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Biomedical subjects

R Touraine

Publications and source records attributed to R Touraine.

At least 73 records · Page 4Linked to original sources
PubMed1985

Maintenance treatment of psoriasis by Tigason: a double-blind randomized clinical trial.

Extensive lesions on 36 patients with psoriasis were treated by Tigason, I mg/kg/day plus PUVA until skin clearance. A clinical score was calculated for each body area, and erythema, scaling, thickness and pruritus of the lesions were scored from 0 to 3. Skin clearing was defined as a clinical score less than 10% of the initial score. Double-blind maintenance treatment was then started. This was Tigason at half of the maximal dose tolerated during the clearing phase of the treatment v. placebo. Relapse of the disease was defined as the occurrence of a clinical score greater than 50% of the initial score. Among the 36 patients randomized, 20 received placebo and 16 received Tigason. Relapses increased quickly in the patients on placebo, but occurred in few patients treated by Tigason with 60% remaining clear after 1 year (P less than 0.05). Surprisingly, the kinetics of disappearance of the most frequent side effect, cheilitis, was the same in the Tigason group and in the placebo group. This double-blind randomized clinical trial shows that Tigason at low doses is an efficient and well-tolerated maintenance treatment of psoriasis.

Adult↗
PubMed1985

Involvement of macrophages in the pathology of toxic epidermal necrolysis.

In toxic epidermal necrolysis (TEN), as in the 'epidermal type' of erythema multiforme, the necrotic epidermis is infiltrated with mononuclear cells. We studied the epidermal infiltrate in seven cases of TEN. About half the cells obtained from pieces of cleaved epidermis dissociated by trypsin were non-epithelial. On cytologic analysis, 80% of these foreign cells exhibited markers of macrophages, 15% were granulocytes and only 5% were lymphocytes (almost exclusively OKT8 T lymphocytes). Semi-thin sections of early prenecrotic lesions showed exocytosis of mononuclear cells within the epidermis with features of satellite cell necrosis and formation of colloid bodies. Almost all these mononuclear cells were macrophages as evidenced by endogenous peroxidase-positive granules. These findings suggest that some kind of macrophage-mediated cytotoxicity may play a role in the necrosis of epidermal cells during TEN.

Adolescent↗
PubMed1985

Lymphocyte transformation test in drug-induced toxic epidermal necrolysis.

Lymphocyte transformation tests (LTT) to drugs remain widely used in drug reactions, despite controversies about their real usefulness. We tested the lymphocytes of 12 patients recovering from a drug-induced Toxic epidermal necrolysis (TEN). There was no difference between the amounts of thymidine incorporated when patients' lymphocytes were cultivated with culprit or innocent drugs. In both situations the lymphocytes from patients reacted like the lymphocytes from controls cultivated with the same panel of drugs. These negative results do not exclude that a hypersensitivity reaction may play a role in the physiopathology of TEN. Anyhow, they clearly indicate that testing lymphocyte transformation to drugs has no practical value in the diagnosis of TEN.

Adolescent↗
PubMed1985

[Angiolymphoid hyperplasia with eosinophilia. Optical and histo-immunological study of 5 cases with an electron microscopy study of one of the cases].

5 cases of angiolymphoid hyperplasia with eosinophilia of the skin are reported. This rare condition was initially described in 1969 by Wells and Whimster. The microscopical pattern is characterised by an atypical vascular proliferation associated with an eosinophilic and lymphoplasmocytic granuloma. In our series, immunohistological study demonstrated the polyclonality of the plasmacytoid component. Electron microscopy performed in one case shows endothelial features even in cells forming clusters without well-defined lumen. These results support the endothelial origin of angiolymphoid hyperplasia with eosinophilia.

Adult↗
PubMed1985

[Ocular sequelae and sicca syndrome following Lyell's syndrome].

The mucous lesions are customary in toxic epidermal necrolysis. The acute ocular lesions have led to definitive sequelae. 22 out of 32 patients surviving to a Lyell's syndrome lend themselves to an ophthalmological supervision. 13 of these 22 patients (59 p. 100) presented a sicca syndrome with a decrease of the lacrimal secretion (12 cases) and/or salivary secretion (8 cases). The sicca syndrome appeared sometimes from the beginning of the acute phase of the Lyell's syndrome or more often a few weeks later. This decrease of the lacrimal flux went along with objective corneal lesions among 11 patients, and 6 of them had a change of the visual function. A biopsy of the accessory salivary glands was performed on 7 of these patients having a reduction of the salivary flux. 5 of these 7 biopsies showed lymphocytic infiltrates giving in 2 cases a nodular aspect, grade III of Chisholm's classification, held to be pathognomonic of Sjögren syndrome. The 13 patients having presented a sicca syndrome differed from the other 9 patients (without sicca syndrome) by a higher severity of their Lyell's syndrome and by a higher age. None of our patients with dry syndrome had antinuclear antibody detected by immunofluorescence on sections of rat's livers. Sicca syndromes with sometimes lymphocytic infiltrate similar to those of Sjögren's syndrome were occasionally imputed to drug reactions. The occurrence of "Sjögren like's syndrome" after a toxic epidermal necrolysis suggests the intervening of autoimmune phenomena in the pathogenesis of this toxic epidermal necrolysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Cutaneous prickle-cell epitheliomas and visceral cancer].

