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Biomedical subjects

L Machet

Publications and source records attributed to L Machet.

At least 73 records · Page 4Linked to original sources
PubMed1997

[Dermatomyositis].

Explore the source record for details and available documents.

Adrenal Cortex Hormones↗
PubMed1997

[Mycobacterium chelonae cutaneous infection: efficacy of prolonged treatment by clarithromycin].

INTRODUCTION: Mycobacterium chelonae is an ubiquitous mycobacterium which is exceptionally pathogenic. It can cause localized skin infections which are difficult to treat because of multiple drug-resistance. CASE REPORT: A 87-year-old woman with bullous pemphigoid was treated with long-term prednisone and developed a skin infection due to M. Chelonae. Treatment with clarithromycin was successful, but relapse occurred 6 months after withdrawal of the antibiotic. DISCUSSION: Clarithromycin is effective in single drug regimen for M. Chelonae infection, but the duration of treatment should be long when immunosuppression cannot be avoided.

Aged↗
PubMed1996

Cutaneous alternariosis: role of corticosteroid-induced cutaneous fragility.

Alternaria is a very common and saprophytic fungus. Cutaneous infection is rare and about 71 cases have been described, mainly in Europe in immunocompromised hosts. We report a case of dermal alternariosis occurring in a woman treated with corticosteroids for dermatomyositis. The cutaneous lesion consisted of an erythematous and scaly plaque on the leg measuring 2 x 2 cm. Cutaneous biopsy showed hyphae and round inclusions stained with PAS and Gomori-Grocott within a polymorphous granuloma. Cultures of cutaneous biopsies grew Alternaria sp. HIV1 and HIV2 serology was negative. The patient was treated by local excision and corticosteroids were decreased. One-year follow-up showed no recurrence. Cutaneous alternariosis is an opportunistic infection. the disease has been described mainly in patients treated with systemic corticosteroids (39 cases out of the 71 reported cases) or local corticosteroids (3/71) and in patients suffering from Cushing's syndrome (7/71) but rarely in HIV-infected patients (3/71). Cutaneous fragility induced by hypercorticism is an important cofactor permitting direct inoculation from the environment.

Aged↗
PubMed1996

[Agranulocytosis induced by dapsone prescribed for dermatitis herpetiformis].

INTRODUCTION: Dapsone is a drug widely prescribed in dermatology. It can lead to undesirable side effects including hematologic disorders. CASE REPORT: A patient with dermatitis herpetiformis was treated with dapsone. Agranulocytosis developed 6 weeks later and was revealed by fever and pneumonia which resolved under antibiotics. The agranulocytosis regressed without specific treatment after drug withdrawal. Blood counts returned to normal 2 weeks later. DISCUSSION: Dapsone-induced agranulocytosis is in common (1/10,000 to 1/20,000). The drug is widely prescribed, particularly for leprosy. Nevertheless, when dapsone is prescribed for dermatitis herpetiformis, the risk of agranulocytosis increases 25-fold reaching 1/400. The indication for dapsone must always made carefully, with surveillance of the blood counts every 15 days during the first 3 months of treatment for dermatitis herpetiformis.

Agranulocytosis↗
PubMed1995

[Photobiological study of lupus erythematosus].

BACKGROUND: Although cutaneous photosensitivity is one of the major criteria used for the diagnosis of systemic lupus erythematosus, this criterion is not precise. OBJECTIVE: To evaluate the interest of photobiological exploration in patients with cutaneous lupus erythematosus, and to compare the results to clinical photosensitivity. METHODS: Nineteen patients consecutively seen in one year, have been tested using a standardized method. RESULTS: Clinical photosensitivity was present in 16 cases. The clinical presentation of cutaneous disease was classified in 3 groups: acute, subacute, and chronic. One patient with no history of photosensitivity had positive photobiological tests, and five patients had negative tests though they experienced clinical photosensitivity. Positive phototests with UVA and UVB were present in 6/8 subacute lupus cases, 3/6 acute lupus cases, 3/5 chronic lupus cases. Histological aspect of cutaneous biopsies from phototest was not characteristic of lupus. Minimal erythematous doses was comparable in lupus group and in controls. No correlation between positivity of phototests and the presence of systemic involvement or anti-Ro/SSA antibodies was established. CONCLUSION: Phototesting is useful to assess photosensitivity in lupus patients.

