[Depilation lasers and lamps]. / Épilation par lasers et lampes.

Regardless of the actual method used, depilation is a process that has been present since antiquity and is found across all the continents. Thanks to the recent introduction of pulsed polychromatic lamps and lasers, long-lasting depilation is now possible. This article describes the theoretical basis for this new technology and discusses the various types of equipment available. Whether such devices are used for aesthetic or medical reasons, doctors must have a knowledge of the various techniques involved, as well as the limitations thereof. They must also be able to manage all potential adverse effects arising during or after depilation sessions.

[The prospective multicenter study on standard photopatch tests by the French Society of Photodermatology from 1991-2001]. / Etude prospective multicentrique 1991-2001 de la batterie standard des photopatch-tests de la Société Française de Photodermatologie.

INTRODUCTION: To develop a standard panel of photopatch tests, the French Society of Photodermatology conducted a prospective study from 1991 to 2001 on the frequency of photoallergens encountered in France and on the relevance of the choice of the various photoallergens. PATIENTS AND METHODS: Thirteen photobiology centers participated in the study from 1991 to 1995, and ten centers from 1995 to 2001. A set of 3 samples of photopatch tests was applied on any patient suspected of photoallergy. On Day 2, two sets were irradiated with ultraviolet A (UVA) and total spectrum (DEM 0.75); with the third set being used as control. Readings were made on D3 and D4. RESULTS: Two thousand sixty-seven patients were tested. Eight hundred fifty-six, i.e., 41% exhibited one or several positive tests. In the majority of cases it was a photoallergy (39.7 to 60% of cases) and eczema (29.5 to 45.6%). Photoaggravation was infrequent (7.9 to 10.3%). Cases of phototoxicity were rare. Sesquiterpenic lactones constantly provoked photoallergy, with 12 cases in 10 years. Although phenothiazines were the most photosensitizing allergens up until 1995, they were then overridden by ketoprofen in 1996 with 107 cases of UVA photosensitive reactions (75 cases) and total spectrum (32 cases). These were followed closely by sun screens, benzophenone (notably Eusolex 4360 with 54 pertinent cases of photoallergy) and dibenzoylmethane (with 31 cases due to Eusolex 8020). UVB filters were all potentially photosensitizing but to a lesser degree from 1 to 5 cases). DISCUSSION: Our results differ from those of Anglo-Saxon teams in the appearance of a new photoallergen, ketoprofen, which provoked numerous photosensitivities in both UVA and UVB. This justifies the systematic addition of this substance in our prospective set. Photoallergy was relatively rare, with around 100 cases reported within 10 years. Total spectrum irradiation of the photopatch tests revealed photoallergies that would not have been found with UVA alone. CONCLUSION: Study of photopatch tests has permitted the uniformization of the methodology in France, an overview of the frequency of the photoallergens tested and the development of a new standard set.

[Actinic prurigo of childhood. 3 familial cases associated with HLA-DR 0407]. / Prurigo actinique de l'enfant. 3 cas dans une fratrie avec association au HLA-DR 0407.

BACKGROUND: Actinic prurigo, as idiopathic skin reaction involving light-exposed areas, was first described in American Indians. Actinic prurigo was early considered to be a particular form at polymorphous phototoxicity, but can be identified as a specific entity on the bases of clinical features and epidemiological characteristics. CASE REPORTS: Three children in the same family developed photosensitive reactions early in childhood with characteristic polymorphous and persistent eczema-like or papulo-nodular pruriginous lesions which predominated in light-exposed areas and appeared several hours after exposure to sun. The lesions persisted during the winter season. The lesions followed a chronic course but tended to improve at puberty. Clinical laboratory tests, serum and urine porphyrin levels and antinuclear factors were normal. Histology and photobiology explorations gave non-specific results. DISCUSSION: These observations have three points in common with actinic prurigo observed in American Indians. HLA typing showed that our three patients, as in white patients in Great Britain, had a significant association with a specific HLA DR1 subtype: DRB1*0407. This DRB1*0407 alleles could play a role in initiating the immune response to a light-induced peptide antigen. This particular genetic predisposition, if confirmed in other studies, would be an additional argument for distinguishing actinic prurigo as a specific polymorphous phototoxicity entity.

[Contact photoallergic eczema caused by ketoprofen]. / Eczéma photo-allergique de contact au kétoprofène.

INTRODUCTION: Since 1983, several cases of allergy and photoallergic contact dermatitis to ketoprofen gel have been reported in Italy and Spain. In France, this drug has been available for topic applications since 1989 and no cases of photoallergy have been reported. CASE REPORT: We observed two cases of photoallergic contact dermatitis to ketoprofen (Profenid gel, Ketum gel). Imputability was suggested by clinical history and proven by patch-tests showing evidence of crossed photoallergy with fenofibrate in both cases. Photoallergic dermatitis to oxybenzone was associated in one case. COMMENTS: Ketoprofen is the predominant nonsteroid anti-inflammatory drug responsible for allergic and/or photoallergic contact dermatitis resulting from topic applications. Its prevalence is probably underestimated in France in light of the number of cases reported in certain Mediterranean countries. Cross reactive photoallergy to ketoprofen and fenofibrate can be explained by the common benzoly-ketone structure of these compounds. In case of skin reaction, the other drug should not be prescribed and benzophenone-containing cosmetics discouraged.

[Fenofibrate photoallergy]. / Photo-allergie au fénofibrate.

Photosensitization to lipid-lowering fibric acid derivatives are rare. We report a case of photoallergy induced by fenofibrate, proved by a positive UVA photo-patch-test. Evolution towards persistent photosensitization is probable, since photobiological abnormalities persisted during four months after fenofibrate was discontinued. The fact that patch-tests to various benzophenones were negative is not in favour of the benzophenone group being responsible for the photosensitization reaction.

[Treatment of solar urticaria: advantage of terfenadine]. / A propos du traitement de l'urticaire solaire: intérêt de la terfénadine.

Solar urticaria is a rare photodermatosis, but it is extremely incapacitating and therapy is usually ineffective. Three patients who took a daily dose of 240 mg terfenadine were able to be normally exposed to sunlight. This efficacy was confirmed by photobiological tests. The minimal dose necessary to induce urticaria was increased at least three times. These results confirming recently published ones. Terfenadine at 240 mg per day seems to be the treatment of choice for solar urticaria because of its efficacy and excellent tolerance-especially as there is no sedative effect.