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Severino M, Sibaud V, Tournier E, Pauwels C, Christol C, Mazereeuw-Hautier J, Paul C, Livideanu CB. Dermatose perforante sous-sorafénib. Ann Dermatol Venereol 2013. [DOI: 10.1016/j.annder.2013.09.370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Mahé E, Maccari F, Beauchet A, Estève E, Reguiai Z, Le Guyadec T, Quiles-Tsimaratos N, Averel-Audran M, Boyer T, Goujon-Henry C, Bravard P, Bouilly-Auvray D, Bastien M, Mery-Brossard L, Géner G, Pauwels C, Sigal ML. Évaluation du parcours de soins avant une première consultation pour un psoriasis. Ann Dermatol Venereol 2013. [DOI: 10.1016/j.annder.2013.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Dabouz F, Maccari F, Chaby G, Benetton N, Khemis A, Lahfa M, Esteve E, Boyé T, Mahé E, Bégon E, Pauwels C, Barbe C, Bernard P, Reguiai Z. Facteurs associés à une efficacité du remplacement de l’etanercept par une deuxième biothérapie pour le traitement du psoriasis. Ann Dermatol Venereol 2013. [DOI: 10.1016/j.annder.2013.09.429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Pauwels C, Fortenfant F, Jouen F, Martinage C, Derumeaux-Burel H, Paul C, Livideanu CB. Dermatose à IgA linéaire : sous-estimation des formes médicamenteuses ? Ann Dermatol Venereol 2013. [DOI: 10.1016/j.annder.2013.09.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mahé E, Maccari F, Beauchet A, Lahfa M, Barthelemy H, Reguiaï Z, Beneton N, Estève E, Chaby G, Ruer-Mulard M, Steiner HG, Pauwels C, Avenel-Audran M, Goujon-Henry C, Descamps V, Begon E, Sigal ML. Childhood-onset psoriasis: association with future cardiovascular and metabolic comorbidities. Br J Dermatol 2013; 169:889-95. [DOI: 10.1111/bjd.12441] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2013] [Indexed: 12/12/2022]
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Van Reeth C, Pauwels C, Bayle N, Loche CM, Gracies JM. Predominant factors of motor deficiencies in adult spastic paresis: Infant vs adult-acquired lesions. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Pauwels C, van Reeth C, Gracies JM. Impact de 8 semaines d’un entraînement physique standardisé sur le relevé du sol dans la maladie de Parkinson. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Van Reeth C, Pauwels C, Bayle N, Loche CM, Gracies JM. Correlation between muscle length, spasticity and motor weakness in adult spastic paresis: Infant vs adult-acquired lesions. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.1040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Van Reeth C, Pauwels C, Bayle N, Loche CM, Gracies JM. Corrélations entre longueur musculaire, spasticité et faiblesse motrice dans la parésie spastique de l’adulte. Comparaison parésie infantile vs acquise. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.1030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Pauwels C, van Reeth C, Gracies JM. Impact of 8 weeks of standardized physical therapy on standing up from the floor in Parkinson's disease. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Colliou N, Picard D, Caillot F, Calbo S, Le Corre S, Lim A, Lemercier B, Le Mauff B, Maho-Vaillant M, Jacquot S, Bedane C, Bernard P, Caux F, Prost C, Delaporte E, Doutre MS, Dreno B, Franck N, Ingen-Housz-Oro S, Chosidow O, Pauwels C, Picard C, Roujeau JC, Sigal M, Tancrede-Bohin E, Templier I, Eming R, Hertl M, D'Incan M, Joly P, Musette P. Long-Term Remissions of Severe Pemphigus After Rituximab Therapy Are Associated with Prolonged Failure of Desmoglein B Cell Response. Sci Transl Med 2013; 5:175ra30. [DOI: 10.1126/scitranslmed.3005166] [Citation(s) in RCA: 164] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Mahé E, Maccari F, Beauchet A, Lahfa M, Barthélémy H, Reguiai Z, Estève E, Beneton N, Maillard H, Chaby G, Ruer-Mullard M, Steiner HG, Pauwels C, Avenel-Audran M, Goujon-Henry C, Descamps V, Begon E, Sigal ML. Étude Resopsocar : le début d’un psoriasis dans l’enfance n’influence pas la fréquence des facteurs de risque cardiovasculaire à l’âge adulte. Ann Dermatol Venereol 2012. [DOI: 10.1016/j.annder.2012.10.