[Adverse effects of hair care in users]. / Effets indésirables des soins capillaires chez les utilisateurs.

The panoply of products used by hair care professionals to wash, dye, shape and beautify hair is not entirely free from adverse events. Such effects consist mainly of irritation dermatitis and allergic contact eczema affecting the scalp, as well as the back and front of the neck, the forehead and periorbital areas, and the cheeks. The most frequently cited allergens include paraphenylenediamine (PPD) in hair dyes, glycerol monothioglycolate (GMTG) in acid perm lotions, and ammonium persulphate in hair lighteners (the latter substance being responsible primarily for contact urticaria). However, care should also be paid to other allergens such as cocamidopropyl betaine among surfactants, as well as certain components in hair formulations such as preservatives and fragrances (as well as minoxidil, frequently used by patients).

The effect of selection history on extinction risk during severe environmental change.

Environments rarely remain the same over time, and populations are therefore frequently at risk of going extinct when changes are significant enough to reduce fitness. Although many studies have investigated what attributes of the new environments and of the populations experiencing these changes will affect their probability of going extinct, limited work has been directed towards determining the role of population history on the probability of going extinct during severe environmental change. Here, we compare the extinction risk of populations with a history of selection in a benign environment, to populations with a history of selection in one or two stressful environments. We exposed spores and lines of the green alga Chlamydomonas reinhardtii from these three different histories to a range of severe environmental changes. We found that the extinction risk was higher for populations with a history of selection in stressful environments compared to populations with a history of selection in a benign environment. This effect was not due to differences in initial population sizes. Finally, the rates of extinction were highly repeatable within histories, indicating strong historical contingency of extinction risk. Hence, information on the selection history of a population can be used to predict their probability of going extinct during environmental change.

[Dermatoporosis, a vintage for atrophoderma and transparent skin]. / La dermatoporose, un "vintage" de l'atrophodermie et de la "peau transparente".

Skin ageing occasionally manifests itself at long-term by severe atrophoderma. Systemic or topical corticotherapy exerts an atrophic impact mimicking the effects of old age. Such atrophoderma condition has been described as transparent skin about 40 years ago, and it received more recently the new denomination of dermatoporosis. Such condition stands out in the medical history to induce clinical consequences. They are sometimes prominent introducing diverse lesions such as Bateman purpura, stellate scars and wounds following minor trauma.

[Patch testing: historical aspects]. / L'historique des patch-tests.

This article reviews the key points in the history of patch testing, which spans more than a century, starting with the first description of the method by J. Jadassohn in 1895. Special attention is paid to the contribution of French schools in this field, which led to the foundation of the Groupe d'études et de recherches en dermato-allergologie (GERDA).

[Patch testing methods in different climatic conditions]. / Patch-tests dans différentes conditions climatiques.

Patch testing in cold and dry climatic conditions presents no practical problems. However, in tropical and subtropical countries, patch testing methods must be adapted in order to avoid irritation.

[Sarcoidal granulomas following injections of botulic toxin A (Botox) for corrections of wrinkles]. / Granulomes sarcoïdosiques après injections de toxine botulique A (Botox) pour correction de rides.

BACKGROUND: The introduction of foreign material into the skin can lead to sarcoidal reactions. Such a reaction is reported, consecutive to injections of botulic toxin A (Botox). CASE REPORT: A 57-year-old woman, noticed the occurrence of frontal and glabellar nodules, 3 weeks after the injection of botulic toxin A (Botox), for the correction of wrinkles. Histopathological examination revealed a sarcoidal granuloma. Clinical and biological investigations were negative, ruling out the hypothesis of systemic sarcoidosis. The lesion could be reproduced experimentally by an intradermal injection of botulic toxin A on the volar aspect of the forearm. Corticosteroids per os associated with intralesional injections of triamcinolone acetonide were followed by a complete regression of the nodules. DISCUSSION: The occurrence of sarcoidal granulomas at the sites of injection of botulic toxin A (Botox(R)) has not been reported - so far - in the literature. Systemic sarcoidosis has been ruled out. The sarcoidal reaction has been reproduced experimentally by the intradermal injection of botulic toxin A, but not by saline. This leads to think that the sarcoidal reaction was provoked by antigenic stimulation, comparable to the Kveim reaction, and did not correspond to "scar sarcoidosis".

