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Meziane M, Hesse S, Chetaille B, Bien-Aimée A, Grob JJ, Richard MA. [Cutaneous large B-cell leg-type lymphoma occurring on a leg burn]. Ann Dermatol Venereol 2009; 136:791-4. [PMID: 19917431 DOI: 10.1016/j.annder.2009.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2008] [Accepted: 02/20/2009] [Indexed: 11/19/2022]
Abstract
BACKGROUND Primary cutaneous B-cell lymphomas form a heterogeneous group of lymphoid proliferations found on the skin. We report a case of primary leg-type cutaneous large B-cell lymphoma occurring on the site a previous leg burn. A few rare cases of cutaneous lymphoma forming on burn scars have been described, but these concern primary cutaneous lymphomas of the T-cell phenotype. CASE REPORT An 85-year-old man with a history of a burn to the left leg 17 years ago, previously treated with several skin grafts, presented numerous ulcerative budding lesions on the scar area. Histological examination of the skin biopsy revealed the existence in the skin ulcers of atypical large lymphoid cells having an immunoblastic or centroblastic morphology and shown by immunohistochemistry to be of the B-cell phenotype, thereby evoking a diagnosis of large B-cell lymphoma. The lymphoma cells were positive for MUM1/IRF4 and BCL2, and more weakly for BCL6, but negative for CD10. The staging examination revealed only cortical lysis of the left tibia. Temporary initial regression was achieved by polychemotherapy comprising cyclophosphamide, vincristine and prednisone in combination with rituximab. DISCUSSION This case is novel in that it involves primary large B-cell lymphoma, leg type, occurring on burn scar tissue. Venous insufficiency and lymphatic stasis have already been incriminated in the genesis of this type of lymphoma; the prior injury and resulting immune dysregulation at the burn site may have also contributed to the development of this neoplasia.
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Thuny C, Gaudy-Marqueste C, Nicol I, Gabert J, Costello R, Grob JJ, Richard MA. Chronic eosinophilic leukaemia revealed by lymphomatoid papulosis: the role of the FIP1-like 1-platelet-derived growth factor receptor alpha fusion gene. J Eur Acad Dermatol Venereol 2009; 24:234-5. [PMID: 19686260 DOI: 10.1111/j.1468-3083.2009.03382.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ahmed F, En Naciri A, Grob JJ, Stchakovsky M, Johann L. Dielectric function of ZnTe nanocrystals by spectroscopic ellipsometry. NANOTECHNOLOGY 2009; 20:305702. [PMID: 19584414 DOI: 10.1088/0957-4484/20/30/305702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We have studied the optical properties of ZnTe nanocrystals (ZnTe-nc) by spectroscopic ellipsometry. The ZnTe-nc are embedded in a SiO2 matrix by an ion implantation technique. Two doses of 1 x 10(16) and 5 x 10(15) cm(-2) of tellurium and zinc ions are implanted in a 250 nm thick SiO2 layer thermally grown on silicon with respective implantation energies of 180 and 115 keV. Subsequent thermal treatments at 800 degrees C lead to the formation of ZnTe-nc. Their sizes are characterized by transmission electron microscopy. The ZnTe-nc obtained with the 1 x 10(16) cm(-2) dose are self-organized into two layers parallel to the surface. Their mean radius ranges between 4-17 nm and 7-17 nm. The ZnTe-nc obtained with the 5 x 10(15) cm(-2) dose are self-organized into one layer with a mean radius between 4-17 nm. A critical points (CPs) dispersion model is used to extract the optical responses of the ZnTe-nc. The optical properties such as the dielectric function and the second derivative of the dielectric function are presented and analyzed. The dielectric function spectra reveal distinct structures attributed to band gap and optical transitions at higher energy. The correlation between the optical responses and the size of the nanocrystals is also given.
