Professeur Pierre Agache 1927-2003.
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Journal Article↗
Biomedical subjects
Philippe Humbert
Publications and source records attributed to Philippe Humbert.
High iron and low ascorbic acid concentrations in the dermis of atopic dermatitis patients.
BACKGROUND: Atopic dermatitis (AD) is a chronic inflammatory skin disease in which reactive oxygen species (ROS) may be involved. Iron catalyses ROS formation and ascorbic acid (AA) scavenges these species. OBJECTIVE: The aim of this work was to determine iron and AA levels in AD patients' dermis and to compare their concentrations with those of healthy volunteers' dermis. METHODS: Five AD patients and 5 healthy subjects (controls) were enrolled in this study. Iron and AA were collected from human dermis by microdialysis and assessed by atomic absorption spectrometry and gas chromatography-mass spectrometry, respectively. RESULTS: The AD dermis demonstrated higher iron concentrations (44.3 +/- 4.6 microg/l) compared to controls (21.8 +/- 1.2 microg/l) as well as a significantly lower concentration of AA (46.7 +/- 0.6 vs. 176.8 +/- 14.5 microg/ml, respectively). CONCLUSION: These results suggest that iron and AA dermis levels could be indicators of inflammatory tissues and might be implicated in dermatological diseases such as AD.
Adult↗
Validation of a microdialysis-gas chromatographic-mass spectrometric method to assess 8-methoxypsoralen in psoriatic patient dermis.
8-Methoxypsoralen (8-MOP) is currently used in PUVA therapy (psoralen+UVA) to treat dermatological diseases such as psoriasis, vitiligo and atopic dermatitis. The aim of this work was to validate a method for collecting 8-MOP from patient dermis by a non invasive technique, microdialysis, and then to assess this molecule by gas chromatography-mass spectrometry (GC-MS). 5-Methoxypsoralen (5-MOP) was used as an internal standard. The calibration curve demonstrated a linear relationship between the peak areas of 8-MOP and 5-MOP over a wide range of 8-MOP concentrations (0.9-100 ng/ml). Within- and between-run precisions were measured, using four different 8-MOP concentrations, which varied from 98.0 to 102.0% and from 98.5 to 101.8%, respectively. The limits of detection and quantification were 0.29 and 0.52 ng/ml, respectively. The method was validated and then applied to determine the pharmacokinetic of 8-MOP in ten psoriatic patient dermis, after oral intake of this drug. The results demonstrated that the association of microdialysis with the GC-MS method was an efficient procedure to collect and assess 8-MOP in human dermis, in vivo.
Adult↗
[Induced acne].
Induced acne belongs to the clinical forms of acne. Some dermatoses present with acne-like patterns. They can be induced or perpetuated by non physiological factors. Among these factors, medicines must always be considered, taken either topically (dermocorticoids, sulfur, anti-acneic topics) or generally (androgens, oral corticoids, ACTH, anti-epileptics, anti-depressive drugs, anti-tuberculosis medications). Halogens (iodine, bromine) found in inhaled or orally taken pharmaceutical products, or associated with occupational contact, can also induce acne. Acne of exogenous origin has been described in some specific occupations, and are induced by exposure to chlorine, industrial oils, tar. Sun exposure, PUVA therapy and ionizing radiation are potentially acneigenous. Finally acne caused by cosmetics includes acne cosmetica, brilliantine and oily creams acne and detergent acne.
Acne Vulgaris↗
[City/hospital networks for leg ulcers and treatment with ialuset].
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Ambulatory Care↗
Iron and ascorbic acid concentrations in human dermis with regard to age and body sites.
BACKGROUND: Reactive oxygen species (ROS) contribute to processes relating to cutaneous aging. Iron catalyses ROS formation whereas ascorbic acid (AA) plays a fundamental role in defending the organism against undesirable ROS action. OBJECTIVE: The aim of this work was to determine the ex vivo iron and AA concentrations in human dermis from different age groups to better understand their role. METHODS: Skin fragments were collected from 66 female patients during surgical operations and were grouped according to age: group I (<15 years, before puberty, n = 12), group II (15-50 years, adults, n = 42), and group III (>50 years, advanced age adults, n = 12). Two sites were investigated: the abdomen (unexposed areas) and face (exposed sites). Iron and AA were collected from human dermis by microdialysis and assessed by atomic absorption spectrometry and gas chromatography mass spectrometry, respectively. RESULTS: Iron concentrations in the dermis were significantly higher in group III (27.4 +/- 20.9 microg/l) than in group I (13.8 +/- 3.3 microg/l; p< 0.05 ). An inverse correlation between AA dermis levels and increasing age was detected. For groups III and I, iron and AA concentrations were significantly different in dermis from the face compared to that of the abdomen (p < 0.05). CONCLUSION: This study shows for the first time that there is a direct relationship between iron and AA concentrations in the dermis and aging. Moreover, iron and AA concentrations differed according to body site.
