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Perales A, Lipsker D, Cribier B, Lenormand C. Non-scarring alopecia of lupus erythematosus: A comprehensive review. Ann Dermatol Venereol 2023; 150:260-269. [PMID: 37598015 DOI: 10.1016/j.annder.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/05/2023] [Accepted: 04/04/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND Although non-scarring alopecia (NSA) is a frequent clinical finding in patients with systemic lupus erythematosus (SLE), it has been poorly described in the literature. It is considered a nonspecific sign in the current classification of skin lesions of LE. The aim of this study was to give an updated overview of the spectrum of NSA in LE patients, with emphasis on the clinical significance thereof. METHOD We conducted a review of the English literature using the PubMed-Medline database using the keywords "Alopecia" + "Lupus erythematosus". Publications describing LE patients with NSA were included. RESULTS Data for 237 patients from 27 publications were analyzed. Ninety-one patients had diffuse NSA, 43 had patchy NSA, 83 had lupus hair, 3 had alopecia of dermal cutaneous LE, and 17 had alopecia of linear and annular lupus panniculitis of the scalp. Patients with diffuse/patchy NSA and lupus hair shared the following features: strong association with systemic activity of LE, subtle clinical/trichoscopic signs of inflammation, histological aspect consistent with lesions specific to cutaneous LE, high likelihood of response to SLE therapy, and absence of progression to scarring alopecia. Association with SLE was rare in patients with dermal cutaneous LE or linear and annular lupus panniculitis of the scalp, and skin-directed therapies were most often effective. One patient of each subtype progressed to scarring alopecia. DISCUSSION Diffuse/patchy NSA and lupus hair may represent a topographic variation of a single entity specific for LE. Prospective studies are warranted to further document the clinical significance of this manifestation.
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Affiliation(s)
- A Perales
- Clinique dermatologique, Université de Strasbourg et Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, 67091 Strasbourg, France
| | - D Lipsker
- Clinique dermatologique, Université de Strasbourg et Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, 67091 Strasbourg, France
| | - B Cribier
- Clinique dermatologique, Université de Strasbourg et Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, 67091 Strasbourg, France
| | - C Lenormand
- Clinique dermatologique, Université de Strasbourg et Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, 67091 Strasbourg, France.
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2
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Dieudonné C, Lipsker D. Reticulate skin pigmentation disorders: A morphologic approach. The concept of reticulate disorders of keratinization. Ann Dermatol Venereol 2023; 150:290-293. [PMID: 37429764 DOI: 10.1016/j.annder.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/02/2022] [Accepted: 03/30/2023] [Indexed: 07/12/2023]
Affiliation(s)
- C Dieudonné
- Dermatology Department, Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, 67000 Strasbourg, France.
| | - D Lipsker
- Dermatology Department, Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, 67000 Strasbourg, France
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3
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Schaeffer M, Lipsker D. Paradoxical joint and muscle pain in a patient treated with anifrolumab and belimumab. J Eur Acad Dermatol Venereol 2023; 37:e1198-e1199. [PMID: 37170932 DOI: 10.1111/jdv.19184] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/05/2023] [Indexed: 05/13/2023]
Affiliation(s)
- M Schaeffer
- Clinique Dermatologique, Hôpitaux Universitaires, Strasbourg Cedex, France
| | - D Lipsker
- Faculté de Médecine, Université de Strasbourg et Clinique Dermatologique, Hôpitaux Universitaires, Strasbourg Cedex, France
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4
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Matucci-Cerinic C, Engel F, Lipsker D. Early morphea appearing as a port-wine stain: A clinical challenge. Ann Dermatol Venereol 2023; 150:148-151. [PMID: 36658067 DOI: 10.1016/j.annder.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/25/2022] [Accepted: 11/08/2022] [Indexed: 01/19/2023]
Affiliation(s)
- C Matucci-Cerinic
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DINOGMI), Università degli Studi di Genova, Genova, Italy; Unità Operativa Semplice Dipartimentale Centro Malattie Autoinfiammatorie e Immunodeficienze, IRCCS Istituto Giannina Gaslini, Genova, Italy; Faculté de Médecine, Université de Strasbourg et Clinique Dermatologique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
| | - F Engel
- Cabinet de Dermatologie, Haguenau, France
| | - D Lipsker
- Faculté de Médecine, Université de Strasbourg et Clinique Dermatologique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
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5
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Lipsker G, Lipsker D. Congenital spilo-melanocytic nevus: a speckled lentiginous naevus and a spilus-like congenital melanocytic nevus in close proximity. J Eur Acad Dermatol Venereol 2022; 36:e926-e927. [PMID: 35771121 DOI: 10.1111/jdv.18391] [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: 11/30/2022]
Affiliation(s)
- G Lipsker
- Faculté de Médecine, Université de Paris, Paris, France
| | - D Lipsker
- Faculté de Médecine, Université de Strasbourg, Strasbourg, France
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6
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Lenormand C, Lipsker D. Lupus erythematosus: Significance of dermatologic findings. Ann Dermatol Venereol 2021; 148:6-15. [PMID: 33483145 DOI: 10.1016/j.annder.2020.08.052] [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: 04/22/2020] [Revised: 06/07/2020] [Accepted: 08/31/2020] [Indexed: 11/24/2022]
Abstract
Herein, the different skin manifestations in patients with lupus erythematosus are reviewed, and their diagnostic, pathogenic and prognostic relevance are discussed, as well as their impact on therapeutic choices. The so-called specific lesions of LE result from an autoimmune pathomechanism and they allow diagnosis of LE by simple clinicopathological correlation since the findings are characteristic. They include the classic acute, subacute and chronic variants, characterised microscopically by interface dermatitis; the dermal variants of lupus, such as tumid lupus, displaying dermal perivascular lymphocytic infiltrate with mucin deposition under the microscope, and lupus profundus, in which lymphocytic lobular panniculitis progressing to hyaline fibrosis is found. Antimalarials are the treatment of choice for patients with specific LE lesions. The presence of some dermatological signs is the result of thrombotic vasculopathy. Their recognition allows the identification of lupus patients at increased cardiovascular risk and with a worse overall prognosis. Those signs include reticulated erythema on the tip of the toes, splinter hemorrhages, atrophie blanche, pseudo-Degos lesions, racemosa-type livedo, anetoderma, ulceration and necrosis. Those clinical manifestations, often subtle, must be recognised, and if present, patients should be treated with antiplatelet drugs. Finally, neutrophilic cutaneous lupus erythematosus includes a few entities that suggest that autoinflammatory mechanisms might play a key role in certain lupus manifestations. Among those entities, it is very important to diagnose neutrophilic urticarial dermatosis, which can mimic a classic lupus flare, because it is characterised by rash with joint pain, but immunosuppressants are not helpful. Dapsone is the treatment of choice.
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Affiliation(s)
- C Lenormand
- Faculty of medicine, University of Strasbourg, and Dermatology clinic, Strasbourg university hospital, Strasbourg, France
| | - D Lipsker
- Faculty of medicine, University of Strasbourg, and Dermatology clinic, Strasbourg university hospital, Strasbourg, France.
