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Biomedical subjects

J F Cuny

Publications and source records attributed to J F Cuny.

At least 19 recordsLinked to original sources
PubMed2005

Study to determine the efficacy of topical morphine on painful chronic skin ulcers.

OBJECTIVE: To assess the efficacy of the topical application of morphine on painful chronic skin ulcers. METHOD: A prospective bi-centric controlled double-blind randomised study was conducted involving 24 patients with painful chronic skin ulcers using topically applied morphine versus placebo. Ten milligrams of morphine hydrochloride with Intrasite Gel or Intrasite Gel with placebo were applied daily for five days. All patients were treated with a level II analgesic treatment. A numeric pain scale lower than 4/10 and no need for a 'rescue' treatment (morphine sulphate) indicated that the treatment was successful. Local and systemic tolerance of the treatments was analysed daily. RESULTS: Twenty-four patients were included in the study, but only 18 started the protocol. Only 2/11 patients were completely relieved in the morphine group compared with 1/7 in the placebo group. Local and general tolerance of morphine was good. The peripheral efficacy of morphine is under discussion. CONCLUSION: The results suggest that topical morphine cannot be an alternative to morphine administered by other routes (subcutaneously or orally) in painful chronic skin ulcers. Stimulation of peripheral morphine receptors by systemic morphine could explain the difference between these results and those of previous studies.

Administration, Cutaneous↗
PubMed2004

[Effect of smoking on the effectiveness of antimalarial drugs for cutaneous lesions of patients with lupus: assessment in a prospective study].

PURPOSE: Smoking has been involved in the failure of antimalarial therapy in patient with chronic or subacute erythematosus lupus. METHODS: We report a prospective study of 26 patients with chronic, subacute or systemic erythematosus lupus who were treated with antimalarials. Several variables including smoking are compared in responders and non-responders. RESULTS: Despite the reduced number of patients study that does not permit to allow significative results, it seems that among responders and non-responders, in other respects comparables, there is no difference in the presence of smoking, its quantity or its duration. CONCLUSION: The significance of molecular interactions between some components of tobacco and antimalarials have still to be established.

Adult↗
PubMed2001

[Pseudoainhum in lamellar ichthyosis].

INTRODUCTION: Pseudoainhum is an affection characterized by the appearance of a constricting band around a digit or limb which may lead to spontaneous amputation. There are various etiologies which can be either congenital or resulting from a concomitant disease. We report herein an original case which occurred during lamellar ichthyosis. CASE-REPORT: We present the case of a thirty-year-old woman affected by a severe form of lamellar ichthyosis who, in a few months, developed a pseudoainhum of the third left finger. Biological results were normal. X-rays of this finger showed distal resorption of the bone. The painful evolution and the absence of any conservative treatment compelled us to propose amputation of the third phalanx. DISCUSSION: Other cases of pseudoainhum have been observed in many disease responsible for vascular or neurological abnormalities. They can also result in physical traumatisms or be associated with many dermatoses, such as hereditary palmar and plantar keratodermas. As far as we know, this lesion has never been described during lamellar ichthyosis but could result in the keratinization disorders observed in this congenital ichthyosis.

Adult↗
PubMed2001

[Hamartoma oligemicus].

BACKGROUND: Naevus oligemicus is a rare affection caused by selective vasoconstriction of the deeper vessels ("thermal" skin blood flow), with respect of the superficial vascular plexus ("nutrient" blood flow). We report the fourth case. CASE REPORT: A 45 year-old man presented erythematocyanotic lesions with sensation of coolness on the abdomen and the thighs. These lesions had first been noted by the patient 3 years earlier. Physical examination and laboratory investigations were normal. Histology of a lesion revealed a non-specific superficial dermatitis. Result of skin surface thermometry of both areas showed that the surface temperature of the involved skin was up to 2 degrees C lower than the surrounding control skin. DISCUSSION: We don't know why there is a selective vasoconstriction of the deeper vessels and not of the superficial vascular plexus. Naevus oligemicus belongs to the pharmacological naevus group because of the absence of any histologic vascular abnormality. The functional abnormality has not been identified. This could be explained either by increased sympathetic vasoconstrictor tone in the autonomic sympathetic vasoconstrictor nerves supplying the deeper thermoregulatory vasculature in the affected skin, or by increased sensitivity of these vessels to vasoconstrictor catecholamines.

Diagnosis, Differential↗
PubMed2000

[Large crusted ulceration of the scalp: first manifestation of cryptococcosis in an AIDS patient].

BACKGROUND: Cryptococcosis is an infection caused by the yeast-like fungus Cryptococcus neoformans. It primarily occurs in immunocompromised hosts. Crytptococcosis is usually a systemic disease and may be serious if the lungs or the central nervous system are involved. CASE REPORT: We describe a case of cutaneous cryptococcosis without systemic involvement occurring as the first manifestation of AIDS. The skin lesion in our patient consisted of a large crusted ulceration on the scalp. Fluconazole was successful. DISCUSSION: This case is a new observation of primary cutaneous cryptococcosis in a patient with AIDS. Clinical appearance may be misleading; skin lesions may be the primary sign in immunocompromised patients. Rapid treatment and secondary prophylaxis are required.

AIDS-Related Opportunistic Infections↗
PubMed1997

Occupational contact dermatitis to propacetamol. Allergological and chemical investigations in two new cases.

