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Pottier C, Guichard E, Thomann C, Denevault-Sabourin C, Maruani A, Leducq S. Knowledge of community pharmacists on infantile haemangioma: Gaps and lack confidence to deliver propranolol still need to be filled. Acta Paediatr 2024; 113:1017-1023. [PMID: 38287483 DOI: 10.1111/apa.17128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 01/31/2024]
Abstract
AIM To evaluate the knowledge, practices and self-confidence of community pharmacists, pharmacy technicians and pharmacy students about infantile haemangioma (IH) and propranolol treatment. METHODS A national survey was conducted in France from May 2022 to October 2022. A 42-item online questionnaire was used to assess pharmacists' knowledge of the epidemiology, clinical features and management of IH and propranolol treatment. RESULTS The survey included 255 participants. The mean age was 34.9 years (±9.0); 225 (88%) were women. In all, 193 (76%) practised in urban pharmacies. Altogether, 83 participants (33%) had delivered oral propranolol solution for IH in the last 6 months. Participants' median score for self-confidence regarding propranolol dispensing was five (interquartile range, 2.5-6) on a scale of 1 to 10. Overall, 96 (38%) had more than 50% correct answers on the questionnaire. Multinomial regression models showed high scores on the questionnaire associated with high self-confidence when delivering oral propranolol solution, low number of years since graduation and having already delivered propranolol treatment. CONCLUSION This study highlights a lack of knowledge of IH and modalities of propranolol treatment by community pharmacists and slight self-confidence when delivering propranolol. Greater cooperation between healthcare professionals could improve the proper use of medicine.
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Affiliation(s)
| | - Elie Guichard
- CHRU Tours, Clinical Investigation Center- INSERM 1415, Tours, France
| | - Claire Thomann
- Pharmacy Department, Tours University Hospital, Tours, France
| | - Caroline Denevault-Sabourin
- Faculty of Pharmacy, University of Tours, Tours, France
- Team "Proteolytic Mechanisms in Inflammation", INSERM, UMR1100, Research Center for Respiratory Diseases (CEPR), Tours, France
| | - Annabel Maruani
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), CHRU Tours, Tours, France
- University of Tours, University of Nantes, INSERM 1246-SPHERE, Tours, France
| | - Sophie Leducq
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), CHRU Tours, Tours, France
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Poizeau F, Maruani A, Staumont-Sallé D, Jouan N, Ly S, Schollhammer M, Reverte M, Dibao-Dina C, Duong TA, Matard B, Penso-Assathiany D, Dupuy A, Carriot M, Seï JF, Corgibet F, Guillot B, Barbarot S, Leducq S, Bertolotti A, Tannous J, Chaby G, Jullien D, Pépin E, Quéreux G, Beylot-Barry M, Chosidow O. Promoting clinical research in community-based practice: Threats and opportunities. Ann Dermatol Venereol 2024; 151:103272. [PMID: 38688174 DOI: 10.1016/j.annder.2024.103272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/12/2023] [Accepted: 03/04/2024] [Indexed: 05/02/2024]
Affiliation(s)
- F Poizeau
- Centre de Preuves en Dermatologie, Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085, F-35000 Rennes, France.
| | - A Maruani
- Centre de Preuves en Dermatologie, Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; CHRU de Tours, Service de Dermatologie, Unité de Dermatologie pédiatrique, 37000 Tours, France; Universités de Tours et de Nantes, Inserm 1246-SPHERE, Nantes, France
| | - D Staumont-Sallé
- Centre de Preuves en Dermatologie, Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; CHU Lille, Service de Dermatologie, Univ Lille, INSERM U1286, Lille Inflammation Translational Research Institute (INFINITE) F-59000, Lille, France
| | - N Jouan
- Centre de Preuves en Dermatologie, Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Cabinet de Dermatologie, 29200 Brest, France
| | - S Ly
- Cabinet de Dermatologie, Gradignan, France; Service de Dermatologie, Hôpital St André, Bordeaux, France
| | - M Schollhammer
- Cabinet de Dermatologie, 29200 Brest, France; Service de Dermatologie, CHU Brest, Brest, France
| | - M Reverte
- Cabinet de Dermatologie, 83120 Sainte-Maxime, France
| | - C Dibao-Dina
- Universités de Tours et de Nantes, Inserm 1246-SPHERE, Nantes, France; Département Universitaire de Médecine Générale, Université de Tours, Tours, France
| | - T-A Duong
- Service de dermatologie générale et oncologique, CHU Ambroise Paré, Boulogne-Billancourt, France
| | - B Matard
- Centre Sabouraud, Hôpital Saint Louis, Paris, France
| | | | - A Dupuy
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085, F-35000 Rennes, France
| | - M Carriot
- Infirmière puéricultrice de recherche, CIC 1415 de Tours, Tours, France
| | - J-F Seï
- Centre de Preuves en Dermatologie, Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Fédération Française de Formation Continue et d'Évaluation en Dermatologie Vénéréologie
| | - F Corgibet
- Centre de Preuves en Dermatologie, Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France
| | - B Guillot
- Centre de Preuves en Dermatologie, Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Dermatologue, Université de Montpellier, Montpellier, France
| | - S Barbarot
- Centre de Preuves en Dermatologie, Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Nantes Université, Service de Dermatologie, CHU Nantes, INRAE, UMR 1280, PhAN, F-44000 Nantes, France
| | - S Leducq
- Centre de Preuves en Dermatologie, Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Service de Dermatologie, CHRU Tours, 37000 Tours, France
| | - A Bertolotti
- Centre de Preuves en Dermatologie, Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; CIC-INSERM1410, Service de Maladies Infectieuses - Dermatologie, CHU de la Réunion, Saint Pierre, La Réunion, France
| | - J Tannous
- Centre de Preuves en Dermatologie, Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France
| | - G Chaby
- Centre de Preuves en Dermatologie, Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Service de Dermatologie, CHU Amiens, 80000 Amiens, France
| | - D Jullien
- Centre de Preuves en Dermatologie, Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Hospices Civils de Lyon, Hôpital E. Herriot, Service de Dermatologie, Lyon F-69003; Université Lyon-1, INSERM Unité 1111-CIRI, Lyon F-69007, France
| | - E Pépin
- Centre de Preuves en Dermatologie, Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Dermatologue, FFFCEDV, Villepreux, France
| | - G Quéreux
- Service de Dermatologie, CHU Nantes, Université de Nantes, CIC 1413, Inserm UMR 1302/EMR6001 INCIT, F-44000 Nantes, France
| | - M Beylot-Barry
- Centre de Preuves en Dermatologie, Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; Service de Dermatologie, CHU Bordeaux, INSERM U1312, Bordeaux Institute of Oncology, Univ Bordeaux, Bordeaux, France
| | - O Chosidow
- Centre de Preuves en Dermatologie, Société Française de Dermatologie, 10 Cité Malesherbes, 75009 Paris, France; AP-HP, Hôpital Pitié-Salpêtrière, consultation dermatoses faciales, Paris, France
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Kuentz P, Engel C, Laeng M, Chevarin M, Duffourd Y, Martel J, Piard J, Morice-Picard F, Aubert H, Bessis D, Guerrot AM, Maruani A, Boccara O, Mazereeuw-Hautier J, Ott H, Phan A, Puzenat E, Quelin C, Thauvin-Robinet C, Faivre L, Vabres P. Clinical phenotype of the PIK3R1-related vascular overgrowth syndrome. Br J Dermatol 2024:ljae167. [PMID: 38623710 DOI: 10.1093/bjd/ljae167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/25/2024] [Accepted: 04/12/2024] [Indexed: 04/17/2024]
Abstract
Here we report 19 additional mosaic PIK3R1 patients with clinical phenotyping, showing that the PIK3R1 phenotype is indistinguishable from the PIK3CA-related phenotypes, although the MCAP phenotype is consistently absent in PIK3R1 patients. We also report novel PIK3R1 variants. We consider that the meaning of PROS should shift from “PIK3CA-related overgrowth spectrum” to “PI3-kinase-related overgrowth spectrum”.
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Affiliation(s)
- Paul Kuentz
- Université de Franche-Comté, CHU Besançon, Oncobiologie Génétique Bioinformatique, FHU-TRANSLAD et Institut GIMI, F-25000 Besançon, France
- Université de Bourgogne, INSERM UMR1231 GAD "Génétique des Anomalies du Développement", F-21000 Dijon, France
| | - Camille Engel
- Université de Bourgogne, INSERM UMR1231 GAD "Génétique des Anomalies du Développement", F-21000 Dijon, France
- Université de Franche-Comté, CHU Besançon, Centre de Génétique Humaine, F-25000 Besançon, France
| | - Mathieu Laeng
- Université de Franche-Comté, CHU Besançon, Oncobiologie Génétique Bioinformatique, FHU-TRANSLAD et Institut GIMI, F-25000 Besançon, France
| | - Martin Chevarin
- Université de Bourgogne, INSERM UMR1231 GAD "Génétique des Anomalies du Développement", F-21000 Dijon, France
- CHU Dijon, Unité Fonctionnelle "Innovation diagnostique dans les maladies rares", FHU-TRANSLAD et Institut GIMI, F-21000 Dijon, France
| | - Yannis Duffourd
- Université de Bourgogne, INSERM UMR1231 GAD "Génétique des Anomalies du Développement", F-21000 Dijon, France
- CHU Dijon, Unité Fonctionnelle "Innovation diagnostique dans les maladies rares", FHU-TRANSLAD et Institut GIMI, F-21000 Dijon, France
| | - Jéhanne Martel
- CHU Dijon, Centre de référence MAGEC Nord "Maladies rares de la peau et des muqueuses d'origine Génétique à Expression Cutanée", FHU-TRANSLAD et Institut GIMI, F-21000 Dijon, France
| | - Juliette Piard
- Université de Bourgogne, INSERM UMR1231 GAD "Génétique des Anomalies du Développement", F-21000 Dijon, France
- Université de Franche-Comté, CHU Besançon, Centre de Génétique Humaine, F-25000 Besançon, France
| | - Fanny Morice-Picard
- CHU Bordeaux, Service de Dermatologie, Centre de référence MAGEC Sud "Maladies rares de la peau et des muqueuses d'origine Génétique à Expression Cutanée", F-33000 Bordeaux, France
| | - Helene Aubert
- CHU Nantes, Service de Dermatologie, F-44000 Nantes, France
| | - Didier Bessis
- CHU Montpellier, Service de Dermatologie, F-34000 Montpellier, France
| | - Anne-Marie Guerrot
- CHU Rouen, Service de Génétique, NGP "Centre normand de médecine génomique et de médecine personnalisée", F-76000 Rouen, France
| | - Annabel Maruani
- CHU Tours, Service de Dermatologie, Centre de référence MAGEC Nord "Maladies rares de la peau et des muqueuses d'origine Génétique à Expression Cutanée", F-37000 Tours, France
| | - Olivia Boccara
- CHU Necker-Enfants Malades, Service de Dermatologie, Centre de référence MAGEC Nord "Maladies rares de la peau et des muqueuses d'origine Génétique à Expression Cutanée", F-75000 Paris, France
| | - Juliette Mazereeuw-Hautier
- CHU Toulouse, Service de Dermatologie, Centre de référence MAGEC Sud "Maladies rares de la peau et des muqueuses d'origine Génétique à Expression Cutanée", F-31000 Toulouse, France
| | - Hagen Ott
- Kinder- und Jugendkrankenhaus Auf der Bult, Pädiatrische Dermatologie und Allergologie, Epidermolysis bullosa-Zentrum, D-30000 Hannover, Deutschland
| | - Alice Phan
- HCL-Femme-mère-enfant, Service de Néphrologie-Rhumatologie-Dermatologie, F-69029 Bron, France
| | - Eve Puzenat
- Université de Franche-Comté, CHU Besançon, Service de Dermatologie, F-25000 Besançon, France
| | - Chloe Quelin
- CHU Rennes, Service de génétique clinique, F-35000 Rennes, France
| | - Christel Thauvin-Robinet
- Université de Bourgogne, INSERM UMR1231 GAD "Génétique des Anomalies du Développement", F-21000 Dijon, France
- CHU Dijon, Unité Fonctionnelle "Innovation diagnostique dans les maladies rares", FHU-TRANSLAD et Institut GIMI, F-21000 Dijon, France
| | - Laurence Faivre
- Université de Bourgogne, INSERM UMR1231 GAD "Génétique des Anomalies du Développement", F-21000 Dijon, France
- CHU Dijon, Centre de Génétique et Centres de référence Anomalies du Développement et Déficience Intellectuelle, FHU-TRANSLAD et Institut GIMI, F-21000 Dijon, France
| | - Pierre Vabres
- Université de Bourgogne, INSERM UMR1231 GAD "Génétique des Anomalies du Développement", F-21000 Dijon, France
- CHU Dijon, Centre de référence MAGEC Nord "Maladies rares de la peau et des muqueuses d'origine Génétique à Expression Cutanée", FHU-TRANSLAD et Institut GIMI, F-21000 Dijon, France
- Reference centre for rare diseases, St John's Institute of Dermatology, St Thomas' Hospital, London, UK
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4
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Faivre L, Crépin JC, Réda M, Nambot S, Carmignac V, Abadie C, Mirault T, Faure-Conter C, Mazereeuw-Hautier J, Maza A, Puzenat E, Collonge-Rame MA, Bursztejn AC, Philippe C, Thauvin-Robinet C, Chevarin M, Abasq-Thomas C, Amiel J, Arpin S, Barbarot S, Baujat G, Bessis D, Bourrat E, Boute O, Chassaing N, Coubes C, Demeer B, Edery P, El Chehadeh S, Goldenberg A, Hadj-Rabia S, Haye D, Isidor B, Jacquemont ML, Van Kien PK, Lacombe D, Lehalle D, Lambert L, Martin L, Maruani A, Morice-Picard F, Petit F, Phan A, Pinson L, Rossi M, Touraine R, Vanlerberghe C, Vincent M, Vincent-Delorme C, Whalen S, Willems M, Marle N, Verkarre V, Devalland C, Devouassoux-Shisheboran M, Abad M, Rioux-Leclercq N, Bonniaud B, Duffourd Y, Martel J, Binquet C, Kuentz P, Vabres P. Low risk of embryonic and other cancers in PIK3CA-related overgrowth spectrum: Impact on screening recommendations. Clin Genet 2023; 104:554-563. [PMID: 37580112 DOI: 10.1111/cge.14410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 07/07/2023] [Accepted: 07/19/2023] [Indexed: 08/16/2023]
Abstract
The PIK3CA-related overgrowth spectrum (PROS) encompasses various conditions caused by mosaic activating PIK3CA variants. PIK3CA somatic variants are also involved in various cancer types. Some generalized overgrowth syndromes are associated with an increased risk of Wilms tumor (WT). In PROS, abdominal ultrasound surveillance has been advocated to detect WT. We aimed to determine the risk of embryonic and other types of tumors in patients with PROS in order to evaluate surveillance relevance. We searched the clinical charts from 267 PROS patients for the diagnosis of cancer, and reviewed the medical literature for the risk of cancer. In our cohort, six patients developed a cancer (2.2%), and Kaplan Meier analyses estimated cumulative probabilities of cancer occurrence at 45 years of age was 5.6% (95% CI = 1.35%-21.8%). The presence of the PIK3CA variant was only confirmed in two out of four tumor samples. In the literature and our cohort, six cases of Wilms tumor/nephrogenic rests (0.12%) and four cases of other cancers have been reported out of 483 proven PIK3CA patients, in particular the p.(His1047Leu/Arg) variant. The risk of WT in PROS being lower than 5%, this is insufficient evidence to recommend routine abdominal imaging. Long-term follow-up studies are needed to evaluate the risk of other cancer types, as well as the relationship with the extent of tissue mosaicism and the presence or not of the variant in the tumor samples.