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7
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Bourlond F, Velter C, Lipsker D. Penile edema following self-injection: A report on two cases. Ann Dermatol Venereol 2021; 148:55-56. [PMID: 33461794 DOI: 10.1016/j.annder.2020.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/26/2020] [Accepted: 07/16/2020] [Indexed: 11/29/2022]
Affiliation(s)
- F Bourlond
- Clinique dermatologique, HUS, 1, place de l'Hôpital, 67091 Strasbourg, France.
| | - C Velter
- Clinique dermatologique, HUS, 1, place de l'Hôpital, 67091 Strasbourg, France
| | - D Lipsker
- Clinique dermatologique, HUS, 1, place de l'Hôpital, 67091 Strasbourg, France
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Klein C, Lipsker D. Mandibular sterile osteitis as a manifestation of synovitis, acne, pustulosis, hyperostosis, osteitis syndrome: a literature review. J Eur Acad Dermatol Venereol 2020; 35:e335-e338. [PMID: 33331027 DOI: 10.1111/jdv.17089] [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: 11/30/2022]
Affiliation(s)
- C Klein
- Clinique Dermatologique, Université de Strasbourg et Hôpitaux Universitaires de Strasbourg, Strasbourg Cedex, France
| | - D Lipsker
- Clinique Dermatologique, Université de Strasbourg et Hôpitaux Universitaires de Strasbourg, Strasbourg Cedex, France
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9
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Pham F, Schissler C, Schaeffer M, Lachmann HJ, Lipsker D. Diagnostic value of skin biopsy in autoinflammatory diseases for patients with recurrent fever and urticarial eruption. Clin Exp Dermatol 2020; 46:728-730. [PMID: 33185903 DOI: 10.1111/ced.14508] [Citation(s) in RCA: 1] [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] [Received: 11/07/2020] [Accepted: 11/10/2020] [Indexed: 11/30/2022]
Affiliation(s)
- F Pham
- Dermatology Clinic, Strasbourg University Hospitals, Strasbourg, France
| | - C Schissler
- Dermatology Clinic, Strasbourg University Hospitals, Strasbourg, France
| | - M Schaeffer
- Clinical Research Methodology Group, Public Health Service, Strasbourg University Hospitals, Strasbourg, France
| | - H-J Lachmann
- National Amyloidosis Centre, University College London, Gower Street, London, UK
| | - D Lipsker
- Dermatology Clinic, Strasbourg University Hospitals, Strasbourg, France.,Faculty of Medicine, University of Strasbourg, Strasbourg, France
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10
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Lemasson J, Frumholtz L, Lenormand C, Lipsker D, Jachiet M, Moulin S, Chiaverini C, Le Duff F, Passeron T, Cordoliani F, Bagot M, Montfort JB, Senet P, De Masson A, Cassius C, Petit A, Misery L, Moguelet P, Cordel N, Fardet L, Begon E, Frances C, Bessis D, Bouaziz JD, Chasset F. Étude nationale française multicentrique de 74 patients atteints de panniculite lupique. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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11
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Osché M, Mitcov M, Lipsker D, Cribier B. [Anatomoclinical and immunohistochemical study of 8 cases of dermatomyofibroma]. Ann Dermatol Venereol 2020; 147:721-728. [PMID: 33059951 DOI: 10.1016/j.annder.2020.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/06/2019] [Accepted: 01/10/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Dermatomyofibroma (DMF) is a rare, benign tumour that is little-known among clinicians. However, it has typical clinical, histological and immunohistochemical features that distinguish it from other fibrous tumours. METHOD We report herein on the clinical, histological and immunohistochemical aspects of eight cases of DMF identified between 2008 and 2019 at the dermatopathology laboratory of Strasbourg. RESULTS Five men and three women of average age at diagnosis of 21 years and 9 months (range: 9 to 54 years) were included. Lesions ranged in size from 1 to 11cm. Most cases involved the upper body (6 cases), with one case on the abdomen and one on the side. The lesions presented as a solitary asymptomatic red or reddish brown nodule or plaque that gradually developed. The plaques were hard and caused functional discomfort on movement of the neck. Well-circumscribed spindle cell proliferation was noted in the reticular dermis parallel to the epidermis, without mitotic figures or cytological atypia. The subcutis was infiltrated in 5 cases. Expression of calponin was positive in all cases but one, while that of caldesmon, PS100 and desmin was negative. Expression of smooth muscle actin was positive in 2 cases, and both cases were also positive for stromylesin-3. CD34 was positive in 2 cases. DISCUSSION DMF is an extensive tumour capable of attaining large diameters and must be completely excised. The main differential diagnoses of DMF are dermatofibrosarcoma protuberans, dermatofibroma, fibrous hamartoma, myofibromatosis and cheloid. It can be identified based on various factors, whether clinical (young age, extensive lesion), histological (horizontal proliferation in the reticular dermis) or immunohistochemical (positive expression of calponin).
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Affiliation(s)
- M Osché
- Clinique dermatologique de Strasbourg, hôpitaux universitaires de Strasbourg, université de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
| | - M Mitcov
- Clinique dermatologique de Strasbourg, hôpitaux universitaires de Strasbourg, université de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - D Lipsker
- Clinique dermatologique de Strasbourg, hôpitaux universitaires de Strasbourg, université de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - B Cribier
- Clinique dermatologique de Strasbourg, hôpitaux universitaires de Strasbourg, université de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
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Lenormand C, Soskin S, Lipsker D. Pigmented spots on the lacrimal caruncle: a key to the diagnosis of Carney complex in a child with multiple lentigines. J Eur Acad Dermatol Venereol 2020; 34:e604-e606. [DOI: 10.1111/jdv.16485] [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)
- C. Lenormand
- Department of Dermatology Hôpitaux Universitaires de Strasbourg Strasbourg Cedex France
- Faculté de Médecine Université de Strasbourg Strasbourg Cedex France
| | - S. Soskin
- Department of Pediatric Endocrinology Hôpitaux Universitaires de Strasbourg Strasbourg Cedex France
| | - D. Lipsker
- Department of Dermatology Hôpitaux Universitaires de Strasbourg Strasbourg Cedex France
- Faculté de Médecine Université de Strasbourg Strasbourg Cedex France
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13
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Bergeret B, Secco LP, Pallure V, Daien C, Pers YM, Gottlieb J, Barete S, Girard C, Lipsker D, Bessis D. Palmoplantar lichen planus-like lupus erythematosus keratoderma: an underrecognized and distinctive cutaneous manifestation of systemic or subacute lupus erythematosus. J Eur Acad Dermatol Venereol 2020; 35:e124-e126. [PMID: 32757396 DOI: 10.1111/jdv.16852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/22/2020] [Accepted: 07/30/2020] [Indexed: 11/26/2022]
Affiliation(s)
- B Bergeret
- Department of Dermatology, Saint-Eloi Hospital, University Hospital of Montpellier, Montpellier, France
| | - L-P Secco
- Department of Dermatology, Saint-Eloi Hospital, University Hospital of Montpellier, Montpellier, France.,Department of Pathology, Gui de Chauliac Hospital, University Hospital of Montpellier, Montpellier, France
| | - V Pallure
- Department of Dermatology, Saint-Eloi Hospital, University Hospital of Montpellier, Montpellier, France.,Department of Dermatology and Internal Medicine, Perpignan Hospital, Perpignan, France
| | - C Daien
- Department of Rheumatology, Lapeyronie Hospital, University Hospital of Montpellier, Montpellier, France
| | - Y-M Pers
- Department of Rheumatology, Lapeyronie Hospital, University Hospital of Montpellier, Montpellier, France
| | - J Gottlieb
- Department of Internal Medicine, Bicètre University Hospital, AP-HP, Paris, France
| | - S Barete
- Department of Dermatology, La Pitié Salpétrière University Hospital, AP-HP, Paris, France
| | - C Girard
- Department of Dermatology, Saint-Eloi Hospital, University Hospital of Montpellier, Montpellier, France.,INSERM U1058, Montpellier, France
| | - D Lipsker
- Department of Dermatology, Civil Hospital, University Hospital of Strasbourg, Strasbourg, France
| | - D Bessis
- Department of Dermatology, Saint-Eloi Hospital, University Hospital of Montpellier, Montpellier, France.,INSERM U1058, Montpellier, France
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Wagner C, Chasset F, Francès C, Lipsker D. [Ungual lesions in lupus erythematosus: A retrospective study of 14 patients]. Ann Dermatol Venereol 2020; 147:823-832. [PMID: 32763004 DOI: 10.1016/j.annder.2020.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 05/12/2020] [Accepted: 06/17/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION There are few studies focusing on ungual lesions in patients with lupus erythematosus (LE). The aim of this study is to describe our experience with ungual lesions in LE patients. MATERIALS AND METHODS A multicentric retrospective descriptive study was performed at the dermatology departments of the university hospitals in Strasbourg and at the Tenon hospital in Paris and involved reviewing the medical records and photographs of patients with ungual lesions. RESULTS Fourteen patients were included: 12 (86 %) were women with a median age of 38 years (28-78 years). All patients had cutaneous LE presenting as follows: 3 isolated forms (21 %), and associated with systemic LE (LES) for remaining 11 patients (79 %). The most frequent ungual or peri-ungual lesions were longitudinal ridging (12 patients, 86 %), onycholysis and cuticular alterations (8 patients each, 57 %), pterygium (7 patients, 50 %), melanonychia, onychoschizia and subungual hyperkeratosis (5 patients with each, 36 %). Among patients with pterygium and onychoschizia, respectively 6 (86 %) and 5 (100 %) presented the discoid LE subtype, while respectively 6 (86 %) and 4 (80 %) had multisystemic involvement. DISCUSSION Ungual lesions do not appear specific and do not in themselves allow diagnosis of LE. They can in fact occur in other diseases such as connective tissue disorders. However, their diagnosis is important because certain of them, such as pterygium, can lead to severe ungual dystrophia, with functional consequences. In our study, pterygium and onychoschizia appeared to be associated with cutaneous discoid lupus erythematosus and multisystemic involvement. The coexistence of peri-ungual lesions related to cutaneous lupus erythematosus and/or multisystemic involvement does not out differentiation of lupus ungual lesions and post-inflammatory lesions.