Placental pathology in asphyxiated newborns treated with therapeutic hypothermia.

OBJECTIVE: To describe the placental findings in asphyxiated newborns treated with hypothermia and to determine their association with the presence and severity of later brain injury. METHODS: Prospective cohort study of the placentas of asphyxiated newborns treated with hypothermia, in whom later brain injury was defined by brain imaging and/or autopsy results. RESULTS: Of the 142 asphyxiated newborns meeting the criteria for hypothermia, 73% had placenta and brain MRI/autopsy available for analysis. Fifty-one percent of these newborns developed brain injury. Sixty-five percent had microscopic placental findings involving the fetal vascular supply, which were comparable in asphyxiated newborns developing or not developing brain injury. Among the asphyxiated newborns with normal placental growth, the placental microscopic findings tended to be more common in those developing brain injury compared to those who did not: chorionic plate meconium in 50% compared to 36%, chorioamnionitis in 75% compared to 44%, and villitis of unknown etiology in 67% compared to 33%, but this did not reach statistical significance. CONCLUSIONS: Antenatal placental processes are common in term asphyxiated newborns treated with hypothermia. The placenta of each asphyxiated term newborn treated with hypothermia should be carefully examined to better understand its role in the progression from perinatal depression to brain injury.

Characterization of the blaCARB-3 gene encoding the carbenicillinase-3 beta-lactamase of Pseudomonas aeruginosa.

We have isolated the blaCARB-3 structural gene encoding the CARB-3 carbenicillinase of Pseudomonas aeruginosa strain Cilote, tested the specificity of blaCARB-3 DNA probes and determined the nucleotide sequence of blaCARB-3. Three restriction fragment probes internal or delimiting the blaCARB-3 structural gene were hybridized with purified plasmid DNA coding for 18 other beta-lactamases (Blas). Under high-stringency conditions, only blaPSE-1, blaPSE-4, and blaCARB-4 sequences cross-hybridized with blaCARB-3. Sequencing of blaCARB-3 identified the structural gene which encodes a polypeptide product of 268 amino acids with a calculated estimated Mr of 29,246 for the mature form of the protein. Homology studies and computer analysis of primary structures confirmed that CARB-3 is a class-A Bla. The CARB-3 carbenicillinase differs from PSE-4 at two positions: Phe (PSE-4) instead of Leu188 (CARB-3), and Glu (PSE-4) instead of Ala266 (CARB-3), which changes the isoelectric value from (PSE-4) 5.4 to 5.75 (CARB-3). The possible effects of these two mutations were examined by comparisons on the 2 A crystal structure of the Staphylococcus aureus penicillinase, and they were shown to be silent substitutions causing no changes in the phenotype. The nucleic acid hybridization studies and sequence data confirmed that carbenicillinase-encoding bla genes are closely related and that blaCARB-3 is a variant of blaPSE-4.

Preservation of neural function in the perinate by high PGE(2) levels acting via EP(2) receptors.

Despite increasingly frequent and longer lasting hypoxic episodes during progressive labor, the neonate is alert and vigorous at birth. We investigated whether high levels of PGs during the perinatal period assist in preserving neural function after such "stressful" hypoxic events. Visual evoked potentials (VEPs) and electroretinograms (ERGs) were recorded before and 45 min after mild moderate asphyxic hypoxia (two 4-min asphyxic-hypoxic periods induced by interrupting ventilation at 8-min intervals) in newborn piglets <12 h old treated or not treated with inhibitors of PG synthase (ibuprofen or diclofenac) with or without PG analogs. At 45 min after the hypoxic episode, P2 and b-wave amplitudes were slightly decreased and latencies were delayed. These changes in the VEP and ERG returned to near normal by 120 min. Ibuprofen and diclofenac decreased brain and retinal PG levels and markedly intensified 45 min after hypoxia-induced changes in VEP and ERG, but cerebral and retinal blood flows improved. Combined treatment with PG synthase inhibitor in combination with 16,16-dimethyl-PGE(2) (a PGE(2) analog), but not with PGI(2) and PGF(2alpha) analogs, and in combination with the EP(2) receptor agonist butaprost (but not EP(1) or EP(3) agonists), prevented ibuprofen- and diclofenac-aggravated postasphyxia electrophysiological changes. In conclusion, high levels of PGE(2) in nervous tissue, via actions on EP(2) receptors, seem to contribute to preservation of neural function in the perinate subjected to frequent hypoxic events.

