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Biomedical subjects

R Laurent

Publications and source records attributed to R Laurent.

At least 37 records · Page 2Linked to original sources
PubMed1999

Cutaneous reaction to ultraviolet irradiation in human-immunodeficiency-virus-infected patients. A case-control study.

BACKGROUND: HIV-infected patients, like renal transplant recipients, are at increased risk of developing skin cancer in photoexposed areas. Previous studies demonstrated that prolonged ultraviolet (UV)-induced erythema and a decreased and delayed tanning could be correlated with an increased risk of skin cancers. OBJECTIVE: As HIV-infected patients are at an increased risk of developing skin cancers, we aimed to assess the cutaneous response to UV irradiation in these patients. METHODS: Twelve HIV-infected patients and 12 healthy volunteers were included in a prospective case-control study. No patient or volunteer had a history of skin cancer or photodermatosis. The minimal erythemal dose (MED) was determined using a solar simulator UV source, and, then, each subject underwent an exposure of 6 MED. The erythemal and pigmentation responses were studied using a visual scale and a tristimulus colorimeter over a 4-week period. RESULTS: We failed to demonstrate any significant differences between HIV-infected patients and controls for erythema and delayed pigmentation. No difference was found for MED between the two groups although most HIV-infected patients received potentially photosensitive drugs. CONCLUSIONS: Our results suggest that, as a group, the HIV-infected patients without a history of photosensitivity or skin cancer did not demonstrate a greater susceptibility to intense UV irradiation in terms of erythema and pigmentation induced by intense UV exposition.

Adult↗
PubMed1999

[Papillomavirus-induced anogenital lesions in 121 HIV seropositive men. Clinical, histological, viral study, and evolution].

OBJECTIVE: To determine the prevalence of the Human Papillomavirus (HPV) in Human Immunodeficiency Virus (HIV) infected men, using clinical examination and molecular hybridization in situ. PATIENTS AND METHODS: From May 1995 to May 1997 we studied the prevalence, clinical and histological characteristics, the types and the evolution of the HPV lesions among 121 HIV-infected men. The HPV DNA was determined by molecular hybridization in situ, using biotinylated probes which recognized HPV types 6/11, 16/18 and 31/33/35 in 79 p. 100 (5/19) of the patients (17 biopsies). RESULTS: Sixteen per cent (19/121) of the patients are HPV infected: genital warts in 37 p. 100 (7/19), anal warts in 37 p. 100 (7/19), and ano-genital warts in 26 p. 100 (5/19) of the patients. In every case of anal codyloma, intracanalar lesions were found. In 47 p. 100 (9/19) of the cases, histological exam showed an intra-epithelial neoplasia. The HPV types 6/11, 16/18 and 31/33/51 were positive in 53 p. 100 (9/17), 35 p. 100 (6/17) and 35 p. 100 (6/17) biopsies respectively. High-risk types of HPV have been noted in 71 p. 100 (12/17) of the biopsies. The evolution of the clinical lesions was: recovering in 47 p. 100 (9/19) of the patients (after 3 months of treatment), recurrence in 16 p. 100 (3/19) of the anal warts (after 1 to 3 months of treatment), stabilization in 16 p. 100 (3/19) of the genital warts (after 6 months of treatment) and extension in 11 p. 100 (2/19) of the anogenital warts (after 3 months of treatment). CONCLUSION: The high prevalence of condyloma and dysplasia emphasizes the importance of the anogenital exam in HIV-positive patients. In case of anal lesions, anuscopy and biopsy are required. We insist on the need to closely follow these patients with HPV lesions in order to adapt treatment. Anal cytology and HPV-DNA detection by Hybrid Capture Assay, should be developed for screening and prevention of the malignant transformation of HPV lesions in this population.

AIDS-Related Opportunistic Infections↗
PubMed1997

[Recurrent pyogenic granuloma or Warner and Wilson-Jones syndrome].

BACKGROUND: Recurrent pyogenic granuloma with multiple satellite lesions is a rare and benign condition; its diagnosis may be clinically evoked from a characteristic natural history. CASE REPORTS: Two 12 year-old boys developed multiple small cutaneous lesions following removal of pyogenic granuloma, at the periphery of the scar. A CO2 laser treatment was decided in one case, and therapeutic abstention in the other one. CONCLUSION: Our two cases completely fit with the classical features of such a condition that generally clears spontaneously. This syndrome must be known because of its "pseudo-metastatic" clinical features, which may mislead the physician.