Abdomen↗
Lipschütz genital ulceration: a rare manifestation of paratyphoid fever.
In 1913, a distinctive clinical entity of acute genital ulcer occurring in an adolescent girl with a non-venereal infectious aetiology was described by Lipschütz. Since the initial description, several aetiologies have been discussed, and among them, paratyphoid fever is very uncommon. After her return from a trip, a 25-year-old girl developed high fever and diarrhoea. Examination of the vulva revealed a genital ulcer. The rest of the general examination was normal. Blood cultures identified Salmonella paratyphi A, and a diagnosis of Lipschütz's ulcer associated with paratyphoid fever was made. Bacteriaemia was then treated with antibiotics and the vulvar ulceration rapidly disappeared. Lipschütz described a distinctive clinical entity of acute genital ulcers occurring in adolescents. To our knowledge, we report herein the second case associated with proved paratyphoid fever. The authors thus recommend that typhoid or paratyphoid fever should be included in the differential diagnosis of genital ulcerations.
Adult↗
Demodicidosis in a child with xantholeukaemia associated with type 1 neurofibromatosis.
Although Demodex follicularum and Demodex brevis are common permanent ectoparasites of human pilosebaceous units, their incidence on children's skin is rare. We report a new case of demodicidosis in a 22-month-old girl undergoing chemotherapy for chronic myelomonocytic leukaemia associated with xanthoma and type 1 neurofibromatosis. The eruption cleared after oral and topical metronidazole therapy. Demodicidosis should be included in the differential diagnosis of facial eruption in immunosuppressed children.
Administration, Cutaneous↗
Minocycline-induced cutaneous polyarteritis nodosa with antineutrophil cytoplasmic antibodies.
Minocycline is an antibiotic widely used in the treatment of acne. Among the induced auto-immune disorders, cutaneous polyarteritis nodosa (PAN) is very rare. A new case is reported below. A 23-year-old female patient treated with minocycline for acne for 24 months developed sub-cutaneous nodules, livedo reticularis and pigmented lesions of the lower limbs. Antineutrophil cytoplasmic antibodies (ANCA) were positive at 1/320. Skin biopsy showed vasculitis of a medium-sized artery. The role of minocycline was suspected using the imputability criteria. The diagnosis of minocycline-induced cutaneous PAN with ANCA was sustained. After withdrawal of the treatment, the nodular lesions decreased spontaneously, whereas livedo disappeared and inflammatory parameters were normalized after oral corticosteroid therapy. Minocycline is a tetracycline which is efficient for treating acne. Auto-immune disorders are frequently observed. Among them, it is very rare to observe cutaneous PAN associated with positive ANCA. The pathophysiological mechanisms are discussed.
Acne Vulgaris↗
Gluten intolerance and skin diseases.
Gluten sensitivity with or without coeliac disease (CD) symptoms and intestinal pathology has been suggested as a potentially treatable cause of various diseases. CD is a chronic disease which improves on withdrawal of wheat gliadins and barley, rye and oat prolamins from the diet. There have been numerous reports linking CD with several skin conditions. A body of evidence shows that dermatitis herpetiformis is actually a cutaneous manifestation of CD. Autoimmune diseases, allergic diseases, psoriasis and miscellaneous diseases have also been described with gluten intolerance. Dermatologists should be familiar with the appraisal of gluten sensitive enteropathy and should be able to search for an underlying gluten intolerance (GI). Serological screening by means of antigliadin, antiendomysial and transglutaminase antibodies should be performed. HLA typing is often useful in association with serologic tests. Intestinal biopsy is usually needed to establish the diagnosis of CD or GI. Thus, gluten intolerance gives rise to a variety of dermatological manifestations which may benefit from a gluten-free diet.
Celiac Disease↗
Comparison of ultraviolet B-induced imbalance of antioxidant status in foreskin- and abdominal skin-derived human fibroblasts.
Ultraviolet B radiation (UVB) is involved in the development of deleterious cutaneous damage. Several changes could be attributed to UVB-induced reactive oxygen species attacks in fibroblasts. However dermal cells from young and adult skin could respond differently to oxidative stress. So antioxidant status and its consequences on cytotoxicity and apoptosis were compared in child foreskin fibroblasts (FF) and adult abdominal skin fibroblasts (AF) in response to UVB. Basal levels of lipid peroxidation tended to be higher in AF than in FF, which could be related to a reshaping of antioxidant defences (higher catalase and lower superoxide dismutase activities). AF and FF appeared to react similarly to high UVB doses as regards cytotoxicity and apoptosis which increased significantly 24h after exposure. The enhancement of cell death could be due to the inherent oxidative stress: glutathione appeared significantly decreased in both cell populations. As a consequence AF, but not FF, presented significantly increased levels of lipid peroxidation, which could be explained by the pre-cited differences of basal antioxidant defences. These results suggest that AF and FF do not respond to UVB by the same pathway.
Abdomen↗