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M Dandurand

Publications and source records attributed to M Dandurand.

At least 19 recordsLinked to original sources
PubMed2006

[Tumoral and pilotropic mycosis fongoides without mucin: evolution towards a pustulous erythroderma].

INTRODUCTION: Pilotropic mycosis fongoides is a particular form of the disease, because of its clinical and histological aspects, its poor prognosis and its resistance to treatment. We report a case of pilotropic mycosis fongoides without mucinosis, immediately tumoral, the fatal progression of which was marked by the occurrence of pustular erythroderma. OBSERVATION: In 1998 a 69 year-old man presented with infiltrated erythro-squamatous plaques and nodules on the limbs associated with follicular lesions predominating on the cervical-cephalic area. Histological explorations revealed a pilotropic infiltrate with atypical CD4+ CD8 CD30 T-cells, without epidermotrophism or mucinosis. Study of genetic rearrangements found a clone lymphocyte T-cell in the skin. Diagnosis of pilotropic mycosis fongoides at the tumoral stage was made and, despite various treatments, the disease developed towards fatal pustular erythroderma. DISCUSSION: At the onset of its progression, pilotropic mycosis fongoides is sometimes difficult to distinguish from classical mycosis fongoides, during which follicular involvement is often seen. However it is important to differentiate these entities because of the poor prognosis of pilotropic mycosis fongoides. Development of tissue micro dissection techniques and lymphocyte T-cell clones from human skin would help to separate these cutaneous T-cell lymphoma sub-groups. Our case report is original because of the absence of dermal mucinosis combined with an immediately tumoral form and the progression towards generalized pustulosis. It also underlines the poor prognosis and resistance to treatment of pilotropic mycosis fongoides.

Aged↗
PubMed2005

High plasma proteasome levels are detected in patients with metastatic malignant melanoma.

BACKGROUND: Proteasomes, nonlysosomal proteolytic structures, are implicated in cell growth and differentiation. An abnormal expression has been described in haematopoietic malignancies and in some solid tumours. OBJECTIVES: To study the plasma proteasome levels in patients with malignant melanoma (MM) using an enzyme-linked immunosorbent assay (ELISA) technique, and to compare them with the values obtained in a normal population and in patients with severe psoriasis or chronic idiopathic urticaria (CIU). METHODS: Plasma proteasome level was measured using a sandwich ELISA test in normal donors (n = 14), and in patients with stage I/II (n = 13), stage III (n = 6) and stage IV (n = 10) MM, severe psoriasis (n = 13) and CIU (n = 6). Tissue proteasome expression was also detected by immunohistology using a monoclonal antibody in paraffin-embedded samples of normal tissue, psoriasis skin and MM. RESULTS: In normal donors, mean +/- SEM plasma proteasome concentration was 2138 +/- 221 ng mL(-1). Patients with stages III and IV MM exhibited a significantly higher value (3373 +/- 470 ng mL(-1) and 8931 +/- 1232 ng mL(-1), respectively). Values in patients with stage I/II MM and CIU were not significantly different from those in normal volunteers. Patients with severe psoriasis also exhibited increased values (3398 +/- 374 ng mL(-1)) but to a lesser extent than in patients with stage IV MM. There was a significant correlation of proteasome levels with serum lactate dehydrogenase in the MM group. Tissue expression as demonstrated by immunohistochemistry paralleled these findings. The strongest expression was seen on MM slides and to a lesser extent in psoriasis samples, the weakest expression being observed in normal skin. CONCLUSIONS: Proteasomes are strongly expressed in cutaneous MM; high levels of circulating proteasomes are detected in patients with metastatic MM with a high melanoma burden, and at a lesser extent in psoriatic patients, which suggests proteasomes represent a marker more of nonspecific inflammation than of early cancer.

Adult↗
PubMed2002

[Septic embolism complicating an aorto-duodenal fistula].