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Wolkenstein P, Revuz J, Roujeau JC, Bonnelye G, Grob JJ, Bastuji-Garin S. Psoriasis in France and associated risk factors: results of a case-control study based on a large community survey. Dermatology 2009; 218:103-9. [PMID: 19060463 DOI: 10.1159/000182258] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2008] [Accepted: 09/18/2008] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Risk factors for psoriasis have been identified. OBJECTIVE To precisely define these associated factors. METHODS A survey was conducted using a questionnaire on a representative sample of the French population. A case-control study was conducted. Cases were persons who declared having had psoriasis during the previous 12 months. For each case, 3 matched controls were selected. Cases and controls were compared using univariate and multivariate analyses. RESULTS The questionnaire was filled out and returned by 6,887 (68.9%) of 10,000 subjects aged 15 years and over; 356 cases were identified. In multivariate analysis, a higher body mass index, current and former smoking habits and beta-blocker intake were independently associated with a higher risk of psoriasis; intake of statins was associated with a decreased risk (p < 0.05). CONCLUSIONS We confirmed the association of overweight, smoking habits and beta-blocker intake with psoriasis and reported a decreased risk associated with statin intake.
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Gaudy-Marqueste C, Jouhet C, Castelain M, Brunet P, Berland Y, Grob JJ, Richard MA. Contact allergies in haemodialysis patients: a prospective study of 75 patients. Allergy 2009; 64:222-8. [PMID: 19178401 DOI: 10.1111/j.1398-9995.2008.01833.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Haemodialysis exposes patients to many potentially sensitizing allergens. OBJECTIVES The primary objective of this study was to evaluate the prevalence of delayed hypersensitivity in a population of haemodialysis patients. Secondary objectives were to identify the possible risk factors for contact sensitization and to propose a series of skin tests adapted to haemodialysis patients. METHODS A prospective monocentric study was carried out in a nonselected population of haemodialysis patients. For each patient, medical history of atopy and allergic contact dermatitis, ongoing treatments (including topical ones), presence of eczema at the site of vascular access for haemodialysis were recorded. Allergological investigation included delayed hypersensitivity tests (European Environmental and Contact Dermatitis Research Group battery, tests GERDA, additional list and a battery of antiseptics and other dialysis-specific allergens) and latex skin prick test. RESULTS Seventy-five patients (41 men, 34 women, mean age of 65 years old), with a mean 3.8 years under dialysis, were included. Nineteen patients (25%) had at least one positive skin test and 13 (17%) a positive patch test to at least one allergen relative to dialysis process including eight tests to lidocaine-prilocaine cream and three to povidone-iodine. Tests results seemed clinically relevant since nine patients had localized pruritus at the fistula site and six patients active eczema around it. CONCLUSION Contact sensitizations are frequent in haemodialysis patients and are linked to vascular access conditioning especially the use of lidocaine-prilocaine cream. Designing a specific test battery could help to diagnose the potential allergens and subsequently to give advice to avoid contact with sensitizing agents.
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Fakhry N, Tessonnier L, Cohen F, Gras R, Grob JJ, Giovanni A, Mundler O, Zanaret M. Management of cervical lymph node recurrence of melanoma of the head and neck. REVUE DE LARYNGOLOGIE - OTOLOGIE - RHINOLOGIE 2009; 130:211-214. [PMID: 20597399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVES To compare the diagnostic accuracy between Positron emission tomography using 2-[fluorine-18] fluoro-2-deoxy-D-glucose (FDG-PET scan) and conventional work-up such as ultrasound (US) and/or Computed tomography (CT) in the detection of cervical lymph node recurrences of melanoma of the head and neck after initial cervical lymph node surgery. METHODS A retrospective review was performed on patients who presented with clinical and/or radiological suspicion of isolated cervical lymph node recurrence after lymph node surgery from April 2004 to January 2007. All patients underwent CT and/or US of the neck, and FDG-PET scan before salvage neck dissection. None of included patients had clinical or radiological detectable distant metastases at the time of the lymph node dissection. Performances of conventional imaging and FDG-PET scan in detection of lymph node recurrence were calculated and compared by using the histopathological results of lymphadenectomy as gold standard with Fischer's exact test. RESULTS Of the twelve cases in included in the study (9 patients, 3 of them had 2 consecutive lymph node redissection for a second lymph node recurrence), melanoma recurrence was found in 10 cases (83%). Sensitivity, specificity, positive predictive value and negative predictive values were 78.6%, 40%, 78.6%, and 40% respectively for conventional imaging and 85.7%, 40%, 80% and 50% for FDG-PET scan. No statistically significant difference was found between the 2 methods. CONCLUSION This is the first study that compares the diagnostic accuracy between FDG-PET scan and conventional imaging in the detection of cervical lymph node recurrence of melanoma of the head and neck. Our results showed that FDG-PET scan is actually not better than conventional imaging to detect these cervical lymphatic recurrences.