Increased "in vivo" lymphocyte blastogenesis in the peripheral blood of patients with atopic dermatitis and allergic contact dermatitis.

The spontaneous 3H-thymidine (3HT) labelling of some lymphocyte subpopulations has been studied in the peripheral blood of five patients with atopic dermatitis and five with widespread allergic contact dermatitis and compared with that in 10 healthy subjects. One hour after addition of 3HT to heparinized blood, lymphocytes were separated and processed with two different rosetting techniques (E-rosette test and Active E-rosette test). The cell suspensions were cytocentrifugated and autoradiography undertaken. An increased number of 3HT labelled lymphocytes was observed in the peripheral blood of patients with dermatitis as compared to controls. These labelled lymphocytes were E-rosette-forming cells (T cells) and E-non-rosette-forming cells (non-rosette-forming T cells and non-T cells). The ratio between the labelling index (LI) of E-rosette- to the LI of non-E-rosette-forming cells was in favour of T cells in allergic contact dermatitis (ratio = 3.09) whereas in atopic dermatitis (ratio = 0.93) the DNA synthesis was relatively greater in the non-rosette-forming cells. It is suggested that this increased LI of peripheral blood lymphocytes could be related to the increased derman mononuclear cell 3HT-labelling that has been reported previously in these inflammatory skin diseases.

Brain abscess due to Petriellidium boydii.

A 22 year-old man died from multiple cerebral abscesses due to Petriellidium boydii 4 1/2 months after an episode of near drowning. The autopsy showed dissemination to heart and kidney. This patient had no immunocompromising disease but was treated with corticosteroids. The treatment of this condition with ventricular shunting and amphotericin B is discussed and compared with the experience of ten other cases reported in the literature.

Brain maturity in regard to the auditory brainstem response in small-for-date neonates.

The auditory brainstem response has been used in neonates at risk of hearing impairment or as a functional measurement of brain maturity. The goal of the present study was to evaluate the auditory brainstem response in small-for-date newborns, in relation to changes observed with fetal maturity in a control group. Compared to controls with similar maturity, a significant delay for the appearance of waves III and V, and between waves I-V was observed in the small-for-date newborns, suggesting an alteration of the auditory pathway within the brainstem rather than an impairment of the peripheral auditive apparatus. Indeed, small-for-date newborns reacted to the test in a similar manner as premature babies in whom such a delay was also observed. Our data would suggest a functional brain immaturity in small-for-date newborns, during the first days of life, in regard to the auditive evoked potential, which may be related to some alterations in brain development reported with fetal malnutrition.

Embryotoxicity of human sera from patients treated with isotretinoin.

Sera of 20 patients treated with 20-40 mg isotretinoin/day were tested for embryotoxicity potential. For each patient, the first sample was taken before treatment (control sample) and the second was taken 2 months after the start of treatment (treated sample). Six embryos displaying six or seven pairs of somites were cultured for 26 hr in each serum sample, when sufficient serum was available. No deaths were observed in the control sample, whereas dead embryos (6%) were observed in the treated sample. The rates of malformed embryos were 13 and 81% in the control and in the treated sample, respectively. The most frequent abnormalities affected the cephalic neural tube, the branchial bars, the yolk sac circulation and the caudal neural tube. Growth and differentiation were significantly decreased in the treated sample. The concentrations of isotretinoin and of two metabolites (trans-retinoic acid and 4-oxo-isotretinoin) were measured in 12 sera. A correlation between embryotoxicity and concentration was established for two of the chemicals. Modulation of the embryotoxicity by drug-induced changes in the serum cannot be excluded.

Allergic contact dermatitis to colophony included in the formulation of flexible collodion BP, the vehicle of a salicylic and lactic acid wart paint.

The authors describe two cases of allergic contact dermatitis to colophony included in the formulation of flexible collodion BP, the vehicle of a wart paint. Patch and repeated open application tests confirmed absence of contact allergy to other constituents. The patients were known to be allergic to various adhesive plasters. The use of flexible collodion USP, which does not contain colophony, is highly advisable whenever possible.

Cutaneous mucinosis associated with multiple frozen joints and bony heterotopic deposits around the hips.

