Biomedical subjects

M de la Brassinne

Publications and source records attributed to M de la Brassinne.

At least 19 recordsLinked to original sources

PubMed2006

A 52-week randomized safety study of a calcipotriol/betamethasone dipropionate two-compound product (Dovobet/Daivobet/Taclonex) in the treatment of psoriasis vulgaris.

BACKGROUND: The calcipotriol/betamethasone dipropionate two-compound product Dovobet/Daivobet/Taclonex(LEO Pharma A/S, Ballerup, Denmark) has been shown to be safe and effective in the treatment of psoriasis for up to 8 weeks. As psoriasis is a chronic disease, long-term treatment may be required, so there is a need to investigate the safety of its use over a longer period of time. OBJECTIVES: To investigate the safety of two treatment regimens involving use of the two-compound product over 52 weeks in the treatment of patients with psoriasis. METHODS: Patients (n = 634) were randomized double-blind to treatment with: (i) 52 weeks of the two-compound product (two-compound group); (ii) 52 weeks of alternating 4-week periods of the two-compound product and calcipotriol (alternating group); or (iii) 4 weeks of the two-compound product followed by 48 weeks of calcipotriol (calcipotriol group). Treatments in all groups were used once daily when required. RESULTS: Adverse drug reactions (ADRs) occurred in 45 (21.7%) patients in the two-compound group, 63 (29.6%) in the alternating group and 78 (37.9%) in the calcipotriol group. The odds ratio for an ADR in the two-compound group relative to the calcipotriol group was 0.46 (95% confidence interval 0.30-0.70; P < 0.001). ADRs of concern associated with long-term topical corticosteroid use occurred in 10 (4.8%) patients in the two-compound group, six (2.8%) in the alternating group and six (2.9%) in the calcipotriol group; those with the highest incidence were skin atrophy, occurring in four (1.9%), one (0.5%) and two (1.0%) patients, respectively, and folliculitis, in three (1.4%), one (0.5%) and no patients, respectively. CONCLUSIONS: Treatment with the two-compound product for up to 52 weeks appears to be safe and well tolerated whether used on its own or alternating every 4 weeks with calcipotriol treatment.

Adult↗

PubMed2006

A novel method of comparing the healing properties of two hydrogels in chronic leg ulcers.

Skin ulcers on the legs have a chronic, relapsing course and are often a significant management challenge. Novel methods of measuring and comparing the effects of different treatments can be of assistance in addressing this situation. A clinical pilot study using original methods was undertaken to compare the healing properties of the alginate gel Flaminal (test) and the hydrocolloid gel Intrasite (control) on chronic leg ulcers. The study was performed over a period of 28 days with two parallel groups of 10 patients. Both the surface (acetate tracing and planimetry) and the volume (Jeltrate mould impression and weighting) of each wound were measured at baseline and after 7, 14 and 28 days of treatment. On both parameters results were superior with the test product compared to the control, with volume reduction being the first parameter to change. Between groups, difference in wound volume reduction was detected as early as day 7 whereas difference in surface reduction was clearly apparent only at day 28. Correlation between wound surface and volume reductions was also better in the test group (r = 0.843 vs. 0.421) than in the control. In conclusion, this pilot study suggests that combining wound surface and volume evaluations allows a more precise analysis of the healing process in venous leg ulcers and that this method is able to detect very early differences in treatments even with limited sample size.

Administration, Cutaneous↗

PubMed2006

Efficacy results of a 52-week, randomised, double-blind, safety study of a calcipotriol/betamethasone dipropionate two-compound product (Daivobet/Dovobet/Taclonex) in the treatment of psoriasis vulgaris.

BACKGROUND: The calcipotriol/betamethasone dipropionate two-compound product is safe and effective in the short-term treatment of psoriasis. OBJECTIVE: The primary objective was to investigate the safety of two treatment regimens involving use of the two-compound product over 52 weeks. The efficacy results are presented here. METHODS: Six hundred and thirty-four patients were randomised double-blind to treatment (once daily, when required) with either: 52 weeks of two-compound product (two-compound group), 52 weeks of alternating 4-week periods of two-compound product and calcipotriol (alternating group), or 4 weeks of two-compound product followed by 48 weeks of calcipotriol (calcipotriol group). RESULTS: There was a trend towards a difference between treatments from the overall treatment effect for the percentage of satisfactory responses for each patient during the study (p = 0.071). This appeared to be due to the comparison of the two-compound and calcipotriol groups (p = 0.025). CONCLUSION: There was a trend towards the efficacy of the two-compound product used for up to 52 weeks being better than that of 4 weeks of the two-compound product followed by 48 weeks of calcipotriol.