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En Naciri A, Mansour M, Johann L, Grob JJ, Rinnert H. Influence of the implantation profiles of Si(+) on the dielectric function and optical transitions in silicon nanocrystals. J Chem Phys 2008; 129:184701. [PMID: 19045417 DOI: 10.1063/1.3009223] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We report optical characterization of silicon nanocrystals embedded in silica thin films by spectroscopic ellipsometry (SE). Silicon nanocrystals (nc-Si) are produced by single energy ion implantation and multienergy Si(+) ion implantation into 250 nm of thermal oxide (SiO(2)) layers on silicon substrate. After thermal annealing, the obtained nc-Si have a Gaussian and uniform profiles for single and multienergy implantation, respectively. SE measurements are performed at room temperature at spectral range from 0.6 to 6.5 eV using the photoelastic modulated spectroscopic ellipsometer. Physical models based on the Maxwell-Garnet approximation combined with Forouhi-Bloomer dispersion formulas and wavelength by wavelength inversion are developed to extract the optical parameters of the layers. The complex dielectric function epsilon(E)=epsilon(r)(E)-iepsilon(i)(E) of nc-Si is determined and analyzed. The obtained epsilon(E) spectra of both uniform and Gaussian profiles are given and compared with those of bulk Si. The nc-Si exhibit a significant reduction of the dielectric function in comparison with bulk Si. We have determined the optical transitions E(1) and E(2) corresponding to Van Hove singularities in the joint density of states. A reduction of the amplitude of E(1) peak with a very weak shift of its energy position is observed. The transition E(2) is characterized by a rather broad peak; the amplitude of this peak is more important than that of E(1). The extended Forouhi-Bloomer model to semiconductor is also used to determine the dielectric functions of nc-Si and optical transitions. In epsilon(i)(E) spectra of nc-Si we have observed that not only the optical transition E(1) peak reduced but it tends to disappear and to form with E(2) only a single broad peak centered at around 4.3 eV. The influence of the distribution profile on the sample's structural and optical characteristics is also investigated. Defects caused by implantation are identified by analyzing the dielectric function behavior. For more reliability, photoluminescence analysis are used to obtain direct optical responses of nc-Si.
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Maza A, Renard L, Monestier S, Grob JJ, Richard MA. [Fever with skin rash and polyarthralgia in a genetically black-skinned woman]. MEDECINE TROPICALE : REVUE DU CORPS DE SANTE COLONIAL 2008; 68:297-299. [PMID: 18689326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Adult onset Still's disease (AOSD) is a systemic disorder characterized by intermittent fever, evanescent rash, polyarthralgia or arthritis, and neutrophilic leucocytoclasis. Appearance of skin rash during fever episodes is the characteristic feature. An atypical form of AOSD with a fixed pigmented skin rash was described in 1994. Prognosis of the atypical form is thought to be more severe than that of the classic form. The purpose of this report is to describe the first case of atypical AOSD in a genetically black-skinned woman. Treatment required administration of high-dose systemic corticosteroids.