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Affiliation(s)
- C Wagner
- Clinique dermatologique, université de Strasbourg, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France
| | - F Chasset
- Service de dermatologie et allergologie, faculté de médecine Sorbonne université, Sorbonne université, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris cedex 20, France
| | - C Francès
- Service de dermatologie et allergologie, faculté de médecine Sorbonne université, Sorbonne université, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris cedex 20, France
| | - D Lipsker
- Clinique dermatologique, université de Strasbourg, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France.
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Reymann V, Bessis D, Bergeret B, Lipsker D, Du-Thanh A, Terrail N, Dandurand M, Dereure O. Efficacy and safety of low-dose oral lenalidomide in refractory cutaneous lupus erythematosus: an open series of 19 cases. J Eur Acad Dermatol Venereol 2020; 35:e113-e115. [PMID: 32730681 DOI: 10.1111/jdv.16839] [Citation(s) in RCA: 1] [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)
- V Reymann
- Department of Dermatology and INSERM U1058 Pathogenesis and Control of Chronic and Emerging Infections, University of Montpellier, Montpellier, France
| | - D Bessis
- Department of Dermatology and INSERM U1058 Pathogenesis and Control of Chronic and Emerging Infections, University of Montpellier, Montpellier, France
| | - B Bergeret
- Department of Dermatology, University Hospital of Nimes, Nimes, France
| | - D Lipsker
- Department of Dermatology, University Hospital of Strasbourg, Strasbourg, France
| | - A Du-Thanh
- Department of Dermatology and INSERM U1058 Pathogenesis and Control of Chronic and Emerging Infections, University of Montpellier, Montpellier, France
| | - N Terrail
- Outpatient Delivery Unit, Pharmacy, University Hospital of Montpellier, Montpellier, France
| | - M Dandurand
- Department of Dermatology, University Hospital of Nimes, Nimes, France
| | - O Dereure
- Department of Dermatology and INSERM U1058 Pathogenesis and Control of Chronic and Emerging Infections, University of Montpellier, Montpellier, France
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Abstract
PURPOSE To report on the characteristics of juvenile dermatomyositis (JDM). PATIENTS AND METHODS This was a retrospective, descriptive, cross-sectional, non-interventional, multicenter study conducted in Alsace between 2000 and 2015. The patients, aged 0 to 16years, had JDM according to both the Bohan and Peter and the EULAR/ACR criteria. RESULTS A total of 17 girls and 5 boys were included with a median age at disease onset of 7,8years (Q1-Q3: 4.4-12.9). Median duration of JDM and median patient follow-up were 2.8years and 6.2years, respectively. The most common skin symptoms were papules or Gottron's sign (86 %), nail lesions (82 %), erythema of the face (77 %) and eyelids (59 %), photosensitivity (59 %), and calcinosis (27 %). One patient presented papules with a depressed and porcelain-white center ("Degos-like" lesions). One patient had algodystrophy. Two patients were clinically amyopathic. One girl had intestinal vasculitis. Respiratory function tests were abnormal in 27 % of cases. Median treatment duration was 42 months (Q1-Q3: 19-63). Three patients had a monocyclic form, 12 had a polycyclic form, and 7 had chronic disease. CONCLUSION The frequency of cutaneous and musculoskeletal signs is comparable to that of other large cohorts of JDM. "Degos-like" lesions and algodystrophy have not yet been described in JDM. This study highlights the type and extent of the dermatological manifestations that frequently constitute the presenting complaint in this disease.
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Affiliation(s)
- C Moegle
- Service de dermatologie, hôpital universitaire de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France
| | - D Lipsker
- Service de dermatologie, hôpital universitaire de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France.
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17
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Pham F, El Chehadeh S, Lipsker D. PTEN hamartoma tumor syndrome in children: diagnosis based on cutaneous manifestations with a focus on translucent palmoplantar papules. J Eur Acad Dermatol Venereol 2020; 34:e632-e633. [PMID: 32311800 DOI: 10.1111/jdv.16505] [Citation(s) in RCA: 1] [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: 12/28/2022]
Affiliation(s)
- F Pham
- Clinique Dermatologique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - S El Chehadeh
- Department of Medical Genetics, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - D Lipsker
- Clinique Dermatologique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,Faculté de Médecine, Université de Strasbourg, Strasbourg, France
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18
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Bourlond F, Velter C, Lipsker D. [A case of cutaneous tuberculosis evolving for 50 years]. Ann Dermatol Venereol 2020; 147:653-657. [PMID: 32386803 DOI: 10.1016/j.annder.2019.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/29/2019] [Accepted: 12/31/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Tuberculosis is an infection caused by Mycobacterium (M.) tuberculosis. It is rare in France. Clinical presentations vary, making demonstration of the cause of M. Tuberculosis difficult and rendering diagnosis and management difficult. PATIENTS AND METHODS A 58-year-old man, born in Morocco, consulted for ulceration of the right forefoot that had been present since the age of 3 years. He had previously consulted at several dermatology departments. He had undergone numerous skin biopsies and bacteriological and mycobacteriological cultures but these did not contribute to the diagnosis. Slow extension and oozing were observed over time and resulted in functional disability. Given the evocative clinical aspect and despite further negative screening for mycobacteria, anti-TB quadrotherapy was prescribed and resulted in complete cure of the lesion. DISCUSSION This case underscores the difficulty of diagnosing cutaneous tuberculosis. Such a diagnosis must be clinically suspected in the presence of long lasting destructive or verrucous skin lesions that fail to heal, even where cultures are negative, and anti-TB therapy should be putatively prescribed.
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Affiliation(s)
- F Bourlond
- Clinique dermatologique, université de Strasbourg et hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France
| | - C Velter
- Clinique dermatologique, université de Strasbourg et hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France
| | - D Lipsker
- Clinique dermatologique, université de Strasbourg et hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France.