A 43-year-old man suffered from migrating then additive arthralgias associated with macroscopic and microscopic cutaneous lesions compatible at first sight with reticular erythematous mucinosis. After nine months, the cutaneous picture evolved into a papular mucinosis. The patient developed "multiple frozen joints" with heterotopic bony deposits around the hips. To our knowledge, such articular problems have not yet been described in this condition. Severe systemic complications prompted the authors to treat the patient with plasma exchange and melphalan.

Allergen-antibody complexes in the treatment of atopic dermatitis: preliminary results of a double-blind placebo-controlled study.

Twenty-three adult patients suffering from chronic atopic dermatitis (AD) have been treated by regular injections of complexes made of D. pteronyssinus allergens and specific autologous antibodies. A double-blind placebo-controlled protocol was followed for 4 months, then the patients were treated openly to complete a full year on active therapy. Preliminary results are presented for the first 8 months. Seventy-three percent of patients improved when treated with complexes, showing a mean improvement of more than 70% after 4 months. This study suggests that injections of allergen-antibody complexes is an effective treatment of at least some forms of AD and confirms that airborne allergens are significant exacerbating factors of AD.

Halomethasone (C 48.401-Ba) for the topical treatment of common dermatoses.

C 48.401-Ba cream, containing 0.05% halomethasone was compared in a double-blind between-patients trial with a cream containing 0.1% betamethasone valerate in forty-eight patients suffering from atopic dermatitis and in thirty-nine patients suffering from seborrhoeic dermatitis. A similar comparison was made with ointments containing the same concentration of active ingredient in forty-six patients suffering from atopic dermatitis. Both ointments were also compared in a within-patient double-blind trial in thirty patients suffering from psoriasis. The analysis of the results showed that for the treatment of the above-mentioned dermatoses, both drugs, the cream as well as the ointment, are equally effective and well tolerated.

[Acquired ichthyosis disclosing Hodgkin's disease. Simultaneous recurrence]. / Ichtyose acquise révélant une maladie de Hodgkin. Récidive simultanée.

INTRODUCTION: Hodgkin's lymphoma is rarely evidenced by dermatological signs or symptoms. OBSERVATION: A 37 year-old man progressively developed widespread cutaneous roughness, with small parallel lines producing fish-like scales. A skin biopsy confirmed the diagnosis of acquired ichthyosis, as evidenced by the absence of the epidermal granular layer. The patient's condition was assessed to be satisfactory. However, two months later, his general condition had gradually deteriorated (night sweats, weight loss, axillary and scalp alopecia, and adenopathies). Hodgkin's lymphoma was diagnosed. After treatment with adriamycin, bleomycin, vincristine and dacarbazine, complete remission of the lymphoma was obtained, and concomitantly, the symptoms of acquired ichthyosis resolved; this was confirmed by serial skin biopsies that evidenced the progressive complete restoration of the granular layer. The level of plasmatic vitamin A and carotene, which had decreased before the treatment, returned to normal values. A subsequent relapse of Hodgkin's lymphoma was preceded by the recurrence of ichthyosis; this time vitamin A and carotene levels were not decreased. DISCUSSION: As a paraneoplastic syndrome, acquired ichthyosis as a first sign of Hodgkin's lymphoma is discussed. In the presence of acquired ichthyosis, repeated monitoring of the patient is required since clinical symptoms of Hodgkin lymphoma are often delayed. Acquired ichthyosis is also an early marker of lymphoma recurrence.

[Spectacle-frame acanthoma. Review of the literature and histopathological diagnosis versus chondrodermatitis nodularis helicis (author's transl)]. / Acanthome fissuré. Revue de la littérature et diagnostic histopathologique différentiel avec le nodule douloureux de l'oreille.

Five cases of spectacle-frame acanthoma are reported; four were retro-auricular (three unilateral; one bilateral) and one was present on the left side of the nose. Clinical aspects of the lesions are described by the light of all the other cases that have been previously reported in the literature. Histopathological features are compared to those encountered in chondrodermatitis nodularis helicis for which a frictional origin may also be suspected. In the vast majority of cases, spontaneous resolution is obtained when responsible spectacle frames are removed whereas a few lesions persist indefinitely despite of the fact that corrective measures are applied, on the contrary to what has been reported in previous papers. Apart from removing spectacles, these few cases needed surgical excision for a complete cure. Anatomo-clinical confrontations seem to indicate that those persistent lesions are completely fissured acanthomas.