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lavergne R, Cassaing S, Nocera T, Pauwels C, Cointault O, Basse G, Lavayssière L, Berry A, Kamar N, Lamant L, Iriart X, Linas M, Valentin A, Fillaux J, Paul C, Magnaval J. Simultaneous cutaneous infection due toPaecilomyces lilacinusandAlternariain a heart transplant patient. Transpl Infect Dis 2012; 14:E156-60. [DOI: 10.1111/tid.12020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Revised: 03/29/2012] [Accepted: 06/20/2012] [Indexed: 11/29/2022]
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Du-Thanh A, Merlet S, Maillard H, Bernard P, Joly P, Estève E, Richard M, Pauwels C, Ingen-Housz-Oro S, Guillot B, Dereure O. Combined treatment with low-dose methotrexate and initial short-term superpotent topical steroids in bullous pemphigoid: an open, multicentre, retrospective study. Br J Dermatol 2011; 165:1337-43. [DOI: 10.1111/j.1365-2133.2011.10531.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pauwels C, Bulai Livideanu C, Maza A, Lamant L, Paul C. Cytophagic Histiocytic Panniculitis after H1N1 Vaccination: A Case Report and Review of the Cutaneous Side Effects of Influenza Vaccines. Dermatology 2011; 222:217-20. [DOI: 10.1159/000326912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Accepted: 02/18/2011] [Indexed: 01/09/2023] Open
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Pauwels C, Mazereeuw-Hautier J, Basset-Seguin N, Livideanu C, Viraben R, Paul C, Meyer N. Topical methyl aminolevulinate photodynamic therapy for management of basal cell carcinomas in patients with basal cell nevus syndrome improves patient’s satisfaction and reduces the need for surgical procedures. J Eur Acad Dermatol Venereol 2010; 25:861-4. [DOI: 10.1111/j.1468-3083.2010.03854.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Pauwels C, Bulai-Livideanu C, Chiavassa H, Lamant L, Carrié D, Sorbara AM, Huyghe E, Paul C. [Lumbar panniculitis with subcutaneous abscess revealing pyonephrosis]. Ann Dermatol Venereol 2009; 136:727-9. [PMID: 19801259 DOI: 10.1016/j.annder.2009.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Accepted: 02/20/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND A clinical picture of hypodermitis in the lumbar region may reveal an abscess arising from infection due to pyonephrosis. We report a case below. CASE REPORT A 58 year-old woman consulted for an area of inflammation in the left lumbar region that had been present for two months. The area of inflammation appeared two days after physiotherapy sessions prescribed for lower back pain. Laboratory examinations revealed inflammation associated with moderate renal failure. A skin biopsy sample taken from around the inflamed area showed septal hypodermitis. Ultrasound examination revealed a pocket of liquid measuring 7 x 2 x 2 cm; Proteus mirabilis was isolated following ultrasound-guided needle aspiration,. Magnetic resonance imaging (MRI) and uroscan revealed pyonephrosis with suffusion into the hypodermis and left lumbar fossa. DISCUSSION This was a case of bacterial hypodermitis with abscesses secondary to pyonephrosis. Pyonephrosis may be transferred to the skin, causing fistulas and subcutaneous pus collection. In such rare and potentially misleading clinical settings, the diagnosis can be established by imaging.