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Rohmer E, Mitcov M, Cribier B, Lipsker D, Lenormand C. [Clinical heterogeneity of poikilodermatous mycosis fungoides: A retrospective study of 12 cases]. Ann Dermatol Venereol 2020; 147:418-428. [PMID: 32229035 DOI: 10.1016/j.annder.2020.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 01/08/2020] [Accepted: 02/05/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Poikilodermatous mycosis fungoides is a rare and indolent clinical variant of mycosis fungoides (MF). It can be difficult to distinguish from poikilodermatous parapsoriasis, a group of chronical dermatoses that may sometimes progress to MF. We aimed to specify the clinical, histopathological and developmental features of these entities by means of a retrospective study of 12 cases followed in our center. PATIENTS AND METHODS We identified cases of poikiloderma for which a diagnosis of MF or parapsoriasis was made by the physician. Photographs and histological slides were reviewed, and a final diagnosis of MF was made if the International Society for Cutaneous Lymphoma criteria for the diagnosis of early MF were fulfilled. RESULTS Twelve patients were included, 10 of whom met of the MF criteria. 5 patients had large poikilodermatous patches or thin, well-defined plaques ; 3 patients had the same lesions associated with classical MF lesions ; finally, 4 patients had widespread ill-defined erythematous lesions in a net-like pattern, described as parakeratosis variegata, including 3 MF. 2 patients with well-defined lesions (one associated with classical MF lesions) progressed to the tumoral stage whereas none of the patients with parakeratosis variegata presented such progression. A total of 5 patients had a high skin phototype (IV and V). Two patients had squamous cell carcinoma on poikilodermatous lesions. DISCUSSION Our study suggests that poikilodermatous MF covers a heterogeneous clinical spectrum comprising on one hand a presentation of delimited lesions sharing classical MF risk of progression, and on the other, an entity similar to parakeratosis variegata, an entity overlooked in the French nomenclature, which was particularly benign in our small series, raising the question of its affiliation to the MF group. This question merits further investigation in a larger-scale study.
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Affiliation(s)
- E Rohmer
- Clinique dermatologique, université de Strasbourg et hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
| | - M Mitcov
- Clinique dermatologique, université de Strasbourg et hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - B Cribier
- Clinique dermatologique, université de Strasbourg et hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - D Lipsker
- Clinique dermatologique, université de Strasbourg et hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - C Lenormand
- Clinique dermatologique, université de Strasbourg et hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
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20
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Gusdorf L, Lipsker D. Neutrophilic urticarial dermatosis: an entity bridging monogenic and polygenic autoinflammatory disorders, and beyond. J Eur Acad Dermatol Venereol 2020; 34:685-690. [DOI: 10.1111/jdv.15984] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 09/11/2019] [Indexed: 12/11/2022]
Affiliation(s)
- L. Gusdorf
- Faculté de Médecine Université de Strasbourg, and Clinique Dermatologique Hôpitaux Universitaires Strasbourg France
| | - D. Lipsker
- Faculté de Médecine Université de Strasbourg, and Clinique Dermatologique Hôpitaux Universitaires Strasbourg France
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21
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Ehret M, Lenormand C, Scrivener JN, Gusdorf L, Lipsker D, Cribier B. [Generalized granuloma annulare: A clinicopathological study]. Ann Dermatol Venereol 2020; 147:271-278. [PMID: 32171551 DOI: 10.1016/j.annder.2019.09.617] [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: 10/13/2018] [Revised: 02/13/2019] [Accepted: 09/06/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND Granuloma annulare (GA) is a benign granulomatous skin disorder that is generalized (GGA) in 15 % of cases. Although many case reports describe a relationship between GGA and systemic diseases, few large series have been published, and their association is debated. We present herein a series of GGA in order to describe their clinical and histological features. PATIENTS AND METHODS We included all biopsy-proven cases of GA presenting at the dermatopathology laboratory of Strasbourg where generalized (i.e. over 10 lesions). Clinical features were obtained from patients' medical files. RESULTS We included 35 GGA, with a sex ratio of 0.5. The mean age was 54 years. Lesions were annular or non-annular in equal measure and were symptomatic in 25 % of cases. Most patients (77 %) had an associated disease, already known in 60 % of cases, including dyslipidemia (27 %), diabetes mellitus (20 %), immunosuppressive drugs (17 %), atopy (17 %), auto-immune disease (17 %), hematological disease (14 %), and cancer (9 %). Histological analysis revealed the predominant pattern to be interstitial (54 %) rather than palisading (20 %), having no correlation with clinical type. Eosinophils were frequent (46 %) in GA but were not correlated with systemic disease or drug taking. Among the 40 % of patients treated, 50 % had a successful outcome on topical corticosteroids, doxycycline, antimalarial drugs or phototherapy. DISCUSSION GGA differs from localized GA, which is mostly associated with an already known systemic disease, whether metabolic, infectious or neoplastic, uncorrelated with clinical or histological features, and screening is necessary.
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Affiliation(s)
- M Ehret
- Clinique dermatologique, université de Strasbourg et hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
| | - C Lenormand
- Clinique dermatologique, université de Strasbourg et hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - J-N Scrivener
- Clinique dermatologique, université de Strasbourg et hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - L Gusdorf
- Clinique dermatologique, université de Strasbourg et hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - D Lipsker
- Clinique dermatologique, université de Strasbourg et hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - B Cribier
- Clinique dermatologique, université de Strasbourg et hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
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22
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Moegle C, Grillon A, Anheim M, Lipsker D, Velter C. Impulse control disorder-linked hypersexuality complicated by disseminated gonococcal infection in a patient with Parkinson's disease. Rev Neurol (Paris) 2020; 176:292-293. [PMID: 32139181 DOI: 10.1016/j.neurol.2019.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/16/2019] [Accepted: 10/18/2019] [Indexed: 11/25/2022]
Affiliation(s)
- C Moegle
- Department of dermatology, university hospitals of Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France
| | - A Grillon
- Laboratory of bacteriology, university hospitals of Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France
| | - M Anheim
- Department of neurology, university hospitals of Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France.
| | - D Lipsker
- Department of dermatology, university hospitals of Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France
| | - C Velter
- Department of dermatology, university hospitals of Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France
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23
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Maitrepierre F, Schissler C, Cribier B, Lipsker D. Ulcérations de lésions cutanées lymphomateuses sous brentuximab-védotin chez un patient atteint de syndrome de Sézary. Ann Dermatol Venereol 2020; 147:198-201. [DOI: 10.1016/j.annder.2019.09.615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 03/23/2019] [Accepted: 09/05/2019] [Indexed: 11/17/2022]
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24
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Wagner C, Chasset F, Fabacher T, Lipsker D. Lupus érythémateux et atteinte unguéale : revue de la littérature. Ann Dermatol Venereol 2020; 147:18-28. [DOI: 10.1016/j.annder.2019.10.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 09/18/2019] [Accepted: 10/09/2019] [Indexed: 11/29/2022]
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25
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Moegle C, Severac F, Lipsker D. Epidemiology of juvenile dermatomyositis in Alsace. Br J Dermatol 2019; 182:1307-1308. [PMID: 31823358 DOI: 10.1111/bjd.18799] [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)
- C Moegle
- Dermatology Department, Strasbourg University Hospital, Strasbourg, France
| | - F Severac
- Department of Public Health Medicine, Strasbourg University Hospital, Strasbourg, France
| | - D Lipsker
- Dermatology Department, Strasbourg University Hospital, Strasbourg, France
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26
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Bergeret B, Lipsker D, Pallure V, Barete S, Gottlieb J, Durand L, Pers YM, Bessis D. Kératodermie palmo-plantaire livedoïde, une manifestation cutanée méconnue du lupus érythémateux systémique ou subaigu. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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27
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Marzolf G, Kieny A, Gusdorf L, Engel F, Lipsker D, Lenormand C. Pseudo-maladie sérique à la ceftazidime avec réaction croisée à l’aztréonam. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Samama B, Benardais K, Lipsker D, Boehm N. GLUT1 expression in human papillomavirus-positive anogenital lesions. J Eur Acad Dermatol Venereol 2019; 34:873-875. [PMID: 31746025 DOI: 10.1111/jdv.16102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 11/11/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND GLUT1, an ubiquitous glucose transporter in the mammalian cells, is upregulated in many tumours, including human papillomavirus (HPV)-induced head and neck or cervical cancer. OBJECTIVE To study in anogenital lesions whether or not GLUT1 expression correlates with genomic high-risk HPV integration, the first step in neoplastic transformation. METHODS Forty-three HPV-positive biopsies positive for either low-risk or high-risk HPV were selected. Paraffin sections adjacent to those tested for the presence of HPV were processed for GLUT1 immunocytochemistry. GLUT1 expression was analysed by two histologists, blinded to HPV type and status and then compared with HPV typing results. RESULTS Two main staining patterns were observed, either staining from the basal to the granular layer or staining of superficial layers only. The first staining pattern corresponded to lesions with high number of episomal HPV-positive nuclei. Superficial staining was observed in lesions with low number of episomal HPV nuclei or when high-risk HPV was integrated in the cell genome. CONCLUSION Our results show that GLUT1 overexpression correlates with the number of episomally infected cells in the lesion, but not with the type (low or high risk) of HPV.
