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Biomedical subjects

O Dereure

Publications and source records attributed to O Dereure.

At least 91 records · Page 5Linked to original sources
PubMed1999

[Dubreuilh melanoma: and epidemiologic and prognostic study].

BACKGROUND: Lentigo maligna melanoma is a specific histoclinical type of melanoma. We studied the epidemiologic features of lentigo maligna melanoma (Dubreuilh's melanoma) and compared prognosis with other types of melanoma. PATIENTS AND METHODS: A retrospective review of 516 cases of cutaneous melanomas, seen from 1985 to 1997, identified 29 cases of lentigo maligna melanoma. Epidemiologic, clinical and prognostic data were collected using a common scoring system for all patients. The chi-squared test, univariate log rank analysis, Cox multiple regression model for multivariate analysis, and actuarial survival curves were applied. RESULTS: The 29 cases of lentigo maligna melanoma (16 women, 13 men) accounted for 5.9 p. 100 of all melanomas. Mean age at diagnosis was 73 years compared with 54 years for others melanomas. Predominant localization was head and neck. There was no prior history of nevi compared with 50 p. 100. Mean delay to diagnosis was 4 years versus 1 year. All patients have had an occupation with to sun exposure. Mean tumoral thickness was 2 mm. Survival was the same as for extensive superficial melanomas and better than for nodular melanomas. Multivariate analysis showed that prognosis was not better in case of lentigo maligna melanoma. Tumoral thickness was the main prognosis factor. DISCUSSION: Our findings confirmed the specific nature of lentigo maligna melanoma and suggested that sun exposure plays an important role. Multivariate analysis did not show that prognosis was any better in case of lentigo maligna melanoma than in other types of melanoma. The thickness of the tumor must be taken into account as for other melanomas.

Actuarial Analysis↗
PubMed1998

[Apropos of a case of epidermoid carcinoma of the nail bed with intraneural metastasis to the median nerve].

The authors report a case of squamous cell carcinoma of the nail bed with multiple metastases including a metastasis of the median nerve. This particular site raises the problem of the mechanism of dissemination and the aggressiveness of this squamous cell carcinoma of the nail bed contrasts with the data reported in the literature. The initial treatment of this tumour must consist of amputation of the distal phalanx.

Amputation, Surgical↗
PubMed1998

[Pheochromocytoma manifesting as toe necrosis].

BACKGROUND: Cutaneous manifestations of pheochromocytoma other than sweating, and facial pallor during paroxysmal episodes of hypertension are exceptional. CASE REPORT: We observed partial necrosis of the fourth toes which revealed pheochromocytoma. DISCUSSIONS: Signs of peripheral vascular disease are uncommon during the course of pheochromocytoma. Only four cases have been reported in the literature. Occurrence of distal necrosis in combination with hypertension and palpable pulses is suggestive of pheochromocytoma requiring assay of urinary catecholamines. The pathogenic mechanisms of necrosis would be vasospasm of cutaneous vessels due to excessive plasmatic catecholamine levels and thrombocytosis as an aggravating factor.

Adrenal Gland Neoplasms↗
PubMed1997

Efficacy of Daflon 500 mg in venous leg ulcer healing: a double-blind, randomized, controlled versus placebo trial in 107 patients.

The objective of this study was to evaluate the efficacy of Daflon 500 mg (Dios)* in venous ulcers. A multicenter, double-blind, randomized, controlled versus placebo (Plac) trial was conducted, with stratification according to the size of ulcer (< or = 10 cm and > 10 cm). The protocol called for a two-month treatment with Dios (one tablet = 450 mg micronized purified Diosmin) or a placebo, two tablets/day, in addition to compression therapy. Evaluations were performed every fifteen days, from D0 to D60. The primary endpoint, in accordance with Alexander House group requirements were: percentage of patients with complete ulcer healing, ie, comparison between Dios and Plac group at D60, and comparison of survival curves in each group between D0 and D60 (log rank test). Secondary endpoints included ulcer surface area assessed by computerized planimetric measurements, qualitative evaluation of ulcers, and symptoms. The patients were 105 men and women ranging in age from eighteen to eighty-five years, with standard compression stocking, who were undergoing standardized local care of ulcer and had no significant arterial disease (ankle/arm systolic pressure index > 0.8). Fifty-three patients received Dios, and 52 received Plac. The 2 groups were well matched for age (m +/- 1 SD = seventy-one +/- eleven years), gender, ulcer size, and associated disorders. Among patients with ulcer size < or = 10 cm (Dios = 44, Plac = 47) a significantly larger number of patients had a complete ulcer healing at two months in the Dios group (n = 14) in comparison with the Plac group (n = 6) (32% vs 13%, P = 0.028) with a significantly shorter time duration of healing (P = 0.037). No difference was shown for the secondary criteria, except for sensation of heavy legs (P = 0.039) and a less atonic aspect of ulcer (P = 0.030) in favor of Dios. Among the 14 patients with ulcer size > 10 cm (Dios = 9, Plac = 5), subjected to a descriptive analysis only, no ulcer healed. This study showed that a two-month course of Daflon 500 mg at a daily dose of two tablets, in addition to conventional treatment, is of benefit in patients with venous ulcer < or = 10 cm by accelerating complete healing.