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Boone B, De Bacquer D, Pauwels C, Naeyaert J, Brochez L. The role of VEGF-C staining in predicting regional metastasis in melanoma. Melanoma Res 2006. [DOI: 10.1097/00008390-200609001-00085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Martin L, Piette F, Blanc P, Mortier L, Avril MF, Delaunay MM, Dréno B, Granel F, Mantoux F, Aubin F, Sassolas B, Adamski H, Dalac S, Pauwels C, Dompmartin A, Lok C, Estève E, Guillot B. Clinical variants of the preprotuberant stage of dermatofibrosarcoma protuberans. Br J Dermatol 2006; 153:932-6. [PMID: 16225602 DOI: 10.1111/j.1365-2133.2005.06823.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Some cases of dermatofibrosarcoma protuberans (DFSP) do not protrude above the skin. OBJECTIVES To assess the prevalence of these DFSPs and further to describe their presentation and course. METHODS One hundred and forty-three patients were retrospectively collected. They were asked to complete a standardized questionnaire indicating the history and appearance of the DFSP from the first skin changes identified to the time of diagnosis. RESULTS Eighty-one DFSPs were described as protuberant ab initio, and 62 as initially nonprotuberant (npDFSP). The latter remained at this stage for a mean period of 7.6 years. Twenty-nine per cent of npDFSPs were 'morphoea-like', 19% were 'atrophoderma-like' and 42% were 'angioma-like'. Age at diagnosis was similar for both initial presentations. npDFSPs were most often misdiagnosed by physicians. CONCLUSIONS Nearly half the patients first identified their early DFSP-related skin changes as patches. Both this frequency and the long duration at this preprotuberant stage should prompt dermatologists to consider the diagnosis of DFSP earlier, in order to make surgical treatment easier.
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Zuech P, Pauwels C, Duthoit C, Méry L, Somogyi A, Louboutin A, Veyssier-Belot C. Dermatomyosite induite par la pravastatine. Rev Med Interne 2005; 26:897-902. [PMID: 16154665 DOI: 10.1016/j.revmed.2005.07.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2005] [Accepted: 07/19/2005] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The toxic myopathy caused by statins (HMG-CoA reductase inhibitors) is well established. Recent reports add to these effects systemic immune diseases including systemic lupus erythematosus, vasculitis, polymyositis or dermatomyositis. EXEGESIS We report a case of dermatomyositis in a 69-year-old patient treated with pravastatin [Elisor]. She presented with typical features of dermatomyositis 2 years after she started a treatment with pravastatin. The treatment was discontinued and she slowly improved, with a transient dermocorticosteroid treatment. Eight other patients with dermatomyositis and chronic treatment with HMG-CoA reductase inhibitors are reported in the literature. All of them presented with classical features of dermatomyositis. The discontinuation of the treatment was followed by spontaneous clinical and biological improvement in 3/9 patients. The other patients received high doses of corticosteroids and improved, except one patient who died of respiratory failure (pulmonary fibrosis) despite the adjunction of oral cyclophosphamide [Endoxan]. In these patients, dermatomyositis can be considered as a severe adverse reaction to HMG-CoA reductase inhibitors although a distinct casual link cannot be definitely established. CONCLUSION The increasing prescription of statins has led to the parallel increment of reported side-effects, where autoimmune diseases are now described. Among them, our case of dermatomyositis in a patient receiving pravastatin adds to the eight reported cases in the literature and highlights the potential role of statins as triggers of immune systemic diseases.