Anti-Inflammatory Agents↗

PubMed2005

Epidermoid carcinoma and perforating necrobiosis lipoidica: a rare association.

We report the case of a 33-year-old patient who had had insulin-dependent diabetes mellitus (IDDM) since he was 11 months old, and who presented with major perforating necrobiosis lipoidica (PNL) complicated by a well-differentiated epidermoid carcinoma. PNL is a rare clinical form of NL, always associated with diabetes. Only seven cases have been reported to date in the literature, and to the best of our knowledge, an association of epidermoid carcinoma and PNL has never been described. The development of a tumoral transformation on a classical NL plaque has only been described 12 times. The presence of an epidermoid carcinoma on a weakened background with permanent ulceration suggests that early surgical excision of the tumour and of the NL followed by a skin graft might be the treatment of choice. Radiotherapy seems to be a poor therapeutic option.

Adult↗

PubMed2005

[How I treat...varicosities by sclerotherapy].

Sclerotherapy is a technique for the treatment of varicosities, vascular ectasia, and sometimes, leg varicose veins. This method is aesthetic and in some cases therapeutics and uses sclerosing agents, electrocoagulation and exceptionally LASER. These relatively simple methods are safe and efficient if they are applied with a rigorous procedure by well trained physicians.

Electrocoagulation↗

PubMed2005

[Place of ivermectin in the treatment of scabies].

Ivermectin is the first oral treatment available for scabies. It is however not licensed for use in Belgium. In this article, we review its mechanism of action, its preferential indications among which crusted scabies and institutional outbreaks, its contra-indications and its advantages in comparison with topical treatments.

Antiparasitic Agents↗

PubMed2004

Periungual lipoma: about three cases.

Lipomas are one of the most common benign soft tissue tumors. The usual development sites are the neck, the torso, and the legs. Lipomas of the nail unit are extremely rare. Only five cases have been reported up to now, four in subungual locations and one in the lateral nail fold. We report three cases of peri-ungual lipomas, one on the digit and two on the toes. Two of them exhibited the histological features of perisudoral lipomas.

Aged↗

PubMed2004

Hyperkeratotic nail discoid lupus erythematosus evolving towards systemic lupus erythematosus: therapeutic difficulties.

Nail changes occur in about 25% of systemic lupus erythematosus (SLE) cases. Onycholysis has been reported as the most frequent abnormality in SLE. Nailbed hyperkeratosis may be observed in both SLE and discoid lupus erythematosus (DLE). Involvement of the nail apparatus in DLE is extremely uncommon and never restricted to it. We report on a patient in whom the clinical features on the proximal nailfold were similar to those observed on the skin of a patient with typical DLE. This has, to the best of our knowledge, not yet been reported. The patient also exhibited a very distinctive prominent subungual hyperkeratosis. Interestingly, the patient developed biological alterations suggesting a systematization of the disease. Only a combination of systemic corticoids, retinoids and antimalarials was able to achieve nail improvement and this partial resistance to therapy may be explained by the very unusual subungual hyperkeratosis.

Dermatologic Agents↗

PubMed2004

[Xanthomas].

Xanthomas are cutaneous lesions due to a local accumulation of spumous cells in the dermal tissue or the tendons. Histologically, they are characterized by the presence of histiocytes, fibroblasts, macrophages and Touton cells full of lipids. Xanthomas may be found on any part of the body and are usually yellow-orange in color. They may or may not be associated to hyperlipoproteinemia which may be genetic or secondary. A blood test and a complete physical examination are necessary in case such a lesion is discovered. When there is no hyperlipemia some types of xanthomas may be associated to rare diseases. Xanthomas are classified according to their clinical features.

Biopsy↗

PubMed2004

[Non bullous impetigo: streptococcal or staphylococcal?].

Non bullous impetigo is very common among the pediatric population. It is caused by bacteria. For twenty years, Staphylococcus aureus has been the most frequently isolated organism (present in 80 % of non bullous impetigo lesions, it is the only pathogen cultured in 50 % of patients). The group A beta-haemolytic streptococcus is at the moment isolated alone in 3% of lesions and in association with S. Aureus in 30 % of patients. An epidemiologic change seems to have occurred. Until the early 1980s, group A beta-haemolytic streptococcus was indeed the most predominant etiologic agent causing non bullous impetigo. Unfortunately, the rate of resistance among staphylococci responsible of non bullous impetigo is increasing. As serious complications can follow this skin infection, an appropriate treatment is necessary combining local care, topical antibiotics and sometimes adjunction of systemic antibiotics.

Humans↗

PubMed2004

[How I treat... Belgian consensus document on the treatment of acne].