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Grob JJ, Auquier P, Dreyfus I, Ortonne JP. Quality of life in adults with chronic idiopathic urticaria receiving desloratadine: a randomized, double-blind, multicentre, placebo-controlled study. J Eur Acad Dermatol Venereol 2008; 22:87-93. [PMID: 18181978 DOI: 10.1111/j.1468-3083.2007.02385.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the effect of desloratadine on quality of life (QoL) in chronic idiopathic urticaria (CIU). STUDY POPULATION Patients with a history of CIU (pruritus and weals lasting = 6 weeks) were included in this multicentre, randomized, double-blind placebo-controlled study that took place in dermatology centres throughout France. During the study, patients were randomized to receive desloratadine 5 mg daily or placebo for 42 days. MAIN OUTCOME MEASURES Variation of the scores of two QoL dermatology-specific tools between baseline and day 42, the French translation version of the Dermatology Life Quality Index (DLQI) and the VQ-Dermato (a French-language scoring instrument). RESULTS The intent-to-treat population comprised 137 patients [desloratadine (n = 65) or placebo (n = 72)]. Desloratadine treatment was associated with significantly greater improvements from baseline to day 42 compared with placebo in DLQI overall score (-6 vs. -2.2 points; P < 0.002) and VQ-Dermato score (18.5 vs. 29.1 points; P = 0.009). Mean scores for sleep disruption and disruption of daily activities were significantly lower in the desloratadine group than in the placebo group from day 1 to the end of the study. CONCLUSIONS Desloratadine 5 mg/day was associated with significant improvements in two separate dermatology-specific measures of QoL in patients with CIU. QoL proved to be a relevant primary outcome measure for therapeutic trials in CIU.
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Langan SM, Bouwes Bavinck JN, Coenraads PJ, Diepgen T, Elsner P, Grob JJ, Linder D, Naldi L, Svensson A, Williams HC. Update on the Activities of the European Dermato-Epidemiology Network (EDEN). Dermatology 2006; 213:1-2. [PMID: 16778417 DOI: 10.1159/000092828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Négrier S, Saiag P, Guillot B, Verola O, Avril MF, Bailly C, Cupissol D, Dalac S, Danino A, Dreno B, Grob JJ, Leccia MT, Renaud-Vilmer C, Bosquet L. [Guidelines for clinical practice: Standards, Options and Recommendations 2005 for the management of adult patients exhibiting an M0 cutaneous melanoma, full report. National Federation of Cancer Campaign Centers. French Dermatology Society. Update of the 1995 Consensus Conference and the 1998 Standards, Options, and Recommendations]. Ann Dermatol Venereol 2005; 132:10S3-10S85. [PMID: 16521904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
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Monestier S, Gaudy C, Gouvernet J, Richard MA, Grob JJ. Multiple senile lentigos of the face, a skin ageing pattern resulting from a life excess of intermittent sun exposure in dark-skinned caucasians: a case-control study. Br J Dermatol 2005; 154:438-44. [PMID: 16445772 DOI: 10.1111/j.1365-2133.2005.06996.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Different patterns of skin ageing can be described depending on the predominant lesions, i.e. wrinkles, laxity, atrophy, senile lentigos (SLs), etc. They may correspond to different epidemiological contexts. OBJECTIVES To identify and assess the epidemiological factors for a skin ageing pattern characterized by a high density of SLs on the face, or 'lentigo ageing pattern' (LAP). METHODS An age- and sex-matched case-control study was conducted in individuals aged between 60 and 80 years, comparing cases (n = 118) with a very high number of SLs on the face for their age, and controls (n = 118) with no or very few SLs for their age. The cases and controls were recruited in two hospitals. RESULTS In univariate and multivariate analysis, LAP was associated with skin types III and IV, with frequent sunburns, and with the part of the lifetime cumulative sun exposure which was received during vacations. Conversely, there was no link with the occupational and everyday exposures and the total cumulative exposure. LAP was associated with multiple solar lentigos of the upper back. No relationship was found with postmenopausal hormonal therapy, number of naevi, or freckles. CONCLUSIONS Different epidemiological factors may account for the different skin ageing patterns. LAP seems to develop preferentially in dark-skinned caucasians who have repeatedly received intermittent and intense sun irradiations throughout their life, and have often developed solar lentigos on the upper back earlier in life, whereas the 'prominent wrinkling' pattern is known to affect light-skinned people and smokers with a life excess of continuous exposure.