Adult↗
PubMed1995

[Cutaneous candidiasis due to Candida parapsilosis occurring in the course of idiopathic aplastic anemia].

Candida parapsilosis is a very common and saprophytic fungus. Its pathogenic role has been reported in intensive care units after invasive instrumentations. We report a case of dermal candidiasis due to Candida parapsilosis occurring in an immunocompromised patient suffering from aplastic anemia treated with corticosteroids. The histopathological aspect was non specific, showing a polymorphous granulomatous reaction in the middermis. Findings of periodic acid-Schiff and Grocott-Gomori stains revealed a large number of pseudohyphae and spores. Candida parasilosis was cultured from a skin biopsy. The route of skin infection is discussed: direct inoculation or septic localization after fungemia.

Adrenal Cortex Hormones↗
PubMed1995

[Cutaneous periarteritis nodosa resistant to combined corticosteroids and immunosuppressive agents. Efficacy of treatment with intravenous immunoglobulins].

INTRODUCTION: Cutaneous polyarteritis nodosa is a subset of polyarteritis nodosa (PAN) characterized by a good prognosis because of the absence of severe visceral involvement. Dapsone, colchicin, non steroidal anti-inflammatory drugs are the first line treatments of cutaneous PAN. Corticosteroids are an alternative therapy. CASE-REPORT: A case of cutaneous PAN followed for 6 years is reported. Dapsone, colchicin, corticosteroid and cyclophosphamide have failed to control cutaneous lesions. Intravenous immunoglobulins 400 mg/kg/d five day monthly for 5 months was successful, but a cutaneous relapse occurred 3 months later which was another time controlled with intravenous immunoglobulins. DISCUSSION: Some cases of necrotizing vasculitis have been treated with intravenous immunoglobulins. This is the first reported case of cutaneous PAN treated with intravenous immunoglobulins. Because of the lack of controlled studies, the indications of intravenous immunoglobulins in vasculitis are restricted to those resistant to corticosteroids and immunosuppressive therapy.

Cyclophosphamide↗
PubMed1994

Study of cutaneous extensibility in lymphoedema of the lower limbs.

We have studied changes in the elasticity and viscosity of the skin in patients with lymphoedema, using a technique involving vertical extensibility by suction. We measured parameters which included immediate extensibility (Ue, which reflects the elastic properties of the skin), and delayed extensibility (Uv which reflects intracutaneous movements of a viscous type). In grade III lymphoedema, Ue is decreased and Uv is increased. These changes are explained by volume variations and histological alterations, and tend to normalize after treatment. Our study shows that measurement of extensibility is useful in evaluation of volume variations, effects of therapy, and disease evolution, as Ue variations correlate with volume variations and with Uv changes. This technique also provides information which is useful in assessing patients' functional difficulties in relation to skin infiltration, and might be of value in lymphoedema follow-up.

Adolescent↗
PubMed1994

Ultrasound imaging of psoriatic skin: a noninvasive technique to evaluate treatment of psoriasis.

BACKGROUND: The aim of our study was to image psoriasis plaques by ultrasound to assess the changes in psoriasis and to measure and quantify them objectively. MATERIALS AND METHODS: Thirty-one psoriasis plaques were studied in 19 patients. Measurements of skin thickness were obtained with a high resolution B-mode echographic system. RESULTS: Some changes were seen in psoriatic skin. A new structural element was observed: a wide subepidermal nonechogenic band. The other changes were a decrease in dermal echoes that were less intense and less dense, and an increase in the epidermal and dermal skin thicknesses. The skin thickness was increased in all psoriasis plaques as compared to apparently normal skin (P < 0.001). The average increase was 67% for whole skin and 200% for epidermis. CONCLUSIONS: Ultrasound imaging of psoriatic skin allowed the identification of different skin changes induced by psoriasis, and particularly, the differentiation between epidermal and dermal alterations. We presume that epidermal thickness reflects epidermal proliferation and desquamation, and the increase in the dermal and whole skin thickness reflects infiltration. We feel that ultrasound imaging of psoriatic skin is a quantitative method that is as easy and noninvasive as the psoriasis area and severity index (PASI). It could be used for following up patients with psoriasis and could achieve widespread use, especially in research protocols.

Adult↗