1
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Fernandez AP, Dauden E, Gerdes S, Lebwohl MG, Menter MA, Leonardi C, Gooderham M, Gebauer K, Tada Y, Lacour JP, Bianchi L, Egeberg A, Pau-Charles I, Mendelsohn AM, Rozzo SJ, Mehta NN. Tildrakizumab efficacy and safety in patients with psoriasis and concomitant metabolic syndrome: post hoc analysis of 5-year data from reSURFACE 1 and reSURFACE 2. J Eur Acad Dermatol Venereol 2022; 36:1774-1783. [PMID: 35460287 PMCID: PMC9545614 DOI: 10.1111/jdv.18167] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 09/24/2021] [Revised: 12/15/2021] [Accepted: 01/18/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Limited data are available on long-term efficacy and safety of biologics in patients with psoriasis and metabolic syndrome (MetS), a common comorbidity. OBJECTIVES This analysis updates tildrakizumab efficacy and safety for up to 5 years in patients with and without MetS. METHODS This was a post hoc analysis of the double-blind, randomized, placebo-controlled, phase 3 reSURFACE 1 (NCT01722331) and reSURFACE 2 (NCT01729754) trials in adult patients with moderate to severe chronic plaque psoriasis. Analyses included data through Week 244 from patients who continuously received tildrakizumab 100 (TIL100) or 200 mg (TIL200) and entered the extension studies, stratified by baseline MetS status. Efficacy was assessed via Psoriasis Area and Severity Index (PASI) scores. Safety was evaluated from exposure-adjusted incidence rates (EAIRs) of treatment-emergent adverse events (TEAEs). RESULTS reSURFACE 1 and reSURFACE 2 analyses included 26 and 44 TIL100-treated patients with MetS, 98 and 167 TIL100-treated patients without MetS, 34 and 30 TIL200-treated patients with MetS, and 111 and 130 TIL200-treated patients without MetS, respectively. There were no clinically relevant differences in PASI 75/90/100 response rates at Week 244 between patients with vs without MetS. The proportion of patients with vs without MetS achieving absolute PASI score <3 at Week 244 was 53.8% vs 69.4% and 77.3% vs 80.8% in reSURFACE 1 and 2, respectively, for TIL100-treated patients and 58.8% vs 72.1% and 63.3% vs 72.3%, respectively, for TIL200-treated patients. In both studies, median reduction from baseline PASI score at all time points in patients with vs without MetS was >83% vs >89% for TIL100 and >85% vs >90% for TIL200. Pooled EAIRs of TEAEs, serious TEAEs, and TEAEs of special interest were similar in patients with and without MetS. CONCLUSIONS Tildrakizumab maintains efficacy and a favorable safety profile over 5 years in patients with psoriasis regardless of MetS status.
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Affiliation(s)
- A P Fernandez
- Departments of Dermatology and Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - E Dauden
- Dermatology Department, Instituto de Investigación Sanitaria La Princesa (IIS-IP), Madrid, Spain
| | - S Gerdes
- Department of Dermatology, Psoriasis-Center, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - M G Lebwohl
- Department of Dermatology, Mount Sinai Hospital, New York, NY, USA
| | - M A Menter
- Division of Dermatology, Baylor Scott & White, and Texas A&M College of Medicine, Dallas, TX, USA
| | - C Leonardi
- Central Dermatology and Saint Louis University School of Medicine, St. Louis, MO, USA
| | - M Gooderham
- Probity Medical Research, Peterborough, ON, Canada.,SKiN Centre for Dermatology, Peterborough, ON, Canada.,Queen's University, Kingston, ON, Canada
| | - K Gebauer
- Fremantle Dermatology, Fremantle, Western Australia, Australia
| | - Y Tada
- Teikyo University, Tokyo, Japan
| | - J P Lacour
- Department of Dermatology, University of Nice Sophia Antipolis, Nice, France
| | - L Bianchi
- Dermatology Unit, Tor Vergata University Hospital, Rome, Italy
| | - A Egeberg
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | | | - S J Rozzo
- Sun Pharmaceutical Industries, Inc., Princeton, NJ, USA
| | - N N Mehta
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
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2
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Say M, Tella E, Boccara O, Sauvage M, Bourrat E, Tian Y, Monfort JB, Lok C, Desierier F, Beneton N, Abasq-Thomas C, Kupfer-Bessaguet I, Mallet S, Lacour JP, Plantin P, Sigal ML, Mazereeuw-Hautier J, Mahé E. Leg ulcers in childhood: A multicenter study in France. Ann Dermatol Venereol 2021; 149:51-55. [PMID: 34218940 DOI: 10.1016/j.annder.2021.05.004] [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] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/30/2021] [Accepted: 05/19/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Leg ulcers in adults are a major public health concern. Their incidence increases with age and many causes have been identified, predominantly associated with vascular diseases. Leg ulcers in children and teenagers are less frequent. The aim of our study was to identify the causes of leg ulcers in children and teenagers, and to evaluate their management. METHODS This retrospective multicenter study was conducted by members of the Angio-dermatology Group of the French Society of Dermatology and of the French Society of Pediatric Dermatology. Data from children and teenagers (< 18 years), seen between 2008 and 2020 in 12 French hospitals for chronic leg ulcer (disease course>4 weeks), were included. RESULTS We included 27 patients, aged from 2.3 to 17.0 years. The most frequent causes of leg ulcer were: general diseases (n=9: pyoderma gangrenosum, dermatomyositis, interferonopathy, sickle cell disease, prolidase deficiency, scleroderma, Ehlers-Danlos syndrome), vasculopathies (n=8: hemangioma, capillary malformation, arteriovenous malformation), trauma (n=4: bedsores, pressure ulcers under plaster cast), infectious diseases (n=4: pyoderma, tuberculosis, Buruli ulcer) and neuropathies (n=2). Comorbidities (59.3%) and chronic treatments (18.5%) identified as risk factors for delayed healing were frequent. The average time to healing was 9.1 months. DISCUSSION Leg ulcers are less frequent in children and teenagers than in adults and their causes differ from those in adults. Comorbidities associated with delayed healing must be identified and managed. Children and teenagers tend to heal faster than adults, but a multidisciplinary management approach is necessary.
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Affiliation(s)
- M Say
- Service de dermatologie et médecine vasculaire, hôpital Victor-Dupouy, 69, rue du Lieutenant-Colonel Prud'hon, 95100 Argenteuil, France.
| | - E Tella
- Service de dermatologie et médecine vasculaire, hôpital Victor-Dupouy, 69, rue du Lieutenant-Colonel Prud'hon, 95100 Argenteuil, France
| | - O Boccara
- Service de dermatologie, centre hospitalier universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - M Sauvage
- Service de dermatologie, centre de référence des Maladies Rares de la Peau, centre hospitalier universitaire Larrey, Université Paul-Sabatier, Toulouse, France
| | - E Bourrat
- Service de pédiatrie générale, centre hospitalier universitaire Robert-Debré, AP-HP, Paris, France
| | - Y Tian
- Service de pédiatrie générale, centre hospitalier universitaire Robert-Debré, AP-HP, Paris, France
| | - J-B Monfort
- Service de dermatologie, centre hospitalier universitaire Tenon, AP-HP, Paris, France
| | - C Lok
- Service de dermatologie, centre hospitalier universitaire Amiens-Picardie, Amiens, France
| | - F Desierier
- Service de dermatologie, centre hospitalier universitaire Amiens-Picardie, Amiens, France
| | - N Beneton
- Service de dermatologie, centre hospitalier du Mans, Le Mans, France
| | - C Abasq-Thomas
- Service de dermatologie, centre hospitalier Régional Universitaire de Brest, Brest, France
| | | | - S Mallet
- Service de dermatologie, centre hospitalier universitaire La Timone, Assistance Publique des Hôpitaux de Marseille, Marseille, France
| | - J-P Lacour
- Service de dermatologie, centre hospitalier universitaire L'archet, Nice, France
| | - P Plantin
- Service de dermatologie, centre hospitalier de Cornouaille, Quimper, France
| | - M-L Sigal
- Service de dermatologie et médecine vasculaire, hôpital Victor-Dupouy, 69, rue du Lieutenant-Colonel Prud'hon, 95100 Argenteuil, France
| | - J Mazereeuw-Hautier
- Service de dermatologie, centre de référence des Maladies Rares de la Peau, centre hospitalier universitaire Larrey, Université Paul-Sabatier, Toulouse, France
| | - E Mahé
- Service de dermatologie et médecine vasculaire, hôpital Victor-Dupouy, 69, rue du Lieutenant-Colonel Prud'hon, 95100 Argenteuil, France
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3
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Hérissé AL, Charlesworth A, Bellon N, Leclerc-Mercier S, Bourrat E, Hadj-Rabia S, Bodemer C, Lacour JP, Chiaverini C. Genotypic and phenotypic analysis of 34 cases of inherited junctional epidermolysis bullosa caused by COL17A1 mutations. Br J Dermatol 2021; 184:960-962. [PMID: 33393081 DOI: 10.1111/bjd.19752] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 09/03/2020] [Accepted: 09/03/2020] [Indexed: 11/26/2022]
Affiliation(s)
- A L Hérissé
- Departments of Dermatology, Referral Center for Genodermatoses, Department of Dermatology, Referral Center for Genodermatoses, Centre Hospitalier Universitaire de Nice, Nice
| | - A Charlesworth
- Departments of Dermatology, Referral Center for Genodermatoses, Department of Dermatology, Referral Center for Genodermatoses, Centre Hospitalier Universitaire de Nice, Nice
| | - N Bellon
- Department of Dermatology, Referral Center for Genodermatoses, Necker Enfants Malades Hospital, Paris
| | - S Leclerc-Mercier
- Department of Dermatology, Referral Center for Genodermatoses, Necker Enfants Malades Hospital, Paris
| | - E Bourrat
- Department of Dermatology, Referral Center for Genodermatoses, Saint Louis Hospital, APHP Paris, France
| | - S Hadj-Rabia
- Department of Dermatology, Referral Center for Genodermatoses, Necker Enfants Malades Hospital, Paris
| | - C Bodemer
- Department of Dermatology, Referral Center for Genodermatoses, Necker Enfants Malades Hospital, Paris
| | - J P Lacour
- Departments of Dermatology, Referral Center for Genodermatoses, Department of Dermatology, Referral Center for Genodermatoses, Centre Hospitalier Universitaire de Nice, Nice
| | - C Chiaverini
- Departments of Dermatology, Referral Center for Genodermatoses, Department of Dermatology, Referral Center for Genodermatoses, Centre Hospitalier Universitaire de Nice, Nice
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4
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Wollenberg A, Blauvelt A, Guttman-Yassky E, Worm M, Lynde C, Lacour JP, Spelman L, Katoh N, Saeki H, Poulin Y, Lesiak A, Kircik L, Cho SH, Herranz P, Cork MJ, Peris K, Steffensen LA, Bang B, Kuznetsova A, Jensen TN, Østerdal ML, Simpson EL. Tralokinumab for moderate-to-severe atopic dermatitis: results from two 52-week, randomized, double-blind, multicentre, placebo-controlled phase III trials (ECZTRA 1 and ECZTRA 2). Br J Dermatol 2020; 184:437-449. [PMID: 33000465 PMCID: PMC7986411 DOI: 10.1111/bjd.19574] [Citation(s) in RCA: 239] [Impact Index Per Article: 59.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2020] [Indexed: 12/14/2022]
Abstract
Background Tralokinumab, a fully human monoclonal antibody, specifically neutralizes interleukin‐13, a key cytokine driving peripheral inflammation in atopic dermatitis (AD). In phase II studies, tralokinumab combined with topical corticosteroids provided early and sustained improvements in AD signs and symptoms. Objectives To evaluate the efficacy and safety of tralokinumab monotherapy in adults with moderate‐to‐severe AD who had an inadequate response to topical treatments. Methods In two 52‐week, randomized, double‐blind, placebo‐controlled, phase III trials, ECZTRA 1 and ECZTRA 2, adults with moderate‐to‐severe AD were randomized (3 : 1) to subcutaneous tralokinumab 300 mg every 2 weeks (Q2W) or placebo. Primary endpoints were Investigator’s Global Assessment (IGA) score of 0 or 1 at week 16 and ≥ 75% improvement in Eczema Area and Severity Index (EASI 75) at week 16. Patients achieving an IGA score of 0 or 1 and/or EASI 75 with tralokinumab at week 16 were rerandomized to tralokinumab Q2W or every 4 weeks or placebo, for 36 weeks. The trials were registered with ClinicalTrials.gov: NCT03131648 and NCT03160885. Results At week 16, more patients who received tralokinumab vs. placebo achieved an IGA score of 0 or 1: 15·8% vs. 7·1% in ECZTRA 1 [difference 8·6%, 95% confidence interval (CI) 4·1–13·1; P = 0·002] and 22·2% vs. 10·9% in ECZTRA 2 (11·1%, 95% CI 5·8–16·4; P < 0·001) and EASI 75: 25·0% vs. 12·7% (12·1%, 95% CI 6·5–17·7; P < 0·001) and 33·2% vs. 11·4% (21·6%, 95% CI 15·8–27·3; P < 0·001). Early improvements in pruritus, sleep interference, Dermatology Life Quality Index, SCORing Atopic Dermatitis and Patient‐Oriented Eczema Measure were observed from the first postbaseline measurements. The majority of week 16 tralokinumab responders maintained response at week 52 with continued tralokinumab treatment without any rescue medication (including topical corticosteroids). Adverse events were reported in 76·4% and 61·5% of patients receiving tralokinumab in ECZTRA 1 and ECZTRA 2, respectively, and in 77·0% and 66·0% of patients receiving placebo in ECZTRA 1 and ECZTRA 2, respectively, in the 16‐week initial period. Conclusions Tralokinumab monotherapy was superior to placebo at 16 weeks of treatment and was well tolerated up to 52 weeks of treatment. What is already known about this topic?Atopic dermatitis (AD) is a chronic interleukin (IL)‐13‐mediated disease. There is a need for safe and effective long‐term treatment options for AD. Tralokinumab is a fully human monoclonal antibody that binds specifically to IL‐13 with high affinity, thereby preventing receptor interaction and subsequent downstream signalling. Tralokinumab combined with topical corticosteroids showed early and sustained efficacy and safety in a 12‐week, phase IIb trial in moderate‐to‐severe AD.
What does this study add?These are the first pivotal phase III trials demonstrating that by specifically targeting IL‐13 alone, patients can achieve significant improvements in AD signs and symptoms and quality of life, and maintain these improvements over time without the requirement for topical corticosteroids. These trials provide evidence that tralokinumab offers a long‐term, well‐tolerated treatment option for patients with moderate‐to‐severe AD.
Linked Comment: Morra and Drucker. Br J Dermatol 2021; 184:386–387. Plain language summary available online
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Affiliation(s)
- A Wollenberg
- Department of Dermatology and Allergy, Ludwig Maximilian University of Munich, Munich, Germany
| | - A Blauvelt
- Oregon Medical Research Center, Portland, OR, USA
| | - E Guttman-Yassky
- Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - M Worm
- Division of Allergy and Immunology, Department of Dermatology, Venereology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - C Lynde
- Lynde Dermatology, Probity Medical Research, Markham, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - J-P Lacour
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - L Spelman
- Veracity Clinical Research, Brisbane, QLD, Australia.,Probity Medical Research, Woolloongabba, QLD, Australia
| | - N Katoh
- Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - H Saeki
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Y Poulin
- Laval University and Centre Dermatologique du Québec Métropolitain and Centre de Recherche Dermatologique du Québec Métropolitain, Québec, QC, Canada
| | - A Lesiak
- Department of Dermatology and Pediatric and Oncologic Dermatology, Medical University of Łódź, Łódź, Poland
| | - L Kircik
- Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Indiana University Medical Center, Indianapolis, IN, USA
| | - S H Cho
- Department of Dermatology, The Catholic University of Korea, Seoul, South Korea
| | - P Herranz
- Department of Dermatology, Hospital Universitario La Paz, Madrid, Spain
| | - M J Cork
- Sheffield Dermatology Research, Department of Infection, Immunity, and Cardiovascular Disease, The University of Sheffield and Sheffield Teaching Hospitals NIHR Clinical Research Facility, Sheffield, UK
| | - K Peris
- Dermatology, Catholic University and Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | | | - B Bang
- LEO Pharma A/S, Ballerup, Denmark
| | | | | | | | - E L Simpson
- Department of Dermatology, Oregon Health & Science University, Portland, OR, USA
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5
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Rezzag-Mahcene C, Cardot-Leccia N, Lacour JP, Montaudié H, Passeron T. Successful treatment of recalcitrant genital lichen planus with secukinumab. J Eur Acad Dermatol Venereol 2020; 35:e321-e323. [PMID: 33617056 DOI: 10.1111/jdv.17068] [Citation(s) in RCA: 2] [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] [Indexed: 11/30/2022]
Affiliation(s)
- C Rezzag-Mahcene
- Department of Dermatology, CHU Nice, Université Côte d'Azur, Nice, France
| | - N Cardot-Leccia
- Department of Pathology, CHU Nice, Université Côte d'Azur, Nice, France
| | - J-P Lacour
- Department of Dermatology, CHU Nice, Université Côte d'Azur, Nice, France
| | - H Montaudié
- Department of Dermatology, CHU Nice, Université Côte d'Azur, Nice, France.,INSERM, U1065, C3M, Université Côte d'Azur, Nice, France
| | - T Passeron
- Department of Dermatology, CHU Nice, Université Côte d'Azur, Nice, France.,INSERM, U1065, C3M, Université Côte d'Azur, Nice, France
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6
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Lacour JP. Les scores d’évaluation de la dermatite atopique. Ann Dermatol Venereol 2020; 147:11S12-11S18. [PMID: 33250133 DOI: 10.1016/s0151-9638(20)31083-8] [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] [Indexed: 10/22/2022]
Abstract
Scores evaluating the severity of atopic dermatitis are less well known and less used in daily practice of dermatologists than those for psoriasis, but things are changing. Indeed, the numerous trials and therapeutic advances in the field of eczema have also imposed the use of scales to objectively assess the severity of the disease and its improvement with treatment. The scores were initially numerous and poorly validated, but there is currently a trends towards simplification and standardization, with the work in particular of the Harmonizing Outcome Measures for Eczema (HOME) group. Scores for objective clinical signs, patient-reported symptoms, quality of life, and long-term disease control are now considered to be the core outcome set. The most used scores are detailed in this article. © 2020 Elsevier Masson SAS. All rights reserved.
