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Biomedical subjects

J Bazex

Publications and source records attributed to J Bazex.

At least 91 records · Page 5Linked to original sources
PubMed1997

[Celiac disease associated with cutaneous sarcoidosic granuloma].

Coeliac disease can be associated with numerous internal, skin and mucosa involvements: their physiopathology is often obscure. We report the case of a 14-year old female patient who suffered from a coeliac disease diagnosed in 1988 with considerable improvement with a gluten-free diet. Her two daughters also presented coeliac disease and her sister suffered from nevoid basal cell carcinoma syndrome. Four years later, she presented non pruriginous small nodules over both lower extremities. Skin biopsy revealed a non-caseating granuloma into the derm: we only could evocate sarcoidosis affecting the skin. The dermatological lesions improved during the following weeks with a gluten free diet and relapsed each time this diet was stopped. Many clinical associations with coeliac disease have been described with numerous visceral and skin-mucosa involvements. Eight cases of coeliac disease associated with sarcoidosis affecting the lung have been reported: in five cases, coeliac disease preceded sarcoidosis and in one case sarcoidosis relapsed each time gluten was reintroduced like in our case. This two diseases seem to share immunological and genetic disturbances.

Adult↗
PubMed1997

Cutaneous manifestations of relapsing polychondritis in a patient receiving goserelin for carcinoma of the prostate.

Relapsing polychondritis is a chronic rheumatologic disorder of unknown etiology. Cutaneous manifestations occur in nearly half of the patients and often precede cartilaginous involvement. We present the case of a man with a history of prostatic adenocarcinoma who underwent monthly injections of goserelin (Zoladex), an LH-RH analogue. Five months after the beginning of the treatment, he presented cutaneous manifestations, which then recurred monthly, after each goserelin injection. After goserelin interruption and replacement with another treatment (cyproterone acetate), the patient was asymptomatic for 2 months. A cutaneous relapse then occurred followed by a typical cartilaginous involvement. In our observation, goserelin seems to have triggered the cutaneous manifestations of relapsing polychondritis. An hormonal precipitating factor in relapsing polychondritis has already been suggested by reports of patients whose disease worsened under chorionic gonadotropin treatment or during pregnancy.

Adenocarcinoma↗
PubMed1997

[Importance and results of photo-patch tests in photobiological research].

Photo patch tests (Standard battery of the SFPD) were made on 45 patients who were suspected of exogenous photosensitization during 1996. Certain suspected topicals or drugs completed the battery. The results obtained are analysed and compared with those in the literature.

Anti-Infective Agents, Local↗
PubMed1997

[Hypersensitive urticarial vasculitis after natisedine intake].

BACKGROUND: Various skin and mucosal reactions can be observed after administration of quinidine derivatives. CASE REPORT: A patient who was taking Natisédine (quinidine phenylethyl barbiturate) intermittently and at reintroduction developed a papulopurpuric eruption (without thrombopenia) producing extensive centrifugal annular infiltration and central healing which regressed approximately one week after drug withdrawal. This eruption was associated with moderate 24 h proteinuria. The clinical aspect was that of vasculitis purpura as confirmed histology. Direct immunofluorescence only demonstrated C3 deposits in the vessel walls of the superficial dermis. The quinidine moiety of this drug (currently removed from the formulation) appears to be the responsible agent (imputability score: 13 B3). DISCUSSION: Thrombopenic purpura by synthesis of anti-platelet antibodies induced by quinidine derivatives is well known. Inversely, cases of non-thrombopenic purpura imputable to these same derivatives is uncommon (7 reported cases). The pathophysiological mechanisms involved might be similar (antigenic similarity between the platelet surface and endothelium).

Aged↗
PubMed1997

[Syphilitic labial leucokeratosis].

BACKGROUND: Several diagnoses, including syphilis, can be entertained in patients with leukokeratosis of the buccal mucosa. We report a case of labial leucokeratosis which revealed latent syphilis. CASE REPORT: A 36-year-old man with a past history of genital syphilis chancre which have been treated 12 years earlier, developed buccal leucokeratosis with no other clinical manifestation. Histology showed dermal infiltration containing plasma cells, polynuclears and lymphocytes. Blood tests were positive for syphilis. Complementary examinations were unable to detect another localization. Leucokeratosis regressed completely after one injection of Extencilline. There has been no recurrence at one year. DISCUSSION: The clinical and histological presentations of syphilis can mimic different skin diseases. Serodiagnosis alone is significant. Isolated buccal lesions are rarely described in syphilis suggesting serodiagnosis should always be ordered. Whatever the clinical stage of the diseases, serological surveillance after treatment for syphilis is essential.

Adult↗
PubMed1997

[Contact eczema induced by propylene glycol. Concentration and vehicle adapted for for patch tests].

INTRODUCTION: Contact dermatitis to propylene glycol, a widely used compound, is often difficult to evidence with skin tests. CASE REPORTS: We observed three cases of contact eczema to a dermal cream (Zovirax) used for labial herpes simplex. Patch-tests were positive in all three cases when the entire product was used but negative for each of the constituent components. The initial diagnosis could be an allergic reaction to the composition between the components as has been described elsewhere. Skin tests were completed with patch-tests using propylene glycol at concentrations over 5 p. 100 or with a vehicle other than vaseline (commercial tests use 5 p. 100 propylene glycol in vaseline). The results of these tests provided evidence allowing the diagnosis of contact dermatitis to the dermal cream due to allergic reaction to propylene glycol. DISCUSSION: Our three cases illustrate the frequency of false negative reactions to propylene glycol on commercial patch-tests. In agreement with data in the literature, these tests show that propylene glycol must be used at concentrations up to 10 to 20 p. 100 to identify allergic reactions with patch-tests.

