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2.
Ann Dermatol Venereol ; 148(4): 207-208, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34756608
5.
Ann Dermatol Venereol ; 146(8-9): 550-556, 2019 Sep.
Artigo em Francês | MEDLINE | ID: mdl-30929872

RESUMO

BACKGROUND: Statin-induced necrotizing autoimmune myopathy (NAM) has been recently characterized. Herein we report an accurate description of the clinical and histological characteristics of cutaneous rash associated with NAM. PATIENTS AND METHODS: A 61-year-old woman presented a skin rash involving the face, the chest and the back of the hands with heliotropic distribution coupled with proximal symmetrical muscle weakness. Rosuvastatin had been introduced 8 months earlier. Creatinine kinase levels were dramatically raised. Screening for lupus and dermatomyositis antibodies were negative. The cutaneous histology was consistent with neutrophilic lupus while a muscle biopsy revealed no inflammation but showed necrotic and regenerative myofibres. Finally, antibodies directed against 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) were found at high levels (1658UA/ml vs. normal<13.0UA/ml), resulting in diagnosis of necrotizing autoimmune myopathy (NAM). Intensive immunosuppressive therapy resulted in excellent improvement. DISCUSSION: NAM is a severe acquired autoimmune myopathy characterised by severe proximal weakness and specific positive antibodies (anti-HMGCR or anti-signal recognition particle). It is classically associated with statin use. Some extra-muscular symptoms have been described in previous studies. We report the third accurate description of cutaneous rash associated with statin-induced NAM involving HMGCR antibodies. The skin rash was evocative of connective tissue disease and our diagnosis was based on immunology and muscle histology. CONCLUSION: Dermatologists must be able to recognise this rare entity of "pseudo-dermatomyositis" and then discontinue statin intake if present and carry out further investigations consisting of muscle biopsy and serological tests.


Assuntos
Autoanticorpos/sangue , Doenças Autoimunes/sangue , Doenças Autoimunes/induzido quimicamente , Hidroximetilglutaril-CoA Redutases/imunologia , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Músculo Esquelético/patologia , Doenças Musculares/sangue , Doenças Musculares/induzido quimicamente , Rosuvastatina Cálcica/administração & dosagem , Doenças Autoimunes/complicações , Doenças Autoimunes/diagnóstico , Dermatomiosite/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Doenças Musculares/complicações , Doenças Musculares/diagnóstico , Necrose/sangue , Necrose/induzido quimicamente , Necrose/complicações , Necrose/diagnóstico , Síndrome
7.
Ann Dermatol Venereol ; 145(6-7): 405-412, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29661476

RESUMO

INTRODUCTION: Adult T-cell leukemia/lymphoma (ATLL) is a hematological malignancy associated with chronic HTLV-1 infection. AIM: To describe skin lesions in ATLL. METHODS: A descriptive, retrospective study between 1996 and 2016, including all patients diagnosed with ATLL at Saint-Louis Hospital (Paris, France). RESULTS: Thirty-seven ATLL patients were included. Fifteen patients (41%) had a cutaneous localization of the disease, which was present from the beginning of the disease for two thirds of them. ATLL types in patients with cutaneous localization of the disease were as follows: lymphoma, n=5, chronic, n=4, smoldering, n=4, acute, n=2. Half the patients had 2 or more cutaneous manifestations. The cutaneous localizations observed were as follows: nodulotumoral (n=8), plaques (n=7), multipapular (n=6), macular (n=4), purpuric (n=2). Among the 15 patients with cutaneous localization, median overall survival was significantly shorter in the acute and lymphoma types compared to the smoldering and chronic types (8.7 months vs. 79 months, P=0.003). DISCUSSION: ATLL is a hematologic malignancy with variable expression that is diagnosed only very rarely in metropolitan France, but that should be sought in patients from countries with high HTLV-1 prevalence in the event of a chronic eruption with patches, papules, plaques and/or tumors. The chronic and smoldering types are relatively indolent, whereas the acute and lymphoma forms have a poor prognosis.


Assuntos
Leucemia-Linfoma de Células T do Adulto/complicações , Neoplasias Cutâneas/etiologia , Adulto , Feminino , Humanos , Leucemia-Linfoma de Células T do Adulto/patologia , Masculino , Paris , Estudos Retrospectivos , Neoplasias Cutâneas/patologia , Fatores de Tempo
9.
J Eur Acad Dermatol Venereol ; 30(1): 20-4, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26568080

RESUMO

BACKGROUND: The incidence of skin cancer has reached epidemic proportions in the white population and is significantly elevated in agricultural populations, who are exposed to ultraviolet radiation during their professional activities. In 2014, the Agricultural Social Insurance Mutual Benefit Fund (MSA) offered its customers who work in agriculture and live in rural areas with reduced access to dermatologists the ability to participate in a 1-day teledermoscopic (TDS) screening event. OBJECTIVE: This study's aim was to assess the feasibility of real-time mobile TDS triage of a large number of agricultural workers by trained medical officers and occupational physicians. METHODS: Fifteen TDS screening centres were located in different areas of France. Individuals older than 18 years who worked in agriculture and lived in rural area near a TDS screening centre were invited to participate in a 1-day screening event and were examined by an MSA physician. In cases of suspicious skin lesions, clinical and dermoscopic images were obtained and transferred immediately to four dermatologists who were simultaneously present at the tele-platform for diagnosis and decision-making. Low-quality images were retaken. RESULTS: Two-hundred eighty-nine patients underwent skin cancer screening. Among 199 patients (69%), 390 suspicious lesions were identified and generated 412 pictures. All lesions were analysed by dermatologists. For 105 patients (53%), no follow-up was required. Seventeen patients were referred to local dermatologists for rapid examination, including 12 cases of suspected malignant melanocytic lesions. Among the 12 patients with suspected melanoma, face-to-face visits were conducted within 10 days for 11 of them, and 1 case of melanoma was confirmed by histopathology. CONCLUSIONS: Our study suggests that teledermoscopy performed in the context of occupational medicine and targeted to agricultural populations is feasible and could be useful for improving skin cancer screening in at-risk populations while avoiding face-to-face examinations by a dermatologist in 53% of cases.


