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Biomedical subjects

J E Arrese

Publications and source records attributed to J E Arrese.

At least 19 recordsLinked to original sources

[Hic et Nunc. Naevus or melanoma?].

In Wallonia, the incidence of cutaneous melanoma has steadily increased over the past decades. Hopefully, the early diagnosis made at the premetastatic stage has benefited from great advances both in the clinical and laboratory fields. Thanks to the "Groupement Oncologique Universitaire Wallonie-Liège" (GOUWL) organization, some efforts are currently made in order to better frame and normalize the management of cancer patients. Some medical staffs involved in prospective clinical research bring by their own experience further practical insights for the benefit to the patients. In this field, Belgium is not destituted. We report a brief review of the contribution of the Mosan Study Group of Pigmentary Tumors (GMETP) at the University Hospital of Liège.

Belgium↗

[The skin and menopause].

The estrogen deficit occurring at menopause manifests itself under various modalities in the diverse organs and their functions. Skin does not escape this global involutive process. In addition to the effects of chronological ageing, sunlight exposure and other environmental and endogenous stimuli, the climacteric appears to exert some dramatic consequences on skin biology and aspect. The epidermis, its adnexae and the dermis are altered by this process. The epidermis may become xerotic and exhibits altered functions. The dermis thins out and its elasticity decreases in concert with the decline in bone mass. The skin microcirculation is impaired. These aspects are some of the better-worked out skin climacteric changes of which in turn seem to be stabilized or in part reversible with hormone replacement therapy (HRT).

Female↗

[Genophotodermatoses].

Genophotodermatoses can result from a defect in melanin synthesis, a defect in DNA repair or a congenital photosensibility.

Humans↗

[Merkel cell carcinoma].

Merkel cell carcinoma is a neuroendocrine tumor of the skin, originating from neuroendocrine cells. A case report of Merkel cell carcinoma, discovered in a 77-Year-old woman, was diagnosed and confirmed on a biopsy. Diagnostic and therapeutic orientations of this unusual but malignant tumor are described.

Aged↗

Itraconazole corneofungimetry bioassay on Malassezia species.

Yeasts of the genus Malassezia are part of the normal skin biocenosis and are involved in a series of distinct skin disorders and specific dermatomycoses in man and animals. Several species are currently distinguished. Their relative in vitro susceptibility to antifungals appears different according to the species and to the nature and route of administration of the drug. Corneofungimetry is an ex vivo bioassay allowing to test the fungal response on human stratum corneum following oral intake of a given antifungal by volunteers. Two series of cyanoacrylate skin surface strippings (CSSS) were harvested from the volar forearm of 30 volunteers before and after a 2-week treatment with itraconazole 200 mg daily. They were coated by olive oil and inoculated with suspensions of seven different Malassezia spp. After a 1-week culture on CSSS, the amount of viable yeasts was assessed using neutral red staining assisted by computerized image analysis. Growth of the seven species was not similar on the CSSS from untreated stratum corneum. The ranking order from the most proliferative to the least was M. restricta, M. sympodialis, M. globosa, M. furfur, M. obtusa, M. slooffiae and M. pachydermatis. Their growth was abated to almost the same level after itraconazole treatment. It is concluded that in vivo treatment with itraconazole is highly active against all Malassezia spp. colonizing the human stratum corneum.

Administration, Oral↗

[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↗

[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↗

[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↗

[Keeping onychomycoses in check].

According to individuals, onychomycoses or their treatments can be held in check. Some of the "promises" sometimes offered by pharmaceutical companies are not fully kept and hopes of cure may remain wild. Some special therapeutic strategies should be employed in case of recalcitrant or recurrent onychomycosis.

Administration, Oral↗

[Synopsis of invasive dermatomycoses in immunocompromised host].

The immune system plays a prominent role in the defense against a wide variety of pathogen fungi. Thus, the immunocompromised patient becomes a potential victim of mycoses originating from the skin. These mycoses may become invasive and a fatal issue is possible. In other circumstances, the inoculation site is pulmonary or digestive, and the cutaneous lesions represent secondary localizations.

Dermatomycoses↗

[How to investigate....A darkened skin lesion during pregnancy. A difficult task for the clinician].

Cancers rarely coexist with pregnancy. Cutaneous melanoma, however, is one of the most frequently encountered neoplasms during pregnancy. Gestation may also be a period during which the aspect of some melanocytic naevi can change eventhough the tumor remains benign. Distinction between a benign and a malignant lesion may then be a dilemma. Clinical morphometry, dermoscopy, skin surface biopsy, conventional histology and immunohistochemistry are valuable means that can be used to secure maximum diagnostic confidence.

Biopsy↗

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↗

Gamma-probe-directed lymphatic mapping and sentinel lymphadenectomy in primary cutaneous melanoma.

BACKGROUND: Radiotracer and blue-dye lymphatic mapping is a recommended combined method to guide sentinel lymphadenectomy and full regional lymph node dissection in selected patients with cutaneous melanoma. OBJECTIVE: To evaluate the diagnostic accuracy and the prognostic value of gamma-probe-directed lymphatic mapping in cutaneous melanomas. METHODS: Sixty-five stage I and II melanoma patients underwent gamma-probe-directed lymphatic mapping. Sentinel lymph nodes were studied by both conventional and immunohistochemical stainings. The median follow-up was 11 months. RESULTS: Sensitivities of preoperative and intraoperative sentinel lymph node detection were 100 and 98%, respectively. Only 1 failure of detection and 1 missed same-basin metastasis were experienced in the axillary and cervical areas, respectively. Eleven patients (16.9%) had sentinel node metastases leading to adjuvant therapy. CONCLUSION: Gamma-probe-directed lymphatic mapping is useful for staging melanoma. However, in the expectation of a more specific identification of the sentinel lymph node, the standard protocol remains recommended for exploring the axillary and cervical areas. The histological examination supported in some cases by immunohistochemistry remains mandatory in all cases.

Female↗

[How I explore ... an orphan metastasis from melanoma].

A presumed melanoma metastasis is sometimes found without any evidence for the primary neoplasm. Such an orphan metastasis merits a complementary exploration. Searching for the primary melanoma must then be performed using non invasive and clinically oriented methods. Beside a thorough skin examination, otorhinolaryngological, ophtalmic and gynecologic searches are recommended. In addition, paraclinical investigations are conducted according to the metastatic location, the gender and the functional complaints of the patient. The prognosis of these orphan metastases is not more dramatic than when the primary lesion is identified. Therapies are similar to those proposed in the classical presentation of the disease.

Diagnosis, Differential↗