INTRODUCTION: Aorto-duodenal fistulas are rare complications of aortal prostheses. We report a case revealed by septic embolism. OBSERVATION: A 63 year-old man with past history of obliterating arteriopathy of the legs and bifemoral aortal bypass was hospitalized in a dermatology unit because of bilateral ecchymotic and purpural lesions of the soles of the feet and fever. Hemocultures were positive for E. coli and alpha hemolytic streptococci. The search for a deep infectious area was negative. Gastro-esophageal fibroscopy revealed an aorto-duodenal fistula showing a fresh blood clot in the second duodenum. DISCUSSION: Aorto-duodenal fistulas are rare complications of aortal prostheses, the high mortality of which is often related to late diagnosis. The initial symptoms such as fever, abdominal pain, palpable mass and digestive bleeding are inconstant and the clinical profile polymorphous. Any suspicion of septic embolism in a patient with an aortal vascular prosthesis must lead to the search for prosthetic infection and an aorto-duodenal fistula, notably in the presence of osteomyelitis at distance from the prosthesis. A scan and/or scintigraphy with normal polynuclears do not eliminate the diagnosis of an aortal-duodenal fistula and a gastro-esophageal fibroscopy should be performed.

Abdominal Pain↗
PubMed2000

Angiosarcoma of the scalp and face: failure of an interferon alpha treatment.

Angiosarcoma of the scalp and face is a rare malignant endothelial tumor arising in elderly people. Treatment is disappointing and prognosis remains poor. We report two cases of angiosarcoma of the scalp and face relapsing after classical therapy with surgery and radiotherapy and treated with interferon alpha. The tolerance was poor and the disease progressed 2 and 5 months after the onset of the treatment. When used alone, interferon alpha does not appear as an effective treatment in this kind of angiosarcoma.

Aged↗
PubMed2000

Eruptive pseudoangiomatosis arising in adulthood: 9 cases.

Eruptive pseudoangiomatosis has only been reported in children up till now. The purpose of this study is to present the clinical characteristics of eruptive pseudoangiomatosis in adulthood and to discuss the potential role of infectious agents. A retrospective study concerning nine cases of eruptive pseudoangiomatosis observed over a ten year period was undertaken, concerning clinical, histological and epidemiological aspects of the disease. The patients, 8 women and one man had an acute eruption of numerous papules measuring 2-5 mm in diameter, disseminated on the face, limbs and trunk. The papules were erythematous and telangiectatic, surrounded by a white halo. The lesions blanched completely with pressure and refilled from the center on release. Histological examination was performed on 4 patients, showing dilated blood vessels with plump endothelial cells but no evidence of an increased number of vessels. Epidemiological data revealed the onset of the disease during hospitalisation for treatment of cancer or asthma in four patients and among the five remaining patients, two were hospitalized in a retirement home and one was a nurse in a psychiatric hospital. These data suggest that the eruption could be linked with a infectious disease despite the negativity of some serological investigations. We report for the first time cases of pseudoangiomatosis arising in adulthood.

Adult↗
PubMed1999

Leg ulcers and hydroxyurea: forty-one cases.

BACKGROUND: Hydroxyurea is an antitumor agent used to treat chronic myeloproliferative disorders. Leg ulcerations have been reported in patients undergoing long-term hydroxyurea therapy for myeloproliferative diseases. To better define this dermatological adverse effect of hydroxyurea therapy and to try to understand the pathophysiological process of this disease, we collected medical information for such patients in a multicenter retrospective study. OBSERVATIONS: Forty-one patients (mean age, 67 years) developed leg ulcerations while undergoing hydroxyurea therapy (mean therapy duration, 5 years). The sex ratio was 1, and there was no underlying vascular disease. Hematologic abnormalities were identified. Complete recovery from the ulcerations occurred quickly after withdrawal of treatment in 33 (80%) of the cases. CONCLUSIONS: This longest-reported series of patients confirms the role of hydroxyurea therapy in the onset of leg ulcerations. Healing or improvement requires cessation of treatment. Cutaneous atrophy and impaired wound healing may explain the relationship between hydroxyurea and leg ulcers. In addition, the megaloblastic erythrocytes resulting from the presence of hydroxyurea may circulate poorly through the capillary network. A prospective study in hematologic centers would be valuable.

Adult↗
PubMed1999

An association between autosomal dominant cerebral cavernomas and a distinctive hyperkeratotic cutaneous vascular malformation in 4 families.