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Affiliation(s)
- J-P Lacour
- Service de dermatologie, Hôpital Archet 2, CHU de Nice, CS 23079 06202, Nice, Cedex 3, France.
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7
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Richard MA, Lacour JP, Konstantinou MP, Ruer-Mulard M, Joly P, Aractingi S, Auquier P, Pelvet B, Augustin ML, Mahé E, Chalmers RJG. Secukinumab efficacy in reducing the severity and the psychosocial impact of moderate-to-severe psoriasis as assessed by the Simplified Psoriasis Index: results from the IPSI-PSO study. J Eur Acad Dermatol Venereol 2020; 35:677-684. [PMID: 32815591 PMCID: PMC7984225 DOI: 10.1111/jdv.16893] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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] [Received: 04/22/2020] [Accepted: 07/09/2020] [Indexed: 11/26/2022]
Abstract
Background The utility of the Simplified Psoriasis Index (SPI), a recently developed multidomain tool for assessing psoriasis, was investigated in a study assessing response to secukinumab. Methods In an open‐label, multicentre study involving 17 French centres, patients with moderate‐to‐severe plaque psoriasis received secukinumab 300 mg subcutaneously once weekly from baseline to W4, then every 4 weeks until W48. Dermatologist‐scored SPI psoriasis severity (proSPI‐s) was compared with Psoriasis Area and Severity Index (PASI). Patient self‐assessed severity (saSPI‐s) and psychosocial impact (SPI‐p) were compared with PASI and Dermatology Life Quality Index (DLQI), respectively. Results We included 120 patients (69.2% male; mean age 45.9 years; mean duration of psoriasis 21.6 years). Mean baseline scores were as follows: proSPI‐s 24.9, saSPI‐s 23.5, PASI 23.1, SPI‐p 8.2 and DLQI 13.6. Severity scores achieved by 16 weeks (proSPI‐s 2.3, saSPI‐s 2.2 and PASI 2.2) were maintained to W52. Reductions in mean psychosocial impact scores were maintained to W52 (SPI‐p and DLQI, respectively, 2.1 and 1.5 at W16; 1.5 and 1.9 at W52). Conclusions Decrease of PASI scores in response to secukinumab was closely correlated with proSPI‐s, supporting the latter's suitability for assessing response to therapy. Although the correlation between PASI and saSPI‐s was slightly weaker, patients were able to complete a valid assessment of their psoriasis independently, and thus potentially remotely. With the added benefit of psychosocial impact assessment (SPI‐p), SPI provides a valid tool enabling patients to assess their own psoriasis, remotely if necessary.
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Affiliation(s)
- M-A Richard
- CEReSS-EA 3279, Research Centre in Health Services and Quality of Life Aix Marseille University, Marseille, France.,Department of Dermatology, University Hospital Timone Marseille, APHM, Marseille, France
| | - J-P Lacour
- Department of Dermatology, University Hospital of Nice, Archet-2 Hospital, Nice, France
| | - M-P Konstantinou
- Department of Dermatology, Larrey Hospital and Paul Sabatier University, Toulouse, France
| | | | - P Joly
- Department of Dermatology, Rouen University Hospital, University of Rouen Normandie, Rouen, France
| | - S Aractingi
- Department of Dermatology, Cochin-Tarnier Hospital, Paris, France
| | - P Auquier
- CEReSS-EA 3279, Research Centre in Health Services and Quality of Life Aix Marseille University, Marseille, France.,Department of Public Health, University Hospital Timone Marseille, APHM, Marseille, France
| | - B Pelvet
- R&D, Novartis Pharma SAS, Rueil-Malmaison, France
| | - M L Augustin
- R&D, Novartis Pharma SAS, Rueil-Malmaison, France
| | - E Mahé
- Department of Dermatology, Victor Dupouy Hospital, Argenteuil, France
| | - R J G Chalmers
- Centre for Dermatology, University of Manchester, Manchester, UK
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8
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Charlesworth A, Hérissé AL, Bellon N, Leclerc-Mercier S, Bourrat E, Hadj-Rabia S, Bodemer C, Lacour JP, Chiaverini C. Genotypic and Phenotypic Analysis of 34 Cases of Inherited Junctional Epidermolysis Bullosa caused by COL17A1 Mutations. Br J Dermatol 2020. [PMID: 32911566 DOI: 10.1111/bjd.19548] [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: 01/05/2023]
Abstract
Inherited epidermolysis bullosa defines a heterogeneous group of genodermatoses characterized by skin and/or mucosa fragility resulting in blistering. The junctional variant (JEB) is associated with mutations affecting the genes expressing the components of the dermo-epidermal junction (DEJ) [1-2]. We report 34 JEB patients with COL17A1 genetic mutations diagnosed in our Center between 1993 and 2019. Medical and biological records were collected with a standardized questionnaire.
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Affiliation(s)
- A Charlesworth
- Department of Dermatology, Referral center for genodermatoses, Centre Hospitalier Universitaire de Nice, Nice, France
| | - A L Hérissé
- Department of Dermatology, Referral center for genodermatoses, Centre Hospitalier Universitaire de Nice, Nice, France
| | - N Bellon
- Department of Dermatology, Referral center for genodermatosesMAGEC, Necker Enfants Malades Hospital, Paris, France
| | - S Leclerc-Mercier
- Department of Dermatology, Referral center for genodermatosesMAGEC, Necker Enfants Malades Hospital, Paris, France
| | - E Bourrat
- Department of Dermatology, Referral center for genodermatosesMAGEC Saint Louis Hospital APHP Paris, Paris, France
| | - S Hadj-Rabia
- Department of Dermatology, Referral center for genodermatosesMAGEC, Necker Enfants Malades Hospital, Paris, France
| | - C Bodemer
- Department of Dermatology, Referral center for genodermatosesMAGEC, Necker Enfants Malades Hospital, Paris, France
| | - J P Lacour
- Department of Dermatology, Referral center for genodermatoses, Centre Hospitalier Universitaire de Nice, Nice, France
| | - C Chiaverini
- Department of Dermatology, Referral center for genodermatoses, Centre Hospitalier Universitaire de Nice, Nice, France
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9
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Di Filippo Y, Cardot-Leccia N, Long-Mira E, Andreani M, Richez V, Lacour JP, Passeron T, Montaudié H. Reactive angioendotheliomatosis revealing a glomerulopathy secondary to a monoclonal gammopathy successfully treated with lenalidomide. J Eur Acad Dermatol Venereol 2020; 35:e115-e118. [PMID: 32735354 DOI: 10.1111/jdv.16840] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Y Di Filippo
- Dermatology Department, Université Côte d'Azur, CHU Nice, Nice, France
| | - N Cardot-Leccia
- Department of Histopathology Laboratory Central of Pathology, Université Côte d'Azur, CHU Nice, Nice, France
| | - E Long-Mira
- Laboratory of Clinical and Experimental Pathology, Université Côte d'Azur, CHU Nice, France
| | - M Andreani
- Nephrology Department, Université Côte d'Azur, CHU Nice, Nice, France
| | - V Richez
- Hematology Department, Université Côte d'Azur, CHU Nice, Nice, France
| | - J-P Lacour
- Dermatology Department, Université Côte d'Azur, CHU Nice, Nice, France
| | - T Passeron
- Dermatology Department, Université Côte d'Azur, CHU Nice, Nice, France.,INSERM, U1065, Centre Méditerranéen de Médecine Moléculaire, Université Côte d'Azur, Nice, France
| | - H Montaudié
- Dermatology Department, Université Côte d'Azur, CHU Nice, Nice, France.,INSERM, U1065, Centre Méditerranéen de Médecine Moléculaire, Université Côte d'Azur, Nice, France
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10
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Del Giudice P, Boudoumi D, Le Guen B, Reverte M, Gutnecht J, Lacour JP, Kraemer JP, Motard A, Roa M. Catastrophic acute bilateral lower limbs necrosis associated with COVID-19 as a likely consequence of both vasculitis and coagulopathy. J Eur Acad Dermatol Venereol 2020; 34:e679-e680. [PMID: 32557889 PMCID: PMC7323041 DOI: 10.1111/jdv.16763] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/03/2020] [Accepted: 06/08/2020] [Indexed: 11/28/2022]
Affiliation(s)
- P Del Giudice
- Infectiology-Dermatology Unit, Centre Hospitalier de Fréjus-Saint-Raphaël, Fréjus, France
| | - D Boudoumi
- Pneumology Unit, Centre Hospitalier de Fréjus-Saint-Raphaël, Fréjus, France
| | - B Le Guen
- Pneumology Unit, Centre Hospitalier de Fréjus-Saint-Raphaël, Fréjus, France
| | - M Reverte
- Infectiology-Dermatology Unit, Centre Hospitalier de Fréjus-Saint-Raphaël, Fréjus, France
| | - J Gutnecht
- Infectiology-Dermatology Unit, Centre Hospitalier de Fréjus-Saint-Raphaël, Fréjus, France
| | - J P Lacour
- Dermatology Department, CHU Nice, Nice, France
| | - J P Kraemer
- Pneumology Unit, Centre Hospitalier de Fréjus-Saint-Raphaël, Fréjus, France
| | - A Motard
- Biology Laboratory, Centre Hospitalier de Fréjus-Saint-Raphaël, Fréjus, France
| | - M Roa
- Pneumology Unit, Centre Hospitalier de Fréjus-Saint-Raphaël, Fréjus, France
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11
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Seneschal J, Lacour JP, Bewley A, Faurby M, Paul C, Pellacani G, De Simone C, Horne L, Sohrt A, Augustin M, Hammond E, Reich K. A multinational, prospective, observational study to estimate complete skin clearance in patients with moderate-to-severe plaque PSOriasis treated with BIOlogics in a REAL world setting (PSO-BIO-REAL). J Eur Acad Dermatol Venereol 2020; 34:2566-2573. [PMID: 32364296 PMCID: PMC7818467 DOI: 10.1111/jdv.16568] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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] [Received: 08/05/2019] [Accepted: 03/27/2020] [Indexed: 12/16/2022]
Abstract
Background Anti‐tumour necrosis factor (TNF) and anti‐interleukin (IL)‐12/23 biologics revolutionized plaque psoriasis treatment by enabling ≥75% improvement in the Psoriasis Area and Severity Index (PASI 75) in clinical trials. Modern biologics are now reported to achieve PASI 100 (complete skin clearance) in clinical trials. However, real‐world evidence of skin clearance rates with biologics is limited. PSO‐BIO‐REAL was conducted to understand the real‐world burden of plaque psoriasis. Objective The primary objective of this observational study was to estimate the proportion of patients who achieved complete skin clearance at 6 months. Secondary objectives included maintenance of response and evaluation of complete skin clearance at 12 months. Methods PSO‐BIO‐REAL was a multinational, prospective, real‐world, non‐interventional study of skin clearance and patient‐reported outcomes (PROs) with biologics. A total of 846 patients from the United States (32%), France (28%), Italy (22%), the United Kingdom (11%) and Germany (8%) were enrolled and followed for one year. Eligible patients were aged ≥18 years with moderate‐to‐severe plaque psoriasis who had initiated a biologic for plaque psoriasis. Patients could be biologic‐naïve or switching biologics (biologic‐experienced). Assessments were made at baseline and at months 6 and 12. Results At 6 and 12 months, 23% and 26% of patients achieved complete skin clearance, respectively. Prior to study entry, 60% were biologic‐naïve. The proportion of patients achieving complete skin clearance was lower among biologic‐experienced patients (20% at both months 6 and 12) compared with biologic‐naïve patients (25% at month 6, 30% at month 12). The rate of complete skin clearance decreased as the number of prior biologics and baseline comorbidities increased. Conclusion Only one in four patients achieved complete skin clearance after 6 months of treatment with biologics. The study indicates there still is an unmet need for more efficacious biologics for patients with psoriasis.
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Affiliation(s)
- J Seneschal
- Department of Dermatology and Paediatric Dermatology, National Reference Centre for Rare Skin Diseases, Saint-André Hospital, University of Bordeaux, Bordeaux, France
| | - J-P Lacour
- Department of Dermatology, Archet 2 Hospital, University Hospital of Nice, Nice, France
| | - A Bewley
- Department of Dermatology, Barts Health NHS Trust London, London, UK
| | - M Faurby
- LEO Pharma A/S, Ballerup, Denmark
| | - C Paul
- Toulouse University and Larrey Hospital, Toulouse, France
| | - G Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - C De Simone
- Department of Dermatology, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Rome, Italy
| | - L Horne
- AstraZeneca, Gaithersburg, MD, USA
| | - A Sohrt
- LEO Pharma A/S, Ballerup, Denmark
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | - K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, and Skinflammation® Center, Hamburg, Germany
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12
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Simpson EL, Lacour JP, Spelman L, Galimberti R, Eichenfield LF, Bissonnette R, King BA, Thyssen JP, Silverberg JI, Bieber T, Kabashima K, Tsunemi Y, Costanzo A, Guttman-Yassky E, Beck LA, Janes JM, DeLozier AM, Gamalo M, Brinker DR, Cardillo T, Nunes FP, Paller AS, Wollenberg A, Reich K. Baricitinib in patients with moderate-to-severe atopic dermatitis and inadequate response to topical corticosteroids: results from two randomized monotherapy phase III trials. Br J Dermatol 2020; 183:242-255. [PMID: 31995838 DOI: 10.1111/bjd.18898] [Citation(s) in RCA: 237] [Impact Index Per Article: 59.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Baricitinib, an oral selective Janus kinase 1 and 2 inhibitor, effectively reduced atopic dermatitis (AD) severity in a phase II study with concomitant topical corticosteroids. OBJECTIVES To evaluate the efficacy and safety of baricitinib in patients with moderate-to-severe AD who had an inadequate response to topical therapies. METHODS In two independent, multicentre, double-blind, phase III monotherapy trials, BREEZE-AD1 and BREEZE-AD2, adults with moderate-to-severe AD were randomized 2 : 1 : 1 : 1 to once-daily placebo, baricitinib 1 mg, 2 mg, or 4 mg for 16 weeks. RESULTS At week 16, more patients achieved the primary end point of Validated Investigator's Global Assessment of AD (0, 1) on baricitinib 4 mg and 2 mg compared with placebo in BREEZE-AD1 [N = 624; baricitinib 4 mg 16·8% (P < 0·001), 2 mg 11·4% (P < 0·05), 1 mg 11·8% (P < 0·05), placebo 4·8%], and BREEZE-AD2 [N = 615; baricitinib 4 mg 13·8% (P = 0·001), 2 mg 10·6% (P < 0·05), 1 mg 8·8% (P = 0·085), placebo 4·5%]. Improvement in itch was achieved as early as week 1 for 4 mg and week 2 for 2 mg. Improvements in night-time awakenings, skin pain and quality-of-life measures were observed by week 1 for both 4 mg and 2 mg (P ≤ 0·05, all comparisons). The most common adverse events in patients treated with baricitinib were nasopharyngitis and headache. No cardiovascular events, venous thromboembolism, gastrointestinal perforation, significant haematological changes, or death were observed with any baricitinib dosage. CONCLUSIONS Baricitinib improved clinical signs and symptoms in patients with moderate-to-severe AD within 16 weeks of treatment and induced rapid reduction of itch. The safety profile remained consistent with prior findings from baricitinib clinical development in AD, with no new safety concerns.
