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Biomedical subjects

J Revuz

Publications and source records attributed to J Revuz.

At least 271 records · Page 15Linked to original sources

Crossover study of thalidomide vs placebo in severe recurrent aphthous stomatitis.

A multicentric crossover randomized trial of 100 mg of thalidomide vs placebo each for 2 months was conducted in patients with severe aphthous stomatitis of more than 6 months' duration. Seventy-three patients were included. Complete remission was obtained in 32 patients who received thalidomide and in 6 patients who received placebo. The confidence interval of the difference between the two treatments ranged from 25% to 53%. Most of the patients who did not achieve a complete remission had a dramatic improvement with regard to the number of aphthae when they were receiving thalidomide. Thirteen of 17 patients who had a complete remission while they were receiving thalidomide had a recurrence with placebo, 19 +/- 9 (mean +/- SD) days after stopping this drug. Side effects were significantly more frequent with thalidomide, especially drowsiness and constipation. We concluded that thalidomide in a dosage of 100 mg/d is an effective treatment of severe aphthous stomatitis but is not without some risk.

Adult↗

Prognostic factors and predictive signs of malignancy in adult dermatomyositis. A study of 32 cases.

Dermatomyositis (DM) is an inflammatory myopathy with a severe prognosis mainly determined by its association with malignancy. We present the results of a study of 32 adults with DM. Our aim was to define predictive signs of cancer and establish prognostic factors according to patient survival. Thirteen (41%) of the 32 patients had DM associated with malignancy. After 7 years of follow-up, the overall mortality rate was 52%. Mortality was higher for patients with malignancy. Cutaneous necrosis and an elevated erythrocyte sedimentation rate appeared as potential markers of associated malignancy. Classic signs of poor prognosis, such as age and association with cancer were found. Interestingly, extensive cutaneous lesions on the trunk and an elevated erythrocyte sedimentation rate were also more frequent among the patients who died. Our results demonstrate that selected groups of patients with DM, in part defined by cutaneous signs, have a poor prognosis.

Adult↗

Local blanching after epicutaneous application of EMLA cream. A double-blind randomized study among 50 healthy volunteers.

EMLA cream is a topical formulation based upon the eutectic mixture of lidocaine and prilocaine and is used in clinical settings to produce local analgesia after application under occlusive dressing. A blanching reaction has been reported to occur locally after application, but it is not clear whether this reaction is caused by the anesthetic mixture, by the vehicle or the occlusion. We studied this blanching reaction in 50 healthy volunteers in a double-blind randomized assay: EMLA versus placebo, under occlusive dressing for 1 h, each subject being his own control. We found 33 cases (66%) of blanching after application of EMLA cream versus 3 cases (6%) after placebo, this difference being highly significant. Blanching was observed without delay, after removal of the dressing, and was very transient, disappearing in less than 3 h in all cases. We thus conclude that the blanching reaction is (1) frequent but very transient, and (2) determined by the anesthetic mixture included in EMLA cream and not by the vehicle alone, nor by the occlusion, since it is not found with the placebo. The precise mechanism of this reaction is unknown.

Administration, Cutaneous↗

[Treatment of Kaposi's disease].

Several clinical, epidemiological and immunological data support the opportunistic nature of Kaposi's disease. Although the physiopathology of the disease is unknown, its characteristics, and particularly its immunological dependence, have repercussions on treatment which must avoid making the immunological process worse, especially since the proliferation is rarely life-threatening. Recent therapeutic innovations, such as alpha interferon, have failed to bring the expected results which are disappointing in the form associated with the acquired immunodeficiency syndrome. In the classical form of the disease radiotherapy and chemotherapy provide a satisfactory improvement without any side-effect that might threaten the patient's life.

Acquired Immunodeficiency Syndrome↗

Penile melanosis.

Five patients with penile melanosis are described. The lesions consisted of macular hyperpigmentation of the penile shaft and/or glans. Histologically only hyperpigmentation of the basal cell layer was observed with no melanocytic hyperplasia. Patients had follow-up for 3 to 13 years; enlargement of some lesions was observed, but the condition remained benign. The main differential diagnostic problem was with acral lentiginous melanoma. Penile melanosis shares clinical and microscopic features with Laugier-Hunziker syndrome of the buccal mucosa and vulvovaginal melanosis. We suggest that the three disorders be grouped as essential melanotic hyperpigmentation of mucosa.

Adolescent↗