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Affiliation(s)
- Laurence Faivre
- Equipe INSERM UMR1231, Génétique des Anomalies du Développement, FHU TRANSLAD, Université Bourgogne Franche-Comté, Dijon, France
- Centre de Génétique, Centre de Référence Anomalies du Développement et Syndromes Malformatifs et FHU TRANSLAD, CHU Dijon Bourgogne, Dijon, France
| | - Jean-Charles Crépin
- Equipe INSERM UMR1231, Génétique des Anomalies du Développement, FHU TRANSLAD, Université Bourgogne Franche-Comté, Dijon, France
- Service de Dermatologie, CHU Dijon Bourgogne, Dijon, France
- Centre de référence Maladies Rares Génétiques à Expression Cutanée (MAGEC), CHU Dijon, Dijon, France
| | - Manon Réda
- Oncogénétique, Centre de lutte contre le cancer Georges François Leclerc, Dijon, France
| | - Sophie Nambot
- Equipe INSERM UMR1231, Génétique des Anomalies du Développement, FHU TRANSLAD, Université Bourgogne Franche-Comté, Dijon, France
- Centre de Génétique, Centre de Référence Anomalies du Développement et Syndromes Malformatifs et FHU TRANSLAD, CHU Dijon Bourgogne, Dijon, France
- Oncogénétique, Centre de lutte contre le cancer Georges François Leclerc, Dijon, France
| | - Virginie Carmignac
- Equipe INSERM UMR1231, Génétique des Anomalies du Développement, FHU TRANSLAD, Université Bourgogne Franche-Comté, Dijon, France
- Centre de référence Maladies Rares Génétiques à Expression Cutanée (MAGEC), CHU Dijon, Dijon, France
| | | | - Tristan Mirault
- Université Paris Cité, PARCC INSERM U970, Centre de référence des maladies vasculaires rares, Hôpital européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France
| | | | | | - Aude Maza
- Service de Dermatologie, CHU Toulouse, Toulouse, France
| | - Eve Puzenat
- Service de Dermatologie, CHU Besançon, Besançon, France
| | | | | | - Christophe Philippe
- Equipe INSERM UMR1231, Génétique des Anomalies du Développement, FHU TRANSLAD, Université Bourgogne Franche-Comté, Dijon, France
- UF6254 Innovation en Diagnostic Génomique des Maladies Rares, Plate-forme de Biologie Hospitalo-Universitaire, CHU Dijon-Bourgogne, Dijon, France
| | - Christel Thauvin-Robinet
- Equipe INSERM UMR1231, Génétique des Anomalies du Développement, FHU TRANSLAD, Université Bourgogne Franche-Comté, Dijon, France
- Centre de Référence Déficiences Intellectuelles de Causes Rares, CHU Dijon Bourgogne, Dijon, France
| | - Martin Chevarin
- Equipe INSERM UMR1231, Génétique des Anomalies du Développement, FHU TRANSLAD, Université Bourgogne Franche-Comté, Dijon, France
- UF6254 Innovation en Diagnostic Génomique des Maladies Rares, Plate-forme de Biologie Hospitalo-Universitaire, CHU Dijon-Bourgogne, Dijon, France
| | - Claire Abasq-Thomas
- Département de Pédiatrie et Génétique Médicale, CHU Brest Morvan, Brest, France
| | - Jeanne Amiel
- Service de Médecine Génomique des Maladies Rares et Centre de Référence Anomalies du Développement et Syndromes Malformatifs, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
| | - Stéphanie Arpin
- Service de Génétique Clinique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs, CHRU de Tours, Tours, France
| | | | - Geneviève Baujat
- Service de Médecine Génomique des Maladies Rares et Centre de Référence Anomalies du Développement et Syndromes Malformatifs, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
| | - Didier Bessis
- Département de Dermatologie, CHRU de Montpellier, Montpellier, France
| | - Emmanuelle Bourrat
- Service de dermatologie, centre de référence maladies génétiques à expression cutanée MAGEC, CHU St-Louis, Service de pédiatrie générale, CHU Robert Debré, Paris, France
| | - Odile Boute
- Service de Génétique Clinique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs, CHU Lille, Lille, France
| | - Nicolas Chassaing
- Service de Génétique Médicale et Centre de Compétence Anomalies du Développement et Syndromes Malformatifs, CHU Toulouse, Toulouse, France
| | - Christine Coubes
- Département de Génétique Médicale, Maladies rares et Médecine Personnalisée, et Centre de Référence Anomalies du Développement et Syndromes Malformatifs, CHRU de Montpellier, Montpellier, France
| | - Bénédicte Demeer
- Centre d'Activité de Génétique Clinique et Oncogénétique, CHU d'Amiens, Amiens, France
| | - Patrick Edery
- Service de génétique, Centre de Référence Anomalies du Développement, Hospices Civils de Lyon, Bron, France
- INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, GENDEV Team, Université Claude Bernard Lyon 1, Bron, France
| | - Salima El Chehadeh
- Service de Génétique Médicale, Centre de Référence Déficiences Intellectuelles de Causes Rares, Institut de Génétique Médicale d'Alsace (IGMA), CHRU de Strasbourg, Strasbourg, France
| | - Alice Goldenberg
- Service de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs, CHU de Rouen et Centre Normand de Génomique Médicale et Médecine Personnalisée, Rouen, France
| | - Smail Hadj-Rabia
- Service de Dermatologie et Centre de Référence des Maladies Rares Génétiques à Expression Cutanée (MAGEC), Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, Hôpital Universitaire Necker Enfants Malades, Paris, France
| | - Damien Haye
- Service de Génétique Clinique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs, CHRU de Tours, Tours, France
| | - Bertrand Isidor
- Service de Génétique Médicale et Centre de Référence Anomalies du Développement et Syndromes Malformatifs, CHU de Nantes, Nantes, France
| | - Marie-Line Jacquemont
- Unité de Génétique Médicale et Centre de Référence Anomalies du Développement et Syndromes Malformatifs, CHU de la Réunion, Saint-Pierre, France
| | - Philippe Khau Van Kien
- Unité de Génétique Médicale et Cytogénétique, Centre de Compétence Anomalies du Développement et Syndromes Malformatifs, CHU de Nîmes, Nîmes, France
| | - Didier Lacombe
- Service de Génétique Médicale et Centre de Référence Anomalies du Développement et Syndromes Malformatifs, CHU de Bordeaux, Bordeaux, France
| | - Daphné Lehalle
- Equipe INSERM UMR1231, Génétique des Anomalies du Développement, FHU TRANSLAD, Université Bourgogne Franche-Comté, Dijon, France
| | - Laetitia Lambert
- Service de Génétique Clinique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs, CHU de Nancy, Nancy, France
| | | | | | - Fanny Morice-Picard
- Service de Génétique Clinique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs, CHU de Nancy, Nancy, France
- Service de Dermatologie, CHU de Bordeaux, Bordeaux, France
| | - Florence Petit
- Service de Génétique Clinique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs, CHU Lille, Lille, France
| | - Alice Phan
- Service de Dermatologie, CHU de Lyon, Lyon, France
| | - Lucile Pinson
- Département de Génétique Médicale, Maladies rares et Médecine Personnalisée, et Centre de Référence Anomalies du Développement et Syndromes Malformatifs, CHRU de Montpellier, Montpellier, France
| | - Massimiliano Rossi
- Service de génétique, Centre de Référence Anomalies du Développement, Hospices Civils de Lyon, Bron, France
- INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, GENDEV Team, Université Claude Bernard Lyon 1, Bron, France
| | - Renaud Touraine
- Service de Génétique Clinique et Centre de Compétence Anomalies du Développement et Syndromes Malformatifs, CHU de Saint-Etienne, Saint-Etienne, France
| | - Clémence Vanlerberghe
- Service de Génétique Clinique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs, CHU Lille, Lille, France
| | - Marie Vincent
- Service de Génétique Médicale et Centre de Référence Anomalies du Développement et Syndromes Malformatifs, CHU de Nantes, Nantes, France
| | - Catherine Vincent-Delorme
- Service de Génétique Clinique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs, CHU Lille, Lille, France
| | - Sandra Whalen
- Unité Fonctionnelle de Génétique Clinique, Hôpital Armand-Trousseau, Paris, France
| | - Marjolaine Willems
- Département de Génétique Médicale, Maladies rares et Médecine Personnalisée, et Centre de Référence Anomalies du Développement et Syndromes Malformatifs, CHRU de Montpellier, Montpellier, France
| | - Nathalie Marle
- UF6254 Innovation en Diagnostic Génomique des Maladies Rares, Plate-forme de Biologie Hospitalo-Universitaire, CHU Dijon-Bourgogne, Dijon, France
| | - Virginie Verkarre
- Service d'Anatomie Pathologique, Hôpital Européen Georges Pompidou, Paris, France et INSERM UMR 970, Equipe 13, PARCC Université de Paris Cité, Paris, France
| | - Christine Devalland
- Service d'Anatomie Pathologique, Hôpital Nord Franche Comté, Trevenans, France
| | | | - Marine Abad
- Service d'Anatomie Pathologique, CHU Besançon, Besançon, France
| | | | | | - Yannis Duffourd
- Equipe INSERM UMR1231, Génétique des Anomalies du Développement, FHU TRANSLAD, Université Bourgogne Franche-Comté, Dijon, France
| | - Jehanne Martel
- Centre de référence Maladies Rares Génétiques à Expression Cutanée (MAGEC), CHU Dijon, Dijon, France
| | - Christine Binquet
- INSERM, Université de Bourgogne, CHU Dijon Bourgogne, CIC 1432, Module Épidémiologie Clinique, Dijon, France
| | - Paul Kuentz
- Equipe INSERM UMR1231, Génétique des Anomalies du Développement, FHU TRANSLAD, Université Bourgogne Franche-Comté, Dijon, France
- Oncobiologie Génétique Bioinformatique, PCBio, CHU Besançon, Besançon, France
| | - Pierre Vabres
- Equipe INSERM UMR1231, Génétique des Anomalies du Développement, FHU TRANSLAD, Université Bourgogne Franche-Comté, Dijon, France
- Service de Dermatologie, CHU Dijon Bourgogne, Dijon, France
- Centre de référence Maladies Rares Génétiques à Expression Cutanée (MAGEC), CHU Dijon, Dijon, France
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Navarro M, Allemang-Trivalle A, Leducq S, Jonville-Bera AP, Maurier A, Zejli T, Edée AE, Harchaoui E, Giraudeau B, Maruani A. Indication for a Pneumocystis Prophylaxis Therapy in Patients with Vascular Anomalies Treated with PIK3/AKT/mTOR Pathway Inhibitors: Experts' Opinion and Systematic Review from the Literature. Dermatology 2023; 239:942-951. [PMID: 37793356 DOI: 10.1159/000533675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 08/14/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Vascular anomalies (VAs) are increasingly being treated with PI3K/AKT/mTOR pathway inhibitors. These drugs have immunosuppressive properties and thus theoretically overexpose patients to opportunistic infections, especially Pneumocystis jirovecii pneumonia (PJP). PJP prophylaxis use lacks consensus. We aimed to investigate the prevalence of PJP in patients receiving mTOR/PI3K/AKT inhibitors for VAs and determine any indication for pneumocystis prophylaxis in this population. METHODS The study was conducted in 2 parts: (1) we sent a survey to a panel of international experts of VAs asking about their use of pneumocystis prophylaxis drugs and (2) we performed a systematic review of the literature of all published cases of patients receiving these drugs for VA to estimate the prevalence of PJP in this population. RESULTS Answers from 68 experts were analyzed: 21 (30.9%) answered they always add PJP prophylaxis when prescribing mTOR inhibitors, 20 (29.4%) case-by-case, and 27 (39.7%) never. For the systematic review, among 3,053 reports screened, 217 were included involving 1,189 patients (1,143 received sirolimus, 38 everolimus, 4 alpelisib, 4 miransertib). Among the 1,189 cases, 2 (0.2%) PJP were reported: one under sirolimus and one under everolimus. Thus, the prevalence of PJP was estimated at 0.88 cases/1,000 patients under sirolimus (95% CI: -0.84 to 2.59) and 26.31 cases/1,000 under everolimus (95% CI: -24.58 to 77.18). Patients with PJP never received prophylaxis drugs. We found no PJP cases under alpelisib and miransertib. PJP prophylaxis was given in 218 (18.3%) cases, more frequently for children (91.3 vs. 77.2% in the non-prophylaxis group, p = 0.012), mostly trimethoprim-sulfamethoxazole (186 patients, 85.3%). CONCLUSION Our study shows that even if PJP is a rare event, it may occur in patients with VAs treated with an mTOR inhibitor. Although our results cannot allow for revising guidelines, prophylaxis with TMP-SMX might be appropriate for a subgroup of patients with risk factors for PJP.
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Affiliation(s)
- Maxime Navarro
- CHRU Tours, Department of Dermatology, Unit of Pediatric dermatology, Tours, France
- Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Tours), Tours, France
| | | | - Sophie Leducq
- CHRU Tours, Department of Dermatology, Unit of Pediatric dermatology, Tours, France
- Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Tours), Tours, France
- University of Tours, University of Nantes, INSERM 1246-SPHERE, Tours, France
| | - Annie-Pierre Jonville-Bera
- University of Tours, University of Nantes, INSERM 1246-SPHERE, Tours, France
- CHRU Tours, Department of Clinical Pharmacology, Regional Pharmacovigilance Center, Tours, France
| | - Anaïs Maurier
- CHRU Tours, Department of Clinical Pharmacology, Regional Pharmacovigilance Center, Tours, France
| | - Tarik Zejli
- CHRU Tours, Clinical Investigation Center of Tours, INSERM 1415, Bretonneau Hospital, Tours, France
| | - Afi-Emiliène Edée
- Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Tours), Tours, France
| | - Emilie Harchaoui
- CHRU Tours, Department of Dermatology, Unit of Pediatric dermatology, Tours, France
- University of Tours, University of Nantes, INSERM 1246-SPHERE, Tours, France
| | - Bruno Giraudeau
- University of Tours, University of Nantes, INSERM 1246-SPHERE, Tours, France
- CHRU Tours, Clinical Investigation Center of Tours, INSERM 1415, Bretonneau Hospital, Tours, France
| | - Annabel Maruani
- CHRU Tours, Department of Dermatology, Unit of Pediatric dermatology, Tours, France
- Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Tours), Tours, France
- University of Tours, University of Nantes, INSERM 1246-SPHERE, Tours, France
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6
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Skrek S, Di Lernia V, Beauchet A, Bursztejn AC, Belloni Fortina A, Lesiak A, Thomas J, Brzezinski P, Topkarci Z, Murashkin N, Torres T, Epishev R, Chiriac A, McPherson T, Akinde M, Maruani A, Luna PC, Vidaurri de la Cruz H, Mallet S, Leducq S, Sergeant M, Zitouni J, Mahil SK, Smith CH, Flohr C, Bachelez H, Mahé E. Clinical and epidemiological features of psoriasis exacerbations in children with SARS-CoV-2 infection. J Eur Acad Dermatol Venereol 2023; 37:e1192-e1195. [PMID: 37326146 DOI: 10.1111/jdv.19261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/13/2023] [Indexed: 06/17/2023]
Affiliation(s)
- S Skrek
- Department of Dermatology, Hôpital Victor Dupouy, Argenteuil, France
| | - V Di Lernia
- Dermatology Unit, Arcispedale S. Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - A Beauchet
- Department of Public Health, Hôpital Raymond Poincaré, Garches, France
| | - A-C Bursztejn
- Department of Dermatology, Hôpitaux de Brabois, Centre Hospitalier Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| | - A Belloni Fortina
- Pediatric Dermatology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - A Lesiak
- Department of Dermatology, Paediatric Dermatology and Oncology, Medical University of Lodz, Lodz, Poland
| | - J Thomas
- J. T. Skin Care Centre, Chennai, India
| | - P Brzezinski
- Department of Dermatology, Voivodship Specialist Hospital in Slupsk, Slupsk, Poland
| | - Z Topkarci
- Department of Dermatology, Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - N Murashkin
- Department of Dermatology, Federal State Autonomous Institution, Scientific Center of Children's Health of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - T Torres
- Department of Dermatology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - R Epishev
- Department of Dermatology, Federal State Autonomous Institution, Scientific Center of Children's Health of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - A Chiriac
- Department of Dermatology, Nicolina Medical Center, P. Poni Institute of Macromolecular Chemistry, Romanian Academy, Iași, Romania
| | - T McPherson
- Department of Dermatology, Oxford University Hospitals NHS Trust, Oxford, UK
| | - M Akinde
- Department of Paediatric Dermatology, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A Maruani
- Unit of Pediatric Dermatology, Department of Dermatology, University of Tours and Nantes, INSERM 1246 SPHERE - CHRU Tours, Tours, France
| | - P C Luna
- Department of Dermatology, Hospital Alemán, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - H Vidaurri de la Cruz
- Servicio de Dermatología Pediátrica, Hospital General de México Dr. Eduardo Liceaga, Secretaría de Salud, Ciudad de México, Mexico
| | - S Mallet
- Department of Dermatology, Hôpital de la Timone, Assistance-Publique-Hôpitaux de Marseille, Marseille, France
| | - S Leducq
- Unit of Pediatric Dermatology, Department of Dermatology, University of Tours and Nantes, INSERM 1246 SPHERE - CHRU Tours, Tours, France
| | - M Sergeant
- Department of Dermatology, Hôpitaux de Brabois, Centre Hospitalier Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| | - J Zitouni
- Department of Dermatology, Hôpital Victor Dupouy, Argenteuil, France
| | - S K Mahil
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - C H Smith
- Department of Paediatric Dermatology, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - C Flohr
- Department of Dermatology, Oxford University Hospitals NHS Trust, Oxford, UK
| | - H Bachelez
- Department of Dermatology, Hôpital Saint-Louis, AP-HP, Paris, France
- Laboratory of Genetic Skin Diseases, INSERM U1163, Imagine Institute, Université de Paris, Paris, France
| | - E Mahé
- Department of Dermatology, Hôpital Victor Dupouy, Argenteuil, France
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7
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Hanafi B, Beauchet A, Di Lernia V, Lasek A, Severino-Freire M, Barbarot S, Hadj-Rabia S, Phan A, Bursztejn AC, Maruani A, Chaby G, Quiles-Tsimaratos N, Phan C, Zitouni J, Mazereeuw-Hautier J, Mahé E. Effectiveness of biologic therapies in children with palmoplantar plaque psoriasis: An analysis of real-life data from the BiPe cohorts. Pediatr Dermatol 2023; 40:835-840. [PMID: 37442765 DOI: 10.1111/pde.15393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/25/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Palmoplantar plaque psoriasis is a frequent clinical subtype of childhood psoriasis. This study evaluated the effectiveness of biologic therapies in children with palmoplantar plaque psoriasis using data from the two Biological treatments for Pediatric Psoriasis (BiPe) cohorts. METHODS Data for all 170 patients included in the BiPe cohorts were analyzed. Data on the effectiveness (PGA, PASI between baseline and 3 months of treatment) of biologic therapies were then compared between children with palmoplantar plaque psoriasis (n = 20) and those with generalized plaque psoriasis (n = 136). Clinical and demographic data were also analyzed. RESULTS Children in the palmoplantar group were more likely to be male (p = .04), with an earlier age of psoriasis onset (p < .001), and more frequent nail involvement (p < .001). After 3 months of biologic treatment, mean PGA scores were higher in the palmoplantar group than in the generalized plaque psoriasis group (p = .004). In the palmoplantar group, continuation rates were higher for adalimumab than for etanercept or ustekinumab (p = .01). Primary inefficacy was a more frequent reason for stopping biologic therapies in the palmoplantar group (p = .01), and disease remission was less frequent (p = .05). Combined systemic and biologic therapies were more frequently used in palmoplantar plaque psoriasis (p < .001). CONCLUSIONS This study demonstrated the treatment-resistant nature of palmoplantar plaque psoriasis and indicated that adalimumab could be the most effective biologic treatment. Larger studies are needed to allow therapeutic algorithms for palmoplantar plaque psoriasis to be proposed in pediatric psoriasis management guidelines.
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Affiliation(s)
- Bochra Hanafi
- Dermatology Department, Hôpital Victor Dupouy, Argenteuil, France
| | - Alain Beauchet
- Department of Public Health, Hôpital Raymond Poincaré, Garches, France
| | - Vito Di Lernia
- Dermatology Unit, Arcispedale S. Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Audrey Lasek
- Dermatology Department, Hôpital Saint Vincent de Paul, Université Catholique de Lille, Lille, France
| | - Maëlla Severino-Freire
- Dermatology Department, Centre de référence des maladies rares de la peau et des muqueuses, Hôpital Larrey, Toulouse, France
| | - Sébastien Barbarot
- Dermatology Department, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Smail Hadj-Rabia
- Dermatology Department, INSERM U1163 & Institut Imagine, Centre Hospitalier Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes-Sorbonne, Paris Cité, Paris, France
| | - Alice Phan
- Paediatric Department, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Bron, France
| | - Anne-Claire Bursztejn
- Dermatology Department, Hôpitaux de Brabois, Centre Hospitalier Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| | - Annabel Maruani
- Unit of Pediatric Dermatology, Department of Dermatology, University of Tours and Nantes, INSERM 1246 SPHERE-CHRU Tours, Tours, France
| | | | | | - Céline Phan
- Dermatology Department, Hôpital Victor Dupouy, Argenteuil, France
| | - Jinane Zitouni
- Dermatology Department, Hôpital Victor Dupouy, Argenteuil, France
| | - Juliette Mazereeuw-Hautier
- Dermatology Department, Centre de référence des maladies rares de la peau et des muqueuses, Hôpital Larrey, Toulouse, France
| | - Emmanuel Mahé
- Dermatology Department, Hôpital Victor Dupouy, Argenteuil, France
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8
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Mauguen C, Maruani A, Barbarot S, Abasq C, Martin L, Herbert J, Goronflot T, Gourraud PA, Happe A, Descatha A, Chrétien JM, Beuchée A, Adamski H, Dupuy A, Bouzillé G, Oger E, Droitcourt C. Factors associated with early relapse of infantile haemangioma in children treated for at least six months with oral propranolol: A case-control study using the 2014-2021 French Ouest DataHub. Ann Dermatol Venereol 2023; 150:189-194. [PMID: 37225615 DOI: 10.1016/j.annder.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/08/2022] [Accepted: 03/24/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND The factors associated with early relapse of infantile haemangioma (IH) after a first course of treatment with oral propranolol for at least six months (initiated after the marketing authorization had been granted) have not previously been investigated. OBJECTIVES To identify factors associated with the risk of early relapse in children with IH treated with oral propranolol according to the current prescribing guidelines. METHODS We performed a multicentre, retrospective, case-control study, using the Ouest Data Hub database. All children treated for at least 6 months with oral propranolol for IH between 31 June 2014 and 31 December 2021, and with a follow-up visit at least three months after treatment discontinuation were included. A case was defined as relapse of IH within three months of treatment discontinuation; each case was matched for age at treatment initiation and for centre, with four (relapse-free) controls. The association between relapse and treatment or IH characteristics was expressed as an odds ratio (OR) from univariate and multivariate conditional logistic regressions. RESULTS A total of 225 children were included. Of these, 36 (16%) relapsed early. In a multivariate analysis, a deep IH component was a risk factor for early relapse [OR = 8.93; 95%CI: 1.0-78.9, p = 0.05]. A propranolol dosage level of less than 3 mg/kg/day protected against early relapse [OR = 0.11; 95%CI: 0.02-0.7, p = 0.02]. Tapering before propranolol discontinuation was not associated with a lower risk of early relapse. CONCLUSION The risk factors for late and early relapse are probably different. Investigation of the risk factors for early vs. late IH relapse is now warranted.