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Affiliation(s)
- E L Simpson
- Department of Dermatology, Oregon Health and Science University, Portland, OR, USA
| | - J-P Lacour
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - L Spelman
- Veracity Clinical Research, Brisbane, Australia
| | - R Galimberti
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - L F Eichenfield
- University of California, San Diego and Rady Children's Hospital, San Diego, CA, USA
| | | | - B A King
- Yale University School of Medicine, New Haven, CT, USA
| | - J P Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - J I Silverberg
- Department of Dermatology George Washington University School of Medicine, Washington, DC, USA
| | - T Bieber
- Department of Dermatology and Allergy, University of Bonn, Bonn, Germany
| | - K Kabashima
- Department of Dermatology, Kyoto University, Kyoto, Japan
| | - Y Tsunemi
- Department of Dermatology, Saitama Medical University, Saitama, Japan
| | - A Costanzo
- Humanitas University and Dermatology Unit, Humanitas Research Hospital, Milan, Italy
| | - E Guttman-Yassky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - L A Beck
- Department of Dermatology, University of Rochester Medical Center, Rochester, NY, USA
| | - J M Janes
- Lilly Research Laboratory, Eli Lilly and Company, Indianapolis, IN, USA
| | - A M DeLozier
- Lilly Research Laboratory, Eli Lilly and Company, Indianapolis, IN, USA
| | - M Gamalo
- Lilly Research Laboratory, Eli Lilly and Company, Indianapolis, IN, USA
| | - D R Brinker
- Lilly Research Laboratory, Eli Lilly and Company, Indianapolis, IN, USA
| | - T Cardillo
- Lilly Research Laboratory, Eli Lilly and Company, Indianapolis, IN, USA
| | - F P Nunes
- Lilly Research Laboratory, Eli Lilly and Company, Indianapolis, IN, USA
| | - A S Paller
- Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - A Wollenberg
- Department of Dermatology and Allergology, Ludwig Maximillian University, Munich, Germany
| | - K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Skinflammation® Center, Hamburg, Germany.,Dermatologikum Berlin, Berlin, Germany
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13
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Chambelland A, Aubert H, Bourrat E, Morice-Picard F, Puzenat E, Lacour JP, Chiaverini C. Incontinentia pigmenti in boys: Causes and consequences. Ann Dermatol Venereol 2020; 147:188-193. [PMID: 31982174 DOI: 10.1016/j.annder.2019.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 01/22/2019] [Revised: 05/06/2019] [Accepted: 07/10/2019] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Incontinentia pigmenti (IP) is an X-linked genodermatosis caused by mutation of the NEMO/IKBKG gene. While lethal in male foetuses, heterozygous females survive because of X-inactivation mosaicism. Herein we discuss 9 male patients with IP. MATERIALS AND METHODS This is an observational, descriptive, retrospective, multicentre, French study carried out with the help of the SFDP research group. Statistical analysis was performed both on our own patients and on those reported in the literature. RESULTS Nine boys with no family history of IP but with typical neonatal skin reactions were included. Genetic analysis of blood (n=8) and skin biopsy (n=3) confirmed the diagnosis of IP by identification of common deletion of the IKBKG/NEMO gene (exons 4 to 10) in the state of somatic mosaic in 6 and 2 cases respectively. Where analysed, the karyotype was normal (n=6). Over a median follow-up period of 48 months (3 months to 10 years), 3 patients had neurological abnormalities, 2 had severe ophthalmologic abnormalities, and 1 had dental abnormalities. Extensive skin involvement is a systemic risk factor, unlike cutaneous scarring. CONCLUSION IP in boys is often due to a mosaic mutation that should be sought in blood and skin. Long-term neurological and ophthalmological monitoring is essential, especially in cases of extensive skin involvement.
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Affiliation(s)
- A Chambelland
- Dermatology department, hôpital l'Archet 2, Nice university hospital, 06200 Nice, France.
| | - H Aubert
- Dermatology department, Nantes university hospital, 44093 Nantes, France
| | - E Bourrat
- Dermatology department, Saint-Louis hospital, AP-HP, 75000 Paris, France
| | - F Morice-Picard
- Dermatology department, hôpital Pellegrin, Bordeaux university hospital, 33000 Bordeaux, France
| | - E Puzenat
- Dermatology department, Jean-Minjoz university hospital, Besançon, 25000 Besançon, France
| | - J P Lacour
- Dermatology department, hôpital l'Archet 2, Nice university hospital, 06200 Nice, France
| | - C Chiaverini
- Dermatology department, hôpital l'Archet 2, Nice university hospital, 06200 Nice, France
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14
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Bence C, Hofman V, Chamorey E, Long-Mira E, Lassalle S, Albertini AF, Liolios I, Zahaf K, Picard A, Montaudié H, Lacour JP, Passeron T, Andea AA, Ilie M, Hofman P. Association of combined PD-L1 expression and tumour-infiltrating lymphocyte features with survival and treatment outcomes in patients with metastatic melanoma. J Eur Acad Dermatol Venereol 2019; 34:984-994. [PMID: 31625630 DOI: 10.1111/jdv.16016] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 09/20/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Recent advances obtained with immune checkpoint inhibitors (ICIs) targeting the programmed cell death-1 (PD-1) protein have significantly improved the outcome of patients with metastatic melanoma. The PD-L1 expression in tumour cells as detected by immunohistochemistry is a predictive biomarker in some solid tumours, but appears insufficient as prognostic or predictive factor of response to ICIs in metastatic melanomas. OBJECTIVES We investigated whether the presence and the features of pretreatment CD8+ tumour-infiltrating T lymphocytes (TILs) could be a complementary prognostic or predictive biomarker in patients with metastatic melanoma. METHODS In this retrospective study, we evaluated the association of PD-L1 expression ≥5% of tumour cells combined with TIL features (CD8, CD28, Ki67) with the overall survival (OS) among 51 patients treated with ICIs and 54 patients treated with other treatment options (non-ICIs). RESULTS PD-L1 positivity was observed in 33% and 39% of primary melanomas and matched metastases, respectively, with, however, poor concordance between the primary and the matched metastatic site (κ = 0.283). No significant association was noted between PD-L1 expression and CD8+ TIL profile analysed as single markers and OS or response to immunotherapy. Instead, their combined analysis in primary melanoma samples showed that the PD-L1-/CD8+ status was significantly associated with prolonged OS in the whole population (P = 0.04) and in the subgroup treated with non-ICIs (P = 0.009). Conversely, the PD-L1+/CD8+ status was a good prognostic factor in patients treated with ICIs (P = 0.022), whereas was significantly associated with poor prognosis in patients treated with non-ICIs (P = 0.014). While the expression of CD28 was not related to outcome, the Ki67 expression was significantly associated with poor OS in the subgroup CD8+ TIL+/PD-L1- (P = 0.02). CONCLUSIONS The pretreatment combination of PD-L1 expression with the level of CD8+ TILs could better assess OS and predict therapeutic response of patients with metastatic melanoma treated by either immunotherapy or other treatment regimens.
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Affiliation(s)
- C Bence
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France
| | - V Hofman
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,CNRS, INSERM, Institute of Research on Cancer and Ageing of Nice (IRCAN), Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,Hospital-Related Biobank (BB-0033-00025), Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France
| | - E Chamorey
- Biostatistics Unit, Antoine Lacassagne Comprehensive Cancer Center, Nice, France
| | - E Long-Mira
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,CNRS, INSERM, Institute of Research on Cancer and Ageing of Nice (IRCAN), Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,Hospital-Related Biobank (BB-0033-00025), Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France
| | - S Lassalle
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,CNRS, INSERM, Institute of Research on Cancer and Ageing of Nice (IRCAN), Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,Hospital-Related Biobank (BB-0033-00025), Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France
| | | | | | - K Zahaf
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France
| | - A Picard
- Department of Dermatology, Archet Hospital, Université Côte d'Azur, Nice, France
| | - H Montaudié
- Department of Dermatology, Archet Hospital, Université Côte d'Azur, Nice, France
| | - J P Lacour
- Department of Dermatology, Archet Hospital, Université Côte d'Azur, Nice, France
| | - T Passeron
- Department of Dermatology, Archet Hospital, Université Côte d'Azur, Nice, France
| | - A A Andea
- Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - M Ilie
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,CNRS, INSERM, Institute of Research on Cancer and Ageing of Nice (IRCAN), Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,Hospital-Related Biobank (BB-0033-00025), Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France
| | - P Hofman
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,CNRS, INSERM, Institute of Research on Cancer and Ageing of Nice (IRCAN), Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France.,Hospital-Related Biobank (BB-0033-00025), Pasteur Hospital, Université Côte d'Azur, University Hospital Federation OncoAge, Nice, France
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15
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Rathore M, Girard C, Ohanna M, Tichet M, Ben Jouira R, Garcia E, Larbret F, Gesson M, Audebert S, Lacour JP, Montaudié H, Prod'Homme V, Tartare-Deckert S, Deckert M. Cancer cell-derived long pentraxin 3 (PTX3) promotes melanoma migration through a toll-like receptor 4 (TLR4)/NF-κB signaling pathway. Oncogene 2019; 38:5873-5889. [PMID: 31253871 DOI: 10.1038/s41388-019-0848-9] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [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: 05/25/2018] [Revised: 03/30/2019] [Accepted: 04/28/2019] [Indexed: 01/23/2023]
Abstract
Cutaneous melanoma is one of the most aggressive cancers characterized by a high plasticity, a propensity for metastasis, and drug resistance. Melanomas are composed of phenotypically diverse subpopulations of tumor cells with heterogeneous molecular profiles that reflect intrinsic invasive abilities. In an attempt to identify novel factors of the melanoma invasive cell state, we previously investigated the nature of the invasive secretome by using a comparative proteomic approach. Here, we have extended this analysis to show that PTX3, an acute phase inflammatory glycoprotein, is one such factor secreted by invasive melanoma to promote tumor cell invasiveness. Elevated PTX3 production was observed in the population of MITFlow invasive cells but not in the population of MITFhigh differentiated melanoma cells. Consistently, MITF knockdown increased PTX3 expression in MITFhigh proliferative and poorly invasive cells. High levels of PTX3 were found in tissues and blood of metastatic melanoma patients, and in BRAF inhibitor-resistant melanoma cells displaying a mesenchymal invasive MITFlow phenotype. Genetic silencing of PTX3 in invasive melanoma cells dramatically impaired migration and invasion in vitro and in experimental lung extravasation assay in xenografted mice. In contrast, addition of melanoma-derived or recombinant PTX3, or expression of PTX3 enhanced motility of low migratory cells. Mechanistically, autocrine production of PTX3 by melanoma cells triggered an IKK/NFκB signaling pathway that promotes migration, invasion, and expression of the EMT factor TWIST1. Finally, we found that TLR4 and MYD88 knockdown inhibited PTX3-induced melanoma cell migration, suggesting that PTX3 functions through a TLR4-dependent pathway. Our work reveals that tumor-derived PTX3 contributes to melanoma cell invasion via targetable inflammation-related pathways. In addition to providing new insights into the biology of melanoma invasive behavior, this study underscores the notion that secreted PTX3 represents a potential biomarker and therapeutic target in a subpopulation of MITFlow invasive and/or refractory melanoma.
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Affiliation(s)
- M Rathore
- Université Côte d'Azur, INSERM, C3M, Nice, France
- Equipe labellisée Ligue Contre le Cancer 2016, Nice, France
- The Hormel Institute, University of Minnesota, Austin, MN, USA
| | - C Girard
- Université Côte d'Azur, INSERM, C3M, Nice, France
- Equipe labellisée Ligue Contre le Cancer 2016, Nice, France
| | - M Ohanna
- Université Côte d'Azur, INSERM, C3M, Nice, France
- Equipe labellisée Ligue Contre le Cancer 2016, Nice, France
| | - M Tichet
- Université Côte d'Azur, INSERM, C3M, Nice, France
- Laboratory of Translational Oncology, ISREC, EPFL, Lausanne, Switzerland
| | - R Ben Jouira
- Université Côte d'Azur, INSERM, C3M, Nice, France
| | - E Garcia
- Université Côte d'Azur, INSERM, C3M, Nice, France
| | - F Larbret
- Université Côte d'Azur, INSERM, C3M, Nice, France
- Equipe labellisée Ligue Contre le Cancer 2016, Nice, France
| | - M Gesson
- Université Côte d'Azur, INSERM, C3M, Nice, France
| | - S Audebert
- Aix-Marseille University, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France
| | - J-P Lacour
- Université Côte d'Azur, CHU Nice, Nice, France
| | - H Montaudié
- Université Côte d'Azur, CHU Nice, Nice, France
| | - V Prod'Homme
- Université Côte d'Azur, INSERM, C3M, Nice, France
- Equipe labellisée Ligue Contre le Cancer 2016, Nice, France
| | - S Tartare-Deckert
- Université Côte d'Azur, INSERM, C3M, Nice, France.
- Equipe labellisée Ligue Contre le Cancer 2016, Nice, France.
| | - M Deckert
- Université Côte d'Azur, INSERM, C3M, Nice, France.
- Equipe labellisée Ligue Contre le Cancer 2016, Nice, France.
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16
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Bucchia M, Barbarot S, Reumaux H, Piram M, Mahe E, Mallet S, Balguerie X, Phan A, Lacour JP, Decramer S, Hatchuel Y, Jean S, Begon E, Joubert A, Merlin E, Wallach D, Meinzer U, Bourrat E. Age-specific characteristics of neutrophilic dermatoses and neutrophilic diseases in children. J Eur Acad Dermatol Venereol 2019; 33:2179-2187. [PMID: 31166045 DOI: 10.1111/jdv.15730] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 05/08/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Our suggested 'modern' concepts of 'neutrophilic dermatoses' (ND) and 'neutrophilic disease' were based on observations in adult patients and have not been studied in paediatric patients. Only a minority of ND occurs in children, and little is known about age-specific characteristics. OBJECTIVES To describe age-specific characteristics of ND in children and to study whether our suggested 'modern' classification of ND may be applied to children. METHODS We conducted a retrospective multicentre study in a French cohort of 27 paediatric patients diagnosed with pyoderma gangrenosum (PG) or Sweet's syndrome (SS). RESULTS Demographics and distribution of typical/atypical forms were similar in patients diagnosed with PG and SS. Atypical ND were more frequent in infants (90%), when compared to young children (60%) and adolescents (33%). Neutrophilic disease was observed in 17/27 patients and was most frequent in infants. Neutrophilic disease of the upper respiratory tract, as well as cardiac neutrophilic disease, was only observed in infants, whereas other locations were similarly found in infants, young children and adolescents. In infants and young children, ND were associated with a large spectrum of general diseases, whereas in adolescents associations were limited to inflammatory bowel disease and Behçet's disease. CONCLUSIONS Our study describes the concept of ND in paediatric patients and shows that they have some characteristics different from ND occurring in adults. ND occurring in infants can be associated with a large spectrum of general diseases. Occurrence of neutrophilic disease is frequent in children. Thus, ND occurring in young paediatric patients should incite clinicians to schedule complementary explorations in order to search for involvement of other organs and to rule out monogenetic autoinflammatory syndromes.
