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Biomedical subjects

J L Perrot

Publications and source records attributed to J L Perrot.

At least 37 records · Page 2Linked to original sources
PubMed1997

The role of technetium-99m sestamibi single photon emission tomography in the follow-up of malignant melanoma and the detection of lymph node metastases.

In the follow-up of patients with malignant melanoma treated by surgical resection of the cutaneous tumour, it is important to achieve early detection of possible lymph node metastasis. In many cases, clinical examination alone will not be sufficient. In our study, single-photon emission tomography (SPET) with technetium-99m sestamibi (MIBI) was used in the assessment of 30 patients with previously resected malignant melanoma when the clinical examination raised the suspicion of lymph node metastasis. Using MIBI, 16 out of 17 lymph node metastases were detected and confirmed by histology. No false-positive results were obtained during this prospective study. It is concluded that MIBI scintigraphy may be useful in the early detection of lymph node metastases of malignant melanomas. If our preliminary results are confirmed, early detection of lymph node metastasis of previously resected malignant melanoma by 99mTc-MIBI scintigraphy may have a significant impact on the management of these patients.

Evaluation Studies as Topic↗
PubMed1996

[Metastatic epidermoid carcinoma in idiopathic CD4+ T lymphocytopenia syndrome].

INTRODUCTION: Skin cancers are more frequent and more aggressive in immunosuppressed patients. CASE REPORT: A 58-year-old man was seen in January 1994 for squamous cell carcinoma of the right shoulder which had grown to 7 x 7 cm in the last 5 months. The patient had a past history of surgical exeresis of 5 squamous cell carcinomas and 3 basal cell carcinomas. Despite complete exeresis, the disease spread to localized then diffuse skin metastases. Acitretine and alpha-interferon were uneffective. Polychemotherapy stabilized the situation but several bronchopulmonary infections with atypical germs led to death (in February 1995). The patient had CD4 lymphocytopenia with a count < 100/mm3 in January 1994 of unknown origin (viral infection was eliminated). DISCUSSION: Our patient had idiopathic CD4 lymphocytopenia. In 40 p. 100 of the cases CD4 lymphocytopenia is caused by AIDS and in 53 p. 100 by other diseases, especially skin diseases including Kaposi syndrome, mycosis fungoides, squamous cell or basal cell carcinoma. The cutaneous carcinomas which often develop in AIDS patients with low CD4 counts are usually less aggressive than in our patient. Certain neoplasia could be the cause of the lymphopenia. CD4 counts are usually more variable and lymphopenia of shorter duration in other etiologies.

CD4 Lymphocyte Count↗
PubMed1995

[Acquired myelodysplastic syndromes after treatment of melanoma with fotemustine and dacarbazine].

INTRODUCTION: Secondary myelodysplasia after antimitotic therapy is a rare complication usually observed with alkylating agents. The condition usually progresses to acute leukaemia with very poor short term prognosis. CASE REPORT: We report the cases of 2 women who developed myelodysplasia 2 and 9 months after treatment associating dacarbazine and fotemustine for visceral metastases of a malignant melanoma. DISCUSSION: The frequency of these rare complications is probably underestimated because of the rapid unfavourable outcome of metastatic malignant melanoma. We were unable to determine whether dacarbazine, fotemustine or their combination was incriminated in this complication. Risk could be reduced by carefully determining the cumulative doses of these antimitotics.

Aged↗
PubMed1995

[Bullous manifestations of Kaposi disease associated with AIDS].

INTRODUCTION: We report the apparently first description of bullous Kaposi's sarcoma in a patient with AIDS. CASE REPORT: Kaposi's sarcoma was observed in a HIV positive homosexual who had developed AIDS. The delay between the development of Kaposi's sarcoma and the appearance of bullae was 6 months. Bullae occurred after oedema and necrosis of the subepidermic derma. DISCUSSION: This unusual clinical presentation of Kaposi's syndrome in an AIDS patient led to rapid tumor extention and would thus suggest a rapidly unfavourable prognosis.

Acquired Immunodeficiency Syndrome↗
PubMed1994

[Porphyria cutanea tarda induced by HMG CoA reductase inhibitors: simvastatin, pravastatin].

INTRODUCTION: Based on experimental data, HMG CoA reductase inhibitors are theoretically contraindicated in patients with porphyria. These new cholesterol lowering drugs are increasingly being prescribed. We report the first case of drug-related porphyria cutanea tarda due to HMG CoA reductase inhibitors. CASE REPORT: Porphyria cutanea tarda was diagnosed in a patient with chronic alcoholism 18 months after beginning a treatment with simvastatin followed by pravastatin. These drugs were given under different trade names and reintroduced successively leading to acute episodes. Total withdrawal of HMG CoA reductase inhibitors was followed by clinical normalization. COMMENTS: This case confirmed the theoretical contraindication for the use of HMG CoA reductase inhibitors in patients with porphyria. The risk of revealing porphyria with this type of cholesterol lowering drugs is emphasized. Since these drugs are used very frequently, similar cases may well be reported soon.

Aged↗
PubMed1994

[Isolated burns after white-spirit ingestion in attempted suicide].

INTRODUCTION: We report an unusual complications of prolonged contact with white spirit leading to caustic burns. CASE REPORT: A 20-year-old patient was seen for caustic perianal burns several hours after ingesting one-half liter of white spirit in an attempted suicide. Motor diarrhoea also occurred quickly and a prolonged anal evacuation of white spirit. Complementary examinations did not reveal any lesions of the buccal, oesophageal, gastric or rectosigmoidal mucosa. DISCUSSION: Necrosis of the skin due to prolonged contact with petrol products is well known. Usually due to the delapidating action of dissolved petrol products on the superficial hydrolipid film and subjacent cell membranes. The absence of digestive tract lesions could be explained by the rapid onset of motor diarrhoea which may have limited the time of contact and thus protected the digestive tract mucosa which has a high content of mucopoly-saccharides and a low lipid content.

Adult↗
PubMed1993

[A rare cause of loss of consciousness: mastocytosis. Apropos of 3 cases].

The authors report three cases of syncope due to systemic mastocytosis. This is a rare cause of syncope but should be recalled in certain circumstances. In the light of these cases, the authors review the literature with respect to this unusual presentation. Syncope may occur at any age. Loss of consciousness may be more or less complete, brief or prolonged, isolated or recurrent and usually accompanied by prodromal symptoms. The least controversial physiopathogenic mechanism of these syncopes is intense vasoplegia induced by the release of vasoactive mediators, especially histamine. When there is a clinical suspicion of mastocytosis, even in the absence of skin changes, the diagnosis is confirmed by biopsy which shows abnormally high numbers of mastocytes irrespective of the organ biopsied. The treatment of acute forms with collapse is based on intravenous infusion of macromolecular fluids and injections of epinephrine. Prevention is by drugs which inhibit the synthesis of histamine, the degranulation of mastocytes and the production of prostaglandin D2.

Aged↗
PubMed1990

Hyperpigmentation induced by UVB at the application site of estradiol.

We report a case of a 48-year-old woman who presented with chronic essential pruritus and was successfully treated with the transdermal estradiol system because of menopausal discomfort. Suberythemogenic UVB phototherapy was proposed to the patient in order to control her pruritus. She developed hyperpigmentation at the application site of estradiol. To the best of our knowledge, this is the first report suggesting a direct relationship between estrogen and melanin synthesis in humans.

Administration, Cutaneous↗