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Affiliation(s)
- C Mauguen
- Department of Dermatology, CHU Rennes, 35000 Rennes, France.
| | - A Maruani
- University of Tours, INSERM 1246-SPHERE, Department of Dermatology, Tours University Hospital, F-37000 Tours, France; Dermatology Department and Reference Centre for Rare Diseases and Vascular Malformations (MAGEC), Tours University Hospital, 37000 Tours, France
| | - S Barbarot
- Department of Dermatology, CHU Nantes and INSERM CIC 004, 44000 Nantes, France
| | - C Abasq
- Department of Dermatology, Brest University Hospital, 29200 Brest, France
| | - L Martin
- Department of Dermatology, Angers University Hospital, 4, rue Larrey, 49933 Angers, France
| | - J Herbert
- Clinical Data Centre, Public Health and Prevention Unit, Tours University Hospital, 37044 Tours, France
| | - T Goronflot
- Nantes Université, CHU Nantes, Pôle Hospitalo-Universitaire 11: Santé Publique, Clinique des données, INSERM, CIC 1413, 44000 Nantes, France
| | - P-A Gourraud
- Nantes Université, CHU Nantes, Pôle Hospitalo-Universitaire 11: Santé Publique, Clinique des données, INSERM, CIC 1413, 44000 Nantes, France
| | - A Happe
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, 35000 Rennes, France
| | - A Descatha
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, 49000 Angers, France
| | - J-M Chrétien
- Clinical Research Department, Angers University Hospital, 49000 Angers, France
| | - A Beuchée
- Department of Neonatalogy, Rennes University Hospital, Rennes, France
| | - H Adamski
- Department of Dermatology, CHU Rennes, 35000 Rennes, France
| | - A Dupuy
- Department of Dermatology, CHU Rennes, 35000 Rennes, France; Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, 35000 Rennes, France
| | - G Bouzillé
- Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, 35000 Rennes, France
| | - E Oger
- Pharmacovigilance, Pharmacoepidemiology and Drug Information Centre, Department of Clinical Pharmacology, Rennes University Hospital, 35000 Rennes, France
| | - C Droitcourt
- Department of Dermatology, CHU Rennes, 35000 Rennes, France; Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, 35000 Rennes, France
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9
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Leducq S, Maruani A, Bodemer C, Biscardi S, Boccara O, Chinazzo MF, Mahé E, Plantin P, Fraitag S, Mazereeuw-Hautier J, Chiaverini C, Lemelle I, Bessis D, Bourrat E, Mallet S, Bonniaud B, Grall-Lerosey M, Martin L, Boralevi F, Piram M. Accurate diagnosis of acute hemorrhagic edema of infancy: a French multicenter observational study. Eur J Pediatr 2023; 182:4133-4141. [PMID: 37432503 DOI: 10.1007/s00431-023-05098-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/29/2023] [Accepted: 07/04/2023] [Indexed: 07/12/2023]
Abstract
The purpose of the study is to highlight clinical signs that are either suggestive of or against the diagnosis of AHEI to improve diagnosis and management. The medical records of children under 3 years old diagnosed with AHEI were retrospectively reviewed. Clinical data and photographs were reviewed by three independent experts, and the cases were classified as probable, doubtful, or unclear AHEI. Of the 69 cases of children diagnosed with AHEI included in 22 centers, 40 were classified as probable, 22 as doubtful, and 7 as unclear. The median age of patients with probable AHEI was 11 months [IQR 9-15], and they were in overall good condition (n = 33/40, 82.5%). The morphology of the purpura was targetoid in 75% of cases (n = 30/40) and ecchymotic in 70% of cases (n = 28/40) and affected mostly the legs (n = 39/40, 97%), the arms (n = 34/40, 85%), and the face (n = 33/40, 82.5%). Edema was observed in 95% of cases and affected mostly the hands (n = 36/38, 95%) and feet (n = 28/38, 74%). Pruritus was absent in all patients with probable AHEI and described for 6/21 with doubtful AHEI (29%). AHEI was the original diagnosis in only 24 patients (n = 24/40, 60%). The major differential diagnoses were purpura fulminans and urticaria multiforme. Conclusion: AHEI, which the diagnosis is made on clinical findings, is often misdiagnosed. Purpuric lesions localized on the face/ears, arms/forearms, and thighs/legs with edema of the hands without pruritus in a young child with a good overall condition are highly suggestive of AHEI. What is Known: •Acute hemorrhagic edema of infancy (AHEI) is a cutaneous leukocytoclastic vasculitis affecting children under 3 years old. •Appropriate diagnosis is important to distinguish this benign disease from more serious diseases to avoid investigations and treatments, iatrogenic harm and unnecessary follow-up. What is New: •AHEI is an uncommon disorder often misdiagnosed by pediatricians and dermatologists. •Purpuric lesions localized on the face/ears, arms/forearms, and thighs/legs with edema of the hands without pruritus in an infant with a good overall condition are highly suggestive of AHEI.
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Affiliation(s)
- Sophie Leducq
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), Unit of Pediatric Dermatology, CHRU Tours, Tours, France.
- Universities of Tours and Nantes, INSERM 1246-SPHERE, , Tours, France.
| | - Annabel Maruani
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), Unit of Pediatric Dermatology, CHRU Tours, Tours, France
- Universities of Tours and Nantes, INSERM 1246-SPHERE, , Tours, France
| | - Christine Bodemer
- Department of Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), APHP, Paris University, Necker-Enfants Malades Hospital, Paris Centre University, Imagine Institute, Paris, France
| | | | - Olivia Boccara
- Department of Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), APHP, Paris University, Necker-Enfants Malades Hospital, Paris Centre University, Imagine Institute, Paris, France
| | | | - Emmanuel Mahé
- Department of Dermatology, Hôpital Victor Dupouy, Argenteuil, France
| | | | - Sylvie Fraitag
- Pathology Department, Necker-Enfants Malades Hospital, APHP, Paris, France
| | | | | | - Irene Lemelle
- Paediatric Onco-Haematology, Brabois Hospital, University Hospital of Nancy, Vandoeuvre-Lès-Nancy, France
| | - Didier Bessis
- Department of Dermatology, University Hospital of Montpellier, Montpellier, France
| | - Emmanuelle Bourrat
- Department of General Pediatrics, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Stéphanie Mallet
- Department of Dermatology, Hôpital Timone, Aix-Marseille Université, Marseille, France
| | - Bertille Bonniaud
- Department of Dermatology and Genetics of Developmental Anomalies, UMR Inserm 1231, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079, Dijon, France
| | | | | | - Franck Boralevi
- Pediatric Dermatology Unit, Hôpital Pellegrin-Enfants, CHU de Bordeaux, France
| | - Maryam Piram
- Department of Pediatrics, CHU Sainte Justine Research Centre, Sainte Justine University Hospital, University of Montreal, Montreal, QC, Canada
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Allemang-Trivalle A, Leducq S, Maruani A, Giraudeau B. Designs used in published therapeutic studies of rare superficial vascular anomalies: a systematic literature search. BMC Med Res Methodol 2023; 23:196. [PMID: 37648985 PMCID: PMC10466846 DOI: 10.1186/s12874-023-02017-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 08/09/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Rare superficial vascular anomalies represent a wide range of diseases. Their management is difficult given the broad spectrum and the lack of clinical trials assessing treatment efficacy. A randomized clinical trial of vascular anomalies is difficult because of the rarity of the diseases and is enhanced by the population of interest often being children. Therefore, suitable designs are needed. We conducted a methodological systematic literature search to identify designs implemented for investigating the treatment of rare superficial vascular anomalies. METHODS We conducted a literature search on January 25, 2021, of the PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, ClinicalTrials.gov and European Union Clinical Trials Register databases. This systematic methodological literature search was registered at the Prospective Register of Systematic Reviews (PROSPERO: CRD42021232449). Randomized and non-randomized studies were included if they met the following criteria: were prospective studies of rare superficial vascular anomaly therapies, dealt with humans (adults and children) and were published in English from 2000. We excluded case reports/case series reporting fewer than 10 patients, reviews, retrospective studies, animal studies, studies of systemic or common vascular anomalies and non-therapeutic studies. We did not assess risk of bias in the included studies because our review was a methodological one focused on the design used. The review provided a descriptive analysis of relevant features of eligible research studies. RESULTS From 2046 articles identified, we included 97 studies (62 reports and 35 ongoing studies): 25 randomized controlled studies, 7 non-randomized comparative studies, 64 prospective cohorts and 1 case series. Among the 32 comparative studies included, 21 used a parallel-group design. The 11 other studies used different designs such as cross-over, randomized placebo phase, delayed-start, within-person, or challenge-dechallenge-rechallenge or used a historical control group or an observational run-in period. CONCLUSIONS Our systematic literature search highlights the lack of randomized control trials in superficial vascular anomalies due to the rarity of patients and their heterogeneity. New designs are emerging and can overcome the limitations of testing treatments in parallel groups.
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Affiliation(s)
- Aude Allemang-Trivalle
- Université de Tours, Université de Nantes, INSERM, SPHERE U1246, Tours, France.
- INSERM CIC1415, CHRU de Tours, Tours, France.
| | - Sophie Leducq
- Université de Tours, Université de Nantes, INSERM, SPHERE U1246, Tours, France
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (Maladies Génétiques rares à Expression Cutanée-Tours), CHRU de Tours, Tours, France
| | - Annabel Maruani
- Université de Tours, Université de Nantes, INSERM, SPHERE U1246, Tours, France
- INSERM CIC1415, CHRU de Tours, Tours, France
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (Maladies Génétiques rares à Expression Cutanée-Tours), CHRU de Tours, Tours, France
| | - Bruno Giraudeau
- Université de Tours, Université de Nantes, INSERM, SPHERE U1246, Tours, France
- INSERM CIC1415, CHRU de Tours, Tours, France
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11
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Orly J, Bisdorff A, Fraissenon A, Joly A, Boulouis G, Guibaud L, Tavernier E, Mallet S, Marcelin C, Miquel J, Martin L, Droitcourt C, Gusdorf L, Abasq C, Dadban A, Chiaverini C, Vabres P, Herbreteau D, Boccara O, Wassef M, Maruani A. Intramuscular capillary-type hemangioma: Diagnosis, treatment, and outcomes. A French multicentric retrospective study of 66 cases. Eur J Radiol 2023; 165:110962. [PMID: 37423018 DOI: 10.1016/j.ejrad.2023.110962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 07/02/2023] [Accepted: 07/03/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE Intramuscular capillary-type hemangiomas (ICTHs) are rare entities, belonging to the group of intramuscular "hemangiomas." The diagnosis remains challenging. We aimed to assess the diagnostic criteria, treatments and outcomes of ICTHs. METHODS This retrospective study collected all cases of ICTH followed up in 9 French hospital centers, reviewed by an adjudication expert group. RESULTS Among 133 patients screened, 66 with ICTH were included. The median age of patients at diagnosis was 28.0 years, interquartile range (21.0---36.0). The lesion, mainly presenting as a gradually increasing mass (83.9%), was painless (88.9%) and was located in the head and neck (42.4%). MRI (available in all cases) mainly revealed a well-delineated lesion, isointense to the muscle on T1-weighted images, with enhancement after contrast injection; hyperintense on T2-weighted images; and containing flow voids. Among the 66 cases, 59 exhibited typical ICTH features and 7 shared some imaging features with arteriovenous malformations. These latter were larger than typical ICTHs and more painful and appeared on imaging as less well delimited and more heterogeneous tissue masses, with larger tortuous afferent arteries, earlier draining vein opacification and mild arteriovenous shunting. We propose to name these lesions arteriovenous malformation (AVM)-like ICTH. Pathological reports were similar in typical and AVM-like ICTH, showing capillary proliferation with mainly small-size vessels, negative for GLUT-1 and positive for ERG, AML, CD31 and CD34, with low Ki67 proliferation index (<10%), and adipose tissue. The most frequent treatment for ICTH was complete surgical resection (17/47, 36.2%), preceded in some cases by embolization, which led to complete remission. CONCLUSIONS ICTH can be diagnosed on MRI when it is typical. Biopsy or angiography are required for atypical forms.
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Affiliation(s)
- Jordan Orly
- CHRU Tours, Department of Dermatology, Unit of Pediatric Dermatology, Tours, France; Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Tours), Tours, France
| | - Annouk Bisdorff
- Reference Center for Vascular Anomalies FAVA-multi, University Hospital of Lariboisière, Coordinator of the Constitutive Center for Superficial Arteriovenous Malformations in Children and Adults, AP-HP, Department of Neuroradiology, Paris, France
| | - Antoine Fraissenon
- Service d'Imagerie, Consultation Multidisciplinaire des Angiomes, Centre de Compétence National Malformations Vasculaires Superficielles, Hôpital Femme Mère Enfant, Université Claude Bernard Lyon 1, Lyon-Bron, France; Service de Radiologie Mère-Enfant, Hôpital Nord, Saint-Etienne, France; CREATIS, UMR 5220, U1294 Lyon, France
| | - Aline Joly
- Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Tours), Tours, France; CHRU Tours, Department of Maxillo-facial Surgery, Tours, France
| | - Grégoire Boulouis
- Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Tours), Tours, France; CHRU Tours, Department of Neuroradiology and Interventional Radiology, Tours, France
| | - Laurent Guibaud
- Service d'Imagerie, Consultation Multidisciplinaire des Angiomes, Centre de Compétence National Malformations Vasculaires Superficielles, Hôpital Femme Mère Enfant, Université Claude Bernard Lyon 1, Lyon-Bron, France
| | - Elsa Tavernier
- University of Tours, University of Nantes, INSERM 1246-SPHERE, Tours, France; CHRU Tours, Clinical Investigation Center INSERM 1415, Tours, France
| | - Stéphanie Mallet
- University Hospital Center of Marseille, Department of Dermatology, Marseille, France
| | - Clément Marcelin
- University Hospital Center of Bordeaux, Department of Radiology, Bordeaux, France
| | - Juliette Miquel
- University Hospital Center of La Réunion, Department of Pediatric Dermatology, Saint-Pierre, La Réunion, France
| | - Ludovic Martin
- University Hospital Center of Angers, Department of Dermatology, Angers, France
| | | | - Laurence Gusdorf
- University Hospital Center of Reims, Department of Dermatology, Reims, France
| | - Claire Abasq
- University Hospital Center of Brest, Department of Dermatology, Brest, France
| | - Ali Dadban
- University Hospital Center of Amiens, Department of Dermatology, Amiens, France
| | | | - Pierre Vabres
- University of Bourgogne, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Dijon, France
| | - Denis Herbreteau
- Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Tours), Tours, France; CHRU Tours, Department of Neuroradiology and Interventional Radiology, Tours, France
| | - Olivia Boccara
- Department of Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Necker), University Hospital Necker-Enfants Malades, Paris, France
| | - Michel Wassef
- University Hospital of Lariboisière, AP-HP, Department of Pathology, Paris, France
| | - Annabel Maruani
- CHRU Tours, Department of Dermatology, Unit of Pediatric Dermatology, Tours, France; Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Tours), Tours, France; University of Tours, University of Nantes, INSERM 1246-SPHERE, Tours, France.
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12
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Schachner LA, Blume-Peytavi U, Andriessen A, Izakovic J, Maruani A, Micali G, Murashkin N, Salavastru C, Torrelo A. Algorithm to attenuate atopic dermatitis and for promoting a healthy skin barrier using skincare in newborns and infants. Ital J Dermatol Venerol 2023; 158:224-235. [PMID: 37278500 DOI: 10.23736/s2784-8671.23.07336-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The human skin barrier is structurally and functionally immature at birth, with elevated skin surface pH, lower lipid content, and lower resistance to chemicals and pathogens. Infants at risk for atopic dermatitis (AD) may present with xerosis almost immediately after birth. The current algorithm on skincare for newborns and infants aims to promote a healthy skin barrier and potential mitigation of AD. The project used a modified Delphi hybrid process comprising face-to-face discussions followed by an online follow-up replacing a questionnaire. During the meeting, a panel of eight clinicians who treat newborns and infants discussed the systematic literature review results and a draft algorithm addressing non-prescription skincare for neonates and infants. Online the panel reviewed and adopted the algorithm using evidence coupled with the panel's expert opinion and clinical experience. The algorithm provides clinical information for pediatric dermatologists, dermatologists, and pediatric healthcare providers treating neonates and infants. The advisors adopted a scale based on clinical signs for the algorithm: 1) scaling/xerosis; 2) erythema; and 3) erosion/oozing. Skincare for newborns and infants includes: aim for a cool environment and soft cotton clothing, give lukewarm baths (~5 min, 2-3 x week) with consideration of a gentle cleanser (pH 4-6) and the application of a full-body moisturizing after bath, while avoiding products with toxic and irritating ingredients. A growing body of evidence recognizes the benefits of ongoing daily use of non-alkaline cleansers and moisturizers. Gentle cleansers and moisturizers containing barrier lipids help maintain the protective skin barrier when applied from birth onwards.
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Affiliation(s)
- Lawrence A Schachner
- Department of Pediatric Dermatology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ulrike Blume-Peytavi
- Department of Dermatology and Allergology, Clinical Research Center of Hair and Skin Science, Charité-Universitatsmedizin, Berlin, Germany
| | - Anneke Andriessen
- Radboud Academy, Radboud UMC Nijmegen, Andriessen Consultants, Malden, the Netherlands -
| | - Jan Izakovic
- Department of Dermatology, Miller School of Medicine, University of Miami, Miami, FL, USA
- Department of Pediatric Dermatology, Basel University Children's Hospital (UKBB), Basel, Switzerland
- Private Practitioner, Basel, Switzerland
| | - Annabel Maruani
- Unit of Pediatric Dermatology, Department of Dermatology, University Hospital Center of Tours, Tours, France
| | | | - Nikolay Murashkin
- FGAU National Medical Research Center of Children's Health of the Ministry of Health of Russia, Moscow, Russia
- Sechenov First Moscow State Medical University, Moscow, Russia
- Central State Medical Academy of the Presidential Administration of the Russian Federation, Moscow, Russia
| | - Carmen Salavastru
- Department of Pediatric Dermatology, Colentina Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Antonio Torrelo
- Department of Dermatology, Niño Jesús Children University Hospital, Madrid, Spain
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van Eeghen AM, Stemkens D, Fernández-Fructuoso JR, Maruani A, Hadzsiev K, Gaasterland CMW, Klein Haneveld MJ, Vyshka K, Hugon A, van Eeghen AM, van Balkom IDC. Consensus recommendations on organization of care for individuals with Phelan-McDermid syndrome. Eur J Med Genet 2023:104747. [PMID: 37003574 DOI: 10.1016/j.ejmg.2023.104747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 03/05/2023] [Accepted: 03/18/2023] [Indexed: 04/03/2023]
Abstract
The manifestations of Phelan-McDermid syndrome (PMS) are complex, warranting expert and multidisciplinary care in all life stages. In the present paper we propose consensus recommendations on the organization of care for individuals with PMS. We indicate that care should consider all life domains, which can be done within the framework of the International Classification of Functioning, Disability and Health (ICF). This framework assesses disability and functioning as the outcome of the individual's interactions with other factors. The different roles within care, such as performed by a centre of expertise, by regional health care providers and by a coordinating physician are addressed. A surveillance scheme and emergency card is provided and disciplines participating in a multidisciplinary team for PMS are described. Additionally, recommendations are provided for transition from paediatric to adult care. This care proposition may also be useful for individuals with other rare genetic neurodevelopmental disorders.
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Affiliation(s)
- A M van Eeghen
- Emma Center for Personalized Medicine, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, Netherlands; Advisium, 's Heeren Loo, Amersfoort, Netherlands.
| | - D Stemkens
- VSOP - National Patient Alliance for Rare and Genetic Diseases, Soest, the Netherlands
| | | | - A Maruani
- Excellence Center for Autism Spectrum & Neurodevelopmental Disorders, Inovand, Child and Adolescent Psychiatry Department, Hôpital Robert Debre, APHP, Paris, France; CRMR DICR, Rare Disease Center for Intellectual Disabilities, Defiscience, France
| | - K Hadzsiev
- Department of Medical Genetics, Medical School, University of Pécs, Pécs, Hungary
| | - C M W Gaasterland
- Emma Center for Personalized Medicine, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - M J Klein Haneveld
- Emma Center for Personalized Medicine, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Klea Vyshka
- University Hospital Robert Debre, Paris, France
| | - A Hugon
- University Hospital Robert Debre, Paris, France
| | - A M van Eeghen
- Emma Center for Personalized Medicine, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, Netherlands; Advisium, 's Heeren Loo, Amersfoort, Netherlands
| | - I D C van Balkom
- Jonx, Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, Netherlands; Rob Giel Research Centre, Department of Psychiatry, University Medical Center Groningen, Groningen, Netherlands
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14
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Leducq S, Dugard A, Allemang-Trivalle A, Giraudeau B, Maruani A. Design and Methodological Issues of Within-Person (Split-Body) Randomized Controlled Trials Evaluating a Topical Treatment: A Systematic Review. Dermatology 2023; 239:720-731. [PMID: 36990057 DOI: 10.1159/000530149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/06/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Topical drugs are often used as first-line treatment for dermatological conditions. A within-person design may then be well adapted: it consists of randomizing lesions/body sites rather than patients, which are then concomitantly treated by the different drugs compared, reducing inter-group variability and therefore requiring fewer patients than the classical parallel-group trial. OBJECTIVES The aim of this review was to provide a methodological overview of within-person randomized trials (WP-RCTs) in dermatology. METHODS We searched for eligible trials published between 2017 and 2021 in MEDLINE, Embase, and Central in dermatology journals and the 6 highest-impact-factor general medical journals. Two authors selected publications and extracted data independently. RESULTS From 1,034 articles identified, we included 54 WP-RCTs, mainly for acne vulgaris, psoriasis, actinic keratosis, and atopic dermatitis. In most of the trials, patients had only 2 lesions/body sites. In none of the trials, did we detect a potential carry-across effect (known to be the major methodological problem in WP-RCTs). Twelve studies reported a care provider applying the treatment, and in 26 studies, the patients themselves applied the treatment. Finally, we also highlight statistical issues for the statistical analysis: overall, 14 (26.9%) studies used a test for independent observations, thus ignoring the between-lesion correlation. CONCLUSION Our systematic review highlights that despite the publication of the CONSORT checklist extension for WP-RCTs in 2017, this design is rarely used, and when it is, there are methodological and reporting concerns.