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Affiliation(s)
- B Samama
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France.,Faculty of Medicine, Institute of Histology, University of Strasbourg, Strasbourg Cedex, France.,Hôpitaux Universitaires de Strasbourg, Strasbourg Cedex, France
| | - K Benardais
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France.,Faculty of Medicine, Institute of Histology, University of Strasbourg, Strasbourg Cedex, France.,Hôpitaux Universitaires de Strasbourg, Strasbourg Cedex, France
| | - D Lipsker
- Clinique Dermatologique, Hôpitaux Universitaires de Strasbourg, Strasbourg Cedex, France
| | - N Boehm
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France.,Faculty of Medicine, Institute of Histology, University of Strasbourg, Strasbourg Cedex, France.,Hôpitaux Universitaires de Strasbourg, Strasbourg Cedex, France
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Paleau A, Candolfi E, Souply L, De Briel D, Delarbre JM, Lipsker D, Jouglin M, Malandrin L, Hansmann Y, Martinot M. Human babesiosis in Alsace. Med Mal Infect 2019; 50:486-491. [PMID: 31548143 DOI: 10.1016/j.medmal.2019.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 05/06/2018] [Revised: 09/02/2018] [Accepted: 08/28/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Human babesiosis is a rare parasitic anthropozoonosis transmitted to humans by tick bites. Fifty-six cases of human babesiosis have been recorded in Europe. Two cases of babesiosis were reported in Alsace, France, in 2009. We performed a retrospective observational descriptive study to assess the epidemiology of the disease in Alsace. METHODS Patients were included if they had a positive serology result for Babesia and/or a positive blood smear and/or a positive PCR result. The tests were performed in the microbiology laboratories of the university hospitals of Strasbourg, the civil hospitals of Colmar, and the hospital of Mulhouse between January 1, 2005 and December 31, 2015. Included patients were divided into three groups: definite case group (positive PCR or positive blood smear or seroconversion), possible case group (positive serology results without seroconversion with a compatible clinical picture and without other confirmed diagnoses), and incompatible case group (positive serology results without seroconversion, without compatible clinical picture and/or with other confirmed diagnoses). The compatible clinical picture was defined by the presence of flu-like symptoms and fever (≥38°C). RESULTS Fifty-one patients had at least one positive result. Three cases were excluded (missing files). There were six definite cases, 12 possible cases, and 30 incompatible cases. All patients in the definite case group were immunocompetent. No deaths occurred. CONCLUSIONS Human babesiosis is probably underdiagnosed due to its non-specific symptoms, lack of awareness about the disease, and the difficulty in making a diagnosis.
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Affiliation(s)
- A Paleau
- Service de maladies infectieuses, boulevard Louis-Escande, 71018 Mâcon cedex, France.
| | - E Candolfi
- Laboratoire de parasitologie et de mycologie médicale, plateau technique de microbiologie, hôpitaux universitaires de Strasbourg, 1, place de l'hôpital, BP 426, 67091 Strasbourg, France.
| | - L Souply
- Laboratoire de microbiologie, hôpital Pasteur, hôpitaux civils de Colmar, 39, avenue Liberté, 68024 Colmar cedex, France.
| | - D De Briel
- Laboratoire de microbiologie, hôpital Pasteur, hôpitaux civils de Colmar, 39, avenue Liberté, 68024 Colmar cedex, France.
| | - J M Delarbre
- Laboratoire de microbiologie, centre hospitalier de Mulhouse, site Emile-Muller, 20, avenue Docteur René-Laennec, 68100 Mulhouse, France.
| | - D Lipsker
- Service de dermatologie, consultation dermatologie, oncodermatologien, CHU de Strasbourg, hôpital civil, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France.
| | - M Jouglin
- BIOEPAR, Inra, Oniris, 44307 Nantes, France.
| | - L Malandrin
- BIOEPAR, Inra, Oniris, 44307 Nantes, France.
| | - Y Hansmann
- Service des maladies infectieuses et tropicales, 1, place de l'Hôpital, NHC BP 426, 67091 Strasbourg cedex, France.
| | - M Martinot
- Unité d'infectiologie, centre hospitalier de Colmar, 39, avenue de la Liberté, 68024 Colmar, France.
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Affiliation(s)
- D. Lipsker
- Faculté de Médecine Clinique Dermatologique Université de Strasbourg et Hôpitaux Universitaires Strasbourg France
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Affiliation(s)
- L. Frumholtz
- Clinique de Dermatologie Nouvel Hôpital Civil F‐67091 Strasbourg France
| | - D. Lipsker
- Clinique de Dermatologie Nouvel Hôpital Civil F‐67091 Strasbourg France
- Faculté de Médecine Université de Strasbourg F‐67091 Strasbourg France
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Chasseuil E, McGrath J, Seo A, Balguerie X, Bodak N, Chasseuil H, Denis‐Musquer M, Goldenberg A, Goussot R, Irvine A, Khumalo N, King M, Küry S, Lipsker D, Mallet S, Mayosi B, Nanda A, Puzenat E, Salort‐Campana E, Sidbury R, Shimamura A, Bézieau S, Mercier S, Barbarot S. Dermatological manifestations of hereditary fibrosing poikiloderma with tendon contractures, myopathy and pulmonary fibrosis (
POIKTMP
): a case series of 28 patients. Br J Dermatol 2019; 181:862-864. [DOI: 10.1111/bjd.17996] [Citation(s) in RCA: 4] [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: 01/27/2023]
Affiliation(s)
- E. Chasseuil
- CHU de Poitiers Service de dermatologie Poitiers France
| | - J.A. McGrath
- St John's Institute of Dermatology King's College London Guy's Hospital London U.K
| | - A. Seo
- Department of Genome Sciences University of Washington Seattle WA U.S.A
| | - X. Balguerie
- CHU de Rouen Clinique dermatologique Rouen France
| | | | - H. Chasseuil
- CHU de Poitiers Service de dermatologie Poitiers France
| | | | | | | | | | | | - M.C. King
- Department of Genome Sciences University of Washington Seattle WA U.S.A
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Birckel E, Lipsker D, Cribier B. [Efficacy of photopheresis in the treatment of erosive lichen planus: A retrospective study]. Ann Dermatol Venereol 2019; 147:86-92. [PMID: 31230777 DOI: 10.1016/j.annder.2019.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 10/03/2017] [Revised: 01/17/2019] [Accepted: 02/08/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Erosive lichen planus of the skin and mucosa is an invalidating disease that impacts the quality of life of patients and for which there is no codified treatment. Herein we report retrospective efficacy data for extracorporeal photopheresis (ECP) in the treatment of erosive lichen planus in 11 patients. PATIENTS AND METHODS We treated 10 women and 1 man with PCE for erosive lichen planus refractory on average to two previous treatments. PCE was administered in two sessions on two successive days every two weeks at the start of treatment, followed by more widely spaced cycles. The primary evaluation criterion was partial or complete clinical efficacy. RESULTS PCE had a positive effect on all 11 patients. We noted 6 complete remissions and 5 partial remissions. Complete remission was achieved within a mean 5.5 months, with improvement in symptoms occurring earlier. Relapse was frequent during the intervals between PCE sessions and on discontinuation of treatment but resumption of PCE once again proved effective. DISCUSSION Our study supports the data in the literature from 28 published cases. Treatment efficacy and improvement in symptoms were rapidly apparent. PCE is generally a well-tolerated treatment, with only one patient dropping out of our study, but it imposes certain scheduling, technical and cost constraints. These constraints and the frequency of relapse underscore the question of treatment duration. The initial therapeutic schedule for PCE does not appear to modify the times required to achieve remission of erosive lichen planus.