This article describes the consensus on the treatment of acne, reached by a Belgian working group. An effective treatment has to rely as much as possible on the pathophysiologic factors: the increased production of sebum, the abnormal desquamation (retention hyperkeratosis) of the epithelium of he sebaceous gland, the proliferation of Propionibacterium acnes and inflammation. The therapeutic arsenal contains topical as well as systemic drugs. This consensus gives an overview of both modalities and an algorithm is presented describing the practical approach to acne treatment.

Acne Vulgaris↗

PubMed2003

[Ectodermal dysplasias].

The ectodermal dysplasias form a heterogeneous group of rare and complex genetic diseases with different ectodermal derivates abnormalities. The aim of this paper is to present briefly the anhidrotic form or Christ-Siemens-Touraines's syndrome and the hidrotic form or Clouston's syndrome.

Ectodermal Dysplasia↗

PubMed2003

[Sutures in skin surgery].

Dermatologists performing skin surgery mostly use the square knot. Other underused or even forgotten suturing techniques may still be helpful in some instances. We shall emphasize some simple techniques such as the horizontal mattress suture, the "cross stitch", the "corner stitch" (half buried mattress suture), the buried dermal suture, the buried vertical mattress suture, the continuous mattress suture and the running intradermal suture. In given circumstances, all of them may improve suturing and promote healing. Technical aspects, advantages and disadvantages of each type of suture will be briefly described.

Dermatologic Surgical Procedures↗

PubMed2003

[Hand, foot and mouth disease, a not so benign affection: clinical reminder and potential complications].

Hand-foot-and-mouth disease is an infection appearing in epidemics and due, in most cases, to Coxsackie-virus A16 and/or Enterovirus 71 or, less often, to other Coxsackie-virus serotypes. The symptomatology mostly consists in vesicular eruption of the anterior part of the buccal mucosa as well as of hands and feet. Its evolution, although often benign, can include cardiopulmonary and neurological complications. The latter complications require a quickly detection and treatment, and prevention of virus transmission to other people must be adequate.

Cardiovascular Diseases↗

PubMed2003

[Medication of the month. Tazarotene 0.05%-0.1% (Zorac)].

Since April 28th, a new topical retinoid is available in Belgium: tazarotene (Zorac) gel (Pierre Fabre). It exists at two concentrations: 0.05% or 0.1%. It is the first receptor-selective topical retinoid. It is indicated in the treatment of plaque-type psoriasis. In the USA, tazarotene is also licensed for use in the treatment of acne and several studies show its efficacy for the treatment of other skin diseases like photodamage and ichthyoses.

Administration, Topical↗

PubMed2003

[Urticaria and systemic diseases].

Urticaria is a transient eruption of erythematous or oedematous swelling of the dermis and is usually associated with itching which clinically is very easy to diagnose. However, it causes several etiological, pathophysiological and therapeutic problems. We will develop the acute and chronic urticaria as well as their different associations with systemic diseases. Some current data concerning chronic idiopathic autoimmune urticaria is reviewed. The management and therapeutics will be discussed.

Acute Disease↗

PubMed2002

[Green nail syndrome or chloronychia].

"Green nails" or chloronychia is an infection mostly caused by Pseudomonas ueruginosa but also by other bacterial or fungal contamination. The clinical appearance consists in a typical triad: green discoloration of the nail plate associated with proximal chronic paronychia and disto-lateral onycholysis. Exposition to moist environment, microtraumatisms, oaychotillomania and associated nail diseases such as psoriasis may promote infection by Pseudomonas. Treatment consists in cutting of the detached nail plate, brushing the nail bed with a 2% sodium hypochlorite solution twice daily and eviction of the repeated immersions by wearing cotton and latex gloves.

Administration, Topical↗

PubMed2001

[A non-infectious pyodermatitis: Pyoderma gangrenosum].

Pyoderma gangrenosum (PG) is a rare chronic inflammatory skin disease characterized by the recurring development of necrotizing and painful ulcers. The skin lesions appear spontaneously or after minor traumatic injuries. Sites of predilection include the lower limbs and the trunk but any part of the body may be affected. PG is not an infectious disease; although the etiology is not completely understood, an immune disturbance is certainly involved. An underlying systemic disorder is associated in up to 50% of the cases, specially inflammatory bowel diseases, arthritis, paraproteinemias and hematologic malignancies. Chronic venous or arterial ulcers as well as bacterial gangrene are the most frequent false diagnoses. A right diagnosis, based upon the distinctive clinical features and a compatible histology, is essential to avoid surgical procedure that often tends to exacerbed the process. Because of its persistent and recurrent nature, systemic long-term therapy based upon corticosteroids associated with sulfones or immunosuppressive agents is required.

Adrenal Cortex Hormones↗