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Affiliation(s)
- Sophie Leducq
- Université de Tours, Université de Nantes, INSERM, SPHERE U1246, Tours, France
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), CHRU Tours, Tours, France
| | - Amandine Dugard
- Université de Tours, Université de Nantes, INSERM, SPHERE U1246, Tours, France
| | | | - Bruno Giraudeau
- Université de Tours, Université de Nantes, INSERM, SPHERE U1246, Tours, France
- INSERM CIC 1415, Tours, France
| | - Annabel Maruani
- Université de Tours, Université de Nantes, INSERM, SPHERE U1246, Tours, France
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), CHRU Tours, Tours, France
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15
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Godeau M, Shourick J, Dreyfus I, Casassa É, Bergeron A, Severino-Freire M, Granier Tournier C, Malloizel-Delaunay J, Boccara O, Aubert H, Maruani A, Chiaverini C, Labrèze C, Mazereeuw-Hautier J. cLFM‐Qol
: a specific quality of life measurement tool for children from 11 to 15 years with low‐flow malformations. J Eur Acad Dermatol Venereol 2023. [PMID: 36972023 DOI: 10.1111/jdv.19061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 03/08/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Low-flow malformations (LFMs) are rare diseases with a significant impact on health-related quality of life (HRQoL), especially in children. No disease-specific questionnaire is available for children with LFMs. OBJECTIVE To develop and validate a specific HRQoL questionnaire for children from 11 to 15 years old suffering from LFMs. METHODS A preliminary questionnaire based on a verbatim from focus groups was created and sent to children from 11 to 15 years old suffering from LFMs, together with a dermatology specific and a generic HRQoL questionnaire (cDLQI and EQ-5D-Y). RESULTS A total of 75 from 201 included children responded to the questionnaires. The final version of the questionnaire (cLFM-QoL) included 15 questions and was not divisible into subscales. It demonstrated excellent internal consistency (cronbach 0.89), convergent validity and readability (SMOG 6.04). cLFM-QoL mean score (+ SD) was 12.9/45 (8.03) for all grades of severity, for mild 8.22/45 (7.5), moderate 14.03/45 (8.35), severe 12.35/45 (6.59) or very severe patients 20.7/45 (3.39) (p 0.006). CONCLUSION cLFM-QoL is a validated short and easy to use specific questionnaire with excellent psychometric capacities. It will be suitable for any children 11 to 15 with LFMs, in daily practice or clinical trials.
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Affiliation(s)
- Marion Godeau
- Reference Center for Rare Skin Diseases, Dermatology Department, CHU toulouse, Paul Sabatier University, Occitanie, Toulouse, France
| | - Jason Shourick
- Pôle santé publique et médecine sociale, Epidemiology Department, CHU Toulouse, Faculté de médecine de Purpan, Occitanie, Toulouse, France
| | - Isabelle Dreyfus
- Reference Center for Rare Skin Diseases, Dermatology Department, CHU toulouse, Paul Sabatier University, Occitanie, Toulouse, France
| | - Éline Casassa
- Reference Center for Rare Skin Diseases, Dermatology Department, CHU toulouse, Paul Sabatier University, Occitanie, Toulouse, France
| | - Anaïs Bergeron
- Centre d'Etudes et de Recherches en Psychopathologie et psychologie de la Santé, Psychopathology Department, Toulouse II Jean Jaurès University, Occitanie, Toulouse, France
| | - Maella Severino-Freire
- Reference Center for Rare Skin Diseases, Dermatology Department, CHU toulouse, Paul Sabatier University, Occitanie, Toulouse, France
| | - Céline Granier Tournier
- Reference Center for Rare Skin Diseases, Dermatology Department, CHU toulouse, Paul Sabatier University, Occitanie, Toulouse, France
| | | | - Olivia Boccara
- Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Dermatology Department, Necker-Enfants Malades Hospitals, Île-de-France, Paris, France
| | - Hélène Aubert
- Dermatology Derpartment, CHU Nantes, Nantes, Pays de la Loire, France
| | - Annabel Maruani
- Dermatology Department, CHRU Tours, François Rabelais University, Centre, Tours, France
| | - Christine Chiaverini
- Dermatology Department, CHU Nice, Archet 2 Hospital, Provence-Alpes-Côte d'Azu, Nice, France
| | - Christine Labrèze
- Pediatric Dermatology Unit, CHU Bordeaux, Pellegrin children's Hospital, Aquitaine, Bordeaux, France
| | - Juliette Mazereeuw-Hautier
- Reference Center for Rare Skin Diseases, Dermatology Department, CHU toulouse, Paul Sabatier University, Occitanie, Toulouse, France
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16
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Orly J, Bisdorff A, Joly A, Edee AE, Tavernier E, Herbreteau D, Boccara O, Wassef M, Maruani A. Characteristics, Natural Course and Treatment of Intramuscular Capillary-type Haemangioma: A Systematic Literature Review. Acta Derm Venereol 2023; 103:adv00893. [PMID: 36939537 PMCID: PMC10041649 DOI: 10.2340/actadv.v103.4432] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 11/29/2022] [Indexed: 03/21/2023] Open
Abstract
Intramuscular capillary-type haemangiomas (ICTH) are rare vascular anomalies that can easily be misdiagnosed as other entities. A systematic review was performed of all cases of ICTH in the literature since its first description in 1972. An adjudication committee reviewed cases to include only ICTHs. Among 1,143 reports screened, 43 were included, involving 75 patients. The most frequent differential diagnosis was intramuscular venous malformations. The mean age of patients at diagnosis was 21.2 years. ICTH was mainly described as a gradually increasing mass (81.8%), painless (73.9%), that could occur anywhere in the body but most frequently on the head and neck (44.0%). Magnetic resonance imaging (MRI) was mainly used for diagnosis (69.1%) and displayed specific features. The most frequent treatment was complete surgical removal (73.9%), which could be preceded by embolization, and led to complete remission without recurrence in all but 1 case.
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Affiliation(s)
- Jordan Orly
- CHRU Tours, Department of Dermatology, Unit of Pediatric dermatology, Tours, France; Reference center for genodermatoses and rare skin diseases (MAGEC-Tours), Tours.
| | - Annouk Bisdorff
- 3Reference center for vascular anomalies FAVA-multi, University Hospital of Lariboisière; Coordinator of the constitutive center for superficial arteriovenous malformations in children and adults; AP-HP, Department of Neuroradiology, Paris, France
| | - Aline Joly
- Reference center for genodermatoses and rare skin diseases (MAGEC-Tours), Tours, France; Reference center for vascular anomalies FAVA-multi, University Hospital of Lariboisière; Coordinator of the constitutive center for superficial arteriovenous malformations in children and adults; AP-HP, Department of Neuroradiology, Paris, France; CHRU Tours, Department of Maxillo-facial surgery, Tours, France
| | - Afi-Emiliène Edee
- Reference center for genodermatoses and rare skin diseases (MAGEC-Tours), Tours, France
| | - Elsa Tavernier
- University of Tours, University of Nantes, INSERM 1246-SPHERE, Tours, France; CHRU Tours, Clinical Investigation Center INSERM 1415, Tours, France
| | | | - Olivia Boccara
- Department of Dermatology and Reference center for genodermatoses and rare skin diseases (MAGEC-Necker), University Hospital Necker-Enfants Malades, Paris, France
| | - Michel Wassef
- Department of Pathology, University Hospital of Lariboisière, AP-HP, Paris, France
| | - Annabel Maruani
- CHRU Tours, Department of Dermatology, Unit of Pediatric dermatology, Tours, France; Reference center for genodermatoses and rare skin diseases (MAGEC-Tours), Tours, France; University of Tours, University of Nantes, INSERM 1246-SPHERE, Tours, France
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Albert M, Maruani A, Leducq S. Clinical Manifestations and Management of Pediatric Granuloma Annulare: A Systematic Review. J Pediatr 2023:113392. [PMID: 36948386 DOI: 10.1016/j.jpeds.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 02/19/2023] [Accepted: 03/02/2023] [Indexed: 03/24/2023]
Abstract
OBJECTIVE To determine the clinical manifestations, management, and outcomes of pediatric granuloma annulare. STUDY DESIGN We searched MEDLINE via PubMed, Latin American and Caribbean Health Sciences (LILACS), and EMBASE from inception to January 2021. We included all original reports of patients < 18 years of age with a diagnosis of GA and all original reports describing any intervention, including topical or systemic agents, in these patients. Two authors independently extracted socio-demographics and clinical data of the study patients, and treatment(s) used. RESULTS Of 2,440 reports screened, 202 were included (836 patients). The mean age was 5.7 (SD 3.8) years and F:M ratio 1.3:1. Localized GA (n=384, 46.8%) and subcutaneous GA (n=353, 43.0%) were the most prevalent subtypes. The most affected site was lower limbs (n=272/568, 47.9%). Suspected triggering factors were mainly local trauma. Diabetes was associated in 22 (2.6%) patients. The rate of spontaneous remission was high (n=140/155, 90.3%), with a median time of 12 months. The most frequent therapies were surgery and topical corticosteroids. Recurrence was observed in 38.3% (n=168/439) of patients, regardless of treatment. CONCLUSIONS Pediatric GA frequently resolves spontaneously yet displays a high recurrence rate. Hence, in asymptomatic forms, invasive therapies are not recommended as first-line treatment.
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Affiliation(s)
- Marie Albert
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), CHRU Tours, Tours, France; Unit of Pediatric Dermatology, CHRU Tours, Tours, France
| | - Annabel Maruani
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), CHRU Tours, Tours, France; Unit of Pediatric Dermatology, CHRU Tours, Tours, France; Universities of Tours and Nantes, INSERM 1246-SPHERE, 37000 Tours, France
| | - Sophie Leducq
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), CHRU Tours, Tours, France; Unit of Pediatric Dermatology, CHRU Tours, Tours, France; Universities of Tours and Nantes, INSERM 1246-SPHERE, 37000 Tours, France.
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Tabet A, Mahé E, Boralevi F, Maruani A, Hesse S, Gentile S, Mallet S. Herpes zoster in children during the COVID-19 pandemic in France: A retrospective multicenter observational study. Ann Dermatol Venereol 2023; 150:46-48. [PMID: 36813638 PMCID: PMC9940797 DOI: 10.1016/j.annder.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 05/21/2022] [Accepted: 08/30/2022] [Indexed: 02/22/2023]
Affiliation(s)
- A Tabet
- APHM, Aix-Marseille Université, 27, boulevard Jean-Moulin, 13385 Marseille, France.
| | - E Mahé
- Service de Dermatologie, CH Victor Dupouy, 69 Rue du Lieutenant-Colonel Prudhon, 95107 Argenteuil, France
| | - F Boralevi
- Université de Bordeaux, Unité de Dermatologie Pédiatrique, CHU Pellegrin Enfants, place Amélie Raba Léon, 33000 Bordeaux, France
| | - A Maruani
- Universités de Tours et Nantes, SPHERE-INSERM 1246, Service de Dermatologie et Unité de Dermatologie Pédiatrique, CHRU de Tours, 37044 Tours Cedex 9, France
| | - S Hesse
- Aix-Marseille Université, Service de Dermatologie, CHU Timone, 264 Rue Saint-Pierre, 13005 Marseille, France
| | - S Gentile
- Aix-Marseille Université, School of Medicine, La Timone, EA 3279: CEReSS - Health Service Research and Quality of Life Center, Service d'Evaluation Médicale, CHU Conception, 147 boulevard Baille, 13005 Marseille, France
| | - S Mallet
- Aix-Marseille Université, Service de Dermatologie, CHU Timone, 264 Rue Saint-Pierre, 13005 Marseille, France
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Mahé E, Werner A, Cret L, Salinier C, Guellich A, Maruani A, Assathiany R. Therapeutic inertia during isotretinoin treatment of juvenile acne by dermatologists, paediatricians and general practitioners. Ann Dermatol Venereol 2023; 150:39-45. [PMID: 36642678 DOI: 10.1016/j.annder.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 09/28/2022] [Accepted: 11/08/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Isotretinoin is an effective treatment for severe juvenile acne, but it appears to be underused in relation to the recommendations. Therapeutic inertia is defined as a failure to initiate or intensify treatment even when warranted by the recommendations. The aim of this study was to investigate therapeutic inertia among dermatologists (D), paediatricians (P), and general practitioners (GPs) in initiating isotretinoin for moderate-to-very severe juvenile acne. METHODS Data were collected using a questionnaire distributed to French physicians through medical societies via Internet. The questions explored the role in inertia of factors related to physicians, patients, parents, and the healthcare system, and evaluated barriers and facilitators to prescribing isotretinoin. RESULTS In all, 768 physicians responded to the survey (528 D, 178P, and 61 GPs; mean age: 51 years; women: 78 %). Their responses revealed that 99 % of dermatologists felt comfortable prescribing isotretinoin, compared with 8 % and 15 % of paediatricians and GPs (p < 0.05); 93 % of dermatologists were aware of the current guidelines compared with 37 % of paediatricians and GPs. Under 50 % of the physicians had received training on acne in the previous 3 years, regardless of specialty. The most frequently identified factors for inertia were concerns over the psychological consequences of the treatment in adolescents, exclusive requests from parents, and patient unavailability. Paediatricians reported having insufficient knowledge of current recommendations, a lack of training, and a tendency to anticipate poor compliance. Paediatricians and GPs considered that access to first-time prescriptions and peer-to-peer exchanges would constitute facilitating factors in their use of isotretinoin. DISCUSSION Concerns over the psychiatric consequences of isotretinoin in adolescents, the need for frequent follow-up, and lack of continuing medical education were identified as factors favouring inertia in the initiation of isotretinoin treatment in patients with moderate-to-very severe juvenile acne, particularly among paediatricians and GPs. Potential strategies to overcome these barriers include regular training, simplified recommendations in French, and access to first-time prescription for paediatricians and GPs.
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Affiliation(s)
- E Mahé
- Service de dermatologie et médecine vasculaire, Hôpital Victor-Dupouy, 69 rue du Lieutenant-Colonel-Prud'hon, 95107 Argenteuil, France.
| | - A Werner
- AFPA, 30 rue Emile Zola, 45000 Orléans, France
| | - L Cret
- AFPA, 30 rue Emile Zola, 45000 Orléans, France
| | - C Salinier
- AFPA, 30 rue Emile Zola, 45000 Orléans, France
| | - A Guellich
- Service de dermatologie et médecine vasculaire, Hôpital Victor-Dupouy, 69 rue du Lieutenant-Colonel-Prud'hon, 95107 Argenteuil, France
| | - A Maruani
- Service de dermatologie, Unité de dermatologie pédiatrique, Université de Tours et Nantes, INSERM 1246 SPHERE - CHRU Tours, 2 Boulevard Tonnellé, 37044 Tours, France
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Maruani A, Moineau AG, Boccara O, Mazereeuw-Hautier J, Leducq S, Bessis D, Guibaud L, Vabres P, Mallet S, Barbarot S, Chiaverini C, Droitcourt C, Bursztejn AC, Lengelle C, Woillard JB, Herbreteau D, Le Touze A, Binet A, Morel B, Bourgoin H, Gissot V, Giraudeau B, Gruel Y, Tavernier E, Rollin J. Vascular endothelial growth factor, tissue factor, coagulation and fibrinolysis markers in slow-flow vascular malformations: a prospective study of treatment with sirolimus. Br J Dermatol 2023; 188:152-154. [PMID: 36689523 DOI: 10.1093/bjd/ljac028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 09/21/2022] [Accepted: 09/24/2022] [Indexed: 01/22/2023]
Abstract
Slow-flow vascular malformations (VMs), especially those with venous components, can be complicated by localized intravascular coagulopathy (LIC), responsible for pain and impaired quality of life. Several studies have shown the effectiveness of mTOR inhibitors (especially sirolimus) on slow-flow VMs but its effect on coagulation has been poorly studied, especially in children. Our study shows that venous and combined VMs are associated with coagulation abnormalities and provides novel evidence that sirolimus improves coagulopathy in venous malformations. However we did not clearly evidence predictive biomarkers of response to sirolimus but this is the first study attempting to highlight predictive markers of response to sirolimus.
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Affiliation(s)
- Annabel Maruani
- University of Tours, University of Nantes, INSERM, SPHERE U1246, Tours, France
- CHRU Tours, Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Tours), Tours, France
| | - Anne-Guillemette Moineau
- CHRU Tours, Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC-Tours), Tours, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jérôme Rollin
- University of Tours, CHRU Tours, Department of Hemostasis, Tours, France
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21
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Herbreteau JB, Tavernier E, Joly A, Marchand A, Édée AÉ, Tauveron V, Maruani A. Traditional healers or bonesetters ("rebouteux") in France: A survey of their practice, profile, and customers. Ann Dermatol Venereol 2023:S0151-9638(22)00120-X. [PMID: 36653226 DOI: 10.1016/j.annder.2022.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/18/2022] [Accepted: 11/17/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND In France, many people consult "bonesetters" for several medical reasons. Little is known about them. We aimed to investigate the practices of traditional healers in France as well as their profile and that of their customers. METHODS This was a survey carried out in Metropolitan France. A 33-item questionnaire developed by a multidisciplinary group was sent to a sample of 148 traditional healers found on the Internet and by word of mouth. RESULTS Of the 148 questionnaires sent, 89 (60.1 %) were returned and 67 (45.3 %) were analyzed: 51.5 % (n = 34) of respondents were men, and the mean (±standard deviation) age was 51.6 ± 11.6 years. The respondents considered that they had received a gift of healing and were mainly magnetic healers (68.2 %). They became aware of this gift at a mean age of 19.9 ± 14.1 years. The traditional healers practiced mainly in rural areas (54.5 %), at home (59.1 %), and used their hands to transmit energy (95.5 %). They advertised their practice mainly by word of mouth (89.4 %) and had a predominantly female clientele (78.1 %). Various diseases were treated, with the most frequent being subjective complaints (pain, stress, fatigue, insomnia) and dermatological complaints (eczema, accidental and post-herpes-zoster burns, psoriasis, and warts). Most respondents considered their activities to be complementary to conventional medicine, and 10.9 % considered them more effective. Some indicated that they did not consider themselves "healers" but rather "providers of relief". DISCUSSION The results of this survey provide a better understanding of this network of local care that revolves around medicine.
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Affiliation(s)
| | - E Tavernier
- Universités de Tours et Nantes, INSERM 1246-SPHERE, 37000 Tours, France; Centre Hospitalier Régional Universitaire de Tours, Centre d'Investigation Clinique 1415, 37000 Tours, France
| | - A Joly
- Centre Hospitalier Régional Universitaire de Tours, Service de Chirurgie Maxillo-Faciale et chirurgie plastique et brulés, 37044 Tours Cedex 9, France
| | - A Marchand
- Centre Hospitalier Régional Universitaire de Tours, Service de Dermatologie, Unité de Dermatologie Pédiatrique, 37044 Tours Cedex 9, France
| | - A-É Édée
- Centre Hospitalier Régional Universitaire de Tours, Service de Dermatologie, Unité de Dermatologie Pédiatrique, 37044 Tours Cedex 9, France
| | - V Tauveron
- Centre Hospitalier Régional Universitaire de Tours, Service de Dermatologie, Unité de Dermatologie Pédiatrique, 37044 Tours Cedex 9, France
| | - A Maruani
- Universités de Tours et Nantes, INSERM 1246-SPHERE, 37000 Tours, France; Centre Hospitalier Régional Universitaire de Tours, Service de Dermatologie, Unité de Dermatologie Pédiatrique, 37044 Tours Cedex 9, France.