Child↗
PubMed1996

[Genital papillomavirus infections].

The incidence of condyloma acuminata is increasing in all developed countries with highest rates recorded for young sexually males and females, between the ages of 16 and 25 years. Subclinical and latent genital human papillomavirus (HPV) infections are highly prevalent. Direct correlation between number of sexual partners and presence of HPV is evident. Clinical HPV infections such as condylomas (acuminata and papular) are easily recognized, but acetowhite flat macular condylomas require colposcopic examination. High grade IN (cervical CIN II, III, vulvar VIN, anal AIN, penile PIN) are considered to be related to HPV type 16 and 18 (less frequently other types 31, 33, 35, 51), the oncogenic potential of which was demonstrated by in vitro transformation assays and by the fact that they are detected in 50 to 90% of genital neoplasia. Clinical HPV infections (condylomas and low grade IN) are associated with "low risk" HPV types 6/11. The requirement for routine HPV-DNA typing is limited and in general, management is based on clinical and conventional light microscope evaluation. Immunosuppression is a most important risk-factor for the development, the progression and the recurrences of cervical and anal condylomas and neoplasia. Whatever treatment is applied a 30% recurrences rates occur, implying a regular clinical follow up after treatment to prevent recurrences development and neoplasia.

Adult↗
PubMed1996

Skin localization of alveolar echinococcosis of the liver.

Alveolar echinococcosis is a rare parasitic disease caused by the intrahepatic growth of Echinococcus multilocularis larvae. Secondary localizations can be observed; pulmonary metastases are the most frequent and are observed in 22% of patients. Other extrahepatic localizations are less frequent. We describe two patients with abdominal skin involvement. To our knowledge, this has never before been reported. In both patients, the liver lesion was located in the left lobe, and larvae probably spread to the skin via the falciform ligament. In one patient albendazole therapy was effective.

Aged↗
PubMed1996

The multicentre south European study 'Helios'. I: Skin characteristics and sunburns in basal cell and squamous cell carcinomas of the skin.

The aim of this study was to investigate constitutional and environmental determinants of non-melanocytic skin cancer among different populations from south Europe. Between 1989 and 1993 we interviewed incident cases and a random population sample of controls from five centres where a cancer registry was operating, whereas we selected a sample of hospital-based cases and controls from three other centres. Controls were stratified according to the age and sex distribution of cases. In all, 1549 cases of basal cell carcinoma (BCC), 228 of squamous cell carcinoma (SCC) and 1795 controls were interviewed. Both cancers affected primarily sun-exposed sites such as face, head and neck, but the prevalence of BCC on the trunk was higher than for SCC. Pigmentary traits such as hair and eye colour as well as tendency to sunburn were strong and independent indicators of risk for both BCC and SCC. In SCC, adjusted odds ratios (ORs) ranged from 1.6 for fair hair colour to 12.5 for red hair. Light-blonde hair entailed a risk of about 2 for BCC. Pale eye colour was associated with a risk of 1.8 for SCC and 1.4 for BCC. Subjects who always burn and never tan showed an adjusted OR of 2.7 for BCC and 2.0 for SCC. A history of sunburns and a young age at first sunburn were associated with an increased risk for BCC only (OR 1.7). Pigmentary traits and sun sensitivity of the skin confirmed their role as risk indicators. The effect of sunburns, as an indicator of both exposure and sun sensitivity of the skin, is less clear. Nevertheless, its association with BCC suggests, by analogy with melanoma, a relationship with intense sun exposure. Conversely, SCC would require prolonged exposure to sunlight.

Adolescent↗
PubMed1996

The multicentre south European study 'Helios'. II: Different sun exposure patterns in the aetiology of basal cell and squamous cell carcinomas of the skin.