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Affiliation(s)
- M Bucchia
- Centre Hospitalier Le Mans, Service Urgences pédiatriques, Le Mans, France.,Centre de référence des rhumatismes inflammatoires et maladies auto-immunes systémiques rares de l'enfant (RAISE), Service de pédiatrie générale, Maladies Infectieuses et Médecine Interne, Hôpital Robert Debré, Paris, France
| | - S Barbarot
- Service de Dermatologie, CHU de Nantes - Hôtel Dieu, Nantes, France
| | - H Reumaux
- Service de Pédiatrie et médecine générale, CHRU de Lille, Hôpital Jeanne de Flandre, Lille, France
| | - M Piram
- CHU de Bicêtre, Service de Rhumatologue Pédiatrique, CEREMAIA, Le Kremlin-Bicêtre, France.,CESP, U1018 Inserm, Université Paris-Sud, Le Kremlin-Bicêtre, France
| | - E Mahe
- Service de Dermatologie, Unité de Soutien à la Recherche Clinique, Argenteuil, France
| | - S Mallet
- Service de Dermatologie de l'hôpital de la Timone, Aix-Marseille Université, Marseille, France
| | - X Balguerie
- Clinique Dermatologique, CHU de Rouen, Rouen, France
| | - A Phan
- Service de Néphro-Rhumato-Dermatologie Pédiatrique, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, Bron, France
| | - J-P Lacour
- Service de Dermatologie, Centre Hospitalier Universitaire de Nice, Nice, France
| | - S Decramer
- Centre Hospitalier Universitaire de Toulouse, Service de Néphrologie Médecine Interne Pédiatrique, Hôpital des Enfants, Centre De Référence des Maladies Rénales Rares du Sud Ouest, Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institut of Cardiovascular and Metabolic Disease, Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Y Hatchuel
- Service de Pédiatrie, Centre Hospitalier Universitaire de Martinique, Fort de France, France
| | - S Jean
- Service de pédiatrie Centre Hospitalier universitaire de Rennes, Rennes, France
| | - E Begon
- Service de Médecine, Centre Hospitalier René-Dubois, Cergy Pontoise, France
| | - A Joubert
- Service de Dermatologie, CHU de Nantes - Hôtel Dieu, Nantes, France
| | - E Merlin
- CHU Clermont-Ferrand, Pédiatrie Générale Multidisciplinaire, CIC INSERM 1405, Clermont-Ferrand, France
| | - D Wallach
- Médecin (honoraire) des Hôpitaux de Paris, Paris, France
| | - U Meinzer
- Centre de référence des rhumatismes inflammatoires et maladies auto-immunes systémiques rares de l'enfant (RAISE), Service de pédiatrie générale, Maladies Infectieuses et Médecine Interne, Hôpital Robert Debré, Paris, France.,INSERM UMR1149, Université Paris Diderot, Paris, France.,Institut Pasteur, Unité Biologie et génétique de la paroi bactérienne, Paris, France
| | - E Bourrat
- Centre de référence des rhumatismes inflammatoires et maladies auto-immunes systémiques rares de l'enfant (RAISE), Service de pédiatrie générale, Maladies Infectieuses et Médecine Interne, Hôpital Robert Debré, Paris, France.,Service de Dermatologie, Centre Hospitalier Universitaire Saint-Louis, Paris, France
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Tsilika K, Montaudié H, Castela E, Cardot-Leccia N, Passeron T, Lacour JP. A case of lymphoplasmacytic plaque in children. J Eur Acad Dermatol Venereol 2019; 33:e171-e172. [PMID: 30811664 DOI: 10.1111/jdv.15408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- K Tsilika
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - H Montaudié
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - E Castela
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - N Cardot-Leccia
- Department of Pathology, University Hospital of Nice, Nice, France
| | - T Passeron
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - J-P Lacour
- Department of Dermatology, University Hospital of Nice, Nice, France
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18
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Almutairi A, Claeys A, Bahadoran P, Brun P, Guardoli D, Freychet F, Hakimi S, Sebbag N, Lacour JP, Passeron T. Acquired linear hyperpigmentation of the lips - a new entity? J Eur Acad Dermatol Venereol 2019; 33:e230-e231. [PMID: 30719768 DOI: 10.1111/jdv.15471] [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)
- A Almutairi
- Centre Hospitalier Universitaire Nice, Department of Dermatology, Université Nice Côte d'Azur, Nice, France
| | - A Claeys
- Private Dermatological Center, Grenoble, France
| | - P Bahadoran
- Centre Hospitalier Universitaire Nice, Department of Dermatology, Université Nice Côte d'Azur, Nice, France
| | - P Brun
- Private Dermatological Center, Cannes, France
| | - D Guardoli
- Centre Hospitalier Universitaire Nice, Department of Dermatology, Université Nice Côte d'Azur, Nice, France.,Private Dermatological Center 1, Nice, France
| | - F Freychet
- Private Dermatological Center 2, Nice, France
| | - S Hakimi
- Private Dermatological Center 3, Nice, France
| | - N Sebbag
- Private Dermatological Center 4, Nice, France
| | - J-P Lacour
- Centre Hospitalier Universitaire Nice, Department of Dermatology, Université Nice Côte d'Azur, Nice, France
| | - T Passeron
- Centre Hospitalier Universitaire Nice, Department of Dermatology, Université Nice Côte d'Azur, Nice, France.,INSERM U1065, C3M, Team 12, Université Nice Côte d'Azur, Nice, France
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19
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Queille-Roussel C, Nielsen J, Lacour JP. Vasoconstrictor potency of fixed-dose combination calcipotriol (50 μg/g) and betamethasone dipropionate (0.5 mg/g) cutaneous foam versus other topical corticosteroids used to treat psoriasis vulgaris. J DERMATOL TREAT 2019; 30:529-533. [PMID: 30582717 DOI: 10.1080/09546634.2018.1529385] [Citation(s) in RCA: 5] [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] [Indexed: 10/27/2022]
Abstract
Background: It is important to determine the vasoconstrictor potencies of topical corticosteroids used to treat psoriasis to ensure appropriate clinical use. Objective: To compare the vasoconstrictive potencies of fixed-dose combination calcipotriol (50 μg/g) and betamethasone dipropionate (0.5 mg/g) (Cal/BD) cutaneous foam with other topical corticosteroids. Methods: In this Phase I, single-center, healthy volunteer study, Cal/BD foam, clobetasol propionate 0.05% cream (CP; very potent), BD 0.05% ointment (potent), mometasone furoate 0.1% cream (MF; potent), hydrocortisone-17-butyrate 0.1% ointment (HB; moderately potent), and foam vehicle were applied, then removed after 16 h. Skin blanching was visually assessed 2 h later (scale of 0-4). Results: Thirty-six volunteers were randomized. Skin blanching with Cal/BD foam (median [range], 2.00 [0.75-3.00]) was significantly lower than CP cream (3.00 [1.75-4.00]; p < .001), was not significantly different from BD ointment (1.75 [0.75-3.00]; p = .30) and MF cream (2.00 [1.00-3.75]; p = .22), and was significantly greater than HB ointment (1.25 [0.50-3.00]; p < .001) and vehicle (0 [0-0.50]; p < .001). There were no local tolerability reactions or adverse events. Conclusions: The corticosteroid potency of Cal/BD foam was not significantly different from BD ointment and MF cream, significantly stronger than HB ointment, but weaker than CP cream in healthy volunteers.
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Affiliation(s)
- C Queille-Roussel
- a Centre de Pharmacologie Clinique Appliquée à la Dermatologie , Nice , France
| | - J Nielsen
- b LEO Pharma A/S , Ballerup , Denmark
| | - J-P Lacour
- a Centre de Pharmacologie Clinique Appliquée à la Dermatologie , Nice , France.,c Service de Dermatologie, University Hospital of Nice , Nice , France
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20
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Castela E, Tulic MK, Rozières A, Bourrat E, Nicolas JF, Kanitakis J, Vabres P, Bessis D, Mazereeuw J, Morice-Picard F, Baty D, Berard F, Lacour JP, Passeron T, Chiaverini C. Epidermolysis bullosa simplex generalized severe induces a T helper 17 response and is improved by apremilast treatment. Br J Dermatol 2018; 180:357-364. [PMID: 29932457 DOI: 10.1111/bjd.16897] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Epidermolysis bullosa simplex generalized severe (EBS-gen sev) is a genetic disorder caused by mutation in the KRT5 or KRT14 genes. Although it is usually considered a mechanical disease, recent data argue for additional inflammatory mechanisms. OBJECTIVES To assess the inflammation in the skin of patients with EBS-gen sev. METHODS A first immunohistochemical retrospective study was performed on frozen skin samples from 17 patients with EBS-gen sev. A second multicentre prospective study was conducted on 10 patients with severe EBS-gen sev. Blister fluid and epidermis were processed for immunochemical analysis and quantitative real-time polymerase chain reaction. Cytokine expression was analysed in blister fluid and compared with that in controls. RESULTS Histological analysis showed a constant dermal perivascular CD4+ lymphocyte infiltrate in skin biopsies of both blister (n = 17) and rubbed skin (n = 5), an epidermal infiltration of neutrophils and eosinophils in 70% of cases, and increased immunostaining for CXCL9 and CXCL10 in blistering skin. High levels of T helper 17 cytokines were detected in lesional skin. Three adult patients with EBS-gen sev were treated with apremilast, with a dramatic improvement of skin blistering and good tolerance. CONCLUSIONS Our study demonstrates the importance of inflammation in patients with EBS-gen sev and underlines the key role for T helper 17 cells in its pathogenesis. In addition, this study provides promising new therapeutic approaches for this disabling disorder.
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Affiliation(s)
- E Castela
- Department of Dermatology, CHU de Nice, Hôpital Archet 2, 151 Route de Saint Antoine de Ginestière, 06202 Nice CEDEX 2, France.,INSERM U1111-CIRI851, Université Lyon 1, Lyon, France
| | - M K Tulic
- INSERM U1065, Team 12, C3M, Nice, France
| | - A Rozières
- INSERM U1111-CIRI851, Université Lyon 1, Lyon, France
| | - E Bourrat
- MAGEC, Saint-Louis Hospital, Paris, France
| | - J-F Nicolas
- INSERM U1111-CIRI851, Université Lyon 1, Lyon, France.,Department of Allergology and Clinical Immunology, Hospices Civils de Lyon, Lyon, France
| | - J Kanitakis
- Department of Dermatology , Hospices Civils de Lyon, Lyon, France.,Department of Pathology, Hospices Civils de Lyon, Lyon, France
| | - P Vabres
- Department of Dermatology, CHU de Dijon, Dijon, France
| | - D Bessis
- Department of Dermatology, CHU de Montpellier, Montpellier, France
| | | | | | - D Baty
- Scottish Molecular Genetics Consortium, Ninewells Hospital, Dundee, U.K
| | - F Berard
- Department of Allergology and Clinical Immunology, Hospices Civils de Lyon, Lyon, France
| | - J-P Lacour
- Department of Dermatology, CHU de Nice, Hôpital Archet 2, 151 Route de Saint Antoine de Ginestière, 06202 Nice CEDEX 2, France.,CREBHN, CHU de Nice, Nice, France
| | - T Passeron
- Department of Dermatology, CHU de Nice, Hôpital Archet 2, 151 Route de Saint Antoine de Ginestière, 06202 Nice CEDEX 2, France.,INSERM U1065, Team 12, C3M, Nice, France
| | - C Chiaverini
- Department of Dermatology, CHU de Nice, Hôpital Archet 2, 151 Route de Saint Antoine de Ginestière, 06202 Nice CEDEX 2, France.,CREBHN, CHU de Nice, Nice, France
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21
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Kandel M, Allayous C, Dalle S, Mortier L, Dalac S, Dutriaux C, Leccia MT, Guillot B, Saiag P, Lacour JP, Legoupil D, Lesimple T, Aubin F, Beylot-Barry M, Brunet-Possenti F, Arnault JP, Granel-Brocard F, Stoebner PE, Dupuy A, Maubec E, Grob JJ, Dreno B, Rotolo F, Ballon A, Michiels S, Lebbe C, Borget I. Update of survival and cost of metastatic melanoma with new drugs: Estimations from the MelBase cohort. Eur J Cancer 2018; 105:33-40. [PMID: 30384014 DOI: 10.1016/j.ejca.2018.09.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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: 05/28/2018] [Revised: 08/16/2018] [Accepted: 09/24/2018] [Indexed: 01/07/2023]
Abstract
PURPOSE Since 2011, significant progress was observed in metastatic melanoma (MM), with the commercialisation of seven immunotherapies or targeted therapies, which showed significant improvement in survival. In France, in 2004, the cost of MM was estimated at €1634 per patient; this cost has not been re-estimated since. This study provided an update on survival and cost in real-life clinical practice. METHODS Clinical and economic data (treatments, hospitalisations, radiotherapy sessions, visits, imaging and biological exams) were extracted from the prospective MelBase cohort, collecting individual data in 955 patients in 26 hospitals, from diagnosis of metastatic disease until death. Survival was estimated by the Kaplan-Meier method. Costs were calculated from the health insurance perspective using French tariffs. For live patients, survival and costs were extrapolated using a multistate model, describing the 5-year course of the disease according to patient prognostic factors and number of treatment lines. RESULTS Since the availability of new drugs, the mean survival time of MM patients has increased to 23.6 months (95%confidence interval [CI] :21.2;26.6), with 58% of patients receiving a second line of treatment. Mean management costs increased to €269,682 (95%CI:244,196;304,916) per patient. Drugs accounted for 80% of the total cost. CONCLUSION This study is the first that evaluated the impact of immunotherapies and targeted therapies both on survival and cost in real-life conditions. Alongside the introduction of breakthrough therapies in the first and subsequent lines, MM has been associated with a significant increase in survival but also in costs, raising the question of financial sustainability.
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Affiliation(s)
- M Kandel
- Gustave Roussy, Service de Biostatistique et D'Epidémiologie, Villejuif, France; University Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France.
| | - C Allayous
- Dermatology and CIC, Assistance Publique des Hôpitaux de Paris, INSERM U976, University Paris Diderot-Saint-Louis Hospital, Paris, France
| | - S Dalle
- Dermatology, Hospices Civils de Lyon Hospital, Cancer Research Center of Lyon, Claude Bernard University, Lyon France
| | - L Mortier
- Dermatology, Lille Hospital, Lille, France
| | - S Dalac
- Dermatology, Dijon Hospital, Dijon, France
| | - C Dutriaux
- Dermatology, Bordeaux Saint-André Hospital, Bordeaux, France
| | - M T Leccia
- Dermatology, Grenoble Hospital, Grenoble, France
| | - B Guillot
- Dermatology, Montpellier Hospital, Montpellier, France
| | - P Saiag
- Dermatology, Assistance Publique des Hôpitaux de Paris, Ambroise Paré Hospital, Boulogne-Billancourt, France
| | - J P Lacour
- Dermatology, Nice Hospital, Nice, France
| | - D Legoupil
- Dermatology, Brest Hospital, Brest, France
| | | | - F Aubin
- Dermatology, Besançon Hospital, Besançon, France
| | - M Beylot-Barry
- Dermatology, Bordeaux Haut-L'évêque Hospital, Bordeaux, France
| | - F Brunet-Possenti
- Dermatology, Assistance Publique des Hôpitaux de Paris, Bichat Hospital, Paris, France
| | - J P Arnault
- Dermatology, Amiens Hospital, Amiens, France
| | | | | | - A Dupuy
- Dermatology, Rennes Hospital, Rennes, France
| | - E Maubec
- Dermatology, Assistance Publique des Hôpitaux de Paris, Avicennes Hospital, University Paris 13, France
| | - J J Grob
- Dermatology, La Timone Hospital, Marseille, France
| | - B Dreno
- Dermatology, Nantes Hospital, Nantes, France
| | - F Rotolo
- Gustave Roussy, Service de Biostatistique et D'Epidémiologie, Villejuif, France; University Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - A Ballon
- Dermatology and CIC, Assistance Publique des Hôpitaux de Paris, INSERM U976, University Paris Diderot-Saint-Louis Hospital, Paris, France
| | - S Michiels
- Gustave Roussy, Service de Biostatistique et D'Epidémiologie, Villejuif, France; University Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - C Lebbe
- Dermatology and CIC, Assistance Publique des Hôpitaux de Paris, INSERM U976, University Paris Diderot-Saint-Louis Hospital, Paris, France
| | - I Borget
- Gustave Roussy, Service de Biostatistique et D'Epidémiologie, Villejuif, France; University Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France; GRADES, University Paris-Sud, France
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22
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Kelati A, Khemis A, Montaudié H, Lacour JP, Passeron T. Successful treatment of resistant condylomas with nitrizinc complex solution: a retrospective study in 11 patients. J Eur Acad Dermatol Venereol 2018; 33:e88-e89. [PMID: 30198596 DOI: 10.1111/jdv.15241] [Citation(s) in RCA: 3] [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] [Indexed: 11/28/2022]
Affiliation(s)
- A Kelati
- Department of Dermatology, Centre Hospitalier Universitaire Nice, Université Nice Côte d'Azur, Nice, France
| | - A Khemis
- Department of Dermatology, Centre Hospitalier Universitaire Nice, Université Nice Côte d'Azur, Nice, France
| | - H Montaudié
- Department of Dermatology, Centre Hospitalier Universitaire Nice, Université Nice Côte d'Azur, Nice, France.,INSERM U1065, C3M, Team 12, Université Nice Côte d'Azur, Nice, France
| | - J-P Lacour
- Department of Dermatology, Centre Hospitalier Universitaire Nice, Université Nice Côte d'Azur, Nice, France
| | - T Passeron
- Department of Dermatology, Centre Hospitalier Universitaire Nice, Université Nice Côte d'Azur, Nice, France.,INSERM U1065, C3M, Team 12, Université Nice Côte d'Azur, Nice, France
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23
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Taquin H, Fontas E, Massol O, Chevallier P, Balloti R, Beranger G, Lacour JP, Passeron T, Montaudié H. Efficacy and safety data for checkpoint inhibitors in advanced melanoma under real-life conditions: A monocentric study conducted in Nice from 2010 to 2016. Ann Dermatol Venereol 2018; 145:649-658. [PMID: 30098818 DOI: 10.1016/j.annder.2018.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 11/05/2017] [Revised: 02/10/2018] [Accepted: 06/19/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Immunotherapies using anti-CTLA4 and anti-PD1 antibodies have revolutionised the management of patients with advanced melanoma. The aim of our study was to analyse the efficacy and safety of immunotherapies in patients with advanced melanoma under real-life conditions. METHODS We conducted a monocentric, retrospective, observational study that included all patients treated with immunotherapies (ipilimumab, i.e. ipi; nivolumab, i.e. niv and pembrolizumab, i.e. pbr) for advanced melanoma with exclusion of primary mucosal or ocular melanoma. The primary endpoint was progression-free survival (PFS). RESULTS A total of 110 patients were included. Median PFS was better in the anti-PD1 group than in the anti-CTLA4 group (3.9 months vs. 2.9 months, P=0.025). The frequency of adverse events of any grade was 53.4% with ipi, 66.7% with niv and 75% with pbr. DISCUSSION Our study shows slightly inferior efficacy data vs. clinical trials of ipi and niv because patients were presenting more severe illness at inclusion. Nevertheless, the study argues in favour of the superiority of anti-PD1 antibodies vs. anti-CTLA4 antibodies in terms of PFS and best overall response. Moreover, our study exhibits safety data comparable to those from clinical trials except for a lower frequency with ipi. CONCLUSION Our efficacy and safety data obtained under real-life conditions are reassuring since they are consistent with data already published.
