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L Dubertret

Publications and source records attributed to L Dubertret.

353 records · Page 20Linked to original sources
PubMedDate not supplied

Effects of ultraviolet A and antioxidant defense in cultured fibroblasts and keratinocytes.

Lipid peroxidation, measured by the thiobarbituric acid-reactive substances assay, was evaluated for cultured human skin fibroblasts and keratinocytes exposed to ultraviolet A radiation (320-400 nm, UVA). Peroxidation increases with increasing UVA doses and is much lower for keratinocytes than for fibroblasts. Immediate UVA-induced cytotoxicity, monitored by the trypan blue exclusion assay, is also lower for keratinocytes. Thus, cultured human skin keratinocytes are less sensitive than fibroblasts to the immediate deleterious effects of UVA with respect to membrane damage and lipid peroxidation. As a first attempt to understand this lower sensitivity of keratinocytes, basal levels of antioxidant defenses including total glutathione, superoxide dismutase, glutathione peroxidase and catalase were evaluated in both keratinocytes and fibroblasts from the same donors. We failed to correlate this lower susceptibility of keratinocyte to UVA-induced lipid peroxidation and cytotoxicity with a higher antioxidant status.

Adult↗
PubMedDate not supplied

[Lichen pemphigoid associated with developing hepatitis B in a child].

INTRODUCTION: Lichen planus pemphigoides is a rare acquired auto-immune bullous dermatosis which usually affects adults. Only four cases have been reported in children. We describe a new case of lichen planus pemphigoides in a child unusual by its association with an evolutive hepatitis B and by the occurrence of a lichen planus relapse. CASE REPORT: A 10-year-old African boy has been seen for a pruritic dermatosis with papular lichenoid lesions on the trunk and the limbs and blisters on the lower limbs, both arise on lichen planus lesions and normal skin. The diagnosis of lichen planus pemphigoides was confirmed by histology which showed the features of lichen planus on a papule and of a sub-epidermal split on a bulla and by direct and indirect immunofluorescent studies which revealed an IgG and C3 linear deposit at the dermo-epidermal junction and the presence of circulating IgG anti-basement membrane zone antibodies. Laboratory investigations showed an evolutive hepatitis B (HBsAg +). Healing was obtained by dapsone and topical steroid therapy. Eight months after withdrawal of treatment the patient presented a non-bullous relapse of lichen planus. The histology showed a typical aspect of lichen planus and the immunofluorescence studies were negative. The hepatitis B serology was unchanged. The lesions rapidly improved with topical steroid and coaltar. One year later the patient exhibited few slight lichen planus lesions on the limbs and the hepatitis B serology showed the onset of sero-conversion. DISCUSSION: Lichen planus and lichen planus pemphigoides are probably variants of the same disease. Their successive occurrence in our case report favours this hypothesis as does the association with an hepatitis B.

Administration, Cutaneous↗
PubMedDate not supplied

[Erythema annulare centrifugum and relapsing polychondritis].

BACKGROUND: Relapsing polychondritis is a rare systemic disease. Skin involvement occurs in 20 to 50 % of cases. Cutaneous signs are most often related to a leukocytoclastic vasculitis. Association of relapsing polychondritis with neutrophilic dermatosis have also been reported. We report the first case of an erythema annulare centrifugum-like dermatosis associated with relapsing polychondritis, with a two years delay between both conditions. CASE REPORT: A 74 year-old man was seen for papulo-erythematous centrifugal annular lesions that appeared 18 months earlier in a context of bad general conditions. Biological tests were normal. Several skin biopsies were performed, showing at the beginning features of drug reaction and then of lupus-lichen. Treatment with hydroxychloroquine, topical corticosteroids, dapsone and thalidomide were unsuccessful. In the following months, the patient developed fever and relapsing bronchitis. Suddenly, a chondritis of the ears appeared, leading to the diagnosis of relapsing polychondritis. All the cutaneous, chondritic and respiratory signs disappeared with oral steroid therapy. Two years after the diagnosis of relapsing polychondritis the patient developed refractory anemia. DISCUSSION: Cutaneous signs of relapsing polychondritis are frequent and may occur several months or years before the chondritis. They are polymorphous, but to the best of our knowledge, a clinical aspect of erythema annulare centrifugum has never been described. Our observation recalls the sometimes long delay between the cutaneous and the chondritic signs of relapsing polychondritis and the high frequency of dysmyelopoiesis in relapsing polychondritis with cutaneous involvement.

Aged↗
PubMedDate not supplied

[A reddened eye].

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Amoxicillin-Potassium Clavulanate Combination↗
PubMedDate not supplied

[Painful bruising syndrome mimicking cellulitis of the leg].