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Leboulanger N, Bisdorff A, Boccara O, Dompmartin A, Guibaud L, Labreze C, Lagier J, Lebrun-Vignes B, Herbreteau D, Joly A, Malloizel-Delaunay J, Martel A, Munck S, Saint-Aubin F, Maruani A. French national diagnosis and care protocol (PNDS, protocole national de diagnostic et de soins): cystic lymphatic malformations. Orphanet J Rare Dis 2023; 18:10. [PMID: 36639640 PMCID: PMC9837920 DOI: 10.1186/s13023-022-02608-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 12/29/2022] [Indexed: 01/15/2023] Open
Abstract
Cystic lymphatic malformations (LMs) are rare chronic conditions which management differs according to the type (macrocystic LMs, microcystic LMs or both). Studies are lacking due to rarity of the pathology. We aimed to establish a French National Diagnosis and Care Protocol (PNDS: Protocole National de Diagnostic et de Soins), to provide health professionals with free open access synthesis on optimal management and care of patients with LMs ( https://www.has-sante.fr/upload/docs/application/pdf/2021-03/malformations_lymphatiques_kystiques_-_pnds.pdf ). The process included a critical review of the literature and multidisciplinary expert consensus. LMs are congenital but are not always discovered at birth. Nearly 75% of them are located in the head and neck because of the highly dense lymphatic system in this region. Physical examination (showing painless masses with normal skin color and depressible consistency, or cutaneous/mucosal lymphangiectasia) and color Doppler ultrasonography, usually allow for diagnosis. MRI (involving T2 sequences with fat saturation in at least two spatial planes) is the tool of choice for evaluating anatomical extension, characterizing lesions (microcystic and macrocystic), and before considering therapeutic management. A biopsy, coupled to a blood sample, can also be used for molecular biology analyses, to search for activating mutations of the PIK3CA gene, particularly with LM integrating in a syndromic form (CLOVES or Klippel-Trenaunay syndrome) but also in certain isolated (or common) LMs. The spontaneous evolution of LMs, in particular microcystic forms, is often toward progressive aggravation, with an increase in the number of vesicles, thickening, increased oozing and bleeding, while pure macrocystic LMs may regress due to "natural sclerosis", i.e. fibrosis secondary to an inflammatory reorganization after common infantile infections. In case of voluminous LMs or syndromic forms, functional and psychological repercussions can be major, deteriorating the patient's quality of life. LMs must be treated by physicians integrated in multidisciplinary teams, and be personalized. Management is a life-long process that involves one or several of these therapies: conservative management, physical therapy (compression), sclerotherapy, surgery, drugs such as mTOR inhibitors (sirolimus), that has shown efficacy in decreasing the volume of LMs, and, more recently, PI3K-inhibitors in syndromic forms. Psychological and social support is necessary, taking into account the patient and his family.
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Affiliation(s)
- Nicolas Leboulanger
- Otolaryngology - Head and Neck Surgery Department. National Reference Center for Rare Otolaryngological Malformations (MALO), Necker Enfants Malades Hospital, 149 Rue de Sèvres, 75015, Paris, France. .,INSERM U955, Paris Cité University. ERN Cranio, Paris, France.
| | - Annouk Bisdorff
- grid.411296.90000 0000 9725 279XDepartment of Interventional Radiology, Lariboisière Hospital, Paris, France
| | - Olivia Boccara
- grid.412134.10000 0004 0593 9113Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), Necker Enfants Malades Hospital, Paris, France
| | - Anne Dompmartin
- grid.411149.80000 0004 0472 0160Department of Dermatology, CHU Côte de Nacre, Caen, France
| | - Laurent Guibaud
- grid.413852.90000 0001 2163 3825Department of Radiology, Hôpital Mère-Enfant, CHU de Lyon, Lyon, France
| | - Christine Labreze
- grid.42399.350000 0004 0593 7118Department of Dermatology, Pellegrin Hospital, CHU de Bordeaux, Bordeaux, France
| | - Jacques Lagier
- grid.410528.a0000 0001 2322 4179Department of Ophthalmology, CHU de Nice, Nice, France
| | - Bénédicte Lebrun-Vignes
- grid.411439.a0000 0001 2150 9058Pharmacovigilance Unit, AP-HP, Department of Pharmacology, Pitié-Salpêtrière Hospital, Paris, France
| | - Denis Herbreteau
- grid.411167.40000 0004 1765 1600Department of Neuroradiology and Interventional Radiology - Reference Center for Rare Diseases and Vascular Malformations (MAGEC), CHRU de Tours, Tours, France
| | - Aline Joly
- grid.411167.40000 0004 1765 1600Department of Maxillofacial Surgery - Reference Center for Rare Diseases and Vascular Malformations (MAGEC), CHRU de Tours, 37044 Tours, Cedex 9 France
| | - Julie Malloizel-Delaunay
- grid.411175.70000 0001 1457 2980Department of Vascular Medicine, Rangueil Hospital, CHU de Toulouse, Toulouse, France
| | - Arnaud Martel
- grid.410528.a0000 0001 2322 4179Department of Ophthalmology, CHU de Nice, Nice, France
| | - Stéphane Munck
- grid.460782.f0000 0004 4910 6551Département d’enseignement et de Recherche en Médecine Générale, Retines, Healthy, Université Côte d’Azur, 06000 Nice, France
| | | | - Annabel Maruani
- grid.411167.40000 0004 1765 1600Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), CHRU de Tours, Tours, France ,grid.12366.300000 0001 2182 6141INSERM 1246 ‑ SPHERE, Universities of Tours and Nantes, 37000 Tours, France
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Jittamala P, Monteiro W, Smit MR, Pedrique B, Specht S, Chaccour CJ, Dard C, Giudice PD, Khieu V, Maruani A, Failoc-Rojas VE, Sáez-de-Ocariz M, Soriano-Arandes A, Piquero-Casals J, Faisant A, Brenier-Pinchart MP, Wimmersberger D, Coulibaly JT, Keiser J, Boralevi F, Sokana O, Marks M, Engelman D, Romani L, Steer AC, von Seidlein L, White NJ, Harriss E, Stepniewska K, Humphreys GS, Kennon K, Guerin PJ, Kobylinski KC. Correction: A systematic review and an individual patient data meta-analysis of ivermectin use in children weighing less than fifteen kilograms: Is it time to reconsider the current contraindication? PLoS Negl Trop Dis 2023; 17:e0011053. [PMID: 36607893 PMCID: PMC9821483 DOI: 10.1371/journal.pntd.0011053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
[This corrects the article DOI: 10.1371/journal.pntd.0009144.].
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Maruani A, Barbarot S, Gangneux JP, Caseris M, Moreau C, Brun S, Botterel F, Menotti J, Toubiana J, Chouchana L, Beylot-Barry M, Dupin N, Guillot B, Chosidow O. Management of tinea capitis in children following the withdrawal of griseofulvin from the French market: A fast-track algorithm proposed by the Center of Evidence of the French Society of Dermatology. Ann Dermatol Venereol 2022; 149:238-240. [PMID: 36229261 DOI: 10.1016/j.annder.2022.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/07/2022] [Accepted: 07/12/2022] [Indexed: 11/06/2022]
Affiliation(s)
- A Maruani
- Universités de Tours et Nantes, Inserm 1246-SPHERE, CHRU de Tours, service de dermatologie, unité de dermatologie pédiatrique, 37000 Tours, France; Centre de Preuves en Dermatologie, Société Française de Dermatologie Pédiatrique, Société Française de Dermatologie, France.
| | - S Barbarot
- Centre de Preuves en Dermatologie, Société Française de Dermatologie Pédiatrique, Société Française de Dermatologie, France; Nantes Université, Servie de Dermatologie, CHU Nantes, UMR 1280 PhAN, INRAE, F-44000 Nantes, France
| | - J P Gangneux
- Service de Parasitologie-Mycologie, CHU de Rennes, Univ Rennes, Inserm, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F35000 Rennes, France; Société Française de Mycologie Médicale, France
| | - M Caseris
- Infectiologie mobile, Hôpital Robert Debré, AP-HP, 75019 Paris, France; Groupe de Pathologie Infectieuse Pédiatrique de la Société Française de Pédiatrie, France
| | - C Moreau
- Service Pharmacie, Hôpital Robert-Debré (AP-HP), 75019 Paris, France
| | - S Brun
- Service de Parasitologie-Mycologie, Hôpital Avicenne, AP-HP, Université Sorbonne Paris Nord, Bobigny, France; Société Française de Mycologie Médicale, France
| | - F Botterel
- Unité de Parasitologie - Mycologie, Département de Prévention, diagnostic et traitement des infections, CHU de Créteil, AP-HP, Université Paris Est Créteil, Créteil, France; Société Française de Mycologie Médicale, France
| | - J Menotti
- Service de Parasitologie et Mycologie Médicale, Institut des Agents Infectieux, Hospices Civils de Lyon / Université Lyon 1, Lyon, France; Société Française de Mycologie Médicale, France
| | - J Toubiana
- Service de pédiatrie générale et maladies infectieuses, Hôpital Necker Enfants malades, AP-HP, Université de Paris, Paris, France
| | - L Chouchana
- Centre Régional de Pharmacovigilance, Service de Pharmacologie, EA 7323 Pharmacologie et Evaluation des Thérapeutiques chez l'enfant et la femme enceinte, Hôpital Cochin, AP-HP, Université de Paris, Paris, France; Société Française de Pharmacologie et Thérapeutique, France
| | - M Beylot-Barry
- Service de Dermatologie, CHU de Bordeaux, INSERM U1312, Bordeaux, France; Centre de Preuves en Dermatologie, Société Française de Dermatologie, France
| | - N Dupin
- Centre de Preuves en Dermatologie, Société Française de Dermatologie, France; Service de dermatologie Hôpital Cochin AP-HP, Paris, France
| | - B Guillot
- Université de Montpellier, Montpellier, France
| | - O Chosidow
- Service de Dermatologie, Hôpitaux Universitaires Henri-Mondor, AP-HP, Créteil, France; Universités de Tours et Nantes, Inserm 1246-SPHERE, France; Centre de Preuves en Dermatologie, GrIDIST Groupe Infectiologie Dermatologique, ISD-SIDA, Société Française de Dermatologie, Paris, France
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Robert J, Marchand A, Mazereeuw-Hautier J, Boccara O, Martin L, Chiaverini C, Beneton N, Vabres P, Balguerie X, Plantin P, Bessis D, Barbarot S, Dadban A, Droitcourt C, Samimi M, Morel B, Caille A, Maruani A, Leducq S. Quality of life of children with capillary malformations of the lower limbs: Evolution and associated factors. Data from the French national paediatric cohort, CONAPE. Ann Dermatol Venereol 2022; 149:271-275. [PMID: 35810006 DOI: 10.1016/j.annder.2022.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 02/16/2022] [Accepted: 03/30/2022] [Indexed: 01/19/2023]
Affiliation(s)
- J Robert
- University Hospital Center of Tours (CHRU), Department of Dermatology, Unit of Pediatric Dermatology, 37044 Tours Cedex 9, France; CHRU Tours, Reference center for genodermatoses and rare skin diseases - vascular anomalies (MAGEC), 37000 Tours, France
| | - A Marchand
- University Hospital Center of Tours (CHRU), Department of Dermatology, Unit of Pediatric Dermatology, 37044 Tours Cedex 9, France; CHRU Tours, Reference center for genodermatoses and rare skin diseases - vascular anomalies (MAGEC), 37000 Tours, France; CHRU Tours, Clinical Investigation Center-Inserm 1415, 37000 Tours, France
| | - J Mazereeuw-Hautier
- Department of Dermatology and Reference center for genodermatoses and rare skin diseases (MAGEC), Hospital Larrey, University Hospital Center of Toulouse, 31059 Toulouse Cedex 9, France
| | - O Boccara
- Department of Dermatology and Reference center for genodermatoses and rare skin diseases (MAGEC), France Université Paris, Paris-centre, Institut Imagine, Hôpital Universitaire Necker-Enfants Malades, AP-HP, 75015 Paris, France
| | - L Martin
- Department of Dermatology, University Hospital Center of Angers, 49000 Angers, France
| | - C Chiaverini
- Department of Dermatology, University Hospital Center of Nice, 06000 Nice, France
| | - N Beneton
- Department of Dermatology, Hospital Center of le Mans, 72000 Le Mans, France
| | - P Vabres
- Department of Dermatology, University Hospital Center of Dijon, Reference center for genodermatoses and rare skin diseases (MAGEC), 21000 Dijon, France
| | - X Balguerie
- Department of Dermatology, University Hospital Center of Rouen, 76000 Rouen, France
| | - P Plantin
- Department of Dermatology, Hospital Center of Quimper, 29000 Quimper, France
| | - D Bessis
- Department of Dermatology, University Hospital Center of Montpellier, 34000 Montpellier, France
| | - S Barbarot
- Department of Dermatology, University Hospital Center of Nantes, 44000 Nantes, France
| | - A Dadban
- Department of Dermatology, University Hospital Center of Amiens, 80000 Amiens, France
| | - C Droitcourt
- Department of Dermatology, University Hospital Center of Rennes, 35000 Rennes, France
| | - M Samimi
- University Hospital Center of Tours (CHRU), Department of Dermatology, Unit of Pediatric Dermatology, 37044 Tours Cedex 9, France
| | - B Morel
- CHRU Tours, Reference center for genodermatoses and rare skin diseases - vascular anomalies (MAGEC), 37000 Tours, France; CHRU Tours, Department of Pediatric Radiology, 37000 Tours, France
| | - A Caille
- CHRU Tours, Clinical Investigation Center-Inserm 1415, 37000 Tours, France; Universities of Tours and Nantes, SPHERE-INSERM 1246, 37000 Tours, France
| | - A Maruani
- University Hospital Center of Tours (CHRU), Department of Dermatology, Unit of Pediatric Dermatology, 37044 Tours Cedex 9, France; CHRU Tours, Reference center for genodermatoses and rare skin diseases - vascular anomalies (MAGEC), 37000 Tours, France; CHRU Tours, Clinical Investigation Center-Inserm 1415, 37000 Tours, France; Universities of Tours and Nantes, SPHERE-INSERM 1246, 37000 Tours, France
| | - S Leducq
- University Hospital Center of Tours (CHRU), Department of Dermatology, Unit of Pediatric Dermatology, 37044 Tours Cedex 9, France; CHRU Tours, Reference center for genodermatoses and rare skin diseases - vascular anomalies (MAGEC), 37000 Tours, France; Universities of Tours and Nantes, SPHERE-INSERM 1246, 37000 Tours, France.
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Zitouni J, Bursztejn A, Belloni Fortina A, Beauchet A, Di Lernia V, Lesiak A, Thomas J, Topkarci Z, Murashkin N, Brzezinski P, Torres T, Chiriac A, Luca C, Mcpherson T, Akinde M, Maruani A, Epishev R, Vidaurri De La Cruz H, Luna P, Amy De La Breteque M, Lasek A, Bourrat E, Bachelerie M, Mallet S, Steff M, Bellissen A, Neri I, Zafiriou E, Van Den Reek J, Sonkoly E, Kupfer-Bessaguet I, Leducq S, Mahil S, Smith C, Flohr C, Bachelez H, Mahé E. COVID-19 et psoriasis de l’enfant : facteurs associés à une évolution défavorable de la COVID-19 et impact de l’infection sur le psoriasis. Registre Chi-PsoCov. Annales de Dermatologie et de Vénéréologie - FMC 2022. [PMCID: PMC9748132 DOI: 10.1016/j.fander.2022.09.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Sanchez A, Mahe E, Miquel J, Abasq C, Phan A, Mazereeuw‐Hautier J, Lemille J, Maruani A, Bonniaud B, Plantin P, Mallet S, Martin H, Hubiche T, Chiaverini C, Lacour J. Perialar intertrigo in children and adolescents: A multicenter prospective study of 41 cases. Pediatr Dermatol 2022; 39:702-707. [PMID: 35699273 PMCID: PMC9796429 DOI: 10.1111/pde.15036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 05/01/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND/OBJECTIVES We observed isolated cases of perialar intertrigo in children and teenagers that did not appear to correspond to any known clinical entity. The objective of this study was to describe the clinical features of this dermatosis and the clinical characteristics of the patients. METHODS We conducted a prospective, multicenter cohort study in France from August 2017 to November 2019. All the patients under 18 years of age with chronic perinasal intertrigo were included. A standardized questionnaire detailing the clinical characteristics of the patients and the description of the intertrigo. If possible, a Wood's lamp examination of the intertrigo was done. RESULTS Forty-one patients were included (25 boys and 16 girls, average age: 12.1 years). Intertrigo was bilateral in 38 patients (93%). The majority of patients had no symptoms (54%). Pruritus was present in 39% of cases. Orange red follicular fluorescence was present in the perialar region on Wood's light examination in 78% of cases with active fluorescence. The presumptive diagnoses suggested by the investigators were acne (24.4%), seborrheic dermatitis (19.5%), rosacea (9.8%), psoriasis (9.8%) and perioral dermatitis (7.3%). No diagnosis was proposed in 22% of the cases. CONCLUSIONS We describe a previously undescribed clinical sign which is characterized by a chronic bilateral erythematous intertrigo located in the perialar region. It can be isolated or associated with various facial dermatoses.
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Affiliation(s)
- Adrien Sanchez
- Department of Dermatology‐VenereologyHôpital Archet 2, CHU de NiceNiceFrance
| | - Emmanuel Mahe
- Department of Dermatology‐VenereologyCentre Hospitalier d'ArgenteuilArgenteuilFrance
| | - Juliette Miquel
- Pediatric Dermatology UnitHôpital de Saint Pierre, CHU de la RéunionSaint PierreFrance
| | - Claire Abasq
- Department of Dermatology‐VenereologyHôpital Morvan, CHU de BrestBrestFrance
| | - Alice Phan
- Pediatric Dermatology UnitHôpital Femme‐Mère‐Enfant, Hospices Civils de LyonBronFrance
| | | | - Juliette Lemille
- General Medicine, Hôpital Saint‐Jacques, CHU de NantesNantesFrance
| | - Annabel Maruani
- Department of Dermatology, Unit of Paediatric DermatologyUniversity of Tours, CHU de ToursToursFrance
| | | | - Patrice Plantin
- Department of Dermatology‐VenereologyCentre Hospitalier de QuimperQuimperFrance
| | - Stéphanie Mallet
- Department of Dermatology‐VenereologyHôpital de la Timone, Assistance Publique Hôpitaux de MarseilleMarseilleFrance
| | - Hélène Martin
- Department of Dermatology‐VenereologyHôpital Archet 2, CHU de NiceNiceFrance
| | - Thomas Hubiche
- Department of Dermatology‐VenereologyHôpital Archet 2, CHU de NiceNiceFrance
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Marchand A, Caille A, Gissot V, Giraudeau B, Lengelle C, Bourgoin H, Largeau B, Leducq S, Maruani A. Topical sirolimus solution for lingual microcystic lymphatic malformations in children and adults (TOPGUN): study protocol for a multicenter, randomized, assessor-blinded, controlled, stepped-wedge clinical trial. Trials 2022; 23:557. [PMID: 35804404 PMCID: PMC9270761 DOI: 10.1186/s13063-022-06365-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 04/28/2022] [Indexed: 11/24/2022] Open
Abstract
Background Lingual microcystic lymphatic malformations (LMLMs) are rare congenital vascular malformations presenting as clusters of cysts filled with lymph fluid or blood. Even small well-limited lesions can be responsible for a heavy burden, inducing pain, aesthetic prejudice, or oozing, bleeding, infections. The natural history of LMLMs is progressive worsening punctuated by acute flares. Therapeutic options include surgery, laser excision, and radiofrequency ablation but all are potentially detrimental and expose to local relapse. Therefore, the management frequently relies on a “watchful waiting” approach. In complicated LMLMs, treatment with oral sirolimus, a mammalian target of rapamycin (mTOR) inhibitor, is often used. Topical applications of sirolimus on the buccal mucosae have been reported in other oral diseases with good tolerance and none to slight detectable blood sirolimus concentrations. We aim to evaluate the efficacy and safety of a 1 mg/mL sirolimus solution applied once daily on LMLM of any stage in children and adults after 4, 8, 12, 16, 20, and 24 weeks of treatment compared to usual care (no treatment). Methods This is a randomized, multicentric study using an individually randomized stepped-wedge design over 24 weeks to evaluate topical application of a 1 mg/mL sirolimus solution once daily, on LMLM, versus usual care (no treatment), the control condition. Participants begin with an observational period and later switch to the intervention at a randomized time (week 0, 4, 8, or 12). Visits occur every 4 weeks, either in the study center or by teleconsulting. The primary outcome will be the evaluation of global severity of the LMLM on monthly standardized photographs by 3 independent blinded experts using the physical global assessment (PGA) 0 to 5 scale. Secondary outcomes will include lesion size measurement and quality of life assessment, investigator, and patient-assessed global disease and specific symptoms (oozing, bleeding, sialorrhea, eating impairment, taste modification, aesthetic impairment, pain, and global discomfort) assessment. A biological monitoring will be performed including residual blood sirolimus concentration and usual laboratory parameters. Discussion Given the disappointing state of current treatment options in LMLMs, topical sirolimus could become firstline therapy in treating LMLMs if its efficacy and safety were to be demonstrated. Trial registration ClinicalTrials.gov NCT04128722. Registered on 24 September 2019. EudraCT: EUCTR2019-001530-33-FR Sponsor (University Hospital Center of Tours – CHRU Tours): DR190041-TOPGUN French regulatory authorities: ID RCB: 2019-001530-33 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06365-y.