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Grob JJ. [Epidemiology of mycosis fungoides]. Ann Dermatol Venereol 2005; 132 Spec No 2:5S11-2. [PMID: 16385892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
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Grob JJ, Revuz J, Ortonne JP, Auquier P, Lorette G. Comparative study of the impact of chronic urticaria, psoriasis and atopic dermatitis on the quality of life. Br J Dermatol 2005; 152:289-95. [PMID: 15727641 DOI: 10.1111/j.1365-2133.2005.06385.x] [Citation(s) in RCA: 109] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND A better management of chronic skin disorders (CSDs) requires a knowledge of their impact from the patient's point of view. OBJECTIVES To determine which aspects of the patient's life are mainly impaired in the different CSDs, and provide comparative references to estimate better the real impact of the different CSDs. PATIENTS AND METHODS A prospective cross-sectional and matched study of 1356 adult outpatients to compare the health-related quality of life (HRQL) profile in chronic urticaria (466 CU), psoriasis (464 PSO) and atopic dermatitis (426 AD), using the VQ-Dermato, a multidimensional instrument in French validated for CSDs. RESULTS After adjustment for confounders, HRQL dimensions were differently affected in the three CSDs. The 'physical discomfort' dimension was more degraded in AD and CU than in PSO (P < 0.001), and 'leisure activities' more in PSO than in CU (P < 0.001). 'Self-perception' and 'treatment-induced restrictions' dimensions were much less affected in CU than in PSO and AD (P < 0.001). In PSO, the 'daily living activities' dimension was much less impaired than in CU and AD (P < 0.001). No aspect of HRQL was really spared in AD. CONCLUSIONS The comparison shows that CU, PSO and AD are characterized by completely different qualitative profiles of impact on HRQL, which are influenced by their clinical characteristics and usual treatment options. It underlines the severe impairment of CU which is often underestimated.
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Avril MF, Aamdal S, Grob JJ, Hauschild A, Mohr P, Bonerandi JJ, Weichenthal M, Neuber K, Bieber T, Gilde K, Guillem Porta V, Fra J, Bonneterre J, Saïag P, Kamanabrou D, Pehamberger H, Sufliarsky J, Gonzalez Larriba JL, Scherrer A, Menu Y. Fotemustine compared with dacarbazine in patients with disseminated malignant melanoma: a phase III study. J Clin Oncol 2004; 22:1118-25. [PMID: 15020614 DOI: 10.1200/jco.2004.04.165] [Citation(s) in RCA: 335] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To compare fotemustine and dacarbazine (DTIC) in terms of overall response rate (ORR) as primary end-point and overall survival, duration of responses, time to progression, time to occurrence of brain metastases (BM), and to assess safety and quality of life in patients with disseminated cutaneous melanoma. PATIENTS AND METHODS Patients received either intravenous fotemustine 100 mg/m2 weekly for 3 weeks or DTIC 250 mg/m2/d for 5 consecutive days every 4 weeks (two cycles). Nonprogressive patients received a maintenance treatment every 4 weeks (fotemustine 100 mg/m2 or DTIC 250 mg/m2 for 5 days). RESULTS Two hundred twenty-nine patients were randomly assigned to fotemustine or DTIC arms. The best ORR was higher in the fotemustine arm than in the DTIC arm in the intent-to-treat population (n=229; 15.2% v 6.8%; P=.043) and in full analysis set (n=221) (15.5% v 7.2%; P=.053). Similar median durations of responses (5.8 months with fotemustine v 6.9 months with DTIC) and time to progression (1.8 v 1.9 months, respectively) were observed. In patients without BM at inclusion, the median time to BM was 22.7 months with fotemustine versus 7.2 months with DTIC (P=.059). Median survival was 7.3 months with fotemustine versus 5.6 months with DTIC (P=.067). The main toxicity was grade 3 to 4 neutropenia (51% with fotemustine v 5% with DTIC) and thrombocytopenia (43% v 6%, respectively). No significant difference was noted for quality of life between arms. CONCLUSION ORR was higher in the fotemustine arm compared to the DTIC arm in first-line treatment of disseminated melanoma. A trend in favor of fotemustine in terms of overall survival and time to BM was evidenced.