The role of sun exposure in development of basal cell and squamous cell carcinomas among different populations from south Europe was investigated. Between 1989 and 1993 we interviewed incident cases and a random population sample of controls from five centres where a cancer registry was operating, whereas we selected a sample of hospital-based cases and controls from the other three centres. We gathered information on life-long exposure to sunlight during different activities. Results are analysed for 1549 basal cell carcinoma (BCC) cases and 228 squamous cell carcinoma (SCC) cases compared with 1795 controls. We observed a statistically significant increase of risk of SCC with increasing sun exposure beyond a threshold of 70,000 cumulated hours of exposure in a lifetime. Sun exposures during work and holidays were, however, inversely correlated. Odds ratios (ORs) of SCC were up to eight or nine times the reference for the highest exposures (200,000 cumulated hours or more). BCC exhibited a 2-fold increase of risk for lower exposure (8000-10,000 cumulated hours in a lifetime) with a plateau and a slight decrease of risk for the highest exposures (100,000 cumulated hours or more). Outdoor work showed a significantly increased risk of SCC (OR 1.6 for more than 54,000 cumulated hours of exposure in a lifetime), whereas recreational activities such as sun exposure during holidays at the beach (OR 1.6 for more than 2600 cumulated hours of exposure in a lifetime) or during water sports (OR 1.6 for more than 2600 cumulated hours of exposure in a lifetime) were associated with an increased risk of BCC. Risk patterns were different in poor or good tanners with a significant risk trend for good tanners, whereas poor tanners were on a plateau of increased risk at any level of exposure. Solar radiation is associated with a risk of BCC even for relatively short periods of exposure such as during holidays and sports, whereas SCC develops later if exposure continues. The skin's ability to tan modulates the risk of BCC; subjects who tan poorly have a steady risk increase, whereas people who tan easily develop cancer only after prolonged exposures.

Basal Cell Carcinoma↗
PubMed1996

[A new allergen dibromodicyanobutane. Report of a study in 310 patients January-December 1994].

INTRODUCTION: Methylisothiazolinone chloride (Kathon CG) and its derivatives, used as preservatives in cosmetics, have been shown to be allergenic when used in humans although preliminary studies in Guinea pigs failed to reveal any sensitization. Dibromodicyanobutane, associated with phenoxyethanol in Euxyl K400, has been proposed to replace the isothiazolinone derivatives in cosmetics. Preliminary study has shown that these thiazolinone derivatives are not allergenic in Euxyl K400. The similarity of these situations led us to hypothesize that dibromodicyanobutane could become allergenic. METHODS: We tested 0.1 p. 100 dibromodicyanobutane in vaseline in the additional battery of the ICDRG battery in patients with contact eczema. Among the 310 patients tested, 1.94 p. 100 had a positive test for this allergen (during this same period, 1.29 p. 100 of the patients were positive for isothiazolinones). Three patients were hospitalized because of generalized eczema and 1 patient had changed occupation with no effect because the crems containing the allergen had not been avoided. CONCLUSION: Dibromodicyanobutane is a new allergen. Numerous cases of allergy have developed as use of the product becomes more widespread. The consequences of this sensitization may have an economic impact. Animal experimentation has been unable to predict this allergenic effect. Cosmetic products must be precisely labeled with a single international term for each specific molecule and the name of the preservative added to the active substance.

Adolescent↗
PubMed1996

[Oropharyngeal candidiasis resistant to fluconazole in patients infected by HIV].

PURPOSE: To study the susceptibility to fluconazole of Candida albicans strains in oral candidiasis of HIV positive patients. PATIENTS AND METHODS: Eleven HIV positive patients with confirmed oral candidiasis were included in a 4 to 10 months prospective study. In addition, 23 HIV positive patients were evaluated in a restrospective study (14 with oral candidiasis and 9 control subjects). The MICs to fluconazole of C. albicans were characterized by genotyping (electrophoretic karyotype). RESULTS: Thirty patients were evaluable. Oral candidiasis was found in 21 patients; 7/21 patients (33,3 p. 100) developed resistant C. albicans strain (MIC > 32 mg/ml) after a mean fluconazole cumulative dose of 18 g. In this study, the electrophoretic karyotype confirmed the persistence of the same C. albicans strain in each patient. In addition increased colonization by C. krusei or C. glabrata was found in 6/21 patients (28.5 p. 100). DISCUSSION: Our data demonstrate that prolonged treatment with fluconazole dose higher than 13 g induces the emergence of resistant C. albicans with persistence of the same C. albicans strain. Fluconazole has to be reserved to oral candidiasis after failure of a local treatment or to severe cases.

AIDS-Related Opportunistic Infections↗