Necrotizing infundibular (ostial) crystalline folliculitis.

Necrotizing infundibular crystalline folliculitis is a rare condition characterized by folliculocentric waxy papules in the seborrheic areas of adult patients, with intrafollicular filamentous birefringent crystalline deposits as the histopathologic clue. Although the real pathogenesis of necrotizing infundibular crystalline folliculitis remains unclear, the intrafollicular material seems to be derived from an interaction between such superficial microorganisms as gram-positive bacteria (Propionibacterium acnes, Staphylococcus spp), Malassezia yeasts, and sebaceous lipids. Topical or systemic antiacne agents or antimycotics appear to be effective therapy.

Risk score for non-small cell lung cancer patients starting checkpoint inhibitor treatment.

BACKGROUND: Prognosis of metastatic non-small cell lung cancer significantly improved with the availability of checkpoint inhibitors (anti-PD-1/PD-L1). Unfortunately, reliable biomarkers to predict treatment benefit are lacking. PATIENTS AND METHODS: We prospectively collected clinical and laboratory data of 56 non-small cell lung cancer patients treated with a checkpoint inhibitor. The aim was to identify baseline parameters correlating with worse outcome and to create a risk score that enabled to stratify patients into different risk groups. As inflammation is known to promote tumor growth, we focused on inflammation markers in the blood. Disease control (DC) was defined as complete response, partial response, and stable disease on CT scan according to RECIST 1.1. RESULTS: Half of the patients achieved DC. Four parameters differed significantly between the DC group and the no disease control group: Eastern Cooperative Oncology Group performance status (P=0.009), number of organs with metastases (P=0.001), lactate dehydrogenase (P=0.029), and ferritin (P=0.005). A risk score defined as the number of these parameters (0= no risk factor) exceeding a threshold (Eastern Cooperative Oncology Group performance status ≥2, number of organs with metastases ≥4, lactate dehydrogenase ≥262U/L, and ferritin ≥241 µg/L) was associated with overall survival and progression-free survival. Overall survival at 6 and 12 months is as follows: Scores 0-1: 95% and 95%; Score 2: 67% and ≤33%; Scores 3-4: 15% and 0%. Progression-free survival at 6 and 12 months is as follows: Scores 0-1: 81% and 50%; Score 2: 25% and ≤25%; Scores 3-4: 0% and 0%. CONCLUSION: We propose an easy-to-apply risk score categorizing patients into different risk groups before treatment start with a PD-1/PD-L1 antibody.

[Algorithm to facilitate the management of onychomycosis]. / Algorithme de la prise en charge des onychomycoses.

An algorithm is proposed to facilitate the management of onychomycosis and ensure a good therapeutical approach. Its aim is to simplify the diagnosis process by integrating a pertinent anamnesis and physical examination with the classic tool of mycology (direct examination, culture, eventually examination by PCR), in order to give the adequate targeted treatment.

Cet article propose un algorithme afin de faciliter la prise en charge thérapeutique et diagnostique de l'onychomycose. Il vise à simplifier la démarche diagnostique jusqu'à l'identification du champignon dont dépendra le traitement. Il permet de rappeler que toute onychodystrophie n'est pas une onychomycose.