Cerebral cavernomas (CCMs) are vascular malformations that may be inherited as an autosomal dominant condition for which a gene, CCM1, was mapped to chromosome 7. Poorly defined cutaneous malformations were sometimes described in association with CCMs. During a national survey, 57 French CCM families were studied. Co-occurrence of CCMs and a distinctive cutaneous vascular malformation was observed in 4 families. Ten individuals belonging to these families showed similar hyperkeratotic cutaneous capillary venous malformations (HCCVMs). In 3 families, the histology showed orthokeratosis and hyperkeratosis as well as dilated capillaries in the dermis extending to the hypodermis and confirmed the diagnosis of HCCVM. Genetic analysis strongly supports linkage of these families to the CCM1 locus on chromosome 7. The HCCVM seems to be a peculiar cutaneous vascular malformation associated with CCMs. These data strongly suggest that HCCVMs and CCMs in these families are due to the same genetic abnormality.

Adult↗
PubMed1999

[Secondary radiodermatitis caused by endovascular explorations: 5 cases].

BACKGROUND: Fluoroscopically guided interventional procedures expose patients to high doses of ionizing radiation. OBSERVATIONS: We describe 5 patients in whom radiodermatitis developed following vascular catheterization: cardiac catheterization and coronary angioplasty in 4 cases and renal artery catheterization and angioplasty in 1 case. All patients were men. The endovascular procedures have been repeated or prolonged in all cases excepted one. The clinical aspects were those of a chronic radiodermatitis (4 cases) and acute radiodermatitis (1 case). An extensive and painful ulceration was observed in 3 patients for which surgical excision was proposed. In one case lesions were bilateral. Delay of onset after the last exploration varied from a few weeks to 3 years. Biopsy specimen was suggestive of chronic radiodermatitis but, in 2 cases, was not contributive in the absence of clinical proposal. DISCUSSION: About 20 cases of radiodermatitis following coronary angioplasty have been reported in the literature since 1996. The cumulative radiation doses to which the patients were exposed are compatible with the occurrence of radiodermatitis. Coronary angiography using fluoroscopy and cineradiography delivers notably higher radiation doses than any other routine procedure. Even higher levels of radiation may result from percutaneous transluminal angioplasty, which is a more complicated and lengthier procedure frequently repeated. Radiodermatitis have been described during many other vascular procedures like radiofrequency catheter ablation, renal angioplasty, interventional neuroradiologic and hepato-biliary procedures. Medical facilities and physicians performing interventional procedures should be aware of these sides effects and implement measures to reduce the potential for radiation skin injuries.

Aged↗
PubMed1998

[Bullous lichen sclerosus after radiotherapy].

BACKGROUND: Bullous lichen sclerosus is an uncommon observation after radiotherapy and can be misdiagnosed as a radiodermitis or recurrence of the neoplasia. CASE REPORT: Two women developed bullous lichen sclerosus after radiotherapy. The delay after radiotherapy was 4 months and 10 years respectively. Irradiation dose was 60 and 64 grays. The lesions covered more than the irradiated zone in one case. Stabilization or regression of the lesions was obtained with cases I topical corticosteroids, with acitretine in one case. DISCUSSION: These cases, and similar cases reported in the literature, underline the fact that the condition has only been reported in women. This is probably because of the nature of the neoplasias treated (breast cancer in 20 cases and cervical cancer in 1). The delay to onset of the skin lesions are quite variable. Lichen sclerosus or morphea may be observed in the irradiated zone but may also appear at a distance. These lesions are not associated with recurrence of the initial cancer. As no association between breast cancer and localized sclerodermia has been found, the causal role is probably played by radiotherapy, producing a Koebner phenomena in predisposed tissue.

Administration, Topical↗
PubMed1997

[Acute generalized exanthematic pustulosis after intake of clozapine (leponex). First case] case].

BACKGROUND: Acute generalized exanthematic pustulosis is a severe adverse drug reaction which occurs after taking antibiotics. Rare cases implicating psychotrops have been observed. CASE REPORT: A 71-year old women with schizophrenia was given closapine for six weeks when she developed an erythematopustular skin reaction and fever typical of acute generalized exanthematic pustulosis. The skin disease regressed one week after withdrawing clozapine. DISCUSSION: This is the first case of acute generalized exanthematic pustulosis observed after taking the neuroleptic drug, clozapine, used in severe schizophrenia.

Acute Disease↗