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Affiliation(s)
- H Taquin
- Dermatology department, CHU de Nice, 06200 Nice, France
| | - E Fontas
- Biostatistics department, CHU de Nice, 06200 Nice, France
| | - O Massol
- Biostatistics department, CHU de Nice, 06200 Nice, France
| | - P Chevallier
- Radiology department, CHU de Nice, 06200 Nice, France
| | - R Balloti
- U1065, Inserm, centre méditerranéen de médecine moléculaire, équipe 1, 06200 Nice, France
| | - G Beranger
- U1065, Inserm, centre méditerranéen de médecine moléculaire, équipe 1, 06200 Nice, France
| | - J-P Lacour
- Dermatology department, CHU de Nice, 06200 Nice, France
| | - T Passeron
- Dermatology department, CHU de Nice, 06200 Nice, France; U1065, Inserm, centre méditerranéen de médecine moléculaire, équipe 12, 06200 Nice, France
| | - H Montaudié
- Dermatology department, CHU de Nice, 06200 Nice, France; U1065, Inserm, centre méditerranéen de médecine moléculaire, équipe 12, 06200 Nice, France.
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24
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Kelati A, Lagrange S, Le Duff F, Lacour JP, Benasaid R, Breaud J, Passeron T. Laser hair removal after surgery vs. surgery alone for the treatment of pilonidal cysts: a retrospective case-control study. J Eur Acad Dermatol Venereol 2018; 32:2031-2033. [PMID: 29633368 DOI: 10.1111/jdv.14991] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 03/15/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Based on the presumed role of hair in pilonidal cyst (PNC) pathogenesis, laser epilation has been used to decrease recurrences. However, most of the data rely on case reports and uncontrolled series, and the rare controlled studies reported conflicting results. The objective of this study was to investigate the efficacy of laser hair removal (LHR) to decrease the recurrence rate after surgery of PNC vs. surgery alone. METHODS We conducted a retrospective monocentric case-control study in the departments of Pediatric Surgery and Laser Center of Dermatology of the University Hospital of Nice in France from January 2010 to June 2017. We included all patients with PNC who had surgery during the period, and we compared patients who had LHR after surgery to those having surgery alone. The main outcome was the prevalence and number of recurrences of PNC in each group. RESULTS Twelve patients - eight treated with alexandrite laser and four patients with Nd : YAG - were included in the cases group; 29 patients treated with surgery alone were included in the control group. The mean and the median number of laser sessions were 4.2 and 5, respectively (extremes 1-10). The postsurgical recurrence rate without LHR was 51.7%, and their number varied from 1 to 3. A significant decrease in the recurrence rate was observed after LHR (8.3%) compared to control group (P < 0.001). The median duration before recurrence was 14 months for surgery alone. The median follow-up was 18 months (1-30 months) for LHR group and 30 months (6-72 months) for surgery alone group. Two patients had abnormal healing or persistent sinus after surgery alone compared to none in the group who undergone laser procedure after surgery. CONCLUSIONS Laser hair removal decreases the risk of delayed healing and of recurrences of PNL after surgical procedure.
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Affiliation(s)
- A Kelati
- Université Nice Cote d'Azur, Centre Hospitalier Universitaire Nice, Department of Dermatology, Nice, France
| | - S Lagrange
- Université Nice Cote d'Azur, Centre Hospitalier Universitaire Nice, Department of Dermatology, Nice, France
| | - F Le Duff
- Université Nice Cote d'Azur, Centre Hospitalier Universitaire Nice, Department of Dermatology, Nice, France
| | - J-P Lacour
- Université Nice Cote d'Azur, Centre Hospitalier Universitaire Nice, Department of Dermatology, Nice, France
| | - R Benasaid
- Université Nice Cote d'Azur, Hôpitaux Pédiatriques de Nice CHU-Lenval, Department of Pediatric Surgery, Nice, France
| | - J Breaud
- Université Nice Cote d'Azur, Hôpitaux Pédiatriques de Nice CHU-Lenval, Department of Pediatric Surgery, Nice, France
| | - T Passeron
- Université Nice Cote d'Azur, Centre Hospitalier Universitaire Nice, Department of Dermatology, Nice, France.,Université Nice Côte d'Azur, INSERM U1065, C3M, Team 12, Nice, France
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25
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Samimi M, Dreno B, Aractingi S, Beylot-Barry M, Bodemer C, Chosidow O, Cribier B, Lacour JP, Paul C, Richard MA, Gaudy-Marqueste C, Soria A. [On the attractiveness of a university-hospital career in medicine: Obstacles and solutions. The teachers' perspective]. Ann Dermatol Venereol 2018; 145:196-199. [PMID: 29241631 DOI: 10.1016/j.annder.2017.10.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 10/13/2017] [Indexed: 11/29/2022]
Affiliation(s)
- M Samimi
- Service de dermatologie, université François-Rabelais, CHU de Tours, 37000 Tours, France; Laboratoire « biologie des infections à polyomavirus », ISP 1282, INRA, université François-Rabelais, 37000 Tours, France.
| | - B Dreno
- Service de dermatologie, université de Nantes, CHU de Nantes, 44000 Nantes, France; Inserm U892, 44000 Nantes, France
| | - S Aractingi
- Inserm UMRS 938, service de dermatologie, hôpital Cochin Paris, université Paris 5 Descartes, AP-HP, 75005 Paris, France
| | - M Beylot-Barry
- Service de dermatologie, CHU de Bordeaux, 33000 Bordeaux, France; Inserm U1053, université de Bordeaux, 33000 Bordeaux, France
| | - C Bodemer
- Service de dermatologie, hôpital universitaire Necker-Enfant-Malades, AP-HP, 75015 Paris, France; Unité Inserm U1163, institut Imagine, université Paris-Descartes, Sorbonne Cité université, 75015 Paris, France
| | - O Chosidow
- Service de dermatologie, hôpital Henri-Mondor, AP-HP, 94000 Créteil, France; Université Paris-Est Val-de-Marne (UPEC) Créteil, 94000 Créteil, France
| | - B Cribier
- Clinique dermatologique, université de Strasbourg, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France
| | - J-P Lacour
- Service de dermatologie, hôpital universitaire de Nice, 06200 Nice, France
| | - C Paul
- Service de dermatologie, hôpital universitaire de Toulouse, 06200 Toulouse, France; Université Paul-Sabatier, 31400 Toulouse, France
| | - M-A Richard
- Service de dermatologie, hôpital La Timone, Assistance publique-Hôpitaux de Marseille, 13385 Marseille, France; UMR 911, Inserm, « centre de recherche en oncologie biologique et onco pharmacologie » (CRO2), université Aix-Marseille, 13385 Marseille, France
| | - C Gaudy-Marqueste
- Service de dermatologie et oncologie, hôpital La Timone, Assistance publique-Hôpitaux de Marseille, Marseille, France; UMR 911, Inserm, « centre de recherche en oncologie biologique et onco pharmacologie » (CRO2), université Aix-Marseille, 13385 Marseille, France
| | - A Soria
- Service de sermatologie et allergologie, hôpital Tenon, AP-HP, 13385 Marseille, France; Sorbonne université, UPMC université Paris 06, 13385 Marseille, France; Inserm U1135, centre d'immunologie et de maladies infectieuses (Cimi-Paris), 13385 Marseille, France
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Gaudy-Marqueste C, Samimi M, Soria A, Aractingi S, Bodemer C, Chosidow O, Cribier B, Lacour JP, Paul C, Richard MA, Beylot-Barry M, Dreno B. [Guide to university hospital careers in dermatology. The GRENT (Graines Engrais Tuteurs - Seed Fertilizer Plant stick) Program]. Ann Dermatol Venereol 2018; 145:200-209. [PMID: 29449018 DOI: 10.1016/j.annder.2017.11.010] [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: 11/27/2022]
Affiliation(s)
- C Gaudy-Marqueste
- Service de dermatologie et oncologie, hôpital La Timone, Assistance publique-Hôpitaux de Marseille, Marseille, France; UMR 911, Inserm, « centre de recherche en oncologie biologique et onco pharmacologie » (CRO2), université Aix-Marseille, 13385 Marseille, France
| | - M Samimi
- Service de dermatologie, université François-Rabelais, CHU de Tours, 37000 Tours, France; Laboratoire « biologie des infections à polyomavirus », ISP 1282, INRA, université François-Rabelais, 37000 Tours, France
| | - A Soria
- Service de sermatologie et allergologie, hôpital Tenon, AP-HP, 13385 Marseille, France; Sorbonne université, UPMC université Paris 06, 13385 Marseille, France; Inserm U1135, centre d'immunologie et de maladies infectieuses (Cimi-Paris), 13385 Marseille, France
| | - S Aractingi
- Inserm UMRS 938, service de dermatologie, hôpital Cochin Paris, université Paris 5 Descartes, AP-HP, 75005 Paris, France
| | - C Bodemer
- Service de dermatologie, hôpital universitaire Necker-Enfant-Malades, AP-HP, 75015 Paris, France; Unité Inserm U1163, institut Imagine, université Paris-Descartes, Sorbonne Cité université, 75015 Paris, France
| | - O Chosidow
- Service de dermatologie, hôpital Henri-Mondor, AP-HP, 94000 Créteil, France; Université Paris-Est Val-de-Marne (UPEC) Créteil, 94000 Créteil, France
| | - B Cribier
- Clinique dermatologique, université de Strasbourg, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France
| | - J P Lacour
- Service de dermatologie, hôpital universitaire de Nice, 06200 Nice, France
| | - C Paul
- Service de dermatologie, hôpital universitaire de Toulouse, 06200 Toulouse, France; Université Paul-Sabatier, 31400 Toulouse, France
| | - M A Richard
- Service de dermatologie, hôpital La Timone, Assistance publique-Hôpitaux de Marseille, 13385 Marseille, France; UMR 911, Inserm, « centre de recherche en oncologie biologique et onco pharmacologie » (CRO2), université Aix-Marseille, 13385 Marseille, France
| | - M Beylot-Barry
- Service de dermatologie, CHU de Bordeaux, 33000 Bordeaux, France; Inserm U1053, université de Bordeaux, 33000 Bordeaux, France
| | - B Dreno
- Service de dermatologie, université de Nantes, CHU de Nantes, 44000 Nantes, France; Inserm U892, 44000 Nantes, France.
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Chiaverini C, Le Duff F, Deville A, Cardot-Leccia N, Lacour JP, Bahadoran P. Reflectance confocal microscopy for the diagnosis of Langerhans cell histiocytosis. Br J Dermatol 2018; 179:186-187. [PMID: 29341062 DOI: 10.1111/bjd.16349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- C Chiaverini
- Department of Dermatology, Archet 2 Hospital, Nice, France
| | - F Le Duff
- Department of Dermatology, Archet 2 Hospital, Nice, France
| | - A Deville
- Department of Pediatric Oncology, Archet 2 Hospital, Nice, France
| | - N Cardot-Leccia
- Department of Histopathology, Pasteur 2 Hospital, Nice, France
| | - J P Lacour
- Department of Dermatology, Archet 2 Hospital, Nice, France
| | - P Bahadoran
- Department of Dermatology, Archet 2 Hospital, Nice, France
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Sbidian E, Giboin C, Bachelez H, Paul C, Beylot-Barry M, Dupuy A, Viguier M, Lacour JP, Schmutz JL, Bravard P, Mahé E, Beneton N, Misery L, Delaporte E, Modiano P, Barbarot S, Regnier E, Jullien D, Richard MA, Joly P, Tubach F, Chosidow O. Factors associated with the choice of the first biologic in psoriasis: real-life analysis from the Psobioteq cohort. J Eur Acad Dermatol Venereol 2017; 31:2046-2054. [PMID: 28609574 DOI: 10.1111/jdv.14406] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 05/18/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND Decision-making is a complex process. The aim of our study was to assess factors associated with the choice of the first biological treatment in patients with moderate-to-severe psoriasis. METHODS Data on all patients included in the French prospective, observational, cohort, Psobioteq and initiating a first biologic prescription between July 2012 and July 2016 were analysed. Demographic information and clinical features were collected during routine clinical assessments by the dermatology team at the recruiting centres using a standardized case report form. The primary outcome was the nature of the first biologic treatment. Four groups were identified as follows: adalimumab, etanercept, ustekinumab and infliximab groups. Factors associated with the choice of the first biological agent were determined by a multinomial logistic regression model adjusted on year of inclusion. RESULTS The study population included the 830 biological-naïve patients who initiated a first biological agent. The mean age was 46.6 years (±SD 13.9), and 318 patients (38.3%) were female. The most commonly prescribed biologic was adalimumab: 355 (42.8%) patients, then etanercept (n = 247, 29.8%), ustekinumab (n = 194, 23.4%) and infliximab (n = 34, 4.0%). In the multinomial logistic regression analysis, patients were significantly more likely to receive adalimumab if they had a severe psoriasis as defined by baseline PASI or if they had psoriatic arthritis compared to etanercept (aOR, 0.42; 95% CI, 0.16-1.07) and ustekinumab (aOR, 0.15; 95% CI, 0.04-0.52). Patients were significantly more likely to receive ustekinumab (aOR, 2.39; 95% CI, 1.04-5.50) if they had a positive screening for latent tuberculosis compared to adalimumab. Younger patients were also more likely to receive ustekinumab. Patients with chronic obstructive pulmonary disease were more likely to be prescribed ustekinumab or etanercept compared to adalimumab. There was a trend in favour of etanercept prescription in patients with cardiovascular comorbidities, metabolic syndrome and in patients with a history of cancer. CONCLUSION We identified patient- and disease-related factors that have important influence on the choice of the first biological agent in clinical practice. Clinicians appear to have a holistic approach to patient characteristics when choosing a biological agent in psoriasis.