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Affiliation(s)
- A Marchand
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), CHRU Tours, Avenue de la République, 37044, Tours, Cedex 9, France.
| | - A Caille
- Clinical Investigation Center, INSERM 1415, CHRU Tours, 37000, Tours, France.,INSERM U1246 -SPHERE « MethodS in Patients-centered outcomes and HEalth REsearch », University of Nantes, University of Tours, 37000, Tours, France
| | - V Gissot
- Clinical Investigation Center, INSERM 1415, CHRU Tours, 37000, Tours, France.,INSERM U1246 -SPHERE « MethodS in Patients-centered outcomes and HEalth REsearch », University of Nantes, University of Tours, 37000, Tours, France
| | - B Giraudeau
- Clinical Investigation Center, INSERM 1415, CHRU Tours, 37000, Tours, France.,INSERM U1246 -SPHERE « MethodS in Patients-centered outcomes and HEalth REsearch », University of Nantes, University of Tours, 37000, Tours, France
| | - C Lengelle
- Pharmacovigilance Regional Centre (CRPV), CHRU Tours, 37000, Tours, France
| | - H Bourgoin
- Department of Pharmacy, University Hospital Center of Tours, 37000, Tours, France
| | - B Largeau
- Department of Pharmacy, University Hospital Center of Tours, 37000, Tours, France
| | - S Leducq
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), CHRU Tours, Avenue de la République, 37044, Tours, Cedex 9, France.,Clinical Investigation Center, INSERM 1415, CHRU Tours, 37000, Tours, France.,INSERM U1246 -SPHERE « MethodS in Patients-centered outcomes and HEalth REsearch », University of Nantes, University of Tours, 37000, Tours, France
| | - A Maruani
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), CHRU Tours, Avenue de la République, 37044, Tours, Cedex 9, France. .,Clinical Investigation Center, INSERM 1415, CHRU Tours, 37000, Tours, France. .,INSERM U1246 -SPHERE « MethodS in Patients-centered outcomes and HEalth REsearch », University of Nantes, University of Tours, 37000, Tours, France.
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29
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Zitouni J, Bursztejn A, Belloni Fortina A, Beauchet A, Di Lernia V, Lesiak A, Thomas J, Topkarci Z, Murashkin N, Brzezinski P, Torres T, Chiriac A, Luca C, McPherson T, Akinde M, Maruani A, Epishev R, Vidaurri de la Cruz H, Luna P, Amy de la Bretêque M, Lasek A, Bourrat E, Bachelerie M, Mallet S, Steff M, Bellissen A, Neri I, Zafiriou E, van den Reek J, Sonkoly E, Mahil S, Smith C, Flohr C, Bachelez H, Mahé E. Children with psoriasis and COVID-19: factors associated with an unfavourable COVID-19 course, and the impact of infection on disease progression (Chi-PsoCov registry). J Eur Acad Dermatol Venereol 2022; 36:2076-2086. [PMID: 35748102 PMCID: PMC9349726 DOI: 10.1111/jdv.18361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/10/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The COVID-19 pandemic has raised questions regarding the management of chronic skin diseases, especially in patients on systemic treatments. Data concerning the use of biologics in adults with psoriasis are reassuring, but data specific to children are missing. Moreover, COVID-19 could impact the course of psoriasis in children. OBJECTIVES The aim of this study was therefore to assess the impact of COVID-19 on the psoriasis of children, and the severity of the infection in relation to systemic treatments. METHODS We set up an international registry of paediatric psoriasis patients. Children were included if they were under 18 years of age, had a history of psoriasis, or developed it within 1 month of COVID-19 and had COVID-19 with or without symptoms. RESULTS One hundred and twenty episodes of COVID-19 in 117 children (mean age: 12.4 years) were reported. The main clinical form of psoriasis was plaque type (69.4%). Most children were without systemic treatment (54.2%); 33 (28.3%) were on biologic therapies, and 24 (20%) on non-biologic systemic drugs. COVID-19 was confirmed in 106 children (88.3%) and 3 children had two COVID-19 infections each. COVID-19 was symptomatic for 75 children (62.5%) with a mean duration of 6.5 days, significantly longer for children on non-biologic systemic treatments (P = 0.02) and without systemic treatment (P = 0.006) when compared with children on biologics. The six children who required hospitalization were more frequently under non-biologic systemic treatment when compared with the other children (P = 0.01), and particularly under methotrexate (P = 0.03). After COVID-19, the psoriasis worsened in 17 cases (15.2%). Nine children (8%) developed a psoriasis in the month following COVID-19, mainly a guttate form (P = 0.01). DISCUSSION Biologics appear to be safe with no increased risk of severe form of COVID-19 in children with psoriasis. COVID-19 was responsible for the development of psoriasis or the worsening of a known psoriasis for some children.
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Affiliation(s)
- J. Zitouni
- Department of DermatologyHôpital Victor DupouyArgenteuilFrance
| | - A.‐C. Bursztejn
- Department of DermatologyHôpitaux de Brabois, Centre Hospitalier Universitaire de NancyVandœuvre‐lès‐NancyFrance
| | - A. Belloni Fortina
- Pediatric Dermatology Unit, Department of Medicine DIMEDUniversity of PadovaPadovaItaly
| | - A. Beauchet
- Department of Public HealthHôpital Ambroise ParéBoulogne‐BillancourtFrance
| | - V. Di Lernia
- Dermatology UnitArcispedale S. Maria Nuova, Azienda USL‐IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - A. Lesiak
- Department of Dermatology, Peadiatric Dermatology and OncologyMedical Univeristy of LodzLodzPoland
| | - J. Thomas
- J. T. Skin Care CentreChennaiTamil NaduIndia
| | - Z. Topkarci
- Department of DermatologyDr. Sadi Konuk Training and Research HospitalIstanbulTurkey
| | - N. Murashkin
- Department of DermatologyFederal State Autonomous Institution, Scientific Center of Children's Health of the Ministry of Health of the Russian FederationMoscowRussia
| | - P. Brzezinski
- Department of DermatologyVoivodship Specialist Hospital in SlupskUstkaPoland
| | - T. Torres
- Department of DermatologyCentro Hospitalar Universitário do PortoPortoPortugal
| | - A. Chiriac
- Department of Dermatology, Nicolina Medical CenterP. Poni Institute of Macromolecular Chemistry, Romanian AcademyIașiRomania
| | - C. Luca
- Infectious Disease Department, “Sf. Parascheva” Clinical Hospital“Gr. T. Popa” University of MedicineIasiRomania
| | - T. McPherson
- Department of DermatologyOxford University Hospitals NHS TrustOxfordUK
| | - M. Akinde
- Department of Paediatric Dermatology, St John's Institute of DermatologyGuy's and St Thomas' NHS Foundation TrustLondonUK
| | - A. Maruani
- Unit of Pediatric Dermatology, Department of DermatologyUniversity of Tours and Nantes, INSERM 1246 SPHERE ‐ CHRU ToursToursFrance
| | - R. Epishev
- Department of DermatologyFederal State Autonomous Institution, Scientific Center of Children's Health of the Ministry of Health of the Russian FederationMoscowRussia
| | - H. Vidaurri de la Cruz
- Servicio de Dermatología PediátricaHospital General de México Dr. Eduardo Liceaga, Secretaría de SaludCiudad de MéxicoMexico
| | - P.C. Luna
- Department of DermatologyHospital AlemánCiudad Autónoma de Buenos AiresArgentina
| | | | - A. Lasek
- Department of Dermatology, Hôpital Saint Vincent de PaulUniversité Catholique de LilleLilleFrance
| | - E. Bourrat
- Department of DermatologyHôpital Robert Debré, AP‐HPParisFrance
| | - M. Bachelerie
- Department of DermatologyCentre Hospitalier UniversitaireClermont‐FerrandFrance
| | - S. Mallet
- Department of Dermatology, Hôpital de la TimoneAssistance‐publique‐Hôpitaux de MarseilleMarseilleFrance
| | - M. Steff
- Department of DermatologyCentre Hospitalier Intercommunal Robert BallangerAulnay‐sous‐BoisFrance
| | - A. Bellissen
- Department of DermatologyCentre Hospitalier Edmond GarcinAubagneFrance
| | - I. Neri
- Department of DermatologyIRCSS Azienda Ospedaliero Universitaria di BolognaBolognaItaly
| | - E. Zafiriou
- Department of Dermatology, Faculty of Medicine, School of Health SciencesUniversity of ThessalyLarissaGreece
| | | | - E. Sonkoly
- Dermatology and Venereology Division, Department of Medicine SolnaKarolinska InstitutetStockholmSweden,Center for Molecular Medicine (CMM)Karolinska InstitutetStockholmSweden,Dermatology, Department of Medical SciencesUppsala UniversityUppsalaSweden
| | - S.K. Mahil
- St John's Institute of DermatologyGuy's and St Thomas' NHS Foundation Trust and King's College LondonLondonUK
| | - C.H. Smith
- St John's Institute of DermatologyGuy's and St Thomas' NHS Foundation Trust and King's College LondonLondonUK
| | - C. Flohr
- Department of Paediatric Dermatology, St John's Institute of DermatologyGuy's and St Thomas' NHS Foundation TrustLondonUK
| | - H. Bachelez
- Department of DermatologyHôpital Saint‐Louis, AP‐HPParisFrance,Laboratory of Genetic Skin Diseases, INSERM U1163, Imagine InstituteUniversité de ParisParisFrance
| | - E. Mahé
- Department of DermatologyHôpital Victor DupouyArgenteuilFrance
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Pottier C, Eymieux S, Blanchard-Laumonnier E, Robert J, Maruani A, Leducq S. Loose anagen hair syndrome: take a closer look! Br J Dermatol 2022; 187:e156. [PMID: 35613857 DOI: 10.1111/bjd.21623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Cassandre Pottier
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), University Hospital Center of Tours, Tours, France
| | - Sébastien Eymieux
- IBiSA Electron Microscopy Facility, University Hospital Center of Tours, Tours, France.,University of Tours, INSERM U1259, Tours, France
| | - Emmanuelle Blanchard-Laumonnier
- IBiSA Electron Microscopy Facility, University Hospital Center of Tours, Tours, France.,University of Tours, INSERM U1259, Tours, France
| | - Juliette Robert
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), University Hospital Center of Tours, Tours, France
| | - Annabel Maruani
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), University Hospital Center of Tours, Tours, France.,Universities of Tours and Nantes, INSERM 1246-SPHERE, 37000, Tours, France
| | - Sophie Leducq
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), University Hospital Center of Tours, Tours, France.,Universities of Tours and Nantes, INSERM 1246-SPHERE, 37000, Tours, France
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31
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Allemang-Trivalle A, Leducq S, Maruani A, Giraudeau B. Designs des études thérapeutiques dans les anomalies vasculaires rares à expression cutanée. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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32
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Le Helloco C, Maruani A, Le Touze A, Herbreteau D, Leducq S. Lesion of the Anal Margin in a Young Child: A Quiz. Acta Derm Venereol 2022; 102:adv00696. [PMID: 35166854 PMCID: PMC9558758 DOI: 10.2340/actadv.v102.1177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract is missing (Quiz)
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Affiliation(s)
- Claire Le Helloco
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), University Hospital Center of Tours, Avenue de la République, FR-37044 Tours Cedex 9, France.
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Affiliation(s)
- Sarah Chastanet
- Maxillofacial and Facial Plastic Surgery Department, University of Tours, Trousseau Hospital, CHRU Tours, FR-37000 Tours, France.
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Labonnelie A, Soupre V, Maruani A, Cisternino S, Hadj‐Rabia S, Boccara O. Management of sirolimus treatment for tumors associated with Kasabach‐Merritt phenomenon. J Eur Acad Dermatol Venereol 2022; 36:e586-e588. [DOI: 10.1111/jdv.18077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 03/04/2022] [Indexed: 11/30/2022]
Affiliation(s)
- A. Labonnelie
- Department of Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC) University of Paris, Paris‐centre, Institut Imagine, University Hospital Necker‐Enfants Malades, APHP5 Paris France
| | - V. Soupre
- Department of pediatric maxillo‐facial and plastic surgery University Hospital of Necker‐Enfants Malades, APHP5 Paris France
| | - A. Maruani
- Department of Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC) Universities of Nantes and Tours, INSERM 1246‐SPHERE; CHRU Tours Tours France
| | - S. Cisternino
- Department of pharmacy APHP5, University Hospital Necker – Enfants Malades University of Paris, Faculté de Pharmacie, Optimisation Thérapeutique en Neuropsychopharmacologie F‐75006 Paris France
- INSERM UMR‐S 1144 Paris France
| | - S. Hadj‐Rabia
- Department of Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC) University of Paris, Paris‐centre, Institut Imagine, University Hospital Necker‐Enfants Malades, APHP5 Paris France
| | - O. Boccara
- Department of Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC) University of Paris, Paris‐centre, Institut Imagine, University Hospital Necker‐Enfants Malades, APHP5 Paris France
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35
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Lechevalier D, Sigg N, Humeau H, Vermersch C, Leducq S, Maruani A, Martin L. Healthcare transition from childhood to adulthood in pseudoxanthoma elasticum: Patient experience and recommendations for health practitioners. Ann Dermatol Venereol 2022; 149:191-194. [DOI: 10.1016/j.annder.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/04/2021] [Accepted: 02/01/2022] [Indexed: 12/01/2022]
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Schachner LA, Blume-Peytavi U, Andriessen A, Izakovic J, Maruani A, Micali G, Murashkin N, Salavastru C, Torrelo A. Expert consensus on ceramides containing skincare in newborns and infants and potential mitigation of atopic dermatitis. Ital J Dermatol Venerol 2022; 157:23-32. [PMID: 35005855 DOI: 10.23736/s2784-8671.21.07172-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The vulnerable skin of neonates and infants is still developing anatomically and functionally and more susceptible to skin barrier disruption. The current consensus paper explores challenges in caring for neonates and infants' skin, skincare use and evaluates the role of ceramides (CERs) containing cleansers and moisturizers. EVIDENCE AQUISITION A panel of eight clinicians who treat neonates and infants developed a consensus paper on new-born and infant skin barrier integrity and CERs-containing skincare importance. The consensus process consisted of a modified Delphi technique. The selected information from the literature searches, coupled with the panel's opinion and experience, was used to adopt statements to provide clinical data for paediatric dermatologists, dermatologists, and paediatric healthcare providers who treat neonates and infants. EVIDENCE SYNTHESIS Increasingly, evidence supports skincare starting early in life, recognizing the benefits of ongoing daily use of non-alkaline cleansers and moisturizers to maintain skin barrier function. Skincare for neonates and infants should be safe, effective, and fragrance as well as sensitizing agent-free. Skincare with CERs may benefit the stratum corneum's lipid and water content. CONCLUSIONS When applied from birth onwards, gentle cleansers and moisturizers containing barrier lipids help maintain the protective skin barrier and soothe the skin with long-term moisturizing benefits.
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Affiliation(s)
- Lawrence A Schachner
- Dermatology and Pediatrics, Pediatric Dermatology, University of Miami School of Medicine, Miami, FL, USA
| | - Ulrike Blume-Peytavi
- Department of Dermatology and Allergology, Clinical Research Center of Hair and Skin Science, Charité-Universitaetsmedizin, Berlin, Germany
| | - Anneke Andriessen
- Radboud Academy, Radboud UMC, Nijmegen and Andriessen Consultants, Malden, The Netherlands -
| | - Jan Izakovic
- Department of Dermatology, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Pediatric Dermatology, Basel University Children's Hospital (UKBB), Basel, Switzerland.,Dermatology Private Practice, Basel, Switzerland
| | - Annabel Maruani
- Unit of Pediatric Dermatology, Department of Dermatology, University Hospital Center of Tours, Tours, France
| | | | - Nikolay Murashkin
- Research Institute of Pediatrics and Children's Health in Central Clinical Hospital of the Russian Academy of Sciences, Moscow, Russian Federation
| | - Carmen Salavastru
- Pediatric Dermatology Department, Colentina Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Antonio Torrelo
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
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Hazard M, Chinazzo M, Maakaroun‐Vermesse Z, Abasq C, Gaudy‐Graffin C, Tavernier E, Maruani A. Suppressive therapy for recurrent cutaneous herpes infections in children under 12 years: An observational study. Acta Paediatr 2022; 111:138-140. [PMID: 34704300 DOI: 10.1111/apa.16165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 10/25/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Margaux Hazard
- Department of Paediatrics University Hospital Center of Tours Tours France
| | - Marie Chinazzo
- Department of Paediatrics University Hospital Center of Tours Tours France
| | | | - Claire Abasq
- Department of Dermatology University Hospital Center of Brest Brest France
| | | | - Elsa Tavernier
- University of ToursINSERM 1246‐SPHERE Tours France
- Clinical Investigation Center of Tours‐INSERM 1415 Tours France
| | - Annabel Maruani
- University of ToursINSERM 1246‐SPHERE Tours France
- Unit of paediatric Dermatology Department of Dermatology University Hospital Center of Tours Tours France
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Boccara O, Mazereeuw J, Martin L, Bessis D, Hubiche T, Chiaverini C, Dompmartin A, Mallet S, Miquel J, Aubert H, Puzenat E, Abasq C, Gusdorf L, Hadj-Rabia S, Maruani A. Central nervous system screening in capillary malformation-arteriovenous malformation syndrome: an observational study. J Am Acad Dermatol 2021; 87:914-916. [PMID: 34954287 DOI: 10.1016/j.jaad.2021.12.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 12/07/2021] [Accepted: 12/15/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Olivia Boccara
- Department of Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Université Paris, Paris-centre, Institut Imagine, Hôpital Universitaire Necker-Enfants Malades, APHP, Paris, France.