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Nicol I, Boye T, Carsuzaa F, Feier L, Collet Villette AM, Xerri L, Grob JJ, Richard MA. Post-transplant plasmablastic lymphoma of the skin. Br J Dermatol 2003; 149:889-91. [PMID: 14616390 DOI: 10.1046/j.1365-2133.2003.05544.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Grob JJ. La reconnaissance des mélanomes au milieude milliers de tumeurs noires : ≪ oublier ABCD ≫. Rev Med Interne 2003; 24 Suppl 1:11s-12s. [PMID: 14509031 DOI: 10.1016/s0248-8663(03)80004-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Gueydan M, Folchetti G, Christofilis MA, Valéro R, Grob JJ, Vialettes B. [Impetigo herpetiformis, a rare manifestation of severe hypocalcemia]. ANNALES D'ENDOCRINOLOGIE 2002; 63:502-4. [PMID: 12527851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
A case of impetigo herpetiformis associated with profound hypocalcemia secondary to idiopathic hypoparathyroidism is reported. This clinical observation and the review of similar cases in the literature recall that this rare and severe skin disease related to psoriasis can be the first manifestation of hypoparathyroidism and responds very well to the calcium reloading.
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Monestier S, Richard MA, Rey AC, Djemli A, Choux R, Grob JJ. [Multiple papules of the trunk]. Ann Dermatol Venereol 2002; 129:1315-6. [PMID: 12514525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
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Saiag P, Grob JJ, Grosshans E. [Epithelial and melanotic skin tumors. Melanomas]. Ann Dermatol Venereol 2002; 129:S143-8. [PMID: 12718142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
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Wolkenstein P, Consoli S, Roujeau JC, Grob JJ. [The physician-patient relation. Reporting a severe disease. Education of a patient suffering from a chronic disease. Personalizing medical management]. Ann Dermatol Venereol 2002; 129:S7-10. [PMID: 12718118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
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Basset-Seguin N, Dreno B, Grob JJ. [Epithelial and melanotic skin tumors. Epithelial carcinoma]. Ann Dermatol Venereol 2002; 129:S132-6. [PMID: 12718140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
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Andreani V, Richard MA, Blaise D, Gouvernet J, Grob JJ. Naevi in allogeneic bone marrow transplantation recipients: the effect of graft-versus-host disease on naevi. Br J Dermatol 2002; 147:433-41. [PMID: 12207581 DOI: 10.1046/j.1365-2133.2002.04748.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Non-melanoma skin carcinoma is more common in transplant recipients, probably because of immunosuppression. An increased risk of developing melanoma could be a late effect of transplantation. The number of naevi, which is a risk marker for melanoma, is increased in renal transplant recipients of all ages and may be related to immunosuppression. The risk of melanoma has been suspected to be particularly high after bone marrow transplantation. Cutaneous graft-versus-host disease (GVHD) might be an interesting model for the study of interactions between naevi and the immune system. OBJECTIVE To assess whether aBMT exposes an individual to a particularly high risk of melanoma, using naevi as a surrogate measure of the risk. To improve our knowledge of the effect of the immune system on naevi, using GVHD as a model. METHODS We carried out an epidemiological case-control study with two age-, sex- and hair colour-matched controls for each case. The results were analysed with analysis of variance, a general linear model analysis and multivariate analysis. RESULTS The number of naevi was not significantly increased in aBMT patients, as compared with controls, although there was a significant excess on the palms and legs. In exploratory subgroup case-control comparisons and with the general linear model, patients who were conditioned with a combination of two alkylating drugs at high doses, and patients who had an aBMT before the age of 20 years