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Affiliation(s)
- E Sbidian
- Département de Dermatologie, AP-HP, Hôpitaux Universitaires Henri Mondor, UPEC, Créteil, France.,INSERM, Centre d'Investigation Clinique 1430, Créteil, France.,EA 7379 EpidermE, Université Paris-Est Créteil (UPEC), Créteil, France
| | - C Giboin
- Département Biostatistique, Santé Publique et Information Médicale, Centre de Pharmaco-épidémiologie, CIC 1421, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France
| | - H Bachelez
- Service de Dermatologie, Institut Imagine, AP-HP Hôpital Saint-Louis, INSERM UMR 1163, SorbonneParis Cité Université Paris Diderot, Paris, France
| | - C Paul
- Département de Dermatologie, Hôpitaux Universitaires de Toulouse, UMR INSERM 1056, Université Paul Sabatier, Toulouse, France
| | - M Beylot-Barry
- Département de Dermatologie, INSERM U1053, Hôpital Saint-André, Université de Bordeaux, Bordeaux, France
| | - A Dupuy
- Département de Dermatologie, INSERM CIC 1414, Centre Hospitalier Universitaire de Rennes, Hôpital Pontchaillou, Université de Rennes 1, Rennes, France
| | - M Viguier
- Département de Dermatologie, Hôpitaux Universitaires Robert Debré, Reims, France
| | - J-P Lacour
- Département de Dermatologie, Centre de Référence Maladies Rares, Hôpital l'Archet 2, Centre Hospitalier Universitaire de Nice, Nice, France
| | - J-L Schmutz
- Département de Dermatologie et Allergologie, Hôpitaux de Brabois, Centre Hospitalier Régional Universitaire de Nancy, Nancy, France
| | - P Bravard
- Département de Dermatologie, Groupe Hospitalier du Havre, Le Havre, France
| | - E Mahé
- Département de Dermatologie, Hôpital Victor Dupouy, Argenteuil, France
| | - N Beneton
- Département de Dermatologie, Centre Hospitalier du Mans, Le Mans, France
| | - L Misery
- Département de Dermatologie, Centre Hospitalier Régional Universitaire de Brest, Brest, France
| | - E Delaporte
- Département de Dermatologie, Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - P Modiano
- Département de Dermatologie, Groupement des Hôpitaux de l'Institut Catholique de Lille, Hôpital Saint-Vincent-de-Paul, Lille, France
| | - S Barbarot
- Département de Dermatologie, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - E Regnier
- Département de Dermatologie, AP-HP, Hôpitaux Universitaires Cochin, Université Paris Descartes Paris V, Paris, France
| | - D Jullien
- Département de Dermatologie, HCL, Centre Hospitalier Universitaire, Hôpital Edouard Herriot, Lyon, France
| | - M-A Richard
- Département de Dermatologie, Centre Hospitalier Universitaire, Hôpital La Timone, Marseille, France
| | - P Joly
- Department of Dermatology, Rouen University Hospital, INSERM U 1234, Normandie University, Rouen, France
| | - F Tubach
- Département Biostatistique, Santé Publique et Information Médicale, Centre de Pharmaco-épidémiologie, CIC 1421, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France.,Université Pierre et Marie Curie, Sorbonne Universités, Paris, France.,UMR 1123, CIC 1421, ECEVE, INSERM, Paris, France
| | - O Chosidow
- Département de Dermatologie, AP-HP, Hôpitaux Universitaires Henri Mondor, UPEC, Créteil, France.,INSERM, Centre d'Investigation Clinique 1430, Créteil, France.,EA 7379 EpidermE, Université Paris-Est Créteil (UPEC), Créteil, France
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Nguyen S, Ouvrier D, Massalou D, Viau P, Chevallier A, Patouraux S, Passeron T, Lacour JP, Montaudié H. [Lymphedema of the lower limbs: Initial manifestation of gastric linitis plastica]. Ann Dermatol Venereol 2017. [PMID: 28647380 DOI: 10.1016/j.annder.2017.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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] [Indexed: 01/25/2023]
Abstract
BACKGROUND Primary lymphedemas are constitutional abnormalities of the lymphatic system. Secondary lymphedemas occur after damage to the lymphatic system, mainly after cancer treatments or tumour mass compression. There are many other causes, including filariasis, which is nonetheless very rare in France. PATIENTS AND METHODS A 52-year-old man presented with a two-month history of increased size of the left leg. He was asymptomatic and in good general condition. Clinical examination revealed non-pitting lymphedema and ipsilateral hydrocele without loco-regional compressive lymph node. Initial extensive explorations were unremarkable. Lymphoscintigraphy revealed low tracer fixation in the left leg. The symptoms continued to worsen, with exacerbation and bilateralization of the lymphedema. Two months later, axillary lymph nodes appeared corresponding to metastasis from a signet-ring cell carcinoma. Despite two lines of chemotherapy, the patient died 8 months later due to multiple metastatic disease. DISCUSSION Our case is remarkable because the lymphedema was not related to extrinsic compression and was the first symptom of gastric cancer. In the absence of compression, endo-lymphatic micro-metastases could constitute the causative process. Acquired lymphedema of the lower limbs must be recognized as a potential early symptom of gastric carcinoma and should therefore prompt further investigations.
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Affiliation(s)
- S Nguyen
- Service de dermatologie, hôpital Archet 2, CHU de Nice, 151, route de Saint-Antoine-de-Ginestière, 06200 Nice, France
| | - D Ouvrier
- Service d'oncologie digestive, CHU de Nice, Archet 2, 151, route de Saint-Antoine-de-Ginestière, 06200 Nice, France
| | - D Massalou
- Chirurgie générale d'urgence, Pasteur 2, université de Nice, CHU de Nice, 30, voie Romaine, 06000 Nice, France; UMRT24, IFSTTAR, laboratoire de biomécanique appliquée, Aix-Marseille université, boulevard Pierre-Dramard, 13005 Marseille, France
| | - P Viau
- Service de médecine nucléaire, Archet 1, CHU de Nice, 151, route de Saint-Antoine-de-Ginestière, 06200 Nice, France
| | - A Chevallier
- Laboratoire central d'anatomie et cytologie pathologiques, Archet 2, CHU de Nice, 151, route de Saint-Antoine-de-Ginestière, 06200 Nice, France
| | - S Patouraux
- Laboratoire central d'anatomie et cytologie pathologiques, Pasteur 1, CHU de Nice, 30, voie Romaine, 06001 Nice, France
| | - T Passeron
- Service de dermatologie, hôpital Archet 2, CHU de Nice, 151, route de Saint-Antoine-de-Ginestière, 06200 Nice, France
| | - J-P Lacour
- Service de dermatologie, hôpital Archet 2, CHU de Nice, 151, route de Saint-Antoine-de-Ginestière, 06200 Nice, France
| | - H Montaudié
- Service de dermatologie, hôpital Archet 2, CHU de Nice, 151, route de Saint-Antoine-de-Ginestière, 06200 Nice, France.
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Fouques C, Dorez M, Le Duff F, Cardot-Leccia N, Chevallier A, Lacour JP, Bahadoran P, Bongain A. Reflectance confocal microscopy of vulvar epithelial neoplasia: a pilot study. Br J Dermatol 2017; 177:e196-e199. [PMID: 28403517 DOI: 10.1111/bjd.15573] [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: 11/27/2022]
Affiliation(s)
- C Fouques
- Department of Gynecology-Obstetrics, Archet 2 Hospital, Nice, France
| | - M Dorez
- Department of Gynecology-Obstetrics, Archet 2 Hospital, Nice, France
| | - F Le Duff
- Department of Dermatology, Archet 2 Hospital, Nice, France.,Clinical Research Center, Archet 1 Hospital, Nice, France
| | | | - A Chevallier
- Department of Pathology, Archet 1 Hospital, Nice, France
| | - J P Lacour
- Department of Dermatology, Archet 2 Hospital, Nice, France
| | - P Bahadoran
- Department of Dermatology, Archet 2 Hospital, Nice, France.,Clinical Research Center, Archet 1 Hospital, Nice, France
| | - A Bongain
- Department of Gynecology-Obstetrics, Archet 2 Hospital, Nice, France
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Nguyen S, Lacour JP, Passeron T. Topical corticosteroids application in the evening is more effective than in the morning in psoriasis: in reply. J Eur Acad Dermatol Venereol 2017; 31:e406-e407. [PMID: 28295619 DOI: 10.1111/jdv.14216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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)
- S Nguyen
- Department of Dermatology, Archet 2 Hospital, University Hospital of Nice, 06200, Nice, France
| | - J-P Lacour
- Department of Dermatology, Archet 2 Hospital, University Hospital of Nice, 06200, Nice, France
| | - T Passeron
- Department of Dermatology, Archet 2 Hospital, University Hospital of Nice, 06200, Nice, France.,INSERM U1065, team 12, C3M, 06200, Nice, France
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Lacour JP, Paul C, Jazayeri S, Papanastasiou P, Xu C, Nyirady J, Fox T, Papavassilis C. Secukinumab administration by autoinjector maintains reduction of plaque psoriasis severity over 52 weeks: results of the randomized controlled JUNCTURE trial. J Eur Acad Dermatol Venereol 2017; 31:847-856. [PMID: 28111801 DOI: 10.1111/jdv.14073] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 11/04/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND User satisfaction is an important factor associated with treatment adherence in chronic diseases including moderate-to-severe psoriasis. OBJECTIVE To evaluate the efficacy, safety and patient acceptability of 300 and 150 mg secukinumab - a fully human anti-interleukin-17A monoclonal antibody that has demonstrated efficacy in the treatment of patients with moderate-to-severe plaque psoriasis - self-administered by autoinjection. METHODS Patients with moderate-to-severe plaque psoriasis were randomized to secukinumab 300 mg, secukinumab 150 mg or placebo self-administered by autoinjection at baseline, Weeks 1, 2 and 3 and then every 4 weeks from Week 4 to Week 48. Efficacy responses [≥75/90/100% improvement in Psoriasis Area and Severity Index (PASI 75/90/100) and clear/almost clear skin by Investigator's Global Assessment 2011 modified version (IGA mod 2011 0/1)] were measured at Week 52. Patient-reported usability of the autoinjector was evaluated by the self-injection assessment questionnaire to Week 48. RESULTS At Week 52 with secukinumab 300 mg, PASI 75/90/100 and IGA mod 2011 0/1 responses were achieved by 81.4/64.1/38.8% and 69.6% of patients, respectively, by multiple imputation. At Week 52 with secukinumab 150 mg, PASI 75/90/100 and IGA mod 2011 0/1 responses were achieved by 75.2/57.4/33.1% and 60.2% of patients, respectively, by multiple imputation. Patient-assessed acceptability of the autoinjector remained high to Week 48. The proportion of patients experiencing adverse events was greater with secukinumab 300 mg (88.6%) than with secukinumab 150 mg (78.7%). CONCLUSION Self-administration of secukinumab using an autoinjector was associated with robust and sustained efficacy, a good safety profile and high acceptability.
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Affiliation(s)
- J-P Lacour
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - C Paul
- Department of Dermatology, Paul Sabatier University, Toulouse, France
| | - S Jazayeri
- Alliance Dermatology and MOHS Center, Phoenix, AZ, USA
| | | | - C Xu
- Stanford University, Stanford, CA, USA
| | - J Nyirady
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - T Fox
- Novartis Pharma AG, Basel, Switzerland
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Montaudié H, Pradelli J, Passeron T, Lacour JP, Leroy S. Pulmonary sarcoid-like granulomatosis induced by nivolumab. Br J Dermatol 2016; 176:1060-1063. [PMID: 27291635 DOI: 10.1111/bjd.14808] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2016] [Indexed: 01/04/2023]
Abstract
The use of antibodies against programmed death (PD)1, such as nivolumab and pembrolizumab, has dramatically improved the prognosis of patients with advanced melanoma. Nivolumab is also approved in advanced squamous cell nonsmall-cell lung cancer. These immunotherapies are associated with a unique set of toxicities termed immune-related adverse events, which are different from toxicities observed with conventional cytotoxic chemotherapy. We report the case of a 56-year-old man who was diagnosed with metastatic melanoma and who received nivolumab. One week after the second infusion, he developed pulmonary symptoms, dry eye syndrome and a bilateral swelling of the parotid glands. Investigations were negative for infection. The bronchoalveolar lavage differential cell count showed 32% lymphocytes with an increased CD4 : CD8 ratio, and bronchial biopsies revealed noncaseating epithelioid granulomas, without malignant cells. The clinical and radiological courses were rapidly favourable with oral corticosteroid. This case illustrates that sarcoidosis can be induced by nivolumab treatment. With the increasing use of anti-PD1 inhibitors in patients with advanced melanoma and squamous cell nonsmall-cell lung cancer, clinicians should be aware of this potential associated immune-related adverse event.
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Affiliation(s)
- H Montaudié
- Dermatology Department, Archet Hospital, Nice University Hospital, Nice, France
| | - J Pradelli
- Respiratory Department, Pasteur Hospital, Nice University Hospital, Nice, France
| | - T Passeron
- Dermatology Department, Archet Hospital, Nice University Hospital, Nice, France.,INSERM, U1065, Centre Méditerranéen de Médecine Moléculaire, Team 12, Nice, France
| | - J-P Lacour
- Dermatology Department, Archet Hospital, Nice University Hospital, Nice, France
| | - S Leroy
- Respiratory Department, Pasteur Hospital, Nice University Hospital, Nice, France
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Chiaverini C, Bourrat E, Mazereeuw-Hautier J, Hadj-Rabia S, Bodemer C, Lacour JP. [Hereditary epidermolysis bullosa: French national guidelines (PNDS) for diagnosis and treatment]. Ann Dermatol Venereol 2016; 144:6-35. [PMID: 27931749 DOI: 10.1016/j.annder.2016.07.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 10/10/2015] [Accepted: 07/27/2016] [Indexed: 12/22/2022]
Abstract
Hereditary epidermolysis bullosa (EB) is a heterogeneous group of rare genetic diseases characterized by fragile skin and/or mucous membrane, and it may be either local or generalized. It is caused by mutations in genes encoding different proteins involved mainly in the structure and function of the dermal-epidermal junction. Nineteen genes have so far been identified. They are classified by level of skin cleavage (from top to bottom) into four groups: EB simplex, junctional EB, dystrophic EB and Kindler syndrome. Clinically suspected diagnosis is confirmed by immunohistochemical examination of a skin biopsy at specialized centres in order to determine the level of cleavage and the deficient protein. This first step may be followed by genetic analysis. The severity of the disease is highly variable, ranging from localized forms with little effect on quality of life to rapidly lethal forms. In generalized severe forms, the extent and chronicity of lesions, as well as mucosal involvement, can lead to systemic complications: malnutrition, pain, joint contractures, chronic inflammation, amyloidosis, cutaneous squamous cell carcinoma. Some specific forms are associated with other cutaneous signs (nail involvement, alopecia, hyperpigmentation, palmoplantar keratoderma) or extracutaneous involvement (muscular dystrophy or pyloric atresia). No curative treatment of EB is available today. EB requires multidisciplinary medical care, nursing, psychological and social management. This is best provided by a specialized network, involving reference centres, centres of expertise and daily caregivers. The goal of treatment is the prevention and treatment of lesions with specific non-adherent dressings and the prevention, detection and treatment of complications. It is essential not to traumatize the skin (bandaging, friction, etc.). Protein, gene or cell replacement therapy, and allogeneic bone marrow, cord blood or pluripotent stem-cell transplantation are currently being assessed. The aim of these French recommendations (national diagnostic and treatment protocol [PNDS]) is to provide healthcare professionals with guidance on the course of EB and on optimal patient management.
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Affiliation(s)
- C Chiaverini
- Service de dermatologie, centre de référence des épidermolyses bulleuses héréditaires, hôpital l'Archet 2, CHU de Nice, 151, route Saint-Antoine-de-Ginestière, CS 23079, 06202 Nice cedex 3, France
| | - E Bourrat
- Service de dermatologie, centre de référence des maladies génétiques cutanées (MAGEC), hôpital Saint-Louis, CHU Paris - groupe hospitalier Saint-Louis - Lariboisière F.-Widal, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - J Mazereeuw-Hautier
- Service de dermatologie, centre de référence des maladies dermatologiques rares, hôpital Larrey, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse cedex 9, France
| | - S Hadj-Rabia
- Service de dermatologie, filière maladies rares de la peau (FIMARAD), centre de référence des maladies génétiques cutanées (MAGEC), hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75743 Paris cedex 15, France
| | - C Bodemer
- Service de dermatologie, filière maladies rares de la peau (FIMARAD), centre de référence des maladies génétiques cutanées (MAGEC), hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75743 Paris cedex 15, France
| | - J-P Lacour
- Service de dermatologie, centre de référence des épidermolyses bulleuses héréditaires, hôpital l'Archet 2, CHU de Nice, 151, route Saint-Antoine-de-Ginestière, CS 23079, 06202 Nice cedex 3, France.
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Gottlieb AB, Lacour JP, Korman N, Wilhelm S, Dutronc Y, Schacht A, Erickson J, Zhang L, Mallbris L, Gerdes S. Treatment outcomes with ixekizumab in patients with moderate-to-severe psoriasis who have or have not received prior biological therapies: an integrated analysis of two Phase III randomized studies. J Eur Acad Dermatol Venereol 2016; 31:679-685. [PMID: 27696577 PMCID: PMC5412924 DOI: 10.1111/jdv.13990] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [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] [Received: 06/10/2016] [Accepted: 09/16/2016] [Indexed: 01/17/2023]
Abstract
Background Biologics are effective for the treatment of psoriasis. However, treatment outcomes may differ among biologic‐naive patients and those switched from previous biological therapies. Objectives The study's objective was to investigate efficacy and safety of ixekizumab, a high‐affinity anti‐interleukin‐17A antibody, in patients with psoriasis with and without previous exposure to biologics. Methods Data were integrated from the 12‐week induction phase of two etanercept‐controlled Phase III trials. Patients received 80 mg ixekizumab every 2 weeks (IXE Q2W; N = 736) or every 4 weeks (IXE Q4W; N = 733) following a 160‐mg starting dose, or placebo (N = 361). Etanercept (50 mg twice weekly; N = 740) was administered as active control. Psoriasis Area and Severity Index (PASI) 75, PASI 90 and PASI 100 response rates at week 12 were evaluated in patients with or without previous exposure to biologics. Treatment effects were analysed with the Cochran–Mantel–Haenszel test stratified by study; missing values were imputed as non‐response. Results Overall, 497 (19.3%) patients had prior exposure to biologics and 2073 (80.7%) were naive to biologic therapy. PASI 75 was achieved by 91.5% of biologic‐experienced patients and 87.7% of biologic‐naive patients for IXE Q2W, 76.2% and 82.2% for IXE Q4W, respectively, and 34.6% and 50.7%, respectively, for etanercept. Higher response rates favouring each ixekizumab dose over etanercept within subgroups were also seen regarding PASI 90 and PASI 100. Conclusions Contrary to etanercept, the efficacy of ixekizumab was similarly high in patients with and without previous exposure to biologics when administered 80 mg every 2 weeks.
