMed1999

[Oncogenic mucosal human papillomaviruses in Bowen's disease of the hands].

INTRODUCTION: The association between genital Bowen Disease (BD) and human papillomavirus (HPV) especially HPV-16 infection is well known, but it is more rarely related to extragenital BD. The aim of this study was to detect the presence of oncogenic HPV infection in the BD of the hands considering the histology and the presence of oncogenic HPV detected by in situ hybridization (ISH) and polymerase chain reaction (PCR). MATERIAL AND METHODS: Eleven formalin-fixed and paraffin-embedded samples of BD of the hands were selected. We looked for koilocytosis using standard histological procedure. ISH was performed using genomic HPV DNA probes types 16, 18 and 33 labeled with digoxigenin. Next, with a new amplification system using biotinyled tyramide (Kit Dako Gen Point K620) was used to detect hybrids. Otherwise, Baay's HPV type specific primers (type 16, 18, 31 et 33) were chosen for PCR. RESULTS: Koilocytosis were observed in all cutaneous samples. HPV 16 was detected in 9/11 cases (82 p. 100): 2/10 with ISH and 9/11 with PCR. DISCUSSION: We report here the largest series of BD of the hands, associated with HPV type 16 infection. This high rate (82 p. 100) compared to the other series is linked to the high sensitivity of PCR and is increased by the choice of Baay's oligonucleotide primers. Besides, the low HPV rate (2/10) by ISH, is similar to those obtained in the other series. Although ISH is less sensitive than PCR, the morphological study was useful to argue the pathogenicity of HPV. Finally, the high prevalence of genital oncogenic HPV on the hands, plaid in the scratching hypothesis resulting in autoinoculation from HPV lesions in the genital region.

Aged↗
PubMed1997

[Recurrent pyogenic granuloma or Warner and Wilson-Jones syndrome].

BACKGROUND: Recurrent pyogenic granuloma with multiple satellite lesions is a rare and benign condition; its diagnosis may be clinically evoked from a characteristic natural history. CASE REPORTS: Two 12 year-old boys developed multiple small cutaneous lesions following removal of pyogenic granuloma, at the periphery of the scar. A CO2 laser treatment was decided in one case, and therapeutic abstention in the other one. CONCLUSION: Our two cases completely fit with the classical features of such a condition that generally clears spontaneously. This syndrome must be known because of its "pseudo-metastatic" clinical features, which may mislead the physician.

Child↗
PubMed1992

[Calcifying panniculitis].

We report a case of calcifying panniculitis which occurred in a 67-year old woman suffering from chronic renal failure and primarily involved anticoagulant injection sites. Calcifying panniculitis is a rare condition belonging to the spectrum of calciphylaxis first described by Selye in 1962. This disease seems to imply necessarily a specific morbid background including renal failure together with calcium-phosphate metabolism impairment. Following the action of a so-called "challenger" (in the present case calcium heparinate [Calciparine], a subcutaneously administered anticoagulant drug), the lesions start as painful subcutaneous nodules soon turning into plaques of necrosis. The area involved mainly includes the abdomen and thighs, due to the preferential distribution of fat and the classical use of such regions for subcutaneous injections. In our patients, histological examination disclosed an initial involvement of subcutaneous fat vessels mimicking mediacalcosis, soon followed by calcium-phosphate deposits within interadipocyte spaces. An electron microscopy study confirmed the presence of calcium crystals within the cytoplasms of some connective tissue cells and the extracellular matrix. From a review of the literature, it seems reasonable to normalize the calcium-phosphate product by reducing hyperparathyroidism as a first therapeutic step. Then, wide surgical excision of the necrotic areas should be performed to rule out any possibility of self worsening of the lesions and provide the best chance of healing without superinfection. The use of diphosphonates on pathophysiological grounds is discussed.

Aged↗
PubMed1991

The tetracyclines in dermatology.

Tetracycline is one of the most widely used antibiotics. It may share some properties with conventional immunosuppressive drugs and act as an anti-inflammatory agent in the treatment of inflammatory disease. This article reviews cutaneous diseases that have been treated with tetracyclines and their antiinflammatory and immunosuppressive properties.

Humans↗
PubMedDate not supplied

[Granuloma annulare of the photoexposed areas in two liver transplant recipients].