Assuntos
Doenças dos Trabalhadores Agrícolas/diagnóstico , Telefone Celular , Dermoscopia , Neoplasias Cutâneas/diagnóstico , Telemedicina , Doenças dos Trabalhadores Agrícolas/epidemiologia , Feminino , França/epidemiologia , Humanos , Incidência , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Unidades Móveis de Saúde , Neoplasias Cutâneas/epidemiologia
10.
J Eur Acad Dermatol Venereol ; 30(7): 1140-3, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26369288

RESUMO

BACKGROUND: Erythema multiforme major (EMM) is an inflammatory disease affecting skin and mucosae, often triggered by infection with Herpes simplex virus. Some patients have a chronic disease associated with antidesmoplakin autoantibodies, but the pathophysiology remains to be elucidated. First-line treatment is antiviral therapy. With treatment failure or in patients without herpes-triggered disease, thalidomide is effective but has neurological side-effects. Alternatives (dapsone, immunosuppressant agents) are not codified. For many patients, systemic steroids use is chronic. The immunosuppressant drug rituximab (RTX) may be effective. OBJECTIVES: We report five cases of severe chronic EMM treated with rituximab (RTX). METHODS: Five patients with severe chronic EMM for 9-20 years received RTX after failure or side-effects of several treatments, especially antiviral therapy and thalidomide. All had chronic use of steroids. Four patients had antidesmoplakin autoantibodies. RESULTS: Four patients experienced complete or quasi-complete remission of EMM with withdrawal of steroids and one patient partial remission, for 3-11 months. Disease relapsed in all patients, and three received a second cycle of RTX with shorter duration of efficacy. Two patients received a third cycle, one without efficacy. CONCLUSION: The use of RTX for many autoimmune diseases, especially pemphigus, is increasing. Chronic EMM, especially EMM associated to antidesmoplakin autoantibodies, is an inflammatory disease in which the role of B cells is not well understood. However, we report a favourable benefit of RTX treatment for months in five patients with severe disease. RTX could be a therapeutic option in severe, difficult-to-treat EMM.


Assuntos
Eritema Multiforme/tratamento farmacológico , Rituximab/uso terapêutico , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
11.
Theriogenology ; 66(3): 633-47, 2006 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16697037

RESUMO

Reproductive losses in camelids are due to infertility, pregnancy loss, udder diseases and neonatal mortality caused by a variety of infectious diseases. Uterine infection and abortion represent the major complaint in camelid veterinary practice. The major infectious organisms in endometritis and metritis are E. coli and Streptococcus equi subspecies zooepidemicus. Abortion rates due to infectious diseases vary from 10% to more than 70% in some areas. Leptospirosis, toxoplasmosis and chlamydiosis have been diagnosed as the major causes of abortion in llamas and alpacas. In camels, brucellosis and trypanosomiasis represent the major causes of infectious abortion in the Middle East and Africa. Mastitis is rare in South American camelids. The prevalence of subclinical udder infection in camels can reach very high proportions in dairy camels. Udder infections are primarily due to Streptococcus agalactiae and Staphylococcus aureus. Neonatal mortality is primarily due to diarrhea following failure of passive transfer and exposure to E. coli, rotavirus, coronavirus, Coccidia and Salmonella. This paper reviews the etio-pathogenesis of these causes of reproductive losses, as well as the major risk factors and strategies to prevent their occurrence.


Assuntos
Aborto Animal , Camelídeos Americanos/fisiologia , Doenças Transmissíveis/veterinária , Mastite/veterinária , Reprodução , Aborto Animal/microbiologia , Aborto Animal/parasitologia , Animais , Animais Recém-Nascidos , Causas de Morte , Doenças Transmissíveis/complicações , Feminino , Morte Fetal , Masculino , Mastite/microbiologia , Gravidez , Complicações Infecciosas na Gravidez/veterinária , Complicações Parasitárias na Gravidez/veterinária , Reprodução/fisiologia
12.
J Hazard Mater ; 76(1): 113-23, 2000 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-10863018

RESUMO

A quantitative study of the influence of inlet sulfur dioxide concentration (600-3000 ppm), relative humidity (20-60%), reactor temperature (56-86 degrees C) and different amounts (0-30 wt.%) of inorganic additives (NaCl, CaCl(2) and NaOH) on gas desulfurization has been carried out in a continuous downflow fixed-bed reactor containing calcium hydroxide diluted with silica sand. Results show that the reaction rate does not depend on sulfur dioxide partial pressure (zero-order kinetics) and that the temperature and the relative humidity have a positive influence on reaction rate. An apparent activation energy of 32 kJ/mol Ca(OH)(2) has been estimated for the reaction. An empirical reaction rate equation at 71.5 degrees C and 36.7% relative humidity that includes the type and amount of additive is proposed. It has been found that calcium chloride is the best additive studied because it allows for a higher degree of sulfur dioxide removal.


Assuntos
Hidróxido de Cálcio/metabolismo , Dióxido de Enxofre/metabolismo , Poluição do Ar/prevenção & controle , Gases , Umidade , Compostos Inorgânicos/metabolismo , Cinética , Centrais Elétricas , Temperatura
13.
Phys Rev B Condens Matter ; 36(8): 4574-4576, 1987 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-9943467
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