We have studied the incidence of internal malignant neoplasms on patients with squamous cell carcinoma (SCC). This incidence has been compared to expected number of malignant neoplasm in that population by a precise statistical analysis. Two-hundred and eighty-three SCC confirmed by histology are diagnosed on 235 patients (159 men, 76 women). These patients have been followed between December 1970 and November 1982 at the specialized consultation on cutaneous tumors. We have examined all these patients, questioned their doctors, consulted their medical case history, to search an internal malignant neoplasm. Twenty-eight patients had a malignant neoplasm: this malignant tumor has been found 11 times before and 17 times at the same time or after SCC. These 17 malignant neoplasms are the only statistically interesting cases. The annual incidence of malignant neoplasms related to age and sex has been evaluated by consulting French registers. The French incidence has been compared to foreign incidences. This incidence enables us to calculate the expected observed numbers (12 and 5). The expected numbers are 9.15 for men and 2.1 for women. These numbers are not statistically different from observed numbers (12 and 5). The incidence of internal malignant neoplasms on patients with SCC is not different from the incidence of general population.

Adult↗
PubMed1985

[Lyell's syndrome and ectodermosis pluriorificialis during treatment with oxicams: 11 cases].

Piroxicam (Feldene) and isoxicam (Vectren) form a part of a new family of non-steroid anti-inflammatory drugs (NSAID) highly used in France: the oxicams. The cutaneous accidents of all kinds are frequent, estimated from 1 to 3 p. 100 of the patients with piroxicam (16, 20). In addition to the maculo-papular eruptions, there has been reported: lichenoid eruption (21), erythroderma (7), purpuric vasculitis (1, 10, 21), pemphigus (12, 14), bullous dermatosis difficult to classify (15), erythema multiforme and Stevens-Johnson's syndrome (3, 6, 7, 9, 13, 21, 23) and at last many photosensitization accidents (3, 8, 11, 19, 20, 21). We report 11 observations of Lyell's syndrome (8 cases) or Stevens-Johnson's syndrome (3 cases) occurred during treatments by isoxicam or piroxicam. Eight women and 3 men aged from 35 to 80 years begin a Lyell's syndrome or a Stevens-Johnson's syndrome after 9 to 45 days (at an average of 16 days) of a treatment by isoxicam (6 cases) or piroxicam (5 cases). Five patients attacked by a Lyell's syndrome are intubated and ventilated and 2 patients die of a septic shock at the ninth and the thirteenth day of evolution: the duration of hospitalization is from 11 days to 3 and a half months for the Lyell's syndromes survivors and from 7 to 19 days in the cases of Stevens-Johnson's syndrome: 7 surviving patients have ocular sequelae with in 2 cases a complete or partial blindness. A slight hepatic cytolysis is observed 5 times and a neutropenia mainly as a lymphopenia 4 times. In 2 observations, the CMV serology is positive.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

The contractility of fibroblasts in a collagen lattice is reduced by corticosteroids.

Normal human and rat skin fibroblasts, incorporated into a three-dimensional collagen lattice, were assayed for their ability to contract collagen fibrils. This capacity is inhibited in a dose-dependent fashion by both dexamethasone and hydrocortisone. The inhibition is reversed when the corticosteroids are removed from the culture medium, but while the effect of hydrocortisone is almost entirely reversible, that of dexamethasone is not.

Adrenal Cortex Hormones↗
PubMed1984

Psoriasis: a defect in the regulation of epidermal proteases, as shown by serial biopsies after cantharidin application.

The possible role of epidermal serine proteases in the genesis of psoriatic lesions was investigated by sequential biopsies of the epidermal damage induced by topical cantharidin. In the skin of normal subjects, epidermal damage was followed by the transient appearance of proteolytic activity in the upper epidermis accompanied by temporary hyperacanthosis and perivascular inflammatory cells in the superficial dermis. In the uninvolved skin of five patients with psoriasis this proteolysis persisted longer, for more than 7 days. Thereafter, in three of the patients, the proteolysis abated, and this was followed by disappearance of the hyperacanthosis and the dermal infiltrate; in the other two psoriatics the proteolysis and hyperacanthosis increased, and a typical Koebner phenomenon ensued. Migration of neutrophils into the epidermis occurred as a later event. Thus the abnormal persistence of proteolytic activity in the upper epidermis after cantharidin application distinguishes the normal from the psoriatic skin injury response and might initiate the psoriatic lesion.

Cantharidin↗