tended to have a higher count of naevi (P = 0.002 and P = 0.06, respectively). Conversely, there was a trend in favour of a lower count of naevi in patients with diffuse skin lesions of chronic GVHD (P = 0.01). These data were corroborated by multivariate analysis, which showed that conditioning with high-dose chemotherapy, the absence of severe chronic cutaneous GVHD and a young age at transplantation were the main variables that independently predicted an excess of naevi. CONCLUSIONS This study of aBMT patients confirms that chemotherapy stimulates naevus growth. It also suggests for the first time that diffuse lesions of chronic cutaneous GVHD are associated with a decreased number of naevi. Whether allo-immunity, chronic skin inflammation or the masking of naevi by pigmentation and fibrosis is responsible for the decreased number of naevi requires further investigation. With respect to the long-term risk of melanoma in aBMT recipients, our results support an increased risk particularly when aBMT is performed at a young age, and when conditioning is with high doses of alkylating drugs.
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Abstract
INTRODUCTION First used as a sedative, thalidomide was taken out the market because of its teratogenicity. Despite other side effects, especially neuropathies, this drug is now again prescribed in various autoimmune and neoplasic diseases. Recently, venous or arterial thrombotic events have been described after the introduction of thalidomide. EXEGESIS In this report, we describe two new venous thrombosis cases occurring during a treatment with thalidomide. The first case is a 37-year-old man treated for a discoid lupus, who developed three deep-vein thrombosis and a massive pulmonary embolism, with recurrent thrombosis even with an efficient anticoagulation therapy until the final stop of thalidomide. The second one is a 66-year-old woman treated with thalidomide for a multiple myeloma and a melanoma in therapeutic escape, who developed a deep-vein thrombosis two months after the beginning of her treatment. Published reports suggest that most thrombotic events appeared under three months after the introduction of the treatment and that thalidomide could have acted as a precipitating or as a starting factor in a patient population already at risk of thrombosis. Those complications should be particularly severe, but the mechanism underlying thrombosis with thalidomide is unknown. CONCLUSION A complete coagulation check-up is advised before beginning a treatment with thalidomide.
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Richard MA, Saadallah S, Lefevre P, Poullin P, Buscaylet S, Grob JJ. [Extracorporeal photochemotherapy in therapy-refractory subacute lupus]. Ann Dermatol Venereol 2002; 129:1023-6. [PMID: 12442100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
BACKGROUND Extracorporeal photopheresis is a leukapheresis therapy that uses psoralen and ultraviolet A irradiation. We report the case of a woman with a refractory sub acute lupus which dramatically but transitionally responded to extracorporeal photopheresis. CASE REPORT This women, born in 1960, developed erythematous and squamous patches located on face and neckline, associated with hyperpigmented and atrophic lesions on the arms and shoulders. Investigations confirmed the diagnosis of subacute lupus without systemic disease. All lesions progressed, despite all conventional therapies leading to major aesthetic prejudice. Extracorporeal photopheresis was initiated, and after two months, all lesions, including atrophic and healing lesions had regressed, but laboratory abnormalities did not change. Extracorporeal photopheresis was well tolerated. However, treatment was discontinued nine months later, since the cutaneous lesions relapsed. COMMENTS Extracorporeal photopheresis could be efficient in the treatment of cutaneous autoimmune diseases through several immunomodulatory mechanisms. Extracorporeal photopheresis is a potent alternative agent in the therapy of refractory dermatological diseases
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