BACKGROUND AND OBJECTIVE: In 2 new cases of occupational contact dermatitis due to a recently described allergen (propacetamol), a prodrug which is a soluble diethylglycidyl ester of paracetamol, an allergological investigation was performed to elucidate the nature of the allergen involved in the propacetamol contact sensitivity. OBSERVATIONS: Two nurses with eczema of the hands and face had positive patch tests to Pro-Dafalgan. Every day the nurses prepared injections of Pro-Dafalgan (propacetamol dissolved in sodium citrate). The sensitization was due to propacetamol and not to the solvent. To elucidate which part of propacetamol was responsible for the sensitization, the 2 nurses were patch-tested with diethylamine, paracetamol (diluted in different vehicles) and some of their chemical analogues and potential impurities which were all negative. CONCLUSIONS: Propacetamol induces airborne contact dermatitis with no evidence of sensitization to paracetamol or diethylglycine, possibly because of either the presence of unknown impurities and/or an antigenic structure related to the covalent bond of the prodrug.

Acetaminophen↗
PubMed1996

Recurrent annular erythema with purpura: a new variant of leucocytoclastic vasculitis responsive to dapsone.

Annular lesions are rarely reported in the clinical spectrum of leucocytoclastic vasculitis, except in the acute haemorrhagic oedema of the skin. We report three patients who suffered from an extraordinary recurrent annular dermatitis, for 4 years in one case and for decades in the other two. The eruption was characterized by purpuric lesions that had a centrifugal evolution, creating target- or polycyclic patches disseminated on the limbs and trunk. The patients' general condition remained excellent during the attacks. All lesions spontaneously disappeared within 2 weeks, but recurred monthly. In all three cases, the histological changes were consistent with leucocytoclastic vasculitis. One patient had ulcerative colitis and another had a benign immunoglobulin A (IgA) monoclonal gammopathy. These two patients showed a good response to dapsone therapy. This dermatosis probably represents a new and rare variant of leucocytoclastic vasculitis.

Dapsone↗
PubMed1996

[Digestive involvement in dystrophic bullous epidermolysis. Presentation of 2 cases and review of the literature].

Congenital epidermolysis bullosa is an inherited disorder characterized by an anomaly of joint structures between epidermis and dermis. This anomaly involves different malpighian epithelium and particularly in the digestive chorioepithelial junction. Digestive and oropharyngeal manifestations include bullae, erosions and ulcerations that heal by fibrosis, leading to retraction and stenosis. We report two cases of esophageal stenosis, the first one in a young patient with a congenital epidermolysis bullosa of Hallopeau-Siemens and the second one, in a young woman with a Pasini variant. In the first case, the esophageal stenosis was treated by careful dilation. In the second case, the endoscopy induced hemorragic bullae and septicemia, which were treated with antibiotics and total parenteral nutrition.

Adolescent↗
PubMed1995

[Ki-1 positive non-Hodgkin's lymphoma disclosed by mucocutaneous ulcerations and glomerulonephritis].

Malignant lymphoma particularly of T phenotype can be associated with specific or non specific cutaneous lesions. These cutaneous manifestations can occur at the onset of the disease being sometimes the revealing sign or they can appear during the course of the lymphoreticular malignancies. Glomerulonephritis was also described in lymphoma. Ki-1 positive large cell lymphoma was recently identified. A new case is reported with lymphadenopathy and intestinal localisation revealed by cutaneous and mucosal ulcerations principally in the mouth and a focal segmental glomerulonephritis with endo- and extracapillary proliferation. The absence of lymphoma in cutaneous and renal lesions and the clinical presentation support the hypothesis of paraneoplastic manifestations, may be related to a vasculitis.

Glomerulonephritis↗
PubMed1994

[Carcinoid tumor with revealed by skin manifestation].

INTRODUCTION: Carcinoid tumours are often diagnosed late because a large quantity of vasoactive peptides must be accumulated to express the carcinoid syndrome. OBSERVATION: A 54-year-old male was seen for rosacea and intense episodes of vasomotor flush. The rosacea was associated with episodes of diarrhoea. The carcinoid tumour was diagnosed on the basis of raised levels of 5-hydroxyindol acetic acid. Radiology and surgery demonstrated liver, lymph node and mesenteric metastases of the primative carcinoid tumour which could not be located. Treatment combined chemotherapy (5-fluorouracil-streptozotocine) and a somatostatin analogue (octreotide). A good clinical response was obtained with a 1 year follow-up. COMMENTS: This case was discovered in misleading conditions since the rosacea overshadowed the other clinical manifestations of the carcinoid syndrome. Symptomatology resulted from the metastasic carcinoid tumour. Surgery should always be proposed. It is rarely very extensive but does allow reduction of tumour size. The role of medical treatment with a somatostatin analogue should be emphasized. This treatment can be combined with more classical chemotherapy (5-fluorouracil, streptozotocine).

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

[Diffuse neonatal hemangiomatosis. A case with tetralogy of Fallot].

In neonatal disseminated hemangiomatosis, multiple immature capillary hemangiomas are widely distributed in the skin, mucous membranes, and internal organs including the liver, lungs, and larynx. In patients with life-threatening visceral involvement, corticosteroids or interferon may be required. A case in a female infant with tetralogy of Fallot is reported.

Adrenal Cortex Hormones↗