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Mery L, Rafa M, Oro S, Pauwels C, Sigal-Grinberg M. P265 - Traitement de la leishmaniose cutanée par fluconazole : étude prospective dans deux centres hospitaliers d’Ile de France. Ann Dermatol Venereol 2005. [DOI: 10.1016/s0151-9638(05)79994-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Bourdon-Lanoy E, Roujeau JC, Joly P, Guillaume JC, Bernard P, Prost C, Tancrède-Bohin E, Delaporte E, Picard-Dahan C, Albes B, Bedane C, Doutre MS, Chosidow O, Lok C, Pauwels C, Chevrand-Breton J, Sassolas B, Richard MA. Pemphigoïde du sujet jeune. Ann Dermatol Venereol 2005; 132:115-22. [PMID: 15798559 DOI: 10.1016/s0151-9638(05)79220-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Bullous pemphigoid usually affects elderly people. Only a few isolated cases among people younger than 65 years have been reported. OBJECTIVES Describe the clinical and biological characteristics of patients younger than 60 years suffering from bullous pemphigoid, compare them with the usual characteristics known among elderly people and search for potential pathological associations. PATIENTS AND METHODS Retrospective, national, multicenter study. Clinical, biological and histological characteristics were recorded with a standardised questionnaire as well as treatments and associated pathologies. RESULTS Seventy-four cases of bullous pemphigoid diagnosed between June 1970 and March 2002 were analyzed. Mean age at the beginning of the disease was 46 +/- 11.6 years. Further explorations by indirect immunofluorescence of separated skin and/or immuno-electron microscopy and/or immunoblotting were performed for 42 patients (56.8 p. 100). Clinical characteristics among this restricted population were comparable to those found among the 32 other cases. Compared to usual data on bullous pemphigoid in elderly people, we observed a greater proportion of extensive form of disease (75 p. 100), a more frequent head and neck involvement (39.2 p. 100) and an overexpression of anti-BP180 autoantibodies (48 p. 100). Neoplasm was notified for 7 patients (9.5 p. 100), 18 (24.3 p. 100) suffered from a pathology of the basement membrane zone (6 psoriasis, 6 atopic dermatitis and 6 lichen) and 13 from neurological disease, among which 4 were bedridden. Fourty-six patients (62.2 p. 100) received drugs for the long term (mean 2.12 +/- 2.43), 4 patients were treated by PUVAtherapy and 2 by radiotherapy. DISCUSSION Our results suggest that bullous pemphigoid among young people is more severe and more active than the usual form in the elderly. This particular form could be the result of a higher expression of anti-BP180 autoantibodies, which are considered as a marker of poor prognosis in this disease. We also found a high frequency of pathological associations and physical treatment, all responsible for damage to the basement membrane zone, which can involve auto-immunization against hemidesmosome components.
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Gary A, Carvalho P, Louison JB, Helot MF, Gilbert D, Bernard P, Roujeau JC, Bedane C, Delaporte E, Vaillant L, Dreno B, Saiag P, Tancrede-Bohin E, Plantin P, D'Incan M, Sassolas B, Lok C, Labeille B, Pauwels C, Chosidow O, Picard C, Loche F, Guillaume JC, Joly P. Analyse des signes cliniques des malades atteints de pemphigoïde en fonction des antigènes reconnus par leur sérum en immunotransfert. Ann Dermatol Venereol 2004; 131:333-7. [PMID: 15258506 DOI: 10.1016/s0151-9638(04)93611-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Clinical features and extent of bullous pemphigoid lesions differed widely among patients. The pathogenic role of anti-BPAG2 antibodies has been recently demonstrated. The aim of this study was to analyze the relationship between clinical features of bullous pemphigoid patients and the antigens recognized by their serum. PATIENTS AND METHODS One hundred and twelve bullous pemphigoid patients were included in this prospective multicenter study. Inclusion criteria were the following: 1) diagnosis of bullous pemphigoid established on the presence of 3 of the 4 clinical features of bullous pemphigoid, histological picture of bullous pemphigoid and positive direct immunofluorescence; 2) serum available for immunoblotting studies. The clinical and biological findings were prospectively recorded on standard forms. Sera were collected and analyzed using indirect immunofluorescence and immunoblotting on human epidermal extracts. RESULTS Analysis of patient's clinical features depending on the antigens recognized by their serum showed that patients whose serum contained anti-BPAG1 antibodies had more frequently pruritus, blisters on the lower limbs and a positive indirect immunofluorescence. Patients whose serum contained anti-BPAG2 antibodies had blisters more frequently localized on the head, and a more frequently negative indirect immunofluorescence. Patients whose serum was negative by immunoblotting had less frequently urticarial and/or eczematous lesions, bullae less frequently localized on the lower part of the trunk, abdomen and lower limbs, lower eosinophilia and a more frequently negative indirect immunofluorescence. CONCLUSION Patients with circulating anti-BPAG1 antibodies exhibited the most typical, clinical and biological features of bullous pemphigoid.