| | - Juliette Mazereeuw
- Department of Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases, Paul Sabatier University Toulouse, Larrey Hospital, Toulouse, France
| | | | - Didier Bessis
- Department of Dermatology, CHU Montpellier, Montpellier, France
| | | | | | | | | | - Juliette Miquel
- Unit of Pediatric Dermatology, CHU Reunion, Saint Pierre, France
| | - Hélène Aubert
- Department of Dermatology, CHU Nantes, Nantes, France
| | - Eve Puzenat
- Department of Dermatology, CHU Besançon, Besançon, France
| | - Claire Abasq
- Department of Dermatology, CHU Brest, Brest, France
| | | | - Smail Hadj-Rabia
- Department of Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Université Paris, Paris-centre, Institut Imagine, Hôpital Universitaire Necker-Enfants Malades, APHP, Paris, France
| | - Annabel Maruani
- Department of Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Universities of Nantes and Tours, Inserm 1246-SPHERE, CHU Tours, Tours, France
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Zitouni J, Fortina AB, Bursztejn AC, Beauchet A, Lesiak A, Murashkin N, Maruani A, Di Lernia V, Lasek A, Amy de la Breteque M, Torres T, Epishev R, Bourrat E, Bachelez H, Mahé E. COVID-19 et psoriasis chez l’enfant. Données d’une cohorte internationale. Annales de Dermatologie et de Vénéréologie - FMC 2021. [PMCID: PMC8603670 DOI: 10.1016/j.fander.2021.09.439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Introduction Le psoriasis touche 0,5 à 1 % des enfants. L’infection à SARS-CoV-2 pourrait avoir un impact sur le psoriasis (poussées induites voire psoriasis de novo), et les traitements systémiques du psoriasis pourraient favoriser la survenue de formes plus sévères de COVID-19. Chez l’adulte psoriasique la COVID-19 est plus sévère chez les patients âgés, obèses, « non blancs » et sous immunosuppresseurs non biologiques (registre PsoProTect). Il n’existe pas de données pédiatriques. L’objectif de l’étude menée chez des enfants psoriasiques ayant contracté l’infection par le SARS-CoV-2 était de :. – étudier l’impact de l’infection à SARS-CoV2 sur le psoriasis (poussée de psoriasis, changement de phénotype, psoriasis de novo) ; – et étudier l’impact des traitements systémiques, biologiques ou non, sur le risque de développer une forme sévère de COVID-19. Matériel et méthodes Étude transversale, multicentrique, internationale, menée à partir de février 2021, par appel à cas auprès de la SFDP, du GrPso et de la SIDerP (Italie), et relayé par la BSPD (Royaume-Uni) et l’ESPD (Europe). Tout enfant (< 18 ans) psoriasique présentant une infection à SARS-CoV-2 symptomatique ou non était inclus. Le psoriasis pouvait préexister à l’infection ou se développer dans le mois suivant l’infection à SARS-CoV-2 (psoriasis de novo). Résultats Un total de 46 enfants (France, n = 30 ; Italie, n = 3 ; Pologne, n = 9 ; Russie, n = 3 ; et Portugal, n = 1) ont été inclus. L’âge moyen était de 12,2 ± 4,0 ans ; il y avait 20 (43,5%) filles. Les caractéristiques du psoriasis sont détaillées dans le tableau. Quatorze enfants étaient sous biothérapies et 5 sous systémiques oraux. Dans 84,8 % des cas l’infection à SARS-CoV-2 était confirmée. Dans 63 % des cas, il s’agissait de formes symptomatiques, avec en cas de symptômes une durée moyenne des symptômes de 6,4 ± 5,2 j. Le traitement systémique a été maintenu dans 84,2 % des cas. Dans 5 cas le psoriasis s’était aggravé au décours de la COVID-19 avec un phénotype similaire, dans 1 cas il s’agissait d’un psoriasis de novo. Les enfants sous biothérapies ne présentaient pas de formes plus sévères, avec même une tendance, en cas de forme symptomatique, à une durée plus courte des symptômes (4,0 vs 7,5 j, p = 0,047) par rapport aux enfants sans traitements. Discussion Ce 1er travail mené chez l’enfant psoriasique infecté par le SARS-CoV-2 montre que l’infection peut induire dans près de 13 % des cas des poussées de psoriasis, voire un psoriasis de novo. En cas de forme symptomatique, il s’agissait toujours de formes bénignes, et les biothérapies semblaient plutôt associées à une forme moins sévère de COVID-19, confirmant ainsi les données observées chez l’adulte (PsoProTect). Malgré la faiblesse de l’effectif, et en s’appuyant sur les données adultes, nous pouvons rassurer les enfants psoriasis recevant des systémiques, notamment des biothérapies, en cas d’infection par le SARS-CoV-2.
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Luu M, Vabres P, Devilliers H, Loffroy R, Phan A, Martin L, Morice-Picard F, Petit F, Willems M, Bessis D, Jacquemont ML, Maruani A, Chiaverini C, Mirault T, Clayton-Smith J, Carpentier M, Fleck C, Maurer A, Yousfi M, Parker VER, Semple RK, Bardou M, Faivre L. Safety and efficacy of low-dose PI3K inhibitor taselisib in adult patients with CLOVES and Klippel-Trenaunay syndrome (KTS): the TOTEM trial, a phase 1/2 multicenter, open-label, single-arm study. Genet Med 2021; 23:2433-2442. [PMID: 34385668 PMCID: PMC8631579 DOI: 10.1038/s41436-021-01290-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 07/13/2021] [Accepted: 07/13/2021] [Indexed: 11/08/2022] Open
Abstract
PURPOSE PIK3CA pathogenic variants in the PIK3CA-related overgrowth spectrum (PROS) activate phosphoinositide 3-kinase signaling, providing a rationale for targeted therapy, but no drug has proven efficacy and safety in this population. Our aim was to establish the six-month tolerability and efficacy of low-dose taselisib, a selective class I PI3K inhibitor, in PROS patients. METHODS Patients over 16 years with PROS and PIK3CA pathogenic variants were included in a phase IB/IIA multicenter, open-label single-arm trial (six patients at 1 mg/day of taselisib, then 24 at 2 mg/day). The primary outcome was the occurrence of dose limiting toxicity (DLT). Efficacy outcomes were the relative changes after treatment of (1) tissue volume at affected and unaffected sites, both clinically and on imaging; (2) cutaneous vascular outcomes when relevant; (3) biologic parameters; (4) quality of life; and (5) patient-reported outcomes. RESULTS Among 19 enrolled patients, 2 experienced a DLT (enteritis and pachymeningitis) leading to early trial termination (17 treated, 10 completed the study). No serious adverse reaction occurred in the 1 mg cohort (n = 6). No significant reduction in affected tissue volume was observed (mean -4.2%; p = 0.81; SD 14.01). Thirteen (76.4%) participants reported clinical improvement (pain reduction, chronic bleeding resolution, functional improvement). CONCLUSION Despite functional improvement, the safety profile of low-dose taselisib precludes its long-term use.
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Affiliation(s)
- M Luu
- Centre d'Investigation Clinique-module plurithématique, CHU, Dijon, France.
- INSERM CIC1432, UBFC, Dijon, France.
| | - P Vabres
- Centre référence MAGEC, Dijon, France
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs et FHU TRANSLAD, CHU, Dijon, France
| | - H Devilliers
- INSERM CIC1432, UBFC, Dijon, France
- Centre d'Investigation Clinique-module épidémiologie clinique, CHU, Dijon, France
| | - R Loffroy
- Radiologie Interventionnelle, CHU, Dijon, France
| | - A Phan
- Dermatologie Pédiatrique, HFME, Lyon, France
| | - L Martin
- Centre référence MAGEC, CHU, Angers, France
| | | | - F Petit
- Centre de référence Anomalies du Développement et Syndromes Malformatifs, CHU, Lille, France
| | - M Willems
- Centre de référence Anomalies du Développement et Syndromes Malformatifs, Montpellier, France
| | - D Bessis
- Service de Dermatologie, CHU, Montpellier, France
| | - M L Jacquemont
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs, CHU La Réunion, Saint-Pierre, France
| | - A Maruani
- Centre référence MAGEC, CHU, Tours, France
| | | | - T Mirault
- Centre de référence maladies vasculaires rares, Hôpital européen Georges-Pompidou, AP-HP, Paris, France
- INSERM U970 PARCC, Université de Paris, Paris, France
| | - J Clayton-Smith
- Clinical Genetics and Manchester Centre for Genomic Medicine, NHS and Manchester University, Manchester, UK
| | - M Carpentier
- Délégation à la Recherche Clinique et de l'Innovation, CHU, Dijon, France
| | - C Fleck
- Délégation à la Recherche Clinique et de l'Innovation, CHU, Dijon, France
| | - A Maurer
- Centre d'Investigation Clinique-module plurithématique, CHU, Dijon, France
- INSERM CIC1432, UBFC, Dijon, France
| | - M Yousfi
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs et FHU TRANSLAD, CHU, Dijon, France
| | | | - R K Semple
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - M Bardou
- Centre d'Investigation Clinique-module plurithématique, CHU, Dijon, France
- INSERM CIC1432, UBFC, Dijon, France
| | - L Faivre
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs et FHU TRANSLAD, CHU, Dijon, France
- INSERM UMR1231 GAD, Génétique des Anomalies du Développement, Université Bourgogne Franche-Comté, Dijon, France
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Maruani A, Tavernier E, Boccara O, Mazereeuw-Hautier J, Leducq S, Bessis D, Guibaud L, Vabres P, Carmignac V, Mallet S, Barbarot S, Chiaverini C, Droitcourt C, Bursztejn AC, Lengellé C, Woillard JB, Herbreteau D, Le Touze A, Joly A, Léauté-Labrèze C, Powell J, Bourgoin H, Gissot V, Giraudeau B, Morel B. Sirolimus (Rapamycin) for Slow-Flow Malformations in Children: The Observational-Phase Randomized Clinical PERFORMUS Trial. JAMA Dermatol 2021; 157:1289-1298. [PMID: 34524406 DOI: 10.1001/jamadermatol.2021.3459] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Sirolimus is increasingly being used to treat various vascular anomalies, although evidence of its efficacy is lacking. Objective To assess the efficacy and safety of sirolimus for children with slow-flow vascular malformations to better delineate the indications for treatment. Design, Setting and Participants This multicenter, open-label, observational-phase randomized clinical trial included 59 children aged 6 to 18 years with a slow-flow vascular malformation who were recruited between September 28, 2015, and March 22, 2018, in 11 French tertiary hospital centers. Statistical analysis was performed on an intent-to-treat basis from December 4, 2019, to November 10, 2020. Interventions Patients underwent an observational period, then switched to an interventional period when they received oral sirolimus (target serum levels, 4-12 ng/mL). The switch time was randomized from month 4 to month 8, and the whole study period lasted 12 months for each patient. Main Outcomes and Measures The primary outcome was change in the volume of vascular malformations detected on magnetic resonance imaging scan (with centralized interpretation) per unit of time (ie, between the interventional period and the observational period). Secondary outcomes included subjective end points: pain, bleeding, oozing, quality of life, and safety. Results Among the participants (35 girls [59.3%]; mean [SD] age, 11.6 [3.8] years), 22 (37.3%) had a pure venous malformation, 18 (30.5%) had a cystic lymphatic malformation, and 19 (32.2%) had a combined malformation, including syndromic forms. Variations in the volume of vascular malformations detected on magnetic resonance imaging scans associated with the duration period were not overall significantly different between the interventional period and the observational period (all vascular malformations: mean [SD] difference, -0.001 [0.007]; venous malformations: mean [SD] difference, 0.001 [0.004]; combined malformations: mean [SD] difference, 0.001 [0.009]). However, a significant decrease in volume was observed for children with pure lymphatic malformations (mean [SD] difference, -0.005 [0.005]). Overall, sirolimus had positive effects on pain, especially for combined malformations, and on bleeding, oozing, self-assessed efficacy, and quality of life. During sirolimus treatment, 56 patients experienced 231 adverse events (5 serious adverse events, none life-threatening). The most frequent adverse event was an oral ulcer (29 patients [49.2%]). Conclusions and Relevance This observational-phase randomized clinical trial allows for clarifying the goals of patients and families when starting sirolimus therapy for children older than 6 years. Pure lymphatic malformations seem to be the best indication for sirolimus therapy because evidence of decreasing lymphatic malformation volume per unit of time, oozing, and bleeding and increasing quality of life was found. In combined malformations, sirolimus significantly reduced pain, oozing, and bleeding. Benefits seemed lower for pure venous malformations than for the 2 other subgroups, also based on symptoms. Trial Registration ClinicalTrials.gov Identifier: NCT02509468; clinicaltrialsregister.eu Identifier: 2015-001096-43.
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Affiliation(s)
- Annabel Maruani
- University of Tours, University of Nantes, Institut National de la Santé et de la Recherche Médicale, SPHERE U1246, Tours, France.,Centre Hospitalier Régional Universitaire Tours, Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (Maladies Génétiques rares à Expression Cutanée-Tours), Tours, France.,Centre Hospitalier Régional Universitaire Tours, Institut National de la Santé et de la Recherche Médicale Clinical Investigation Center 1415, Tours, France
| | - Elsa Tavernier
- University of Tours, University of Nantes, Institut National de la Santé et de la Recherche Médicale, SPHERE U1246, Tours, France.,Centre Hospitalier Régional Universitaire Tours, Institut National de la Santé et de la Recherche Médicale Clinical Investigation Center 1415, Tours, France
| | - Olivia Boccara
- Department of Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (Maladies Génétiques rares à Expression Cutanée-Necker), University Hospital Necker-Enfants Malades, Paris, France
| | | | - Sophie Leducq
- University of Tours, University of Nantes, Institut National de la Santé et de la Recherche Médicale, SPHERE U1246, Tours, France.,Centre Hospitalier Régional Universitaire Tours, Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (Maladies Génétiques rares à Expression Cutanée-Tours), Tours, France
| | - Didier Bessis
- Department of Dermatology, University Hospital Center of Montpellier, Montpellier, France
| | - Laurent Guibaud
- University Hospital Center of Lyon, Consultation Multidisciplinaire Lyonnaise des Angiomes, Lyon, France
| | - Pierre Vabres
- Department of Dermatology, University Hospital Center of Dijon, Dijon, France
| | - Virginie Carmignac
- Department of Dermatology, University Hospital Center of Dijon, Dijon, France
| | - Stéphanie Mallet
- Department of Dermatology, University Hospital Center of Marseille, Marseille, France
| | - Sébastien Barbarot
- Department of Dermatology, University Hospital Center of Nantes, Nantes, France
| | | | | | | | - Céline Lengellé
- Centre Hospitalier Régional Universitaire Tours, Department of Clinical Pharmacology, Regional Pharmacovigilance Center, Tours, France
| | - Jean-Baptiste Woillard
- Centre Hospitalier Universitaire Limoges, Department of Pharmacology and Toxicology, University of Limoges, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 850, Limoges, France
| | - Denis Herbreteau
- University of Tours, Centre Hospitalier Régional Universitaire Tours, Department of Neuroradiology, Reference Center for Genodermatoses and Rare Skin Diseases (Maladies Génétiques rares à Expression Cutanée-Tours), Tours, France
| | - Anne Le Touze
- Centre Hospitalier Régional Universitaire Tours, Department of Pediatric Surgery, Reference Center for Genodermatoses and Rare Skin Diseases (Maladies Génétiques rares à Expression Cutanée-Tours), Tours, France
| | - Aline Joly
- Centre Hospitalier Régional Universitaire Tours, Department of Pediatric Maxillofacial Surgery, Reference Center for Genodermatoses and Rare Skin Diseases (Maladies Génétiques rares à Expression Cutanée-Tours), Tours, France
| | | | - Julie Powell
- Department of Pediatric Dermatology, Hospital Sainte-Justine, Montréal, Québec, Canada
| | - Hélène Bourgoin
- Centre Hospitalier Régional Universitaire Tours, Department of Pharmacy, Tours, France
| | - Valérie Gissot
- Centre Hospitalier Régional Universitaire Tours, Institut National de la Santé et de la Recherche Médicale Clinical Investigation Center 1415, Tours, France
| | - Bruno Giraudeau
- University of Tours, University of Nantes, Institut National de la Santé et de la Recherche Médicale, SPHERE U1246, Tours, France.,Centre Hospitalier Régional Universitaire Tours, Institut National de la Santé et de la Recherche Médicale Clinical Investigation Center 1415, Tours, France
| | - Baptiste Morel
- University of Tours, Centre Hospitalier Régional Universitaire Tours, Department of Pediatric Radiology, Tours, France
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Moreau C, Le Touze A, Dujardin F, Maruani A. A Blue-pigmented Lesion on the Cheek in a Three-year-old Girl: A Quiz. Acta Derm Venereol 2021; 101:adv00580. [PMID: 34648036 PMCID: PMC9425590 DOI: 10.2340/actadv.v101.364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract is missing (Quiz)
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Affiliation(s)
- Charlotte Moreau
- Department of Dermatology, Unit of Paediatric Dermatology, CHRU Tours, FR-37000 Tours.
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Pottier C, Maruani A, Dujardin F, Robert J. Cutaneous Horn on Four-year-old Child's Arm: A Quiz. Acta Derm Venereol 2021; 101:adv00567. [PMID: 34427317 PMCID: PMC9425611 DOI: 10.2340/00015555-3902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Mofid Y, Faleweei G, Chartier C, Machet L, Vierron E, Gissot V, Tauveront V, Georgescou G, Dujardin PA, Machet MC, Kervarrec T, Patat F, Ossant F, Maruani A. High-Frequency Transient Elastography Prototype to Assess Skin (Dermis) Fibrosis: A Diagnostic Study in Patients with Venous Insufficiency and Controls. Ultraschall Med 2021; 42:503-513. [PMID: 32187631 DOI: 10.1055/a-1047-3146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE High-frequency transient elastography (HF-TE) is a noninvasive technique for assessing shear-wave speed and finally elasticity in thin tissue such as the skin. It has never been validated for monitoring fibrotic skin diseases. The purpose was to evaluate the potential of HF-TE to assess skin fibrosis in patients with chronic venous disorders (CVD). MATERIALS AND METHODS This clinical study enrolled 48 patients at various stages of CVD and 48 paired healthy volunteers. Subjects underwent a clinical examination with an evaluation of Rodnan's fibrosis skin score. We studied the dermis thickness measured using ultrasound (US) and elasticity measurements using cutometer and HF-TE studied according to 3 cutaneous zones positioned on the leg. The area under the receiver operating characteristic curve (AUC) was calculated to evaluate the diagnosis performance for a combined parameter (PRL) based on a logistic regression model using both elasticity and dermal thickness. RESULTS Patients with CVD had significantly higher values of skin elasticity than healthy subjects, 134.5 kPa and 132.1 kPa vs. 91.3 kPa, respectively. The dermis thickness also increased with escalation in CVD stage for all studied zones. The PRL parameter had an AUC value of 0.79 for all zones and stages of CVD clustered. The discriminating power of PRL increased with escalation of the CVD stage; with an AUC value of up to 0.89 for evolved stages, and a sensitivity and specificity of 0.79 and 0.89, respectively. CONCLUSION HF-TE, coupled with a US measurement of dermis thickness, made it possible to propose a new biomarker, which proved to be a good diagnostic tool for skin fibrosis.
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Affiliation(s)
- Yassine Mofid
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | | | | | - Laurent Machet
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
- Department of Dermatology, CHRU Tours, France
| | | | | | | | | | | | | | | | - Frédéric Patat
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
- CHRU Tours, CIC 1415, Tours, France
| | - Frederic Ossant
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
- CHRU Tours, CIC 1415, Tours, France
| | - Annabel Maruani
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
- Department of Dermatology, CHRU Tours, France
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Largeau B, Agier MS, Beau-Salinas F, Pariente A, Maruani A, Vial T, Jonville-Béra AP. Specific features of amoxicillin-associated Drug Reaction with Eosinophilia and Systemic Symptoms syndrome: a nationwide study. J Eur Acad Dermatol Venereol 2021; 35:2415-2420. [PMID: 34459032 DOI: 10.1111/jdv.17631] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/11/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Growing evidence indicates that amoxicillin induces herpesvirus replication in vitro. As these play a central pathophysiological role in Drug Reaction with Eosinophilia and Systemic Symptoms syndrome (DRESS), amoxicillin could present with specific DRESS features. OBJECTIVE To characterize the onset patterns of amoxicillin-associated DRESS. METHODS All cases of DRESS (Kardaun score ≥4) involving amoxicillin and reported in the French Pharmacovigilance Database between January 1, 2004 and November 30, 2019 were included. Onset circumstances for these cases were categorized considering the onset delay from amoxicillin initiation, and the presence of concomitant medications with a compatible time to onset. RESULTS A total of 146 probable cases or definite cases of DRESS were included. Three onset circumstances were identified: (i) 'amoxicillin clear culprit' where amoxicillin was the sole suspect drug or when concomitant drugs of compatible time to onset were not reported to cause DRESS (n = 62); (ii) 'amoxicillin possible culprit' in the presence of other potentially culprit drugs in addition to amoxicillin (n = 44) and (iii) 'flare' where amoxicillin, used after DRESS onset, induced flare-up reactions (n = 40). The median time to onset was 5 days (IQR 2-11) in 'clear culprit', and 18 days (IQR 7-26) in 'possible culprit' cases. In 'flare' cases, the median latency between amoxicillin initiation and flare-up reactions was 3 days (IQR 2-5). CONCLUSIONS Amoxicillin can induce DRESS with a specific early onset and exacerbate DRESS from another drug.
