Biomedical subjects
J J Morand
Publications and source records attributed to J J Morand.
[Acquired and hereditary syphilis] 1946 [classical article].
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[Alithiasic cholecystitis in association with visceral leishmaniasis in an immunodepressed patient].
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[Review: update on erythema nodosum leprosum].
Erythema nodosum leprosum (ENL) is an immunological reaction corresponding to vascularitis due to circulating immune complexes usually occurring during treatment of lepromatous leprosy. The precise mechanism underlying ENL are unclear but involvement of tumor necrosis factor alpha (TNFalpha) is suspected. Based on this suspicion pentoxifylline has been used instead of conventional treatments such as corticosteroids and thalidomide.
[Characteristics of "black skin"].
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[Zygomycoses and blastomycoses].
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[Management of American cutaneous leishmaniasis. Outcome apropos of 326 cases treated with high-dose pentamidine isethionate].
The purpose of this retrospective analysis was to evaluate the outcome of pentamidine isethionate treatment (4 mg/kg of Pentamidine by the intramuscular route on Days 1 and 3) of cutaneous leishmaniasis in 326 cases that occurred during an outbreak among French military personnel in French Guyana from 1998 to 1999. A great difference was found between the 205 patients treated in French Guyana (series G) and 32 patients treated at the Laveran Military Hospital in Marseille, France (series L). Failure rate, i.e. 25% in series L versus 5% in series G, was significantly correlated with the delay to treatment which was much longer in series L. Extensive rhabdomyolysis was observed in all cases tested: this side-effect has not been reported. Based on these findings and a review of the literature on pentamidine isethionate, the authors recommend prompt treatment using lower doses. Other treatment alternatives for American cutaneous leishmaniasis are also presented including two of the latest developments in the field, i.e., oral treatment using miltefosine and topical treatment using agents such as paromomycine.
[Characteristics of genetically pigmented skins].
The analysis shows that apart from the relative hyperpigmentation of the "black" skin (genetically determined and variable according to ethnic group, age, sex and solar exposure), which determines the secondary dyschromic reactions to the majority of the dermatosis, and, except the differences of frequency of diseases related especially to geographical or epidemiologic determinisms, there is no true specificity although some entities are little or not described on "white" skin (dermatosis papulosa nigra, acral punctuated hyperkeratosis, progressive macular hypomelanosis of the trunk, acne keloidalis, pseudofolliculitis barbae, aïnhum...).
[Atypical acral hyperkeratosis in a black woman].
This report describes the case of a 33-year-old black woman who presented atypical hyperkeratosis. Atypical features included location on the dorsum of the foot and presence of punctate pits. The lesion was classified as intermediate between keratosis punctata of the palmar creases and focal acral hyperkeratosis. The main elements of differential diagnosis are Hyperkeratosis lenticularis perstans and punctuated porokeratosis. The clinical and histological features of these lesions are discussed based on a review of the literature. Therapy including application of topical emollients is problematic.
[Ainhum and pseudoainhum: clinical aspects and etiopathogenic hypotheses].
Pseudoainhum is a rare acquired or congenital disorder characterized by progressive development of a fibrotic band on a finger or toe until spontaneous autoamputation occurs. Ainhum is an idiopathic disease involving the fifth toes of black people mainly in tropical zones. Based on experience in five cases and a review of the literature, the authors describe clinical features of these diseases and analyze various etiological hypotheses including infectious (mycosis, mycobacteria), traumatic (plants), vascular (andysplasia), neurological (polyneuritis), and genetic (keratodermia) mechanisms.
[Epidemiologic surveillance of cutaneous leishmaniasis in Guiana. Summary of military data collected over 10 years].
This report describes the results of epidemiological surveillance of cutaneous leishmaniasis in French military personnel in French Guiana. Data was collected regarding microscopic diagnosis, clinical manifestations, and lesion location as well as compliance with vector control measures. Year-to-year variations in the incidence in the general population have been attributed to changes in climatic conditions. Monitoring incidence and density curves, correlation of findings with local epidemiological data, and analysis of the most recent epidemic in 1998/99 (326 cases, attack rate 3.2% men years) highlight the importance of behavioral factors. The proportion of total cases involving military personnel varied widely from 20 to 85%. Investigation consistently showed that failure to apply elementary protective measures against sandfly bites was the most determinant factor in this proportion. Strict compliance with these measures appears to reduce the risk of infection considerably.
[Clinical overview of New World tegumentary leishmaniasis].
This richly illustrated article (80 color photographs) based on the authors' experience in French Guyana documents the clinical diversity of American tegumentary leishmaniasis. Main highlights include the often outstanding aspect of lesions, the high frequency of forms not associated with ulceration or scab formation that must be recognized to achieve diagnosis in travellers returning from endemic zones, and the special prognosis of clinical forms associated with intradermic, lymphatic or hematogenous spread. The article also reviews an original diagnostic method based on culture of cutaneous biopsy specimens on specific nutrient mediums that provides isolates in a high percentage of cases (80%) and thus allows identification of offending parasite.
[Skin manifestations associated with myelodysplastic syndromes].
PURPOSE: Our purpose was to describe cutaneous manifestations associated with myelodysplastic syndromes. METHODS: Data from seven patients with cutaneous vasculitis (four cases), neutrophilic dermatosis (one case), relapsing polychondritis (one case), and possible erythema elevatum diutinum (one case) in association with myelodysplastic syndrome (refractory anaemia RA, RA with excess of blasts--RAEB-, RAEB in transformation RAEBt, chronic myelomonocytic leukaemia--CMML-), and analysis of the literature were reviewed. RESULTS: The cutaneous manifestations of myelodysplastic syndrome may or may not be specific, and may reveal hemopathy transformation. The cutaneous vasculitis are the most frequent and polymorphic. The relation with neutrophilic dermatosis is more specific; they are a spectrum of diseases including pyoderma gangrenosum, Sweet's syndrome, erythema elevatum diutinum (nuclear segmentation anomalies of neutrophils both in the skin and in the blood are a biological marker of the association). Relapsing polychondritis is significantly associated with myelodysplastic syndromes. Their pathogenesis are controversial. CONCLUSION: Early biopsy of cutaneous lesions in myelodysplastic syndromes is indicated. Analysis of blood cell count (and more bone marrow biopsy in relapsing polychondritis) is indispensable in these neutrophilic cutaneous or vasculitis diseases.
[The eumycetomas (fungal mycetomas with black or white grains)].
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