[Scalp burns induced by hair bleaching]. / Brûlure du cuir chevelu induite par les décolorations capillaires.

BACKGROUND: Hair bleaching is increasingly being carried out in hairdressing salons. The products used are a mixture of hydrogen peroxide and persulfates, both active chemical agents. Scalp burns secondary to hair bleaching are a traumatic adverse effect rarely discussed in publications that continue to be little known among healthcare professionals. PATIENTS AND METHODS: We report the case of a 15-year-old girl with a plaque of scarring alopecia on the vertex. This lesion resulted from a deep burn following a hair-bleaching procedure. Healing took around 4 months, resulting in discomfort for our patient. DISCUSSION: This is a rare case of scarring alopecia following a basic chemical burn to the scalp. The oxidation reaction induced by the mixture of hydrogen peroxide and persulfates, prepared in a basic medium, causes bleaching of the melanin pigments in hair. The clinical presentation of a single, well limited, painful, oozing ulceration located at the vertex was similar to the other cases published in the literature. Although a chemical burning mechanism is most often incriminated, the procedure is always coupled with use of a heat source and associated thermal burn may occur. The delayed appearance of the lesion appears to be caused by the forming of surfactants by the hydrogen peroxide/persulfate mixture, resulting in slow dissolution of the oxidizing compounds within the stratum corneum.

[Hypersensitivity to platinum salts and taxanes: The value of skin tests and tolerance induction procedures]. / Hypersensibilité aux sels de platine et aux taxanes : intérêt des tests cutanés et des inductions de tolérance.

AIM: The rate of hypersensitivity reactions to platinum salts (PS) and taxanes (TX) is on the increase. The aim of our study was to show the value of skin testing and efficacy of rapid drug desensitization. PATIENTS AND METHODS: This was a retrospective study conducted between January 2007 and February 2016 in patients consulting for immediate or delayed hypersensitivity to PS and TX. Skin prick tests (pT) and intradermal reaction tests (IDR) were performed according to the ENDA/EAACI recommendations. We used a 12-step desensitization protocol for rapid drug desensitization. RESULTS: Among the 99 patients included (30 men, 69 women, age 60.4) PS were suspected in 86 cases and taxanes in 13 cases. Skin tests were positive in 25 patients (7 pT, 18 IDR), 23 for platinum salts and 2 for taxanes. Rapid drug desensitization was proposed in 50 patients and performed in 33 (30 PS and 3 TX), proved effective in 29 patients, with protocol adaptation being necessary in 7 cases, and was ineffective in 4 patients. The skin tests for the latter 4 patients were positive. Seventy-five percent of patients with positive skin tests to oxaliplatin presented hypersensitivity reactions during desensitization, i.e. twice as many as patients having negative skin tests. Two percent of patient for PS and 7% for TX had cross reactivity. CONCLUSION: This French study confirms the efficacy of the 12-step protocol that allows patients to receive chemotherapy after hypersensitivity reaction. Skin test permits the detection of cross-reactions but their practice must be considered based on the patient's history.

[Livedoid vasculopathy secondary to coeliac disease]. / Vasculopathie livédoïde secondaire à une maladie cœliaque.

BACKGROUND: Livedoid vasculopathy (LV) is a painful ulcerative condition involving white atrophy and livedo; a histopathologic feature seen is occlusive dermal vasculopathy. This may be associated with coagulation disorders such as hyperhomocysteinaemia (HHC). PATIENTS AND METHODS: We report the case of a 52-year-old woman presenting LV in which an abnormal scan image led us to diagnose coeliac disease. This enteropathy had caused vitamin B12 and folic acid deficiency, as well as HHC. Vitamin supplementation and a gluten-free diet resulted in complete healing of the lesions. DISCUSSION: This case underlines the importance of screening for and correction of coagulation disorders in patients with LV. It also suggests that in the event of HHC, coeliac disease should be sought, even in the absence of gastrointestinal symptoms.

[Benefit of the extended-release methylphenidate formulations: a comparative study in childhood]. / Apports des formes de méthylphénidate à libération prolongée: étude comparative chez l'enfant.

UNLABELLED: Methylphenidate (MPH) is a potential therapeutic tool for Attention Deficit with Hyperactivity Disorders (ADHD). In addition to the immediate-release formulation, Ritalin, two extended-release formulations, Ritalin LA and Concerta are available and allow a once-daily administration. We compared the respective benefits of both formulations for the patients and their family in terms of efficacy, handling and tolerance. PATIENTS AND METHODS: This prospective study was based on 30 children aged 6 to 15 years. All patients had a confirmed ADHD and were efficiently treated with Ritalin. The children were consecutively treated with Ritalin LA and Concerta, with a comparable MPH daily dosage, during 2 months for each molecule. The 3 drugs were evaluated individually and comparatively through a battery of questionnaires submitted to the parents and the teachers of each child. RESULTS: Extended-release MPH efficacy was comparable to the immediate-release formulation, Ritalin. For both of them, the once-daily administration appeared beneficial. Concerta was finally prescribed in 18 children, Ritalin LA in 8 cases and Ritalin in 4 cases. In each case the medical choice was consistent with the parents preference. Concerta was appreciated for its persisting efficacy in late afternoon during homework. Concerta and Ritalin LA did not induce significant adverse effects, especially regarding alimentation and sleep. CONCLUSIONS: MPH therapy in ADHD carries an excellent risk/benefit ratio without addictive induced behaviours. The extended-release MPH formulations provide an improvement for the patients in keeping with Ritalin efficacy through a once-daily administration. Regardless of its formulation, MPH indications and guidelines must be respected.