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Affiliation(s)
- A B Gottlieb
- Department of Dermatology, New York Medical College, Valhalla, NY, USA
| | - J-P Lacour
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - N Korman
- Murdough Family Center for Psoriasis, University Hospitals Case Medical Center, Cleveland, OH, USA
| | - S Wilhelm
- Global Medical Affairs, Lilly Deutschland GmbH, Bad Homburg, Germany
| | - Y Dutronc
- Regional Medical Affairs, Lilly France, Neuilly-sur-Seine, France
| | - A Schacht
- Global Medical Affairs, Lilly Deutschland GmbH, Bad Homburg, Germany
| | - J Erickson
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - L Zhang
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - L Mallbris
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - S Gerdes
- Department of Dermatology, Psoriasis-Center, University Medical Center Schleswig-Holstein, Kiel, Germany
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Queille-Roussel C, Bang B, Clonier F, Lacour JP. Enhanced vasoconstrictor potency of the fixed combination calcipotriol plus betamethasone dipropionate in an innovative aerosol foam formulation vs. other corticosteroid psoriasis treatments. J Eur Acad Dermatol Venereol 2016; 30:1951-1956. [PMID: 27306589 PMCID: PMC5108427 DOI: 10.1111/jdv.13714] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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] [Received: 11/30/2015] [Accepted: 04/11/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND An aerosol foam formulation of fixed combination calcipotriol 50 μg/g (Cal) and betamethasone 0.5 mg/g (as dipropionate; BD) has been developed for psoriasis vulgaris treatment. OBJECTIVE To compare Cal/BD aerosol foam pharmacodynamic activity with Cal/BD ointment and with other topical corticosteroids of different potencies by assessing vasoconstrictor potential. METHODS A Phase I, single-centre, investigator-blinded, vehicle-controlled, intra-individual comparison vasoconstriction study. Healthy volunteers received a single application on selected sites of: Cal/BD aerosol foam, clobetasol propionate 0.5 mg/g cream (CP; very potent), Cal/BD ointment (potent), fluocinolone acetonide 0.25 mg/g ointment (FA; moderately potent), BD aerosol foam and aerosol foam vehicle. A seventh untreated site acted as a negative control. Skin blanching was assessed by visual (primary response criterion) and colorimetric a* and L* measurements (secondary criteria), and was analysed over time (6-32 h post-application). RESULTS Thirty-five healthy volunteers were included. All active treatments led to significantly greater skin blanching than control. By visual assessment, skin blanching with Cal/BD aerosol foam was significantly less compared with CP cream [mean AUC0-32 2560 vs. 3831; mean difference = -1272; 95% confidence interval (CI): -1598, -945; P < 0.001], similar to BD aerosol foam (mean AUC0-32 2560 vs. 2595; mean difference = -35; 95% CI: -362, 292; P = 0.83) and significantly greater than Cal/BD ointment (mean AUC0-32 2560 vs. 2008; mean difference = 552; 95% CI: 225, 878; P = 0.001) and FA ointment (mean AUC0-32 2560 vs. 1981; mean difference = 578; 95% CI: 251, 905; P < 0.001). Colorimetric assessments a* and L* also indicated significantly reduced skin blanching with Cal/BD aerosol foam compared with CP cream. No adverse events (AEs) were reported. CONCLUSION Cal/BD aerosol foam can be considered a more potent formulation than Cal/BD ointment and the moderately potent FA ointment, but less potent than the very potent corticosteroid, CP cream.
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Affiliation(s)
- C Queille-Roussel
- Centre de Pharmacologie Clinique Appliquée à la Dermatologie, Nice, France.
| | - B Bang
- LEO Pharma A/S, Ballerup, Denmark
| | | | - J-P Lacour
- Centre de Pharmacologie Clinique Appliquée à la Dermatologie, Nice, France
- Service de Dermatologie, University Hospital of Nice, Nice, France
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Nguyen S, Bahakeem H, Alkhalifah A, Cavalié M, Boukari F, Montaudié H, Lacour JP, Passeron T. Topical corticosteroids application in the evening is more effective than in the morning in psoriasis: results of a prospective comparative study. J Eur Acad Dermatol Venereol 2016; 31:e263-e264. [PMID: 27790782 DOI: 10.1111/jdv.14027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- S Nguyen
- Department of Dermatology, Archet 2 Hospital, University Hospital of Nice, Nice, France
| | - H Bahakeem
- Department of Dermatology, Archet 2 Hospital, University Hospital of Nice, Nice, France
| | - A Alkhalifah
- Department of Dermatology, Archet 2 Hospital, University Hospital of Nice, Nice, France.,Department of Dermatology, Unaizah College of Medicine, Qassim University, Unaizah, Saudi Arabia
| | - M Cavalié
- Department of Dermatology, Archet 2 Hospital, University Hospital of Nice, Nice, France
| | - F Boukari
- Department of Dermatology, Archet 2 Hospital, University Hospital of Nice, Nice, France
| | - H Montaudié
- Department of Dermatology, Archet 2 Hospital, University Hospital of Nice, Nice, France
| | - J-P Lacour
- Department of Dermatology, Archet 2 Hospital, University Hospital of Nice, Nice, France
| | - T Passeron
- Department of Dermatology, Archet 2 Hospital, University Hospital of Nice, Nice, France.,Team 12, C3M, INSERM U1065, Nice, France
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Montaudié H, Chiaverini C, Sbidian E, Charlesworth A, Lacour JP. Inherited epidermolysis bullosa and squamous cell carcinoma: a systematic review of 117 cases. Orphanet J Rare Dis 2016; 11:117. [PMID: 27544590 PMCID: PMC4992553 DOI: 10.1186/s13023-016-0489-9] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [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: 09/10/2015] [Accepted: 07/26/2016] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Inherited epidermolysis bullosa (EB) comprises a highly heterogeneous group of rare diseases characterized by exacerbated skin and/or mucosal fragility and blister formation after minor mechanical trauma. Level of cleavage in the skin, clinical features with immunofluorescence antigen mapping and/or electron microscopy examination of a skin biopsy and/or gene involved, type(s) of mutation present and sometimes specific mutation(s), allow to define the EB type and subtype. This family of genodermatoses exposes patients to several complications, cutaneous squamous cell carcinoma (cSCC) being the most severe of them. OBJECTIVE The aim of this systematic review was to document patients with EB who developed cSCC. METHODS A systematic literature search was performed, from inception to March 2014, using Medline, Embase, Cochrane and ClinicalTrials.gov databases. Only articles published in English and French were selected. The diagnosis of EB had to be confirmed by EM and/or IFM and/or mutation analysis, while cSCC had to be confirmed by histological analysis. RESULTS Of 167 references in the original search, 69 relevant articles were identified, representing 117 cases. cSCCs were identified in all types of EB, though predominantly in recessive dystrophic EB (RDEB) forms (81 cases (69.2 %)). The median age at diagnosis was 36 years old (interquartile range (IQR), 27-48 years and range, 6-71 years) for all forms. Of those with measurements in the literature (88 cases (75.2 %)), tumor size was greater than 2 centimeters in 52 cases (59.1 %). The histopathological characteristics were specified in 88 cases (75.2 %) and well-differentiated forms predominated (73.9 %). No conclusion could be drawn on the choice of surgical treatment or the management in advanced forms. LIMITATIONS This study was retrospective and statistical analysis was not included due to various biases. This study design did not allow to infer prevalence, nor EB subtype risk for cSCC occurrence. CONCLUSIONS Our study correlated with historical data shows that most of the cSCCs occurred in subjects with the RDEB subtype, however reports also show that cSCCs can present in any patients with EB. The first signs of cSCC developed at a younger age in EB patients than in non-EB patients. Interestingly, the cSCC duration, before its diagnosis, was shorter in individuals with RDEB than with junctional EB (JEB) and dominant dystrophic EB (DDEB). This study further emphasizes the importance of regular monitoring of EB patients, particularly with the RDEB subtype as they developed cSCC at a younger age.
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Affiliation(s)
- H Montaudié
- Department of Dermatology, University Hospital of Nice, 151 route de Saint Antoine de Ginestière, Hôpital Archet 2, 06200, Nice, France.
| | - C Chiaverini
- Department of Dermatology, University Hospital of Nice, 151 route de Saint Antoine de Ginestière, Hôpital Archet 2, 06200, Nice, France.,Reference Centre for Hereditary Epidermolysis Bullosa, University Hospital of Nice, Nice, France
| | - E Sbidian
- Department of Dermatology, Henri Mondor Hospital, INSERM, Centre d'Investigation Clinique, Créteil, France
| | - A Charlesworth
- Reference Centre for Hereditary Epidermolysis Bullosa, University Hospital of Nice, Nice, France
| | - J-P Lacour
- Department of Dermatology, University Hospital of Nice, 151 route de Saint Antoine de Ginestière, Hôpital Archet 2, 06200, Nice, France.,Reference Centre for Hereditary Epidermolysis Bullosa, University Hospital of Nice, Nice, France
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Alkhalifah A, Montaudié H, Lacour JP, Lantéri-Minet M, Passeron T. Exacerbation of Hailey-Hailey disease by topiramate. J Eur Acad Dermatol Venereol 2016; 31:e185-e186. [PMID: 27510943 DOI: 10.1111/jdv.13909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A Alkhalifah
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - H Montaudié
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - J-P Lacour
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - M Lantéri-Minet
- Department of Pain Management, University Hospital of Nice, Nice, France
| | - T Passeron
- Department of Dermatology, University Hospital of Nice, Nice, France.,INSERM U1065, Team 12, C3M, Nice, France
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Lorgeou A, Chiaverini C, Le Duff F, Lacour JP, Passeron T. Successful treatment of angiokeratoma circumscriptum naeviforme with long pulse alexandrite laser. J Eur Acad Dermatol Venereol 2016; 31:e186-e187. [PMID: 27511129 DOI: 10.1111/jdv.13910] [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: 11/28/2022]
Affiliation(s)
- A Lorgeou
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - C Chiaverini
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - F Le Duff
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - J-P Lacour
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - T Passeron
- Department of Dermatology, University Hospital of Nice, Nice, France.,INSERM U1065, Team 12, C3M, Nice, France
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Taquin H, Chiaverini C, Marty P, Lacour JP. [A multifocal form of cutaneous leishmaniasis caused by Leishmania infantum in an immunocompetent child treated with a short course of liposomal amphotericin B]. Ann Dermatol Venereol 2016; 143:622-624. [PMID: 27292718 DOI: 10.1016/j.annder.2016.03.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 11/11/2015] [Revised: 01/25/2016] [Accepted: 03/17/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cutaneous leishmaniasis (CL) is a parasitic infestation caused by various species of Leishmania protozoa transmitted by the bite of phlebotomine sand flies. Herein we report a case of multifocal CL due to Leishmania infantum in an immunocompetent child treated with liposomal amphotericin B. PATIENTS AND METHODS A 10-month-old baby was referred for multiple ulcerated nodules of the face and upper limbs present for 5 months and following travel to North Morocco. Histological and parasitological examinations resulted in a diagnosis of CL due to L. infantum. The child was treated with intravenous liposomal amphotericin B in accordance with the schedule for visceral leishmaniasis (10mg/kg over 2 days), and rapid improvement of the lesions was seen within 10 days. DISCUSSION Clinical polymorphism of CL exists according to the infecting species. The multifocal presentation in our patient is very unusual for CL due to L. infantum in an immunocompetent child. To our knowledge, there have been no previous reports of successful use of parenteral liposomal amphotericin B for CL caused by L. infantum as described in our case.
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Affiliation(s)
- H Taquin
- Service de dermatologie, hôpital Archet 2, CHU, route de Saint-Antoine-de-Ginestière, 06200 Nice, France.
| | - C Chiaverini
- Service de dermatologie, hôpital Archet 2, CHU, route de Saint-Antoine-de-Ginestière, 06200 Nice, France
| | - P Marty
- Service de parasitologie-mycologie, hôpital Archet 2, CHU, route de Saint-Antoine-de-Ginestière, 06200 Nice, France
| | - J-P Lacour
- Service de dermatologie, hôpital Archet 2, CHU, route de Saint-Antoine-de-Ginestière, 06200 Nice, France
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Passeron T, Maza A, Fontas E, Toubel G, Vabres P, Livideanu C, Mazer JM, Rossi B, Boukari F, Harmelin Y, Dreyfus I, Mazereeuw-Hautier J, Lacour JP. Treatment of port wine stains with pulsed dye laser and topical timolol: a multicenter randomized controlled trial. Br J Dermatol 2016; 170:1350-3. [PMID: 24641096 DOI: 10.1111/bjd.12772] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2013] [Indexed: 01/06/2023]
Abstract
BACKGROUND Neoangiogenesis occurs within days following laser treatment of port wine stains (PWS), and plays a central role in treatment failures. Topical use of timolol can significantly reduce the production of vascular endothelial growth factor in vitro, and in animal models. OBJECTIVES The aim of this study was to assess the efficacy of topical timolol in combination with pulsed dye laser (PDL) treatment, compared with PDL alone, for treating PWS. METHODS This was a prospective multicenter controlled trial performed in children with PWS of the face who had not previously received laser treatment. After randomization, one group was treated with PDL alone, and the other with PDL followed by twice daily applications of timolol gel. Three laser sessions were performed at 1-month intervals with fixed parameters. The evaluation was performed on standardized pictures by two independent physicians blinded to the treatment received. The primary endpoint was marked or complete improvement of the PWS [Investigator Global Assessment (IGA) 3 or 4] 1 month after the third session. RESULTS Twenty-two children were included. Two patients were lost to follow-up. There was no difference in the success rate between the two groups (IGA 3 or 4 observed in one of 10 patients and two of 12 patients, for PDL alone, and for PDL associated with topical timolol, respectively; P = 1·0). No side-effect related to the application of topical timolol was observed. CONCLUSIONS The addition of timolol gel for preventing neoangiogenesis failed to significantly improve the efficacy of PDL treatment of PWS.
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Affiliation(s)
- T Passeron
- Department of Dermatology, University Hospital of Nice, Nice, France; INSERM U1065, Team 12, C3M, Nice, France
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Debarbieux S, Perrot JL, Erfan N, Ronger-Savlé S, Labeille B, Cinotti E, Depaepe L, Cardot-Leccia N, Lacour JP, Thomas L, Bahadoran P. Reflectance confocal microscopy of mucosal pigmented macules: a review of 56 cases including 10 macular melanomas. Br J Dermatol 2016; 170:1276-84. [PMID: 24359328 DOI: 10.1111/bjd.12803] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2013] [Indexed: 12/23/2022]
Abstract
BACKGROUND Although most mucosal pigmented macules are benign, it can be clinically challenging to rule out an early melanoma. Reflectance confocal microscopy (RCM) is a noninvasive imaging technique useful in discriminating between benign and malignant skin lesions. OBJECTIVES To describe the confocal aspects of benign and malignant mucosal pigmented macules with histopathological correlations. METHODS We retrospectively reviewed the confocal images of 56 labial or genital pigmented macules including 10 macular melanomas. According to the retrospective nature of the study, we evaluated the recorded images chosen by the physicians that performed the RCM examination for each case. RESULTS In benign macules, the most frequently observed pattern was a ringed pattern characterized by round or polycyclic papillae, with a hyper-reflective basal layer; another pattern was characterized by sparse bright dendritic cells in the basal layer, the basal epithelial cells being otherwise less reflective. Roundish cells, a high density of dendritic cells with atypias and intraepithelial bright cells were clues to the presence of malignancy. CONCLUSIONS Reflectance confocal microscopy seems to be a valuable tool to noninvasively differentiate benign from malignant mucosal pigmented macules and target biopsies in cases of equivocal features.