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Affiliation(s)
- E Birckel
- Clinique dermatologique, université de Strasbourg, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
| | - D Lipsker
- Clinique dermatologique, université de Strasbourg, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - B Cribier
- Clinique dermatologique, université de Strasbourg, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
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Lipsker D. Extensive cutaneous necrosis in monoclonal cryoglobulinemia: an example of monoclonal gammopathy of cutaneous significance. J Eur Acad Dermatol Venereol 2019; 33:e167. [DOI: 10.1111/jdv.15397] [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: 11/30/2022]
Affiliation(s)
- D. Lipsker
- Faculté de Médecine Université de Strasbourg et Clinique Dermatologique Hôpitaux Universitaires Strasbourg France
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35
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Hazemann G, Michel C, Mahé A, Lipsker D, Cribier B. [Histopathological study of basaloid follicular hamartoma]. Ann Dermatol Venereol 2019; 146:181-191. [PMID: 30691875 DOI: 10.1016/j.annder.2018.12.007] [Citation(s) in RCA: 2] [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: 04/19/2018] [Revised: 06/29/2018] [Accepted: 12/03/2018] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Basaloid follicular hamartoma (BFH) is a rare tumor first described in 1985. It bears clinical and histologic similarities with basal cell carcinoma (BCC), in particular the so-called infundibulocystic form. We performed a single-center clinicopathological study of a series of typical cases of this entity that is occasionally difficult to diagnose. MATERIALS AND METHODS All cases of BFH seen at the Dermatopathology Laboratory of Strasbourg University Hospital were included and analyzed by means of HE staining and Ber-EP4 and PHLDA1 immunolabelling. Diagnosis was made in the event of basaloid proliferation with anastomosing cords developed from a hair follicle. Clinical data were collected from clinical files. RESULTS We identified 15 cases in 13 patients of mean age 44.8 years (range: 4 to 90) and the sex-ratio was 5/8. Lesions consisted of flesh-colored papules measuring 0.3 to 1.2cm in diameter, without any preferential site. Three patients had multiple lesions consisting of several coalescent papules on a breast for one, sparse papules on the back for another, and hundreds of linear unilateral BFHs, associated with osseous abnormalities, characteristic of Happle-Tinschert syndrome, for the third. All tumors were limited to the superficial and mid dermis, with a vertical orientation and connection to the epidermis in 14 of the 15 patients. In some cases, the outermost cells were basophilic while the central cells were eosinophilic. Peripheral palisading and clefting were frequently observed. Keratin cysts or sebaceous ducts were consistently present, indicating follicular differentiation. Ber-EP4+ cells were restricted to the periphery of the cords and PHLDA1 was weakly expressed. DISCUSSION BFH is a rare entity that must be differentiated from BCC. It presents as solitary or multiple lesions, either grouped in plaques or with a generalized or linear unilateral distribution. Generalized BFH may be associated with autoimmune diseases and linear unilateral BFH with osseous, dental and cerebral abnormalities in Happle-Tinschert syndrome. It is important to distinguish BFH from BCC to avoid inappropriate aggressive treatment.
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Affiliation(s)
- G Hazemann
- Clinique dermatologique, université de Strasbourg, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
| | - C Michel
- Centre hospitalier Emile-Muller, 20, avenue du Dr-René-Laennec, 68100 Mulhouse, France
| | - A Mahé
- Hôpitaux civils de Colmar, 39, rue de la Liberté, 68000 Colmar, France
| | - D Lipsker
- Clinique dermatologique, université de Strasbourg, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - B Cribier
- Clinique dermatologique, université de Strasbourg, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
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Velter C, Messaddeq N, Levy E, Morruzzi C, Cribier B, Dali‐Youcef N, Lipsker D. Abnormal lipid storage related to adipocyte shrinkage in acquired partial lipodystrophy (Barraquer–Simons syndrome). J Eur Acad Dermatol Venereol 2019; 33:2188-2191. [DOI: 10.1111/jdv.15366] [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: 08/27/2018] [Accepted: 10/29/2018] [Indexed: 11/29/2022]
Affiliation(s)
- C. Velter
- Faculté de Médecine Hôpitaux Universitaires de Strasbourg Université de Strasbourg et Clinique Dermatologique Strasbourg France
| | - N. Messaddeq
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC) CNRS/INSERM Université de Strasbourg 1 Rue Laurent Fries, Illkirch France
| | - E. Levy
- Faculté de Médecine Hôpitaux Universitaires de Strasbourg Université de Strasbourg et Clinique Dermatologique Strasbourg France
| | - C. Morruzzi
- Faculté de Médecine Hôpitaux Universitaires de Strasbourg Université de Strasbourg et Clinique Dermatologique Strasbourg France
| | - B. Cribier
- Faculté de Médecine Hôpitaux Universitaires de Strasbourg Université de Strasbourg et Clinique Dermatologique Strasbourg France
| | - N. Dali‐Youcef
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC) CNRS/INSERM Université de Strasbourg 1 Rue Laurent Fries, Illkirch France
- Laboratoire de Biochimie et Biologie Moléculaire Hôpitaux Universitaires de Strasbourg Nouvel Hôpital Civil Strasbourg Cedex France
| | - D. Lipsker
- Faculté de Médecine Hôpitaux Universitaires de Strasbourg Université de Strasbourg et Clinique Dermatologique Strasbourg France
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Gusdorf L, Morruzzi C, Goetz J, Lipsker D, Sibilia J, Cribier B. Mechanics hands in patients with antisynthetase syndrome: 25 cases. Ann Dermatol Venereol 2019; 146:19-25. [DOI: 10.1016/j.annder.2018.11.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 07/16/2018] [Accepted: 11/16/2018] [Indexed: 11/29/2022]
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Reymann V, Bessis D, Lipsker D, Bergeret B, Du Thanh A, Terrail N, Dandurand M, Dereure O. Efficacité et tolérance du lénalidomide oral à faible dose dans le lupus érythémateux cutané réfractaire : une série ouverte de 19 cas. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cesbron E, Bessis D, Jachiet M, Lipsker D, Cordel N, Bouaziz JD, Bagot M, Arnaud L, Barbaud A, Francès C, Chasset F. Risque de thromboses chez les patients traités par thalidomide pour un lupus érythémateux cutané. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Zuelgaray E, Battistella M, Sallé de Chou C, Vignon-Pennamen MD, Rybojad M, Petit A, Cordoliani F, Chasset F, Bachmeyer C, Fardet L, Fautrel B, Cacoub P, Lipsker D, Bagot M, Bouaziz JD. Les éruptions cutanées persistantes de la maladie de Still de l’adulte sont associées à une maladie plus sévère et à une atteinte épidermique en histologie. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Bourlond F, Cribier B, Lipsker D. Diagnostic simple des syndromes de Griscelli et de Chediak–Higashi : dilution pigmentaire et tige pilaire. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Chasseuil E, McGrath J, Seo A, Bodak N, Chasseuil H, Denis-Musquer M, Goldenberg A, Goussot R, Irvine A, Khumalo N, King MC, Küry S, Lipsker D, Mayosi B, Puzenat E, Salort-Compana E, Bézieau S, Mercier S, Barbarot S. Manifestations dermatologiques de la poïkilodermie héréditaire fibrosante due à des mutations du gène FAMB111B : une série de 28 cas. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Blind A, Lenormand C, Schissler C, Cribier B, Lipsker D. Dermite livédoïde de Nicolau sus-pubienne après injections sous-cutanées d’acétate de glatiramère. Ann Dermatol Venereol 2018; 145:671-675. [DOI: 10.1016/j.annder.2018.04.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 03/19/2018] [Accepted: 04/06/2018] [Indexed: 01/13/2023]
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Hazemann G, Gusdorf L, Mitcov M, Lenormand C, Lipsker D. [Multifocal chalazodermic amyloidosis: The concept of immunoglobulinemic elastopathy]. Ann Dermatol Venereol 2018; 145:777-784. [PMID: 30309631 DOI: 10.1016/j.annder.2018.07.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 06/17/2018] [Accepted: 07/31/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Impairment of dermal elastic tissue occurs in different entities associated with immunoglobulins or immunoglobulin-derived protein-secreting clonal plasma cell proliferations, such as amyloid elastosis, anetodermic nodular amyloidosis or monoclonal gammopathy-associated cutis laxa. We report a case of cutaneous immunoglobulinemic amyloidosis revealed by a unique chalazodermic presentation and we review elastic tissue impairment in patients with monoclonal gammopathies. OBSERVATION A 67-year-old woman consulted for non-infiltrated anetodermic lesions on the upper left quadrant of her abdomen present for ten years. She also had a chalazodermic plaque with abnormal skin wrinkling and laxity in her right axilla. Biopsies revealed deep dermal and subcutaneous amyloid deposits. Immunohistochemistry with lambda light chain was positive. Orcein staining and electron microscopy showed extensive elastolysis. The patient presented no signs of systemic involvement, but a very small amount of monoclonal IgGλ gammopathy was detected during follow-up. DISCUSSION This is a unique chalazodermic presentation of immunoglobulinemic amyloidosis that does not fit into a clearly-defined nosological setting. It highlights the complex interactions between immunoglobulin-derived proteins, including light and heavy chains, and elastic tissue components, leading to different types of impairment of the latter. We therefore suggest the unifying concept of immunoglobulinemic elastopathy, underscoring the need to screen for monoclonal gammopathy in patients presenting elastic tissue impairments.
