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Biomedical subjects

A Koessler

Publications and source records attributed to A Koessler.

9 recordsLinked to original sources

[Spironolactone-induced pemphigoid].

BACKGROUND: Sporadic observations would suggest that certain drugs play a role in the development of pemphigoid. A recent case-control study on long-term drug use associated with pemphigoid was unable to confirm the suspected role of these drugs, but did demonstrate a significant association between the development of pemphigoid and use of spironolactone. CASE REPORT: An 82-year-old patient had bullous erythematous lesions on the left thigh suggestive of pemphigoid. Histology and direct cutaneous immunofluorescence confirmed the diagnosis. The patient had been taking alimemazine, adrafinil, flunarizine, spironolactone and furosemide as long-term treatment. Spironolactone alone was withdrawn. The cutaneous lesions regressed and have not recurred during the 18-month follow-up. DISCUSSION: The causal effect of spironolactone in this case of pemphigoid is quite plausible. This hypothesis is favored by the agreement with epidemiological data. Other observations are however required before the causal role of spironolactone in development of pemphigoid can be confirmed.

Aged

[Tumoral sarcoidosis].

INTRODUCTION: We report here an unusual tumoral form of cutaneous sarcoidosis which lead to diagnostical difficulties. CASE REPORT: A 56 year-old woman was hospitalized for a large lumbo-sacral tumor which size had rapidly increased. The tumor was purplish-red, firm, measured 10 x 20 cm and the patient was unable to sit normally. The biopsies demonstrated a dermohypodermal epithelioid and giant cell granuloma without necrosis. We ruled out an infectious granuloma and a foreign body granuloma. There were no extra-cutaneous localizations. This sarcoidal tumor cured with systemic corticosteroids. DISCUSSION: Tumoral cutaneous forms of sarcoidosis are uncommon; 3 other cases of the literature are reported. Before to state positively this forms it is obligatory to rule out all the other aetiologies of sarcoidal granuloma. The existence of extra-cutaneous localizations and multiple skin localizations is helpful to diagnose this uncommon type of sarcoidosis.

Diagnosis, Differential

Comparison of the activity of doxorubicin analogues using colony-forming assays and human xenografts.

The potential use of nude mouse xenografts as a source of human tumor tissue for preclinical assessment of drug activity was examined by a comparison of in vitro sensitivity to four anthracycline derivatives of eight xenografts maintained in nude mice and tumor colony-forming units (CFU) from the xenografts grown in agar. Results obtained in the two systems with doxorubicin (Dx) and a new, closely related derivative (epi-doxorubicin, epi-Dx) correlated well. In vivo tumor growth delay and maximum in vitro tumor CFU kill for these two drugs showed a significant correlation (r = 0.64, P less than .01). Separation of tumors into "sensitive" and "insensitive" tumor populations on the basis of maximum in vitro CFU kill also predicted the in vivo response to these two drugs in 88% of cases. Similar analyses performed on in vitro and in vivo results with two other new anthracyclines (4'-deoxy-doxorubicin, deoxy-Dx and 4'-O-methyl-doxorubicin, O-Me-Dx) showed a significant negative correlation between in vivo and in vitro results; the in vitro system failed to predict in vivo activity of these two drugs. No significant differences in in vitro activity against normal, granulocyte/macrophage progenitors (CFU-GM) or against various tumor CFUs were detected. Thus, the selectivity (activity against normal tissue compared with that against tumor) of the four drugs appeared equal. These data suggest that in vitro screening of drugs using tumor CFUs from nude mouse xenografts may predict the in vivo activity of drugs for which pharmacologic data are available, but illustrate the difficulties in attempting to predict the in vivo activity of new drugs for which no such data are available.

Animals