Adolescent↗
PubMed1996

Nonpigmenting fixed drug eruption: a new case due to betahistine.

We describe a new case of a seldom reported subset of fixed drug eruption, the nonpigmenting type. Aside from their fixed nature and their well-demarcated margins, pigmenting and non-pigmenting subsets of fixed drug eruption exhibit well-separated clinical and histological features allowing easy recognition. The precise physiopathology is currently unknown in both conditions, but a delayed hypersensitivity mechanism is likely. The nature of the inducing drugs of the nonpigmenting eruption is discussed.

Betahistine↗
PubMed1996

Extensive necrotizing livedo reticularis in a patient with chronic renal failure, hyperparathyroidism and coagulation disorder: regression after subtotal parathyroidectomy.

Necrotizing livedo reticularis is an infrequent, life-threatening complication of chronic renal failure. Since Selye's studies in 1962, calciphylaxis, i.e. acute calcium deposition in tissue, is considered the main pathomechanism, especially because hyperparathyroidism are very frequently present. However, other etiological and/or triggering factors, such as coagulation disorders, direct cellular toxicity of parathormone or calcium on endothelium, might be involved, acting perhaps in a cumulative way. We report a case with a circulating anticoagulant which supports this hypothesis.

Adult↗
PubMed1996

[Multifocal lupus vulgaris].

INTRODUCTION: Lupus vulgaris is a subset of cutaneous tuberculosis, classically considered as the resurgence of an endogenous focus. The most usual clinical picture is a unique, often facial, patch and the association with deep, visceral specific lesions is rarely reported. OBSERVATION: A 69-year-old woman was referred for evaluation of multiple patches of the trunk and the limbs, with a histological picture of non caseating tuberculoid granuloma. A previous medical history of tuberculous primary infection of the lungs prompted search for lupus vulgaris, confirmed by the culture of cutaneous lesions. Numerous visceral specific lesions were likely present, especially in the liver. DISCUSSION: Multiple lesions are rarely reported in lupus vulgaris and may be confusing especially with sarcoidosis when confronted with non-specific granulomatous histology. This is especially true when there is visceral involvement, infrequently described in lupus vulgaris (a liver lesion has not been previously reported). Culture of cutaneous samples is required in case of doubt.

Aged↗
PubMed1995

Lethal acute graft-versus-host disease in a liver transplant recipient: relations with cell migration and chimerism.

We report herein the case of a patient who developed fatal acute graft-versus host disease (GvHD) after liver transplantation (LT). GvHD occurred 18 days after LT and was characterized by skin epidermolysis, diarrhea and leucopenia. Skin biopsy showed epidermal dyskeratosis with epithelial necrosis, a lesion consistent with GvHD. Despite immunosuppressive therapy, the patient died within 24 days. In our observation, GvHD occurred although five HLA compatibilities were identified between the donor and the recipient, an apparently favorable and uncommon situation. This case further supports the qualification that LT may be complicated by GvHD and strongly suggests that minor rather than major histocompatibility antigens are the main target of allogenic interactions of GvHD. The involvement of chimerism in GvHD is controversial and requires further investigation.

Cell Movement↗
PubMed1995

[Necrotic angiodermatitis revealing a secondary hyperparathyroidism due to chronic renal insufficiency: healing after subtotal parathyroidectomy].

Severe skin necrosis of poor prognosis have been rarely reported among chronic renal failure patients. Their clinical outbreak must rapidly lead to search for a secondary hyperparathyroidism. Early parathyroidectomy seems is the only treatment able to stop the progression of the skin lesions. From an original clinical observation we discuss the different mechanisms involved.

Adult↗
PubMed1995

[Genetic bases of cutaneous tumors].

Carcinogenesis is a multigenic phenomenon where 3 prevailing types of genes are involved: oncogenes which stimulate the cell proliferation, tumor suppressor genes which act as inhibitors and metastagenes which contribute to the tumor progress. In animal models it has been shown that epithelial skin carcinogenesis proceeds stepwise: initiation, promotion, premalignant progression and finally malignant conversion. The oncogene c-H-ras and the tumor suppressor gene P53 are the genes whose involvement in these steps of epithelial skin cancers are duly established. Less experimental data are available concerning melanoma. the role of the oncogene N-ras, the tumor suppressor gene MTS-1 (encoding for protein p16) ans the metastagene nm 23 has recently be emphasized. Some cytogenetic abnormalities on chromosomes 1, 6, 9, 10, 11 and 17 have also been observed and incite to look for other genes potentially involved in the development of this tumor.

Cell Transformation, Neoplastic↗