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Affiliation(s)
- G Hazemann
- Clinique dermatologique, université de Strasbourg, hôpitaux universitaires de Strasbourg, 1 place de l'hôpital, 67091, Strasbourg, France.
| | - L Gusdorf
- Clinique dermatologique, université de Strasbourg, hôpitaux universitaires de Strasbourg, 1 place de l'hôpital, 67091, Strasbourg, France
| | - M Mitcov
- Clinique dermatologique, université de Strasbourg, hôpitaux universitaires de Strasbourg, 1 place de l'hôpital, 67091, Strasbourg, France
| | - C Lenormand
- Clinique dermatologique, université de Strasbourg, hôpitaux universitaires de Strasbourg, 1 place de l'hôpital, 67091, Strasbourg, France
| | - D Lipsker
- Clinique dermatologique, université de Strasbourg, hôpitaux universitaires de Strasbourg, 1 place de l'hôpital, 67091, Strasbourg, France
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Abstract
Neutrophilic urticarial dermatosis (NUD) is a rare form of dermatosis. In clinical terms, it consists of a chronic or recurrent eruption comprising slightly elevated, pink to reddish plaques or macules. The elementary lesion lasts 24 to 48hours and resolves without leaving any residual pigmentation. Extra-cutaneous signs are common, particularly fever or arthralgia. At histopathology, the dermis contains dense neutrophilic interstitial infiltrate with leukocytoclasis, but without fibrinoid necrosis of vessel walls. NUD often occurs in a setting of underlying systemic disease. The most commonly associated diseases are adult-onset Still's disease, Schnitzler syndrome, lupus erythematosus and cryopyrin-associated periodic syndromes. Treatment of NUD depends on the clinical context. Dapsone and colchicine are often effective.
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Affiliation(s)
- L Gusdorf
- Dermatology Department, Hôpitaux Universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France
| | - D Lipsker
- Dermatology Department, Hôpitaux Universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France.
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Spielmann L, Arnaud L, Severac F, Messer L, Mahé A, Meyer A, Lannes B, Lipsker D, Sibilia J. Population-based prevalence of eosinophilic fasciitis (Shulman syndrome): a capture-recapture study. Br J Dermatol 2018. [PMID: 29526049 DOI: 10.1111/bjd.16535] [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: 11/30/2022]
Affiliation(s)
- L Spielmann
- Service de rhumatologie, centre de compétence maladie rares, Hôpital Pasteur, Colmar, France
| | - L Arnaud
- Service de rhumatologie, Centre National de Référence des Maladies Systémiques et Auto-immunes rares, Université de Strasbourg, Strasbourg, France
| | - F Severac
- Pôle de santé publique, secteur méthodologie et biostatistiques, CHRU Strasbourg, France
| | - L Messer
- Service de rhumatologie, centre de compétence maladie rares, Hôpital Pasteur, Colmar, France
| | - A Mahé
- Service de dermatologie, hôpital Pasteur, Colmar, France
| | - A Meyer
- Service de rhumatologie, Centre National de Référence des Maladies Systémiques et Auto-immunes rares, Université de Strasbourg, Strasbourg, France.,Service de physiologie du muscle, CHRU Strasbourg, France
| | - B Lannes
- Département de pathologie, CHRU Strasbourg et Faculté de Médecine, Université de Strasbourg, France
| | - D Lipsker
- Service de dermatologie, CHRU Strasbourg, France
| | - J Sibilia
- Service de rhumatologie, Centre National de Référence des Maladies Systémiques et Auto-immunes rares, Université de Strasbourg, Strasbourg, France
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Goussot R, Francès C, Cury K, Bessis D, Martin T, Chatelus E, Mahé A, Messer L, Séverac F, Meyer N, Lipsker D. Prospective evaluation of the frequency of genital lichen sclerosus in 79 patients with systemic sclerosis. Br J Dermatol 2018; 179:999-1000. [PMID: 29928761 DOI: 10.1111/bjd.16898] [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: 11/29/2022]
Affiliation(s)
- R Goussot
- Clinique Dermatologique des Hôpitaux Universitaires, 1 Place de l'Hôpital, 67091, Strasbourg CEDEX, France
| | - C Francès
- Service de Dermatologie-Allergologie, Université Paris 6, AP-HP, Hôpital Tenon, Paris, France.,EMSED (Etude des Maladies Systémiques en Dermatologie/Study Group of Systemic Diseases in Dermatology), 61 rue Charles Laffitte, 92200, Neuilly-sur-Seine, France
| | - K Cury
- Service de Dermatologie-Allergologie, Université Paris 6, AP-HP, Hôpital Tenon, Paris, France.,EMSED (Etude des Maladies Systémiques en Dermatologie/Study Group of Systemic Diseases in Dermatology), 61 rue Charles Laffitte, 92200, Neuilly-sur-Seine, France
| | - D Bessis
- EMSED (Etude des Maladies Systémiques en Dermatologie/Study Group of Systemic Diseases in Dermatology), 61 rue Charles Laffitte, 92200, Neuilly-sur-Seine, France.,Service de Dermatologie, Hôpital Public Saint-Eloi et CHRU de Montpellier, Montpellier, France
| | - T Martin
- Service d'Immunologie Clinique et de Médecine Interne, Centre de Référence des Maladies Autoimmunes Systémiques Rares, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - E Chatelus
- Service de Rhumatologie, Hôpital Universitaire de Strasbourg, Strasbourg, France
| | - A Mahé
- Service de Dermatologie, Hôpital Louis Pasteur, Hôpitaux Civils de Colmar, Colmar, France
| | - L Messer
- Service de Rhumatologie, Hôpital Louis Pasteur, Hôpitaux Civils de Colmar, Colmar, France
| | - F Séverac
- GMRC, Service de Santé Publique, CHU de Strasbourg, iCUBE, UMR 7357, Université de Strasbourg, 67091, Strasbourg, France
| | - N Meyer
- GMRC, Service de Santé Publique, CHU de Strasbourg, iCUBE, UMR 7357, Université de Strasbourg, 67091, Strasbourg, France
| | - D Lipsker
- EMSED (Etude des Maladies Systémiques en Dermatologie/Study Group of Systemic Diseases in Dermatology), 61 rue Charles Laffitte, 92200, Neuilly-sur-Seine, France.,Clinique Dermatologique des Hôpitaux Universitaires et Faculté de Médecine, Université de Strasbourg, 1 Place de l'Hôpital, 67091, Strasbourg CEDEX, France
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Lipsker D. Bedside reasoning on causes and mechanisms of diseases in the era of precision medicine: a timeless story? J Eur Acad Dermatol Venereol 2018; 32:1436-1440. [PMID: 29604225 DOI: 10.1111/jdv.14975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 03/09/2018] [Indexed: 11/30/2022]
Abstract
This is a short reflection about bedside reasoning in clinical medicine, emphasizing the importance of distinguishing between causes and mechanisms of diseases. All complex/sporadic diseases result from interactions between a genetic predisposition and environmental factors. The main disease mechanisms resulting in clinical signs involve inflammation, insult of vessels or nerves, pharmacological or hormonal dysfunction, altered metabolism and overload, tumoral proliferations, intrinsic dysfunction, malformation and traumatism. Different mechanisms can occur during the same disease process. The practical consequences of identifying causes and mechanisms of diseases are illustrated. As a unifying concept, a very simple diagnostic flow chart that puts the patient, and not the disease, into centre of reflection and that bridges the gap between basic knowledge and patient care is provided. This diagnostic flow chart helps both the experienced physician and the medical student to perform a complete diagnostic process, addressing the specificities of the clinical findings, the pathogenesis and the causative factors, an aim that has become possible in the era of precision medicine. Two examples of patients with a dermatologic presentation highlight this diagnostic process, which paves the way to rational therapy and to translational research.