BACKGROUND: We report two cases of generalized granuloma annulare occurring in photoexposed areas in two liver transplant recipients. CASE REPORTS: Case 1 was a 65-year-old man who had undergone liver transplantation in 1992. He was given immunosuppressive and antihypertensive therapy. Within 18 months of transplantation, he developed a confluent rash with maculae on sun-exposed areas (neck opening, nape, arms) and sparing the undershirt area. Clinical examination was normal. Skin biopsy revealed a palissade infiltrate located in the middle and upper derma, suggestive of granuloma annulare, with elastophagocytosis patterns (orcein stain and ultrastructure study). Photoexposure granuloma was diagnosed. Case 2 was a 59-year-old man who had undergone liver tranplantation in 1994. He was given immunosuppressive and antihypertensive therapy and developed within 4 months a dark rash on the neck opening and nape, sparing photoprotected areas. Histopathology revealed granuloma annulare. Elastophagocytosis was disclosed by orcein stain and the ultrastructure study. DISCUSSION: This clinical presentation of granuloma annulare in two liver transplant recipients is unusual. We discuss the clinical and histopathological patterns observed in our two cases and the relationships between granuloma annulare and immunosuppression.

Aged↗
PubMedDate not supplied

[Oncogenic human papillomaviruses in extra-genital Bowen disease revealed by in situ hybridization].

BACKGROUND: The association between mucosal oncogenic human papillomaviruses (HPV) and bowenoid papulosis or genital Bowen's disease is well documented. In contrast this association with extra-genital Bowen's disease is poorly studied. The aim of this study was to detect oncogenic (16/18, 31/33/51) and non oncogenic (8/11) mucosal HPV using a in situ hybridization method in 28 skin biopsy specimens of extra-genital Bowen's disease. PATIENTS AND METHODS: Twenty-eight cases of extra-genital Bowen's disease seen in the period 1990-96 in the Dermatology department were included: 19 women and 9 men (mean age: 72 years). Bowen's disease locations were: hands and feet (8 cases), limbs (11 cases), face (8 cases), trunk (1 case). Blinded histopathologic examination confirmed the diagnosis of Bowen's disease and signs of HPV infection (koilocytosis). In situ hybridization was performed using three biotinylated probes detecting HPV types 6/11, 16/18, 31/33/51. RESULTS: Oncogenic HPV genoma was detected in 8 skin samples (28.6 p. 100). In all these cases, 16/18 probe was positive and in two cases, both 16/18 and 31/33/51 probes were positive; 4/8 Bowen's diseases of the extremities were positive for HPV. Koilocytes were found in 6/8 of skin samples with positive HPV detection. DISCUSSION: Mucosal oncogenic HPV are detected by in situ hybridization in 28.6 p. 100 of extra-genital Bowen's disease. In situ hybridization is an easier technique than Southern-Blot hybridization which is the gold standard. Five studies reported similar results and three studies reported different results that we discuss. A precise understanding of oncogenic HPV implication in the development of extra-genital Bowen's disease could lead to the development of new therapeutic strategies (topical cidofovir or imiquimod).

Aged↗
PubMedDate not supplied

[Skin location of multiple myeloma mimicking a vascular tumor].

INTRODUCTION: Cutaneous location of multiple myeloma is rare, and generally develops as a consequence of direct spread from an underlying bony focus of the disease. Metastatic skin lesions without adjacent bone involvement are uncommon. The prognosis is very poor. CASE REPORT: A 74-year-old man consulted for a hemorrhagic cutaneous nodule localized on the left inguinal area. This patient had been treated for five months for a stage I IgG lambda multiple myeloma. The histopathologic examination of the lesion showed a predominantly nodular configuration made up of masses of atypical cells with numerous hemorrhagic areas. The diagnosis of cutaneous metastasis of multiple myeloma was confirmed by the positivity of the cells for anti-IgG lambda antibodies. DISCUSSION: Cutaneous involvement in multiple myeloma without extension from underlying bony focus is exceptional. The lesions generally consist of firm, erythematous nodules involving the neck and lower extremities. To our knowledge, we present here the first case mimicking clinically and histologically a malignant vascular proliferation.

Aged↗