Acyclovir↗
PubMed1997

[Contact allergy to beta blockaders in eye drops: cross allergy?].

INTRODUCTION: Beta-blockers in eye-drops are widely used for the treatment of glaucoma. The potential allergic effect was only recently recognized. CASE REPORT: A 65-year-old man had been treated with eye-drops containing beta-blockers for bilateral chronic glaucoma for 14 years. During the last two years, he developed eczema localized on the upper and lower eyelids. Allergy screening confirmed the implication of timolol and befunolol which had been used successively. Later prescription of eye-drops containing carteolol led to recurrence of the eczema. DISCUSSION: This case of contact allergy with three different beta-blockers in the same patient is similar to others reported in the literature. All beta-blockers have a similar chemical structure, but it cannot act as a haptene. The proposed hypothesis is a cross-sensitivity which develops after primary metabolism to a common aldehyde. The risk of recurrence is high if another beta-blocker eye-drop compound is prescribed in a sensitized patient. The risk of side effects in such sensitized patients when taking oral beta-blockers is unknown.

Adrenergic beta-Antagonists↗
PubMed1997

[Waldenstrom's macroglobulinemia with antibasement membrane activity of monoclonal immunoglobulin].

INTRODUCTION: Waldenström macroglobulinemia is a rare hematologic disorder with characteristic malignant plasma cell proliferation associated with the secretion of a IgM monoclonal immunoglobulin which is the cause of most of the clinical manifestations. Skin involvement is exceptional. We report a new case of Waldenström macroglobulinemia discovered in a patient who developed specific skin lesions with monoclonal immunoglobulin deposits. CASE REPORT: A 50-year-old woman developed spontaneously painful infiltrated erythematopapular plaques over the extension aspects of the limbs. There were no other clinical manifestations. The patient had a kappa IgM monoclonal gammapathy. The diagnosis of Waldenström macroglobulinemia was proposed after the discovery of voluminous intra-abdominal adenopathies and was confirmed by immunohistochemistry of the biopsies, indirect immunofluorescence evidenced reactivity against the epidermal basal membrane. Chemotherapy led to successful regression of the skin lesions, the tumoral mass and circulating IgM. DISCUSSION: This is the second reported case of Waldenström macroglobulinemia with anti-basal membrane monoclonal immunoglobulin. This IgM would recognize an 82 kD antigen on the dermal side of the dermo-epidermal junction situated in the anchoring fibres of the lamina densa, a zone classically involved in acquired bullous epidermolysis.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1997

[Acquired regressive cutaneous non-Langerhans-cell histiocytosis in an infant].

INTRODUCTION: Cutaneous histiocytosis of childhood often regresses spontaneously without treatment. In some cases however, it is difficult to differentiate aggressive forms and electron microscopy and immunohistochemistry can be a valuable help. We report a case of cutaneous histiocytosis in a child which illustrates the difficulties encountered in the classification of histiocytosis. CASE REPORT: An 18-month old girl was brought to consultation with a cutaneous nodule which had developed at the age of 15 months on the labia majora. A second nodule on the chin had regressed spontaneously. Histology showed evidence of dermal histiocyte proliferation. Immunohistochemistry demonstrated is non Langerhans nature which was confirmed by electron microscopy. The clinical course was benign after surgical exeresis of the lesion on the labia majora. DISCUSSION: Different forms of histiocytosis can be classed on the basis of 4 criteria: Langerhans origin or not, acquired or congenital forms, cutaneous or visceral involvement, benign or malignant course. Four diagnosis were possible in our case: histiocytosis X, self-healing congenital histiocytosis, benign cephalic histiocytosis, juvenile xanthogranuloma. We preferred to use the descriptive term of acquired regressive cutaneous non-X histiocytosis of childhood.

Female↗
PubMed1996

[Cutaneous mycobacteriosis].

Tuberculosis is reappearing, due to diminished surveillance, illegal immigration, the HIV epidemic and certainly also due to emerging resistance. The clinical expression of cutaneous tuberculosis depends on the stage of development, the clinical background and the virulence of the germ. Diagnosis is predominantly clinical, but laboratory results also play a role. Treatment involves the quadruple antibiotic treatment prescribed for any tubercular infection. Atypical mycobacteria are widespread throughout the environment and are pathogenic, but also saprophytic, comensal and opportunistic, figure a favourable setting in the immunodeficient individual. Following entry by penetrance, the early lesion is papulonodulary, nodulary, keratoid, crusted, ulcerated, sporotrichoid, generally without peripheral adenopathy. Histological examination discloses a granulomatous reaction limiting the development of the infection; such development is absent in the immunodeficient patient, thus explaining the spread. The most common mycobacterial infection in France, generally in the immunocompetent individual, is "aquarium disease" which follows a benign course; the most common in tropical areas is Mycobacterium ulcerans; whereas Mycobacterium avium intracellulare, fortuitum and chelonae cause, in the immunodeficient patient, severe and extensive infection. Treatment should start as soon as diagnosis is made and the germ identified.

Humans↗