Biomedical subjects

E Amsler

Publications and source records attributed to E Amsler.

8 recordsLinked to original sources

PubMed2004

Evaluation of re-challenge in patients with suspected lidocaine allergy.

BACKGROUND: Lidocaine is an anaesthetic agent used worldwide in various clinical specialties. Although lidocaine hypersensitivity is very rare, clinicians frequently encounter patients with such an alleged diagnosis. Using a questionnaire, we evaluated the results of re-challenge with lidocaine, the gold standard for assessing hypersensitivity reactions in patients who claim to be allergic to this drug. METHODS: A detailed questionnaire was sent to members of the French Dermatological Society, targeting the management of patients claiming lidocaine intolerance. After analysis and recall of doubtful episodes, 199 re-challenges were made. True lidocaine hypersensitivity was finally demonstrated in only 1 patient. CONCLUSIONS: The results of this study demonstrate that patients claiming to be allergic to lidocaine are usually not, their symptoms corresponding in most cases to a vasovagal episode. Re-challenge is safe and may constitute an easy and cheap alternative to skin testing. This should be performed in specialized centres except in case of a vasovagal episode.

Drug Hypersensitivity↗

PubMed2003

[Allergy in chronic urticaria].

Chronic urticaria is an intricate pathology, caused by numerous factors. The number of tests depend on the practitioner but very often no aetiology is found. Allergologist play a role in this research of an aetiology that can be cured. The rate of an allergic aetiology in chronic urticaria is not known but remains weak. Allergy to the aeroallergens has not shown any responsibility in chronic urticaria. Total IgE count is not a major tool in the allergologic investigation. If needed, skin tests confirmed by specific IgE, remains the best way to confirm an allergy. The result will always be interpreted in relation with the clinical history. In addition a double blind versus placebo provocation could be realised. Diets did not show their efficiency. The role of additives are much debated as well. However if they have an influence, this is only through a non-allergic mechanism. Concerning autologous serum skin test, it should allow to identify among chronic idiopathic urticaria, those for which the aetiology could be auto immune. For half of the positive results, an histaminoliberation could be found highlighting the presence of functional autoantibodies anti FcepsilonRIalpha, anti IgE less frequently or both. Progresses are expected before proving their pathogenic role and to define when this test must be done.

Adult↗

PubMed2002

[Ectopic breast cancer of the axilla].

INTRODUCTION: Breast cancer is the most frequent cancer occurring in women. These cancers may rarely develop within ectopic breast tissue. We report a case of ectopic axillary lobular carcinoma presenting as an isolated skin lesion with prolonged evolution. CASE-REPORT: A 62 year-old women had a cutaneous lesion located in her left axilla for the past 4 years. The skin biopsy showed an infiltrating lobular carcinoma. A mammogram and an MRI were as unremarkable as two past mammograms performed since the beginning of the skin lesion. Surgical resection with lymph node dissection, associated with radiotherapy and hormonotherapy with tamoxifen, led to complete remission. DISCUSSION: Ectopic breast tissue is subject to physiological and pathologic changes such as benign or malignant tumours. Cancer occurring in ectopic breast tissue remains rare but this diagnosis must be suspected when confronted with a skin lesion or mass located near the normal breasts.

Antineoplastic Agents, Hormonal↗

PubMed1970