BACKGROUND: Autoerythrocyte sensitization syndrome (painful bruising syndrome) is marked by spontaneous and painful ecchymotic bruising, without any biological abnormality, occurring in women with pathological mental profile. Sometimes, when the inflammation is severe, an infectious cellulitis or muscular compression may be suspected. CASE REPORT: A 21-year-old woman was referred for the rapid occurrence of a diffuse and painful inflammation of the right leg, with fever. The leg was red, warm, with diffuse bruising. The foot was fixed in varus equin. The biological parameters were normal. Magnetic resonance imaging showed normal muscles but modifications in the subcutaneous fat, similar to an acute cellulitis. A cutaneous biopsy showed a moderate oedema of the dermis and erythrocyte extravasation. Antibiotics were inefficient on the pain and the aspect of the lesions. Because of the efficacy of saline serum injections on the symptoms and a pathological psychological profile, an autoerythrocyte sensitization syndrome was suspected. The skin test was negative. Psychiatric evaluation revealed a severe personality disorder associated with depression. The ecchymotic lesions disappeared with adapted psychiatric treatment. DISCUSSION: Painful bruising syndrome occurs most often in young women with various psychiatric problems. The lesions are characterized by recurrent, painful, swollen and bleeding bruises in any part of the body. Fever, abdominal pain and external bleeding are possible. Haematological and immunological findings are usually normal. The histology of early lesions reveals oedema of the dermis and modest perivascular infiltrate, whereas extravasated erythrocytes appear later. The magnetic resonance imaging aspect of the lesions has never been described. Abnormalities of the subcutaneous fat are similar to those of acute cellulitis, expressing the inflammation process secondary to the ecchymoses. The syndrome results from complex somatic and psychological mechanisms. Many drugs were tried for the treatment of the disease, without any significant improvement.

Adult↗
PubMedDate not supplied

[The value of radiological follow-up for stage III melanoma].

INTRODUCTION: The modalities of follow-up (frequency of consultations and interest of repeated radiological examinations) of patients presenting with glandular metastases of melanoma (stage III of the AJCC classification) have not reached a consensus. PATIENTS AND METHODS: Since 1995, we have proposed clinical follow-up every two months and radiological controls with a thoracic-abdominal-pelvic scan every 4 months, to patients at high risk of relapse for the early screening of an infra-clinical relapse. RESULTS: The median follow-up was of 16 months (range: 1 to 82 months). Eight patients out of 24 (33 p. 100) followed-up in this manner, had asymptomatic metastases discovered by the radiological examinations. Among these 8 patients, three presented with a an operable, single, metastatic localization and two patients underwent surgery. One patient relapsed 3 months later, the other was still alive without relapse 24 months later. DISCUSSION: Surgery remains the treatment of choice for all stages of melanoma. In the absence of clearly effective treatment of metastatic melanoma, the early discovery of an infra-clinical metastatic relapse presents two major advantages. The first is the discovery of a single, operable metastasis, as was the case in two of the patients out of 24. The second is to be able to suspend an eventual adjuvant therapy with interferon alpha, as soon as a relapse has been discovered.

Adolescent↗
PubMedDate not supplied

[Drug-induced cutaneous photosensitivity. Results of a consensus meeting].

In France, the use of an official drug adverse reaction assessment method is mandatory since 1984. The method proposes various qualifications for chronologic and semiologic criteria without clear limits. The definitions could vary with the nature of the side-effect. We report here the results of a consensus meeting on drug-induced photosensitivity. Dermatologists and experts in pharmacovigilance studied together how the "French method" could apply to the two variances of drug-induced photosensitivity: phototoxicity and photoallergy.

Drug Eruptions↗
PubMedDate not supplied

Mapping of Papillon-Lefevre syndrome to the chromosome 11q14 region.

Papillon-Lefevre syndrome (PLS) is an autosomal recessive disease which belongs to the palmo-plantar keratoderma (PPK) group. It is characterized by a premature loss of primary and permanent teeth and early onset periodontitis. High consanguinity has been observed in over one-third of PLS families. No candidate genes or gene localizations have been described to date for this disorder. A primary genome-wide search by homozygosity mapping using samples from a large consanguineous family in which 4 siblings were affected by the disease showed homozygosity and linkage in the region of 11q14. Linkage was confirmed in 4 additional families with diverse ethnic and geographic backgrounds, 2 of which were consanguineous. A maximum two-point lod score of 8.19 was obtained for the marker AFM063yg1 (D11S901= for theta = 0. Analysis of recombination events places the gene within a 7-cM interval between AFM063yg1 and AFM269yg9 (D11S4175). No shared haplotype was found for the 5 families analysed.

Chromosome Mapping↗