Biomedical subjects

C Piérard-Franchimont

Publications and source records attributed to C Piérard-Franchimont.

At least 19 recordsLinked to original sources

PubMed2003

Regional variability in mottled subclinical melanoderma in the elderly.

The density in melanin chromatophores becomes heterogeneous in the epidermis during the early events of photoaging. Little is known about the regional variability in the resulting mottled skin appearance on the sun-exposed parts of the body in the elderly. The relationship between these features and the dermal atrophy related to aging is also an area ripe for study. The aim of the present study was to objectively assess and compare such aspects of photoaging in older subjects. A computer-assisted video camera equipped with an internal ultraviolet-emitting unit (Visioscan) was used in combination with image analysis to quantify the infraclinical mottling of the skin on the forehead, neck and dorsal forearm. A Densi Score device served to assess the dermal atrophy by rating the skin folding capacity. A mottled subclinical melanoderma was disclosed on the three evaluation sites in all subjects irrespective of their phototypes. Three main patterns were identified corresponding to regular perifollicular dots, streaky macules along shallow wrinkles and unevenly shaped macules in the interfollicular area. The extent in melanoderma was larger on the forehead than on the neck and forearm. The age after 60 years did not influence the severity of mottled melanoderma, but clearly altered the skin folding capacity. The greatest inter-individual differences in mottled melanoderma were found in phototype II subjects. In conclusion, infraclinical mottled melanoderma is present in all individuals after 60 years of age. This type of epidermal photoaging does not appear to be influenced in older ages. By contrast, skin laxity due to dermal aging continues to progress beyond the age of 60 years.

Aged↗

PubMed2003

[Adverse cutaneous reactions to antidepressants].

Due to the widespread usage of antidepressants by the population, they represent a class of drugs which is at high risk for cutaneous side effects. The diversity in the clinical presentations is large. The variability in their severity is large as well. Morbidity may be quite severe, but the vital prognosis is rarely affected.

Alopecia↗

PubMed2003

[How to manage seborrheic dermatitis].

Seborrhoeic dermatitis results from a peculiar inflammatory reaction directed to yeasts of the genus Malassezia which are present at the skin surface. The current therapeutic strategies to control episodes of the dermatitis target the yeasts, the host reaction or both.

Antifungal Agents↗

PubMed2003

[Skin diseases and obesity].

Obesity is a chronic multifactorial disease representing a major health problem. Among its consequences, diverse facets of the cutaneous physiology are altered. Some dermatoses are also more prevalent. The most typical ones are acanthosis nigricans, skin tags, signs of hyperandrogeny, striae distensae, stasis acroangiodermatitis, leg ulcers, lymphoedema and intertrigo.

Humans↗

PubMed2003

[Medication of the month. Topical pimecrolimus (Elidel)].

Pimecrolimus inhibits some specific steps of the Th1 and Th2 immune reactions. It belongs to the class of ascomycin macrolactams. The topical drug formulation targets cutaneous inflammation, more particularly lymphocytes and mast cells without impairing systemic immunosurveillance. Topical applications are indicated for treating atopic dermatitis. In this indication, it represents an alternative or an adjuvant drug to topical corticosteroids. The treatment of other dermatoses could also benefit from pimecrolimus.

Administration, Cutaneous↗

PubMed2003

[Medication of the month. Lowette, a contraceptive for treating acne in young women].

Acne is a multifactorial disorder affecting the vast majority of adolescents and young adults. Among the therapeutic armamentum, estroprogestative contraception can be offered to young women. The choice must, however, be carefully targeted because the estroprogestative associations do not show similar anti-acne efficacy. A new contraceptive associating 20 micrograms of ethinyl estradiol and 100 micrograms of levonorgestrel (Lowette) has proven its clinical efficacy in this indication.

Acne Vulgaris↗

PubMed2003

[Dying for a tan versus osteomalacia. The solar protection dilemma between charybdis and scylla].

Sun is at the origin of life. It can also be responsible for death. In the past decades cutaneous melanoma killed more and more young adults. Currently, the disease still progresses in the population, but survival increases hopefully. Sun is pointed out as the main culprit. Hence, protection against harmful effects of ultraviolets is mandatory. However, preventive measures to be taken generate heated scientific argument. Sunlight exposure particularly in moderation is indeed necessary for health through vitamin D3 synthesis and psychological effects on wellbeing. Vitamin D3 provides numerous biological effects, particularly on bone calcification and also by inhibiting proliferation and migration of malignant cells including melanoma cells. Hence, we are facing the dilemma between too much and too little ultraviolet light exposure. Anyway, one cannot advocate that people lie in the sun until they burn or until they turn a rich brown complexion.

Humans↗

PubMed2003

[Drug of the month. Voriconazole (Vfend)].

Invasive fungal infections are a rare but important cause of morbidity and mortality among patients with severely compromised host defenses. Despite considerable advances in antifungal therapies over the past years, invasive mycoses remain a stubborn and dramatic problem. Voriconazole is a new triazole antifungal agent which confers a relative survival benefit in fluconazole-resistant invasive candidiasis, and in invasive aspergillosis, fusariosis and Scedosporium infections as well.

Antifungal Agents↗

PubMed2003

[Tinea capitis from here and elsewhere. Geographic variables in prevention].

Few diseases exhibit such regional variability in their epidemiology, even in an area as limited as Belgium, as tinea capitis. Thus, anthropophilic tinea capitis is highly predominant in areas where new immigrants from Black Africa and North Africa have settled. By contrast, zoophilic tinea capitis is found largely in areas where the cat population is infected. Kerion often affects professions in which contact with infected livestock is involved. Prevention of tinea capitis thus has distinct regional features. Treatment, on the other hand, has a universal basis.

Africa↗

PubMed2003

[Leg heaviness and stasis microangiopathy. Preventive and therapeutic approaches].

Venous insufficiency of the legs is a frequent and insidious disorder which, through its consequences' cascade, lead to some cutaneous microangiopathy with relative ischemia. Chronic leg ulcer is the late issue of the process accompanied by varied medical and socio-economic aspects. The pathogeny of the cutaneous lesions is directly related to alterations in hemorrheology and leukocyte adhesion inside capillaries. Elastic contention and some venotropic drugs exert preventive effects on the development of leg ulcers. They also bring some therapeutic improvement of the symptoms of leg heaviness.

Diabetic Angiopathies↗

PubMed2002

Factor XIII a-positive dermal dendrocytes and shear wave propagation in human skin.

BACKGROUND: The in vivo interdependence between the phenotypic characteristics of dermal cells and the strain imposed on the tissue has not been studied thoroughly in humans. In particular the mechanical force modulation of Factor XIII a expression in dermal dendrocytes (DD) remains unknown. MATERIALS AND METHODS: The present study compares the numerical density of Factor XIII a-positive DD and the in vivo shear wave velocity in the skin. The investigation was performed in 20 men of normal weight and 20 obese men before and after entering a slimming process. RESULTS: Excess cutaneous fat places the skin under increased intrinsic tension. The resonance running time measurement (RRTM) and the DD density were significantly reduced in overweight individuals. After a short-term but intense slimming process, the same individuals showed a trend to normalization of these two parameters without, however, reaching significance. Pooling all data yielded a significant logarithmic correlation between RRTM values and densities in Factor XIII a-positive DD. CONCLUSION: Factor XIII a expression in human DD may be partially regulated by the intrinsic resting tensions in the skin.

Adult↗

PubMed2002

Postmenopausal aging of the sebaceous follicle: a comparison between women receiving hormone replacement therapy or not.

BACKGROUND: The endocrine control of sebaceous follicles is complex in women. During aging, a decline in sebum output is often experienced. However, some women report increased seborrhea after the menopause. OBJECTIVE: In this study, the follicular reservoir function was studied during the first decade following the menopause. METHODS: Four evaluations were made at 3-week intervals in two parallel age-matched groups of 50 postmenopausal women receiving hormone replacement therapy (HRT) or not. The Sebumeter served to measure the casual sebum level and the sebum excretion rate on the forehead. In addition, a Visioscan equipped with an ultraviolet-recording camera was used with and without lipid-sensitive tapes interposed between the camera and the skin surface. Follicular openings and sebum pore patterns were studied by image analysis. RESULTS: There was enormous diversity among individual values of sebum output at the skin surface. In untreated women, a significant decline in sebum excretion rate accompanied by an increase in both the sebum replacement time and the mean pore size were evidenced during the first decade after the menopause. The sebum excretion rate and casual level showed a wide range of interindividual differences early after the menopause. These physiological changes were less prominent in women receiving HRT. CONCLUSION: Postmenopausal aging affects the sebum production, but HRT does not significantly control the complex process of seborrhea. However, HRT mitigates the progressive enlargement of the openings of the sebum follicular reservoir.

Estrogen Replacement Therapy↗

PubMed2002

The beneficial toxicity paradox of antimicrobials in leg ulcer healing impaired by a polymicrobial flora: a proof-of-concept study.

BACKGROUND: Some of the views contrasting the beneficial and toxic effects of antimicrobials upon wound healing remain controversial. OBJECTIVE: To assess the clinical relevance of histological findings following antimicrobial applications on chronic leg ulcers. METHOD: The present study was performed in three parallel groups of 17 patients suffering from at least 2 similar chronic leg ulcers. Clinical planimetric assessments were performed before and after 3 and 6 weeks of treatment using hydrocolloid dressings. In addition, 1 ulcer in each patient received applications of povidone-iodine (PVP-I), silver sulfadiazine or chlorhexidine digluconate. Histological examinations were made at inclusion and after the 6-week therapy. Time to healing was also recorded. RESULTS: At entry in the study, fibroblasts, macrophages, neutrophils and vessels were abundant in the ulcers. In addition, focal necrotizing vasculitis was related to the microbiological load. Compared to the control lesions, both the healing rate and time to healing of the leg ulcers showed a modest improvement at the sites receiving silver sulfadiazine (2-7%) or chlorhexidine digluconate (-1 to 5%). By contrast, PVP-I increased significantly the healing rate (4-18%, p < 0.01), and time to healing was reduced by 2-9 weeks (p < 0.01). The 3 antimicrobials decreased the bacterial density, and the vascular margination and migration of inflammatory cells, thus abating the vasculitic changes. PVP-I applications did not alter the microvessels and did not significantly reduce the density in dendrocytes and fibroblasts. By contrast, both silver sulfadiazine and chorhexidine digluconate appeared to alter the superficial microsvasculature including the dendrocyte population. CONCLUSION: Although topical antimicrobials may apparently achieve almost similar activity on the bacterial load inside chronic leg ulcers, the toxicity upon host cells was different among these agents. PVP-I appeared to be an efficient compound in these respects exhibiting a positive and relevant clinical effect.

Anti-Infective Agents, Local↗

PubMed2002

Euclidean and fractal computer-assisted corneofungimetry: a comparison of 2% ketoconazole and 1% terbinafine topical formulations.

BACKGROUND: The corneofungimetry bioassay was designed as a unique model predicting the efficacy of topical and oral antifungals in dermatomycoses. OBJECTIVE: In this 2-step study performed in two groups of 15 volunteers, corneofungimetry was used to compare the effect of 5-day b.i.d. treatments with 2% ketoconazole and 1% terbinafine creams. METHODS: The bioassay was performed using 10 isolates of each of the 3 fungi Trichophyton rubrum, T. mentagrophytes var. interdigitale and Candida albicans put to grow on human stratum corneum. Controls were stratum corneum either untreated or enriched in propylene glycol contained in an unmedicated vehicle. Quantitative assessments were made using both Euclidean and fractal geometry parameters. RESULTS: In comparison with untreated stratum corneum, the fungitoxic activity of the 2% ketoconazole and 1% terbinafine formulations was obvious and similar against dermatophytes. By contrast, 2% ketoconazole was significantly more active against C. albicans than 1% terbinafine. The propylene-glycol-containing vehicle did not exhibit a significant effect upon the dermatophyte growth. Positive linear correlations were yielded between the extent area and the fractal dimension D of dermatophyte mycelia. By contrast, D appeared unrelated to the relative area of dermatophyte growth compared to controls. CONCLUSION: The combination of Euclidean and fractal analyses improves the information provided by the corneofungimetry bioassay. Creams containing 2% ketoconazole and 1% terbinafine appear equally effective against dermatophytes while the former is more potent against Candida albicans.

Administration, Topical↗

PubMed2002

Assessment of topical hypopigmenting agents on solar lentigines of Asian women.

BACKGROUND: So-called darkened age spots encompass distinct pathological processes. The efficacy of topical depigmenting agents is difficult to objectivate. OBJECTIVE: To assess the hypopigmenting effect of three cosmetic formulations using objective biometrological methods. METHODS: 50 women of South-East Asian ancestry were enrolled in this pilot study. They had solar lentigines according to dermoscopic criteria. The lesions were treated by topical hypopigmenting formulations. Products were applied twice daily for 2 or 3 months. Assessments at 1-month intervals were made using narrow-band reflectance spectrophotometry, image analysis of video-recorded ultraviolet light reflection and photodensitometry- and image-analysis-assisted corneomelametry. RESULTS: A 20% azelaic acid formulation and another one containing 5% ascorbyl glucosamine, 1% kojic acid and alpha-hydroxyacid esters appeared inefficacious on solar lentigines. A stabilized soy extract showed a better although modest lightening effect when assessed by corneomelametry. The subclinical or faint mottled skin revealed by ultraviolet light examination better responded (p < 0.05) to treatments. CONCLUSION: Focal epidermal hyperpigmentation is better controlled by topical whitening agents when the increase in melanin content reflects a modest functional hyperactivity of melanocytes.

Administration, Topical↗

PubMed2002

A double-blind placebo-controlled study of ketoconazole + desonide gel combination in the treatment of facial seborrheic dermatitis.

BACKGROUND: The pathobiology of seborrheic dermatitis is rooted in a peculiar inflammatory reaction to Malassezia spp. Both topical corticosteroids and antifungals are routinely used with success, either singly or in combination. OBJECTIVE: To assess the effect of a new combination therapy in this condition. METHODS: Eighteen patients with facial seborrheic dermatitis were treated in a pilot double-blind trial with an anhydrous gel containing the combination of 2% ketoconazole and 0.05% desonide (n = 9) or the unmedicated gel (n = 9). The products were applied once daily for 3 consecutive weeks. Disease severity was assessed at the start and weekly during treatment, as well as 2, 4 and 8 weeks after the end of treatment or at the time of recurrence. The overall clinical assessments were performed using a visual analogue scale. Objective measurements included squamometry X after harvesting the stratum corneum and the erythema index yielded by narrow-band reflectance spectrophotometry. Data were evaluated in an intent-to-treat analysis. RESULTS: The combination therapy yielded reductions in the overall clinical symptom severity of 49, 84 and 92% after 1, 2 and 3 weeks of treatment, respectively. The corresponding improvements with the placebo gel were significantly smaller (p < 0.01), reaching 23, 29 and 42% at successive 1-week intervals. At the end of the 3-week treatment, the clinical signs had completely subsided in 6/9 patients treated with the medicated gel and in only 1/9 patients using the placebo gel. Thus, the clinical response rate was significantly faster (p < 0.01) with the combination therapy than with the vehicle. Differences between the treatment groups using objective noninvasive assessments were also significantly (p < 0.01) in favor of the combination therapy. The squamometry X measurements showed 47, 67 and 74% improvements with the combination gel after 1, 2 and 3 weeks, respectively. The corresponding values with the placebo gel were 34, 46 and 53%, respectively. The erythema index was almost completely reduced to normal at week 2 of treatment in contrast with about 50% reduction with the unmedicated vehicle. None of the patients reported any side effects. CONCLUSION: The combination of ketoconazole with desonide in an anhydrous gel is well tolerated and proves to be significantly more effective than the vehicle for treating facial seborrheic dermatitis. The fast response to treatment and the limited additional improvement between weeks 2 and 3 of the treatment suggest that this combination product may be efficacious with once daily applications for 2 weeks. These data call for expanded studies comparing each single compound, the vehicle and the combination therapy.

Administration, Cutaneous↗

PubMed2002

[Tanning benches to accusation benches].

Sunbeds used in sun parlours do not garantee a controlled innocuity. By contrast, health hazards are obvious in many instances. Forceful tanning is a transitory aspect behind which the spectrum of many skin changes includes accelerated photoageing, irreversible pigmentary and keratotic changes, and cutaneous malignancies including malignant melanoma. In the absence of protection, the eye is also affected. Even if tanning salon exposure increases the risk for skin cancer by a small amount, it represents a significant potential public health hazard given the number of people attending salons. Digital dermoscopy and ultraviolet light videoscopy are new methods allowing to predict the cutaneous ransom to be paid by the sunbed worshippers.

Humans↗

PubMed2002

[Pharma clinics. How I treat ... recurrent herpes labialis].

Recurrent herpes labialis is a frequent disorder. It occurs following the reactivation of the Herpesvirus (HSV1 and more rarely HSV2) inside the Gasser ganglion. Treatment and prevention of recurrent labial herpes are targeted by specific antiviral agents. Spectacular benefits obtained in the immunocompromised patients are less convincing in otherwise healthy subjects. Other prospective ways of therapy are under consideration, including lipopeptides and physical means aiming at modifying the cutaneous pH.

Acyclovir↗