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Joly P, Courville P, Lok C, Bernard P, Saiag P, Dreno B, Delaporte E, Bedane C, Picard C, Sassolas B, Plantin P, D'Incan M, Chosidow O, Pauwels C, Lambert D, Loche F, Prost C, Tancrede-Bohin E, Guillaume JC, Roujeau JC, Gilbert D, Tron F, Vaillant L. Clinical criteria for the diagnosis of bullous pemphigoid: a reevaluation according to immunoblot analysis of patient sera. Dermatology 2004; 208:16-20. [PMID: 14730231 DOI: 10.1159/000075040] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2003] [Accepted: 09/12/2003] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND We previously proposed a set of 4 clinical criteria for the diagnosis of bullous pemphigoid (BP) that consisted of age greater than 70 years, absence of atrophic scars, absence of mucosal involvement and absence of predominant bullous lesions on the neck and head. These results have been challenged because direct immunoelectron microscopy (IEM), which was used as the standard diagnostic criterion in our initial study, does not identify the different antigens of the basement membrane zone. OBJECTIVE To reassess the validity of these clinical criteria for the diagnosis of BP using immunoblot analysis of patient sera as the main diagnostic criterion, in order to precisely identify the antigens recognized by patient sera. METHODS One hundred and eighty-nine sera from patients with various subepidermal autoimmune blistering diseases (AIBDs) were tested by immunoblotting using dermal and epidermal extracts. IEM was used as a complementary diagnostic procedure in a few patients whose serum recognized BPAG2 exclusively or was negative in immunoblotting. RESULTS 142 patients (75%) had at least 3 of the 4 clinical diagnostic criteria. Sera from patients who lacked the set of BP clinical criteria were more frequently immunoblot negative (34%) than sera from patients who had the criteria (18%; p = 0.025). BPAG1 was more frequently recognized by sera from patients with the set of BP clinical criteria (78%) than by sera from patients without the criteria (45%; p = 5.10(-4)). In contrast, BPAG2 was recognized by a great number of sera from patients who lacked the criteria of BP (71%), which was in accordance with the presence of numerous patients with cicatricial pemphigoid in this group. Among patients with various subepidermal AIBDs, the diagnosis of BP could be made with a sensitivity of 86%, a specificity of 90% and an excellent prognostic positive value over 95%, if 3 of these clinical criteria were present. CONCLUSION These results confirm the interest of this set of clinical criteria for the rapid diagnosis of BP.
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Kornfeld S, Veyssier-Belot C, Vinceneux A, Renier JL, Du-Boutin LTH, Pauwels C. [Acquired haemophilia in a patient with systemic lupus erythematosus]. Ann Dermatol Venereol 2002; 129:316-9. [PMID: 11988689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
INTRODUCTION In patients with lupus, the most common acquired circulating anticoagulant is antiprothrombinase which is responsible for thrombosis. The presence of antibodies directed against factor VIII is rarely found in systemic lupus erythematosus. A case of acquired haemophilia in a patient with lupus is reported. CASE REPORT A 30 year-old woman with systemic lupus erythematosus developed a right coxalgia and ecchymotic skin lesions which were prominent on the right arm and forearm. Laboratory values were as follows: positive antinuclear antibodies > 1: 2 560, anti-DNA antibodies (300 IU/ml), prolonged activated partial thromboplastin time, reduced factor VIII activity (1 p. 100) and the presence of antibodies against factor VIII. Magnetic nuclear resonance of the right hip confirmed the presence of an intramuscular hematoma. The patient was initially treated with intravenous pulse and oral corticosteroids, intravenous immunoglobulins and intravenous cyclophosphamide. Clinical and biological improvement was promptly obtained. DISCUSSION In our patient with systemic lupus erythematosus, bleeding revealed acquired haemophilia with antibodies against factor VIII. It should be pointed out that the association between lupus and haemophilia is uncommon and that at present no standardized treatment can be recommended.
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