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Affiliation(s)
- D Lipsker
- Faculté de Médecine, Université de Strasbourg, Strasbourg, France.,Clinique Dermatologique, Hôpitaux Universitaires, Strasbourg, France
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Second J, Lipsker D. Immune deficiency and rosacea. J Eur Acad Dermatol Venereol 2018; 32:e88. [DOI: 10.1111/jdv.14544] [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)
- J. Second
- Dermatology Department; Hôpitaux Universitaires de Strasbourg; Strasbourg France
| | - D. Lipsker
- Dermatology Department; Hôpitaux Universitaires de Strasbourg; Strasbourg France
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Best M, Jachiet M, Molinari N, Manna F, Girard C, Pallure V, Cosnes A, Lipsker D, Hubiche T, Schmutz JL, Le Corre Y, Cordel N, Dandurand M, Dereure O, Guillot B, Du-Thanh A, Bulai Livideanu C, Chasset F, Bouaziz JD, Francès C, Bengoufa D, Vincent T, Bessis D. Distinctive cutaneous and systemic features associated with specific antimyositis antibodies in adults with dermatomyositis: a prospective multicentric study of 117 patients. J Eur Acad Dermatol Venereol 2018; 32:1164-1172. [PMID: 29237090 DOI: 10.1111/jdv.14759] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 11/29/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Identification of myositis-specific autoantibodies (MSAs) for dermatomyositis (DM) could allow the characterization of an antibody-associated clinical phenotype. OBJECTIVE We sought to define the clinical phenotype of DM and the risk of cancer, interstitial lung disease (ILD) and calcinosis based on MSA. METHODS A 3.5-year multicentre prospective study of adult DM patients was conducted to determine the clinical phenotype associated with MSAs and the presence of cancer, ILD and calcinosis. RESULTS MSAs were detected in 47.1% of 117 included patients. Patients with antimelanoma differentiation-associated protein-5 antibodies (13.7%) had significantly more palmar violaceous macules/papules [odds ratio (OR) 9.9], mechanic's hands (OR 8), cutaneous necrosis (OR 3.2), articular involvement (OR 15.2) and a higher risk of ILD (OR 25.3). Patients with antitranscriptional intermediary factor-1 antibodies (11.1%), antinuclear matrix protein-2 antibodies (6.8%) and antiaminoacyl-transfer RNA synthetase (5.1%) had, respectively, significantly more poikiloderma (OR 5.9), calcinosis (OR 9.8) and articular involvement (OR 15.2). Cutaneous necrosis was the only clinical manifestation significantly associated with cancer (OR 3.1). CONCLUSION Recognition of the adult DM phenotype associated with MSAs would allow more accurate appraisal of the risk of cancer, ILD and calcinosis.
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Affiliation(s)
- M Best
- Department of Dermatology, Saint-Eloi Hospital and Montpellier University Hospital, Montpellier, France
| | - M Jachiet
- Department of Dermatology, AP-HP, University of Paris VII Sorbonne Paris City and Saint-Louis Hospital, Paris, France
| | - N Molinari
- Department of Statistics, Montpellier University Hospital, Montpellier, France.,IMAG, CNRS, University of Montpellier, Montpellier, France
| | - F Manna
- Department of Statistics, Montpellier University Hospital, Montpellier, France
| | - C Girard
- Department of Dermatology, Saint-Eloi Hospital and Montpellier University Hospital, Montpellier, France
| | - V Pallure
- Department of Internal Medicine and Dermatology, Perpignan Hospital, Perpignan, France
| | - A Cosnes
- Department of Dermatology, Henri-Mondor Hospital, Créteil, France
| | - D Lipsker
- Faculty of Medicine, University of Strasbourg and Dermatologic Clinic, Strasbourg University Hospital, Strasbourg, France
| | - T Hubiche
- Department of Dermatology and Infectious Diseases, Fréjus Hospital, Fréjus, France
| | - J-L Schmutz
- Department of Dermatology, Brabois Hospital, Nancy University Hospital, Nancy, France
| | - Y Le Corre
- Department of Dermatology, Angers University Hospital, Angers, France
| | - N Cordel
- Unit of Dermatology and Internal Medicine, Guadeloupe University Hospital, Pointe-à-Pitre, Guadeloupe, France
| | - M Dandurand
- Department of Dermatology, Caremeau Hospital, Nîmes, France
| | - O Dereure
- Department of Dermatology, Saint-Eloi Hospital and Montpellier University Hospital, Montpellier, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) U1058, Montpellier, France
| | - B Guillot
- Department of Dermatology, Saint-Eloi Hospital and Montpellier University Hospital, Montpellier, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) U1058, Montpellier, France
| | - A Du-Thanh
- Department of Dermatology, Saint-Eloi Hospital and Montpellier University Hospital, Montpellier, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) U1058, Montpellier, France
| | - C Bulai Livideanu
- Department of Dermatology, Toulouse University Hospital, Toulouse, France
| | - F Chasset
- AP-HP, Department of Dermatology and Allergology, Faculty of Medicine, Tenon Hospital, Sorbonne University, Paris, France
| | - J-D Bouaziz
- Department of Dermatology, AP-HP, University of Paris VII Sorbonne Paris City and Saint-Louis Hospital, Paris, France
| | - C Francès
- AP-HP, Department of Dermatology and Allergology, Faculty of Medicine, Tenon Hospital, Sorbonne University, Paris, France
| | - D Bengoufa
- Department of Immunology, Saint-Louis Hospital, Paris, France
| | - T Vincent
- Department of Immunology, Saint Eloi Hospital, and Montpellier University, Montpellier, France
| | - D Bessis
- Department of Dermatology, Saint-Eloi Hospital and Montpellier University Hospital, Montpellier, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) U1058, Montpellier, France
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