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Biomedical subjects

E Grosshans

Publications and source records attributed to E Grosshans.

At least 19 recordsLinked to original sources

Thermal and sweating responses in normal and atopic subjects under internal and moderate external heat stress.

To compare the thermoregulatory responses of normal subjects and patients with atopic dermatitis, the effect of exercise under moderate heat stress was examined in two groups of subjects. Each group of eight subjects (controls or clinical atopics) underwent a 90-min experiment after being equipped with probes for measurement of core and skin temperatures, heart rate and overall and local sweating rates. Sweat surface tension was determined from sweat collection made at the end of the session. The experimental procedure was as follows: 30 min rest at thermoneutrality, 30 min cycling at 90 W at 36 degrees C, followed by 30 min recovery sitting at rest at 36 degrees C on the cycloergometer. None of the registered variables differed significantly between the normal and atopic subjects except for variations in mean skin temperature, core-to-skin temperature difference and sweat surface tension. Since local sweating on non-affected skin under a controlled thermal clamp was not altered by atopy, it can be concluded that the thermoregulatory modifications under heat stress is of vasomotor origin, the benefit of which, in terms of heat dissipation capacity, remains uncertain. There may be alterations in the constituents of sweat, but not in its excretion rate. Local, rather than central, factors are probably involved in this qualitative change, which remains to be investigated.

Adult

Staphylococcus aureus leukocidin: a new virulence factor in cutaneous infections? An epidemiological and experimental study.

Panton-Valentine leukocidin (PVL) is a Staphylococcus aureus (SA) exotoxin, which kills human granulocytes and monocytes in vitro. Among 43 SA strains from cutaneous infections, 12 were PVL producers, whereas among 49 blood culture strains, only 1 produced PVL. Most PVL-producing strains (11/22) came from 22 primitive cutaneous infections, especially furuncles and abscesses, while only 1 PVL-producing strain came from 21 secondary infections of dermatoses such as bullous or pruritic diseases. Intradermal injections of PVL in rabbits induced edema, erythema and necrosis; histopathological changes at the injection sites consisted mainly in leukocytoclasis and vascular necrosis. All changes were dose dependent, and previous immunization of rabbits partially neutralized PVL-induced effects. Production of PVL in vivo after injections of bacteria seems to be low, and the histopathological lesions induced in the rabbit skin do not appear to be specifically related to PVL activity. However, PVL is a good candidate as a new virulence factor in cutaneous SA infections.

Animals

[Skin tests in allergic vasculitis].

For etiologic checking of cutaneous vasculitis, skin testing may be of valuable help: epicutaneous patch-tests with delayed lecture (48 h.) performed with contact haptens (rubber allergens, azo dyes, resins ...) or drugs in pigmented progressive purpuric skin eruptions; prick-tests submitted to delayed (6-8 h.) clinic and histologic lecture, performed with miscellaneous drug or food-derived, microbial or environmental antigens in necrotizing vasculitis. In these conditions skin testing should be approached with great caution, because of the occurrence of non relevant positive reactions and the risk of precipitation of cutaneous or disseminated lesions of vasculitis.

Drug Hypersensitivity

[Paederus dermatitis: apropos of an outbreak in Conakry (Guinea) in November 1989].

Paederus sabaeus is a coleopter of the Staphylinidae family. With its toxins present in the hemolymph (pederin, pseudopederin, pederone), it causes a delayed vesicular inflammatory dermatosis. The contact between skin and toxin is only possible when the insect is injured or killed, which occurs most frequently when it is crushed on the skin. In November 1989, in Conakry, a huge proliferation of this insect was responsible for an epidemic of Paederus dermatitis. The European sailors working in the port of this town were affected preferentially, as well as the entire European population for sociocultural reasons. The clinical picture is very characteristic when the lesions are linear or "kissing lesions" on both sides of the folded part of an articular joint. This dermatosis is more frequent on the uncovered parts of the body. Healing is spontaneous, requiring 7 to 10 days, if there are no further infections.

Animals

Lichen striatus: a Blaschko linear acquired inflammatory skin eruption.

An illustrative case report and a series of 18 well-documented cases of lichen striatus are presented. The mean age at diagnosis was 3 years (6 months to 14 years; median 2 years). The lesions were predominantly distributed on the trunk in 33% of cases and on the limbs in the remaining two thirds (upper limb: 48%; lower limb: 19%). Pruritus was noted in only 1 of 18 cases. Six cases were associated with clinical features of atopy and/or minor signs of atopic dermatitis (e.g., pityriasis alba). Two cases were considered to be clinically associated with lesions consistent with psoriasis. The mean duration was 9.5 months (4 weeks to 3 years; median 6 months). In one patient, two relapses occurred in 4 years. Hypochromic sequelae were noted in 50% of cases. Lichen striatus is the most common acquired self-limited linear eruption in childhood that follows Blaschko's lines. A new acronym is proposed to emphasize the developmental background of the disease: BLAISE for Blaschko linear acquired inflammatory skin eruption.

Adolescent

[Psoriasis: development and fatal complications].

In a retrospective study we tried to evaluate the number of severe psoriasis with a lethal outcome observed in France in a 20-year period from 1965 to 1985. Among 992 psoriatic in-patients on care during this period in the Dermatology Clinic of Strasbourg, 7 died of different complications directly related to the skin disease or its therapy; 39 further cases could be gathered through different departments of dermatology of France. Patients who died had generalized psoriasis (13 cases), psoriatic erythroderma (15 cases) and generalized pustular psoriasis (18 cases); 18 (39 p. 100) also had psoriatic polyarthritis. Circumstances leading to death (table I) were metabolic disorders, related to erythroderma in most cases, non-specific complications (infections, amyloidosis) or complications of specific treatments (methotrexate, etretinate, corticosteroids, mechlorethamine). A comprehensive review of the literature over a century showed that only 72 lethal psoriasis cases have been reported: this rather low number may be due to the fact that some rare pathologies, such as visceral amyloidosis (12 cases) (table III) and fatal complications of methotrexate therapy (38 cases) (table V), paradoxically are more often published than non-specific complications occurring in severe psoriasis, such as cardiovascular failure or cachexy in erythrodermic patients. However, the review of the literature shows, as our own inquiry, the poor prognosis of generalized pustular forms and of psoriasis-associated polyarthropathies: among 42 lethal cases where enough data were available, 23 (55 p. 100) had psoriatic polyarthritis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent