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Biomedical subjects

E Grosshans

Publications and source records attributed to E Grosshans.

At least 145 records · Page 8Linked to original sources
PubMed1996

[Oxiconazole cream versus ketoconazole cream. A prospective, randomized, double-blind, multicenter study in the treatment of inguinocrural dermatophytoses].

INTRODUCTION: The aim of this study was to compare oxiconazole, 1 p. 100 cream, with ketoconazole, 2 p. 100 cream, applied once-daily, in the treatment of tinea cruris. PATIENTS AND METHODS: A prospective, randomized, double-blind trial was performed in 8 dermatology departments on two parallel groups in patients having this type of mycosis confirmed by mycological examination. RESULTS: The efficacy was analyzed in 66 out of the 79 patients included in the study (36 patients treated with oxiconazole, 30 with ketoconazole). At Day 14, a first assessment was made and 77.1 p. 100 of the patients treated with oxiconazole had been cured; this result was significantly better (p < 0.05) than that obtained with ketoconazole (51.7 p. 100 of cured patients). At Day 21, after a further week of treatment, both treatments were efficient with statistically non-different results between the two groups: 97.2 p. 100 of the patients treated with oxiconazole, versus 86.7 p. 100 with ketoconazole. Thus, a greater rapidity of action of oxiconazole was observed. No correlation was detected between the ratio of cured patients and the duration of the mycosis. The safety was assessed in 74 patients. No adverse effects were reported for the patients treated with oxiconazole, whereas 9 patients treated with ketoconazole experienced contact sensitization reactions and irritant skin reactions due to the application of the product. The difference between the two groups of treatment was statistically greatly significant (p < 0.001). Furthermore, acceptance of the drug on the part of the patient was better (p < 0.05) with oxiconazole. DISCUSSION: After 3 weeks of topical treatment oxiconazole has revealed itself to be as efficient as ketoconazole, but it seems more rapidly efficient and better tolerated than ketoconazole.

Administration, Topical↗
PubMed1996

[Comparative measurements of oral and rectal temperatures in 224 hospitalized patients].

We made a simultaneous measurement of oral temperature with an electronic thermometer and rectal temperature with a glass mercury thermometer in 224 in-patients. The results show that the difference between oral and rectal temperature is unpredictable and often important especially when the patient is febrile. It is impossible to determine a correction factor of the oral temperature which would allow a more sensitive and specific detection of patients with fever.

Adolescent↗
PubMed1996

[Histopathology of exogenous and idiopathic lucites and provocation phototests].

OBJECTIVE: Provocative phototests are used regularly to explore photobiology in patients with photodermatoses. Our objective was to determine the reliability of the phototest in the diagnosis of idiopathic and exogenous light eruption in order to identify the ideal date for the histological examination by correlation between the histological aspects of light- triggered and spontaneous lesions. PATIENTS AND METHODS: Among 66 patients, there were 48 with polymorphous light eruptions, 13 with exogenous eruptions and 5 with chronic actinodermatitis. The histological findings of the provocative phototests were correlated with the clinical aspect, the date of biopsy and the histological aspect of the spontaneous lesions. RESULTS: In polymorphous light eruptions (48 cases) this test triggered a photoallergic reaction in 48% of the patients. There was a good correlation between the histological findings and clinical features in 96% of the cases. The histological image of the light-triggered lesion on day 6 was the closest to that of the spontaneous lesion. In exogenous eruptions and chronic actinodermatitis (18 cases), only 33% of the clinically positive phototests were also positive at histological examination. The histological image was the same for the provocative tests whether they were clinically positive or negative, with signs of epidermal phototoxicity, regeneration acanthosis and moderate perivascular lymphocyte infiltration of the superficial dermal layer. CONCLUSIONS: Our findings confirmed that the phototest provides a good correlation between histological findings and clinical presentation in idiopathic polymorphous light eruptions, justifying simple clinical interpretation, but did not demonstrate a rate of positive results as high as reported in the literature. Day 6 is the ideal date for a phototest biopsy. In exogenous light eruptions, the phototest is less reliable since the correlation between histology and clinical presentation is weaker. It is difficult to reproduce spontaneous lesions with the phototest, but if used, the phototest biopsy should be done on day 18.

Humans↗
PubMed1996

[Abnormal central nervous conduction in long-term treatments with retinoids].

INTRODUCTION: Neurological manifestations are uncommon among the undesirable effects of systemic retinoid therapy. We observed a case of axial rigidity imputable to acitretine. Somesthesic evoked potentials were also altered. We therefore searched for such abnormal findings in patients given long-term systemic retinoid therapy. PATIENTS AND METHODS: A neurological exploration was performed in two groups of patients, G1 and G2, with psoriasis and no neurological complaint. The exploration included a physical examination, a study of the somesthesic evoked potentials of all 4 limbs and an electromyogram in case of abnormal findings. There were 8 patients (3 women, 5 men, mean age 56 years, age range 39-71) in G1 treated with systemic retinoids for a mean 140 months (80-185). Cumulative dose was 50 to 280 g with a daily dose of 0.2 to 0.6 mg/kg/day, i.e 20 to 50 mg/d of etretinate or acitretine. In G2, there were 5 subjects (mean age 42 years, range 21-52) with psoriasis (mean duration 20 years range 14-25) who had never been treated with systemic retinoids. RESULTS: Alterations in somesthesic evoked potentials were observed in 7 of the 8 patients in G1. Bilateral disturbances were seen in 6 cases, demonstrating abnormal lemniscal central nervous conduction in the dorsal and/or cervical level in 3 cases and the cervical level alone in 3 cases. There was one asymmetrical case involving the lumbar level on the right and the dorsal and/or cervical level on the right. Only one of the 5 controls in G2 had a minimal unilateral reduction in somesthesic evoked potentials involving the lower limb. Direct effect of systemic retinoids was retained in absence of any other cause due to metabolic, toxic or deficient disorders or spinal compression. CONCLUSION: Long-term use of systemic retinoids induces frequent latent neurological anomalies expressed as lemniscal central nervous conduction. It is hypothesized that pathogenesis involves changes in the lipid composition of the nervous membranes.

Adult↗
PubMed1995

Tumor of the follicular infundibulum: a clinicopathologic study.

BACKGROUND: Tumor of the follicular infundibulum (TFI) is a rare benign adnexal tumor that has characteristic histopathologic features. OBJECTIVE: Our purpose was to describe the clinical and pathologic features of 12 patients with TFI. METHODS: Of 121,500 cutaneous biopsy specimens recorded between 1981 and 1993, all TFIs were identified and examined by conventional microscopy. The clinical and histologic findings were compared with those of previously published cases. RESULTS: Of the 12 patients, seven had a solitary tumor, two had eruptive TFI involving the face, and three TFIs were incidentally discovered in association with nevus sebaceus or fibroma. TFI-like changes were also observed in the wall of a hybrid cyst. The most discriminating features of TFI were the horizontal platelike organization of the tumor and the dense elastic network beneath the tumor. Of the different forms of TFI, only eruptive tumors can be clinically identified because they are small hypopigmented macules. CONCLUSION: We classify TFIs as (1) solitary tumors, (2) eruptive tumors, (3) TFI associated with other lesions of Cowden's disease, (4) TFI associated with a single tumor such as nevus sebaceus, and (5) TFI-like epidermal changes.

Adenoma↗
PubMed1995

Extracorporeal photochemotherapy in systemic sclerosis and severe morphea.

BACKGROUND: Extracorporeal photochemotherapy (EP) is a new immune-modulating therapy which combines cytapheresis and extracorporeal irradiation of leukocytes by UVA. Recently, patients with systemic sclerosis (SS) have been treated by this method, but the efficacy of EP is still controversial. OBJECTIVE: Our purpose was to evaluate the efficacy and safety of EP in SS and in severe morphea. METHODS: In an open study, 7 patients with SS and 2 patients with severe morphea were treated by EP and were evaluated after 6 months of treatment. No other treatments were allowed during this period. RESULTS: Except one vasovagal reaction, EP was well tolerated in all patients. The surface of the cutaneous sclerosis was unchanged in 3 of the 7 patients with SS, whereas it was aggravated in the remaining 4 patients. There was no improvement of the visceral involvement of SS in these patients. Although the duration of SS was less than 4 years in 6 out of 7 patients, we did not observe any significant benefit from EP in SS patients. One patient with generalized morphea had stopped EP after 3 months because of loss of vascular access and could not be evaluated. In the last patient with linear morphea of the upper limbs, a reduction in the number of morphea plaques was observed, and the remaining lesions were less visible after 16 months of EP. CONCLUSIONS: The present results do not corroborate those previously published with regard to the efficiency of EP in SS of recent onset. The efficacy of ECP in morphea needs further confirmation.

Adolescent↗
PubMed1995

Multinucleate cell angiohistiocytoma. A review and report of four cases.

Multinucleate cell angiohistiocytoma (MCA) was first characterized by Smith & Wilson-Jones. Although only a few cases have been published, this very characteristic benign tumor is probably not rare. The clinical pictures are firm circumscribed papules, mainly of the hands, which progress slowly over the years. The histologic features show an increase of capillaries and venules in the reticular dermis, overlaid by epidermal hyperplasia. Bizarre-shaped multinucleate cells are present between the vessels, and factor XIIIa-positive interstitial cells are increased in number. MCA can be easily recognised if the pathologist is aware of the diagnosis. We present here the clinical, histologic and immunopathologic features of 4 new cases and review the literature.

Adult↗
PubMed1995

Porphyria cutanea tarda and hepatitis C viral infection. A clinical and virologic study.

BACKGROUND AND DESIGN: The role of hepatitis C virus (HCV) infection in porphyria cutanea tarda (PCT) is probable since the global HCV antibody prevalence among patients with PCT is about 70%. The purpose of this study was to evaluate the virologic characteristics in 12 patients with sporadic PCT and in one patient with familial PCT. Anti-HCV antibodies were detected by enzyme-linked immunosorbent assay and confirmed by recombinant immunoblot assay. Hepatitis B virus and antihuman immunodeficiency virus markers were also determined. The polymerase chain reaction was performed to detect the following: (1) both positive and negative HCV RNA strands, (2) HCV RNA titer, and (3) HCV RNA genotype. RESULTS: Seven of the 12 patients with sporadic PCT were HCV positive, and the patient with familial PCT was HCV negative. The age at onset of PCT was significantly lower in HCV-positive patients than in HCV-negative patients. The HCV RNA was detected in all patients who had HCV antibodies, and the replicative intermediate of HCV was detected in three of them. The positive RNA titer ranged from 1:10 to 1:10(6). Four patients were infected by HCV genotype I, two by genotype II, and one patient was coinfected by type I and type II. Three of the seven HCV-positive patients also had HBV antibodies, but HBV DNA was never detected. All patients were negative for the human immunodeficiency virus. CONCLUSIONS: The HCV infection rate was high (58%) in this series, and all HCV-infected patients had HCV RNA, reflecting an active replication of the virus. The young age at onset of PCT suggests that HCV is a major triggering factor of PCT. Nevertheless, the clinical changes of PCT were not related to the virologic findings, suggesting an indirect role of HCV.

Adult↗
PubMed1995

[Quadri-chromic staining in routine cutaneous histopathology (hematoxylin, eosin, saffron and astra blue)].

INTRODUCTION: The routine histologic stains used in dermatopathology are usually hematoxylin-eosin-safran. In order to stain the mucins, specific dyes are necessary. The purpose of this study was to perform a routine quadrichromic stain which included Astra blue as specific dye of mucins. The applications of this hematoxylin-eosin-safran-Astra blue stain were evaluated after 5 years of systematic use. METHODS: The quadrichromic stain was realized by Varistain (Shandon). The time of coloration was 15 minutes for Astra blue pH 2.5, 10 minutes for hematoxylin, 45 seconds for eosin and 4 minutes for safran. A total of 56,000 samples were analyzed using the quadrichromic stain. RESULTS: When mucin was present, it was colored in blue and the contrast with the other dyes was enhanced. Astra blue stained specifically the mucin deposits and it did not modify the other colours. The mucin deposits present in primary and secondary cutaneous mucinoses were most often visible after quadrichromic stain. Because of the variability of the mucin composition, the Astra blue did not react with all mucins. This stain was particularly useful in extramammary Paget's disease and in atrophic malignant papulosis. CONCLUSION: This new stain was easy to perform and allowed a specific coloration of mucin deposits in many cases. The use of four colours therefore improves the results of a routine stain, with a high quality of coloration.

Coloring Agents↗
PubMed1995

[Tumoral sarcoidosis].

INTRODUCTION: We report here an unusual tumoral form of cutaneous sarcoidosis which lead to diagnostical difficulties. CASE REPORT: A 56 year-old woman was hospitalized for a large lumbo-sacral tumor which size had rapidly increased. The tumor was purplish-red, firm, measured 10 x 20 cm and the patient was unable to sit normally. The biopsies demonstrated a dermohypodermal epithelioid and giant cell granuloma without necrosis. We ruled out an infectious granuloma and a foreign body granuloma. There were no extra-cutaneous localizations. This sarcoidal tumor cured with systemic corticosteroids. DISCUSSION: Tumoral cutaneous forms of sarcoidosis are uncommon; 3 other cases of the literature are reported. Before to state positively this forms it is obligatory to rule out all the other aetiologies of sarcoidal granuloma. The existence of extra-cutaneous localizations and multiple skin localizations is helpful to diagnose this uncommon type of sarcoidosis.

Diagnosis, Differential↗
PubMed1994

[Pachydermodactyly. Sequela of obsessive-compulsive neurosis].

Pachydermodactyly is an acquired, asymptomatic swelling of the lateral sides of the fingers and is seen mainly in young men. The formal pathogenesis is a benign fibromatosis. The casual pathogenesis was until now unclear, although we believe, that exogenic factors are the main reason. Consequently Pachydermodactyly has to be considered as a result of compulsion neurosis.

Adolescent↗
PubMed1994

Staphylococcal scalded skin syndrome in adults. A clinical review illustrated with a new case.

Staphylococcal scalded skin syndrome is rarely observed in adults; only 32 cases have been reported. In contrast to infant cases, the mortality rate is high. Two major risk factors have been identified: kidney failure and immunosuppression. In adults, clinical features are similar to those of the typical pediatric disease, but blood cultures are often positive for Staphylococcus aureus. Detection of the exfoliative toxin is required for diagnosis; the newborn mouse bioassay is, therefore, usually performed. New immunologic methods allow precise characterization of the toxins and oligonucleotide probes can be used for rapid detection of toxigenic strains. We report a case of staphylococcal scalded skin syndrome in an immunocompetent adult in whom blood cultures were positive; this is the first case in which both exfoliative toxins A and B have been identified in an adult.

Aged↗
PubMed1994

Mutilating syringoacanthoma.

Syringoacanthoma is a rare tumor derived from the eccrine acrosyringium; very few cases have been reported. The nosology of this tumor remains controversial. We present a new case of syringocanthoma occurring in a 43-year-old woman; the lesion lasted for more than 30 years and caused partial destruction of the earlobe. Histopathologic examination showed a hyperkeratotic intraepidermal tumor, with many large cavities lined by an eosinophilic cuticle and filled with a PAS-positive substance. This case is probably a mutilating variant of syringoacanthoma, despite benign histopathologic features.

Adult↗
PubMed1994

[Cutaneous rhabdomyosarcoma].

OBJECTIVE: The occurrence of a rare alveolar rhabdomyosarcoma in a 16-year old girl seems worth of a case report. OBSERVATION: A large multinodular tumor developed on the buttocks and the external genitalia; systemic symptoms and metastases of lymph nodes and skin occurred very soon and the disease had a lethal outcome within 16 months. A temporary regression was observed after polychemotherapy with daunorubicine, vincritine and 5-fluoro-uracile. COMMENTS: In children the rhabdomyosarcoma is the most frequent sarcoma of soft tissues; the poor prognosis of the alveolar type is assessed by the case of this 16-year old girl; this tumor may progress as a systemic disease and present as a leukemia with rapid impairment of general health, enlargement of lymph nodes, cutaneous nodules and anemia.

Adolescent↗