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Affiliation(s)
- B Largeau
- CHRU de Tours, Service de Pharmacosurveillance, Centre Régional de Pharmacovigilance Centre-Val de Loire, Tours, France
| | - M-S Agier
- CHRU de Tours, Service de Pharmacosurveillance, Centre Régional de Pharmacovigilance Centre-Val de Loire, Tours, France.,Université de Tours, Université de Nantes, INSERM, methodS in Patients-centered outcomes and HEalth ResEarch (SPHERE) - UMR 1246, Tours, France
| | - F Beau-Salinas
- CHRU de Tours, Service de Pharmacosurveillance, Centre Régional de Pharmacovigilance Centre-Val de Loire, Tours, France
| | - A Pariente
- CHU Bordeaux, Service de Pharmacologie Médicale, Centre Régional de Pharmacovigilance, Bordeaux, France.,Université de Bordeaux, INSERM, Bordeaux Population Health Research (BPH) Research Center - UMR 1219, Team Pharmacoepidemiology, Bordeaux, France
| | - A Maruani
- Université de Tours, Université de Nantes, INSERM, methodS in Patients-centered outcomes and HEalth ResEarch (SPHERE) - UMR 1246, Tours, France.,Service de Dermatologie, CHRU de Tours, Tours, France
| | - T Vial
- Hospices Civils de Lyon, Service Hospitalo-Universitaire de Pharmacotoxicologie, Centre Régional de Pharmacovigilance, Lyon, France
| | - A-P Jonville-Béra
- CHRU de Tours, Service de Pharmacosurveillance, Centre Régional de Pharmacovigilance Centre-Val de Loire, Tours, France.,Université de Tours, Université de Nantes, INSERM, methodS in Patients-centered outcomes and HEalth ResEarch (SPHERE) - UMR 1246, Tours, France
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Vermersch C, Boccara O, Chiaverini C, Mazereeuw-Hautier J, Sigg N, Mallet S, Vabres P, Herbreteau D, Le Touze A, Maruani A, Leducq S. Health care transition for patients with vascular malformations: a French multicenter cross-sectional study. Orphanet J Rare Dis 2021; 16:352. [PMID: 34362421 PMCID: PMC8349005 DOI: 10.1186/s13023-021-01970-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 07/19/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Health care transition (i.e., transition from pediatric to adult care) is challenging in chronic conditions but has been poorly studied in rare chronic skin diseases. We investigated the proportion of lost to follow-up among patients with superficial vascular malformations after health care transition. We also collected patients' opinions. This prospective, multicenter, cross-sectional study was performed at 7 French hospitals. We included patients aged 19-25 years, who were followed for a superficial vascular malformation before age 16, and who had completed the transition period in 2020. Data were collected from medical records and a questionnaire was sent to included patients asking about the health care transition. RESULTS Among the 90 patients included, 41 (46%) were lost to follow-up after health care transition period. The age at diagnosis was significantly higher for lost to follow-up than non- lost to follow-up patients. The lost to follow-up proportion was similar between patients who changed and did not change hospitals during the transition. Responses to the questionnaire were obtained for 47 of 90 patients (52.2% response rate); most were satisfied with their care (n = 31/36, 86.1%); however, a lack of psychological support was reported. CONCLUSIONS Health care transition is associated to a high rate of lost to follow-up. Early management seems associated to less lost to follow-up. Further studies are needed to better understand risk factors for a failed health care transition and its consequences.
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Affiliation(s)
- Camille Vermersch
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), CHRU Tours, Avenue de La République, 37044, Tours Cedex 9, France
| | - Olivia Boccara
- Department of Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Necker-Enfants Malades University Hospital, APHP5, Paris, France.,Imagine Institute, Paris University, Necker-Enfants Malades University Hospital, APHP5, Paris, France
| | | | | | - Nina Sigg
- Department of Dermatology, University Hospital Center of Angers, Angers, France
| | - Stéphanie Mallet
- Department of Dermatology, University Hospital Center of Marseille, 13885, Marseille Cedex 5, France
| | - Pierre Vabres
- Department of Dermatology, University Hospital Center of Dijon, Dijon, France
| | - Denis Herbreteau
- Department of Neuroradiology and Interventional Radiology, University Hospital Center of Tours, Tours, France
| | - Anne Le Touze
- Department of Pediatric Surgery, University Hospital Center of Tours, Tours, France
| | - Annabel Maruani
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), CHRU Tours, Avenue de La République, 37044, Tours Cedex 9, France.,Universities of Tours and Nantes, INSERM 1246-SPHERE, 37000, Tours, France
| | - Sophie Leducq
- Department of Dermatology and Reference Center for Rare Diseases and Vascular Malformations (MAGEC), CHRU Tours, Avenue de La République, 37044, Tours Cedex 9, France. .,Universities of Tours and Nantes, INSERM 1246-SPHERE, 37000, Tours, France.
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47
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Bedouelle E, Ben Said B, Tetart F, Milpied B, Welfringer-Morin A, Maruani A, Catteau B, Dezoteux F, Staumont-Sallé D, Mazereeuw-Hautier J, Abasq C, Chiaverini C, Delaunay J, Mallet S, Sterling B, Puzenat E, Raynal M, Collet E, Bernier C. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Series of 49 French Pediatric Cases. J Allergy Clin Immunol Pract 2021; 10:267-274.e5. [PMID: 34332174 DOI: 10.1016/j.jaip.2021.07.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 06/23/2021] [Accepted: 07/02/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare and potentially fatal adverse reaction. It can be difficult to diagnose, even more so among children, because symptoms may mimic other commonly encountered pediatric conditions. OBJECTIVE To describe clinical and laboratory features of DRESS syndrome in the pediatric population (age ≤18 years) and establish causative agents and treatment modalities. METHODS This was a multicenter retrospective study of probable and definite DRESS cases (Registry of Sever Cutaneous Adverse Reaction score ≥ 4) in children hospitalized in 15 French university hospitals between 2000 and 2020. RESULTS We included 49 cases. All children had fever and rash, 69.4% had lymphadenopathy, and 65.3% had facial edema. The most common organ affected was the liver (83.7%). Treatment consisted of topical corticosteroid in only 30.6% and systemic corticosteroid in 55.1%; 12.2% received intravenous immunoglobulin. Among probable and likely culprit drugs, 65% were antibiotics and 27.5% were antiepileptics, median time to DRESS symptom onset after initiation of 15 days (13 days with antibiotics and 21 days with antiepileptics). Twenty-seven children had allergy assessment for causative agents, 65.4% of whom had positive tests. CONCLUSIONS Culprit drugs are frequently antibiotics and antiepileptic drugs, and onset is often less than 2 weeks after treatment starts, especially with antibiotics. Treatment with topical corticosteroids appears to be sufficient in the least severe cases. Treatment by systemic corticosteroid therapy remains the reference treatment in case of severe organ damage.
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Affiliation(s)
- Eve Bedouelle
- Service de Dermatologie, Hôtel Dieu, Centre Hospitalier Universitaire de Nantes, Nantes, France.
| | - Benoit Ben Said
- Service de Dermatologie, Centre Hospitalier Universitaire de Lyon, Lyon, France
| | - Florence Tetart
- Service de Dermatologie, Centre Hospitalier Universitaire de Rouen, Rouen, France; Centre Erik Satie, Unité d'Allergologie, Centre Hospitalier Universitaire de Rouen, Rouen, France
| | - Brigitte Milpied
- Service de Dermatologie et Dermatologie Pédiatrique, Hôpital Saint-André et Pellegrin, Bordeaux, France
| | - Anne Welfringer-Morin
- Service de Dermatologie, Centre de Référence des Génodermatoses et des Maladies Rares à Expression Cutanée, Assistance Publique Hôpitaux de Paris, Hôpital Necker-Enfants Malades Université de Paris, Paris, France
| | - Annabel Maruani
- Université de Tours, INSERM 1246-SPHERE, Service de Dermatologie, Unité de Dermatologie Pédiatrique, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Benoit Catteau
- Service de Dermatologie Center Hospitalier Universitaire de Lille, Université de Lille, Institute for Translational Research in Inflammation, INSERM, Lille, France
| | - Frédéric Dezoteux
- Service de Dermatologie Center Hospitalier Universitaire de Lille, Université de Lille, Institute for Translational Research in Inflammation, INSERM, Lille, France
| | - Delphine Staumont-Sallé
- Service de Dermatologie Center Hospitalier Universitaire de Lille, Université de Lille, Institute for Translational Research in Inflammation, INSERM, Lille, France
| | | | - Claire Abasq
- Service de Dermatologie, Centre Hospitalier Régional Universitaire de Brest, Brest, France
| | | | - Juliette Delaunay
- Service de Dermatologie, Centre Hospitalier Universitaire d'Angers site Larrey, Angers, France
| | - Stéphanie Mallet
- Service de Dermatologie et Cancérologie Cutanée, Hôpital de la Timone, Assistance Publique Hôpitaux de Marseille, Aix-Marseille Université, Marseille, France
| | - Benoit Sterling
- Services de Pédiatrie et Pneumologie Pédiatrique, Hôpital de La Timone-Enfants et Hôpital Nord, Assistance Publique Hôpitaux de Marseille, Aix-Marseille Université, Marseille, France
| | - Eve Puzenat
- Service de Dermatologie, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France
| | - Margot Raynal
- Service de Dermatologie, Centre Hospitalier Universitaire de Rouen, Rouen, France
| | - Evelyne Collet
- Service de Dermatologie, Hôpital Le Bocagen, Centre Hospitalier Régional Universitaire de Dijon, Dijon, France
| | - Claire Bernier
- Service de Dermatologie, Hôtel Dieu, Centre Hospitalier Universitaire de Nantes, Nantes, France.
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48
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Juzot C, Aubert H, Bessis D, Boccara O, Bourrat E, Chiaverini C, Flamant C, Fournet M, Hubiche T, Labrèze C, Martin L, Piram M, Seta V, Finon A, Maruani A, Barbarot S. Transient abdominal telangiectasia of the newborn. Pediatr Dermatol 2021; 38:864-867. [PMID: 34152036 DOI: 10.1111/pde.14620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
We report 20 newborns who developed, at a median age of 7 days, large abdominal patches of radially arranged purplish telangiectasia in a bilateral and symmetrical pattern in relation to the midline, creating a "butterfly wing" pattern. Clinical examination was normal in 13 newborns, six newborns had abdominal distention, and one newborn had poor weight gain due to inadequate breastfeeding. Most lesions spontaneously resolved within 3 months and did not reoccur for 19 newborns. Transient abdominal telangiectasia of the newborn (TATN) appears to be a distinctive entity that has not been previously described.
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Affiliation(s)
- Cécile Juzot
- Department of Dermatology, University Hospital of Nantes, Nantes, France
| | - Hélène Aubert
- Department of Dermatology, University Hospital of Nantes, Nantes, France
| | - Didier Bessis
- Department of Dermatology, University Hospital of Montpellier, Montpellier, France
| | - Olivia Boccara
- Department of Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Paris University, Imagine Institute, Necker-Enfants Malades University Hospital, APHP5, Paris, France
| | - Emmanuelle Bourrat
- Department of General Pediatrics, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Cyril Flamant
- Department of Neonatal Medicine, University Hospital of Nantes, Nantes, France
| | - Marine Fournet
- Department of Pediatric Dermatology, Hôpital Pellegrin-Enfants, University Hospital of Bordeaux, Bordeaux, France
| | - Thomas Hubiche
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - Christine Labrèze
- Department of Dematology, Pellegrin Children's Hospital, Bordeaux, France
| | - Ludovic Martin
- Department of Dermatology, University Hospital of Angers, Angers, France
| | - Maryam Piram
- Department of Pediatrics, Division of Dermatology, CHU Sainte Justine Research Center, CHU Sainte Justine, University of Montréal, Montréal, QC, Canada
| | - Vannina Seta
- Department of Dermatology, Cochin University Hospital, Paris, France
| | - Antoine Finon
- Department of Dermatology, Orléans Hospital, Orléans, France
| | - Annabel Maruani
- Department of Dermatology, Unit of Pediatric Dermatology, University of Tours, Inserm 1246-SPHERE, CHRU Tours, Tours, France
| | - Sébastien Barbarot
- Department of Dermatology, Nantes University, CHU Nantes, UMR 1280 PhAN, INRA, Nantes, France
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49
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Sorlin A, Carmignac V, Amiel J, Boccara O, Fraitag S, Maruani A, Theiler M, Weibel L, Duffourd Y, Philippe C, Thauvin-Robinet C, Faivre L, Rivière JB, Vabres P, Kuentz P. Expanding the clinical spectrum of mosaic BRAF skin phenotypes. J Eur Acad Dermatol Venereol 2021; 35:e690-e693. [PMID: 34051131 DOI: 10.1111/jdv.17413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 05/19/2021] [Indexed: 11/28/2022]
Affiliation(s)
- A Sorlin
- Centre de Génétique et Centre de référence « Anomalies du Développement et Syndromes Malformatifs », Hôpital d'Enfants, Centre Hospitalier Universitaire de Dijon, Dijon, France.,UMR-Inserm 1231 GAD, Génétique des Anomalies du développement, Université de Bourgogne Franche-Comté, Dijon, France
| | - V Carmignac
- UMR-Inserm 1231 GAD, Génétique des Anomalies du développement, Université de Bourgogne Franche-Comté, Dijon, France
| | - J Amiel
- Service de Génétique Médicale, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - O Boccara
- Department of Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Université Paris, Paris-Centre, Institut Imagine, Hôpital Universitaire Necker-Enfants Malades, APHP, Paris, France
| | - S Fraitag
- Service d'Anatomie et de Cytologie Pathologiques, APHP, Hôpital Necker-Enfants Malades, Paris, France
| | - A Maruani
- Service de Dermatologie, Centre de Référence des Maladies Rares - MAGEC, Centre Hospitalier Universitaire de Tours, Université de Tours, SPHERE-INSERM 1246, Tours, France
| | - M Theiler
- Pediatric Skin Center, Department of Dermatology, University Children's Hospital Zurich, Zurich, Switzerland
| | - L Weibel
- Pediatric Skin Center, Department of Dermatology, University Children's Hospital Zurich, Zurich, Switzerland
| | - Y Duffourd
- UMR-Inserm 1231 GAD, Génétique des Anomalies du développement, Université de Bourgogne Franche-Comté, Dijon, France.,Fédération Hospitalo-Universitaire Médecine Translationnelle et Anomalies du Développement (FHU TRANSLAD), Centre Hospitalier Universitaire de Dijon et Université de Bourgogne Franche-Comté, Dijon, France
| | - C Philippe
- UMR-Inserm 1231 GAD, Génétique des Anomalies du développement, Université de Bourgogne Franche-Comté, Dijon, France.,Fédération Hospitalo-Universitaire Médecine Translationnelle et Anomalies du Développement (FHU TRANSLAD), Centre Hospitalier Universitaire de Dijon et Université de Bourgogne Franche-Comté, Dijon, France.,UF Innovation en diagnostic génomique des maladies rares, CHU de Dijon Bourgogne, Dijon, France
| | - C Thauvin-Robinet
- Centre de Génétique et Centre de référence « Anomalies du Développement et Syndromes Malformatifs », Hôpital d'Enfants, Centre Hospitalier Universitaire de Dijon, Dijon, France.,UMR-Inserm 1231 GAD, Génétique des Anomalies du développement, Université de Bourgogne Franche-Comté, Dijon, France.,Fédération Hospitalo-Universitaire Médecine Translationnelle et Anomalies du Développement (FHU TRANSLAD), Centre Hospitalier Universitaire de Dijon et Université de Bourgogne Franche-Comté, Dijon, France
| | - L Faivre
- Centre de Génétique et Centre de référence « Anomalies du Développement et Syndromes Malformatifs », Hôpital d'Enfants, Centre Hospitalier Universitaire de Dijon, Dijon, France.,UMR-Inserm 1231 GAD, Génétique des Anomalies du développement, Université de Bourgogne Franche-Comté, Dijon, France.,Fédération Hospitalo-Universitaire Médecine Translationnelle et Anomalies du Développement (FHU TRANSLAD), Centre Hospitalier Universitaire de Dijon et Université de Bourgogne Franche-Comté, Dijon, France
| | - J-B Rivière
- UMR-Inserm 1231 GAD, Génétique des Anomalies du développement, Université de Bourgogne Franche-Comté, Dijon, France.,Fédération Hospitalo-Universitaire Médecine Translationnelle et Anomalies du Développement (FHU TRANSLAD), Centre Hospitalier Universitaire de Dijon et Université de Bourgogne Franche-Comté, Dijon, France.,UF Innovation en diagnostic génomique des maladies rares, CHU de Dijon Bourgogne, Dijon, France
| | - P Vabres
- UMR-Inserm 1231 GAD, Génétique des Anomalies du développement, Université de Bourgogne Franche-Comté, Dijon, France.,Fédération Hospitalo-Universitaire Médecine Translationnelle et Anomalies du Développement (FHU TRANSLAD), Centre Hospitalier Universitaire de Dijon et Université de Bourgogne Franche-Comté, Dijon, France.,Service de Dermatologie, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - P Kuentz
- UMR-Inserm 1231 GAD, Génétique des Anomalies du développement, Université de Bourgogne Franche-Comté, Dijon, France.,Fédération Hospitalo-Universitaire Médecine Translationnelle et Anomalies du Développement (FHU TRANSLAD), Centre Hospitalier Universitaire de Dijon et Université de Bourgogne Franche-Comté, Dijon, France.,Oncobiologie Génétique Bioinformatique, PCBio, Centre Hospitalier Universitaire de Besançon, Besançon, France
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50
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Hacard F, Giraudeau B, d'Acremont G, Jegou MH, Jonville-Bera AP, Munck S, Pham BN, Mavoungou S, Cornillier H, Guillot B, Beylot-Barry M, Chosidow O, Maruani A. Guidelines for the management of chronic spontaneous urticaria: recommendations supported by the Centre of Evidence of the French Society of Dermatology. Br J Dermatol 2021; 185:658-660. [PMID: 33913519 PMCID: PMC8457139 DOI: 10.1111/bjd.20415] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 04/19/2021] [Accepted: 04/23/2021] [Indexed: 11/30/2022]
Affiliation(s)
- F Hacard
- Department of Allergology and Clinical Immunology, University Hospital of Lyon, 69495, Lyon, France
| | - B Giraudeau
- Universities of Tours and Nantes, 37000, Tours, France
| | | | - M-H Jegou
- Dermatology Office, 33290, Blanquefort, France
| | - A-P Jonville-Bera
- Universities of Tours and Nantes, 37000, Tours, France.,University Hospital of Tours, 37000, Tours, France
| | - S Munck
- Department of Teaching and Research in General Practice, University Nice Sophia Antipolis, 06000, Nice, France
| | - B-N Pham
- University Hospital of Reims, 51000, Reims, France
| | - S Mavoungou
- Centre of Evidence of the French Society of Dermatology, 75009, Paris, France
| | - H Cornillier
- University Hospital Centre of Tours, 37044, Tours CEDEX 9, France
| | - B Guillot
- University of Montpellier, 34000, Montpellier, France
| | - M Beylot-Barry
- University Hospital of Bordeaux, 33000, Bordeaux, France
| | - O Chosidow
- Centre of Evidence of the French Society of Dermatology, 75009, Paris, France.,AP-HP, Henri Mondor Hospital, Paris-Est University, 94010, Créteil, France
| | - A Maruani
- Universities of Tours and Nantes, 37000, Tours, France.,University Hospital Centre of Tours, 37044, Tours CEDEX 9, France
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