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Affiliation(s)
- S Debarbieux
- Department of Dermatology, Centre Hospitalier Lyon Sud, Pierre Bénite, France
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Girard C, Adamski H, Basset-Séguin N, Beaulieu P, Dreno B, Riboulet JL, Lacour JP. [Procedure for daylight methyl aminolevulinate photodynamic therapy to treat actinic keratoses]. Ann Dermatol Venereol 2016; 143:257-63. [PMID: 27016200 DOI: 10.1016/j.annder.2016.02.016] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 01/20/2016] [Accepted: 02/10/2016] [Indexed: 11/30/2022]
Abstract
Actinic keratosis (AK), also known as solar keratosis or pre-cancerous keratosis, is frequently observed in areas of skin exposed to sunlight, particularly in light-skinned patients. In France, photodynamic therapy using red light (conventional PDT) and methylamino 5-levulinate (MAL) is indicated in the treatment of thin or non-hyperkeratotic and non-pigmented multiple AK lesions or large zones covered with AK lesions. It is well-known for its efficacy but also for its side effects, especially pain during illumination, which can limit its use. An alternative to PDT using natural daylight has recently been proposed to treat actinic keratosis lesions, and results in greater flexibility as well as significant reduction in pain. The lesions are prepared as for conventional PDT, with MAL cream being applied by the physician or the patient, after which they are exposed to natural daylight for 2hours. The lesions are then gently cleansed and protected from natural light for 24hours. This paper seeks to provide a precise description of the daylight PDT procedure for the treatment of AK.
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Affiliation(s)
- C Girard
- Service de dermatologie, hôpital Saint-Éloi, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France
| | - H Adamski
- Service de dermatologie, CHU Pontchaillou Rennes, 2, rue Henri-le-Guilloux, 35000 Rennes, France
| | - N Basset-Séguin
- Service de dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - P Beaulieu
- Cabinet de dermatologie, 28, rue Seré-Depoin, 95300 Pontoise, France
| | - B Dreno
- Service de dermatologie, CHU de Nantes, place Alexis-Ricordeau, 44093 Nantes cedex, France
| | - J-L Riboulet
- Cabinet de dermatologie, 9, rue du 29-Juillet, 62000 Arras, France
| | - J-P Lacour
- Service de dermatologie, CHU de Nice, hôpital l'Archet 2, 151, route Saint-Antoine-de-Ginestière, CS 23079, 06202 Nice, France.
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Marmottant-Debled E, Chiaverini C, Fossoud C, Passeron T, Barbarot S, Lacour JP. Evaluation of learning disabilities in segmental neurofibromatosis. Br J Dermatol 2016; 174:1404-6. [PMID: 26833272 DOI: 10.1111/bjd.14436] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
| | - C Chiaverini
- Department of Dermatology, Archet Hospital II, Nice, France
| | - C Fossoud
- Department of Neuropaediatrics, CERTA Paediatric Hospital, CHU-Lenval Nice, Nice, France
| | - T Passeron
- Department of Dermatology, Archet Hospital II, Nice, France
| | - S Barbarot
- Department of Dermatology, Hotel Dieu Hospital, Nantes, France
| | - J-P Lacour
- Department of Dermatology, Archet Hospital II, Nice, France
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Lacour JP, Ulrich C, Gilaberte Y, Von Felbert V, Basset-Seguin N, Dreno B, Girard C, Redondo P, Serra-Guillen C, Synnerstad I, Tarstedt M, Tsianakas A, Venema AW, Kelleners-Smeets N, Adamski H, Perez-Garcia B, Gerritsen MJ, Leclerc S, Kerrouche N, Szeimies RM. Daylight photodynamic therapy with methyl aminolevulinate cream is effective and nearly painless in treating actinic keratoses: a randomised, investigator-blinded, controlled, phase III study throughout Europe. J Eur Acad Dermatol Venereol 2015; 29:2342-8. [PMID: 26435363 DOI: 10.1111/jdv.13228] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 04/17/2015] [Indexed: 01/04/2023]
Abstract
BACKGROUND Unmet needs exist in actinic keratosis (AK) treatment. Daylight photodynamic therapy (DL-PDT) has shown good efficacy and safety results compared to conventional PDT (c-PDT) in a recent Phase III multi-centre randomised controlled trial in Australia among 100 subjects with AKs. OBJECTIVES Demonstrate non-inferior efficacy and superior safety of DL-PDT compared to c-PDT in treating multiple mild and/or moderate facial/scalp AKs. METHODS Phase III, 12 week, multi-centre, randomised, investigator-blinded, controlled, intra-individual study conducted at different latitudes in Europe. AKs of adult subjects were treated once with methyl aminolevulinate (MAL) DL-PDT on one side of the face and MAL c-PDT contralaterally. Endpoints for DL-PDT concerned efficacy (non-inferiority regarding complete lesion response at week 12) and safety (superiority regarding subject's assessment of pain after treatment, on an 11-point numeric rating scale). Safety evaluation also included incidence of adverse events. Subject satisfaction was described using a questionnaire at baseline and last visit. RESULTS At week 12, the total lesion complete response rate with DL-PDT was similar (non-inferior) to c-PDT (70% vs. 74%, respectively; 95% CI [-9.5; 2.4] in PP analysis, confirmed in ITT analysis). In addition, efficacy of DL-PDT was demonstrated regardless of weather conditions (sunny or cloudy). DL-PDT was nearly painless compared to c-PDT (0.7 vs. 4.4, respectively; P < 0.001), better tolerated and resulted in higher subject satisfaction. CONCLUSION DL-PDT in comparison with c-PDT was as effective, better tolerated and nearly painless with high patient satisfaction, and may be considered a treatment of choice to meet needs of patients with mild or moderate facial/scalp AKs.
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Affiliation(s)
- J-P Lacour
- Department of Dermatology, Hôpital Archet2, University Hospital of Nice, Nice, France
| | - C Ulrich
- Charité Campus Mitte, Universitätsmedizin Berlin, Klinik für Dermatologie, Venerologie und Allergologie Hautturmorcentrum der Charité (HTCC), Berlin, Germany
| | | | - V Von Felbert
- Department of Dermatology, University Hospital, RWTH Aachen University, Aachen, Germany
| | | | - B Dreno
- CHU Hotel Dieu, Nantes Cedex 1, France
| | - C Girard
- Department of Dermatology, Hospital Saint Eloi, Montpellier, France
| | - P Redondo
- Department of Dermatology, University Clinic of Navarra, Pamplona, Spain
| | | | | | - M Tarstedt
- Department of Dermatology, Karlskoga Hospital, Karlskoga, Sweden
| | - A Tsianakas
- Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - A W Venema
- Wilhelmina Ziekenhuis Assen, Assen, The Netherlands
| | - N Kelleners-Smeets
- Dermatology Department, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - H Adamski
- Dermatology Department, Pontchaillou Hospital, Rennes, France
| | - B Perez-Garcia
- Hospital Ramón y Cajal, Servicio de Dermatología, Carretera de Colmenar Viejo, Madrid, Spain
| | - M J Gerritsen
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - S Leclerc
- Galderma R&D, Sophia Antipolis, France
| | | | - R-M Szeimies
- Klinik für Dermatologie und Allergologie, Klinikum Vest GmbH, Behandlungszentrum Knappschaftskrankenhaus, Recklinghausen, Germany
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Cinotti E, Debarbieux S, Perrot JL, Labeille B, Long-Mira E, Habougit C, Douchet C, Depaepe L, Hammami-Ghorbel H, Lacour JP, Thomas L, Cambazard F, Bahadoran P. Reflectance confocal microscopy features of acral lentiginous melanoma: a comparative study with acral nevi. J Eur Acad Dermatol Venereol 2015; 30:1125-8. [PMID: 26428577 DOI: 10.1111/jdv.13399] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 08/05/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Acral lentiginous melanoma (ALM) can be difficult to differentiate from acral nevus. Reflectance confocal microscopy (RCM) is widely used for the diagnosis of melanocytic tumours, but the RCM features of ALM and acral nevus have not been described yet. OBJECTIVE To determine the RCM features of ALM and acral nevus, and their correlation with clinical and histological characteristics. METHODS Retrospective study of 17 cases of ALM and 26 acral nevi. RESULTS Pagetoid cells were present in all ALMs with a visible epidermis and in three nevi. A proliferation of atypical melanocytes at the dermal-epidermal junction (DEJ) and/or in the dermis was visible in nine ALMs but not in nevi. The histopathological examination of initial skin biopsies was unable to diagnose ALM in four cases, differing from RCM that could identify malignant tumour cells by exploring the whole lesions. CONCLUSION Reflectance confocal microscopy can help in the differentiation of ALM and acral nevus, and to guide the biopsy.
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Affiliation(s)
- E Cinotti
- Dermatology Department, CHU of Saint-Etienne, Saint Etienne, France
| | - S Debarbieux
- Dermatology Department, Hospices Civils of Lyon, Lyon, France
| | - J L Perrot
- Dermatology Department, CHU of Saint-Etienne, Saint Etienne, France
| | - B Labeille
- Dermatology Department, CHU of Saint-Etienne, Saint Etienne, France
| | - E Long-Mira
- Pathology Department, LPCE, CHU of Nice, Nice, France
| | - C Habougit
- Pathology Department, CHU of Saint-Etienne, Saint-Etienne, France
| | - C Douchet
- Pathology Department, CHU of Saint-Etienne, Saint-Etienne, France
| | - L Depaepe
- Pathology Department, Hospices Civils of Lyon, Lyon, France
| | | | - J P Lacour
- Pathology Department, LPCE, CHU of Nice, Nice, France
| | - L Thomas
- Dermatology Department, Hospices Civils of Lyon, Lyon, France
| | - F Cambazard
- Dermatology Department, CHU of Saint-Etienne, Saint Etienne, France
| | - P Bahadoran
- Pathology Department, LPCE, CHU of Nice, Nice, France.,Centre de Recherche Clinique, INSERM U 1065 Equipe 1 CHU of Nice, Nice, France
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48
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Taquin H, Lacour JP, Le Duff F, Chiaverini C, Passeron T. Treatment of resistant port-wine stains with bosentan and pulsed dye laser: a pilot prospective study. J Eur Acad Dermatol Venereol 2015; 30:1432-4. [PMID: 26304141 DOI: 10.1111/jdv.13275] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- H Taquin
- Department of Dermatology, University Hospital of Nice, Archet 2 Hospital, Route de saint Antoine de Ginestière, Nice, 06200, France
| | - J-P Lacour
- Department of Dermatology, University Hospital of Nice, Archet 2 Hospital, Route de saint Antoine de Ginestière, Nice, 06200, France
| | - F Le Duff
- Department of Dermatology, University Hospital of Nice, Archet 2 Hospital, Route de saint Antoine de Ginestière, Nice, 06200, France.,Clinical Research Center, University Hospital of Nice, Nice, France
| | - C Chiaverini
- Department of Dermatology, University Hospital of Nice, Archet 2 Hospital, Route de saint Antoine de Ginestière, Nice, 06200, France
| | - T Passeron
- Department of Dermatology, University Hospital of Nice, Archet 2 Hospital, Route de saint Antoine de Ginestière, Nice, 06200, France.,INSERM U1065, team 12, C3M, Nice, France
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49
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Chiaverini C, Fontas E, Vabres P, Bessis D, Mazereeuw J, Charlesworth A, Meneguzzi G, Lacour JP. Oral erythromycin therapy in epidermolysis bullosa simplex generalized severe. Br J Dermatol 2015; 173:563-4. [PMID: 25601422 DOI: 10.1111/bjd.13672] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- C Chiaverini
- French Reference Centre for Inherited Epidermolysis Bullosa, Archet Hospital, CS 23079, 06202, NICE Cedex3, France. .,INSERM U1081, CNRS UMR7284, Institute for Research on Cancer and Aging, Nice (IRCAN), Faculty of Medicine, University of Nice Sophia Antipolis, 28 Avenue Valombrose, F-06107, Nice, France.
| | - E Fontas
- Department of Clinical Research, Cimiez Hospital, Nice, France
| | - P Vabres
- Department of Dermatology, University Hospital, PRES Bourgogne Franche-Comté, Dijon, France
| | - D Bessis
- Department of Dermatology, Saint Eloi Hospital, Montpellier, France
| | - J Mazereeuw
- Department of Dermatology, Reference Centre for Rare Skin Diseases, Larrey Hospital, Toulouse, France
| | - A Charlesworth
- French Reference Centre for Inherited Epidermolysis Bullosa, Archet Hospital, CS 23079, 06202, NICE Cedex3, France.,INSERM U1081, CNRS UMR7284, Institute for Research on Cancer and Aging, Nice (IRCAN), Faculty of Medicine, University of Nice Sophia Antipolis, 28 Avenue Valombrose, F-06107, Nice, France
| | - G Meneguzzi
- INSERM U1081, CNRS UMR7284, Institute for Research on Cancer and Aging, Nice (IRCAN), Faculty of Medicine, University of Nice Sophia Antipolis, 28 Avenue Valombrose, F-06107, Nice, France
| | - J-P Lacour
- French Reference Centre for Inherited Epidermolysis Bullosa, Archet Hospital, CS 23079, 06202, NICE Cedex3, France.,INSERM U1081, CNRS UMR7284, Institute for Research on Cancer and Aging, Nice (IRCAN), Faculty of Medicine, University of Nice Sophia Antipolis, 28 Avenue Valombrose, F-06107, Nice, France
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50
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Brun J, Chiaverini C, Bessis D, Bourrat E, Lasek-Duriez A, Hadj-Rabia S, Boralevi F, Lacour JP. [Wells Syndrome in children and atopy: Retrospective study of 11 cases and review of the literature]. Ann Dermatol Venereol 2015; 142:320-31. [PMID: 25846461 DOI: 10.1016/j.annder.2015.02.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 01/20/2015] [Accepted: 02/04/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND Well's syndrome, or eosinophilic cellulitis, is rare in childhood, with fewer than 40 pediatric cases being reported since 1979. The physiopathology is unknown. PATIENTS AND METHODS In February 2012, members of the research group of the Department of Pediatric Dermatology Society submitted their case of Wells' syndrome in children aged 0-15 years. Details of clinical, biological and histological features and of therapeutic strategies were collected by physicians using a standardized questionnaire. Pictures were reviewed by the authors. RESULTS Eleven patients were included (average age: 6 years), with a strong prevalence of atopy (63%). Two types of clinical manifestation were noted: single or multiple cellulitis associated or not with vesiculobullous lesions and fixed urticaria. Eighty-two percent of patients had pruritus and 73% had eosinophilia. For all patients, histological examination of skin biopsies showed an eosinophilic infiltrate extending in the dermis with associated Sweet-like neutrophilic infiltrate being seen in 2 patients. The course of the disease was protracted (mean duration: 8 months) with flare-ups. Treatment varied depending on the doctors (topical or systemic steroids, tacrolimus and dapsone). DISCUSSION Our study confirms some of the data in the literature concerning the clinical, histological features and course of Well's syndrome in children. The key information is the high prevalence of atopic children hitherto unreported. In a setting of insect bites, vaccination, infection or traumatism, this unusual background could explain the onset of inflammatory reaction with eosinophils. Oral or topical steroids appear to be the first-line treatment in children when necessary. CONCLUSION Well's syndrome in children is rare and characterized by its polymorphism. We report for the first time in a series of patients a high prevalence of atopy, which raises new perspectives in understanding these rare diseases. We propose topical steroids as first-line therapy in children with superficial lesions, with oral steroids being given for cellulitic lesions or where topical therapy fails.
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Affiliation(s)
- J Brun
- Dermatologie, hôpital l'Archet 2, CHU de Nice, BP 3079, 06202 Nice cedex 3, France; Pédiatrie, hôpitaux pédiatriques, CHU-Lenval, 57, avenue de la Californie, 06200 Nice, France
| | - C Chiaverini
- Dermatologie, hôpital l'Archet 2, CHU de Nice, BP 3079, 06202 Nice cedex 3, France; Pédiatrie, hôpitaux pédiatriques, CHU-Lenval, 57, avenue de la Californie, 06200 Nice, France.
| | - D Bessis
- Dermatologie, hôpital Saint-Eloi, CHU de Montpellier, 34295 Montpellier cedex 5, France
| | - E Bourrat
- Dermatologie, hôpital Robert-Debré, AP-HP, 75935 Paris cedex 19, France
| | - A Lasek-Duriez
- Dermatologie, hôpital Saint-Vincent, CHRU de Lille, 59037 Lille cedex, France
| | - S Hadj-Rabia
- Dermatologie, hôpital Necker, AP-HP, 75015 Paris, France
| | - F Boralevi
- Dermatologie, hôpital Pellegrin, CHU de Bordeaux, 33076 Bordeaux, France
| | - J-P Lacour
- Dermatologie, hôpital l'Archet 2, CHU de Nice, BP 3079, 06202 Nice cedex 3, France
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