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Biomedical subjects

G Piérard

Publications and source records attributed to G Piérard.

14 recordsLinked to original sources

Dermal dendritic cells in anogenital warty lesions unresponsive to an immune-response modifier.

BACKGROUND: Human papilloma viruses (HPV) are responsible for a variety of proliferative epithelial lesions including anogenital condylomas. These lesions may regress during treatment with an immune-response modifier such as imiquimod. The release of specific cytokines from the monocyte-macrophage lineage induces a cascade of events abating the HPV replication. METHOD: A total of 14 persistent warty anogenital lesions were excised 4 to 7 weeks after completing a 4-month imiquimod treatment. Another series of 25 untreated condylomas and 8 bowenoid papulosis served as controls. All examined lesions had been excised in otherwise healthy individuals with a normal immune status. Lesions were examined for the presence of Langerhans cells and subpopulations of the monocyte/macrophage/dendrocyte lineage using immunohistochemical detection of L1-protein, CD68, lysozyme and Factor-XIIIa. CD45R0-positive T lymphocytes were also identified. HPV capsid antigens and genotypes were searched for using immunohistochemistry and in situ hybridization, respectively. RESULTS: The persistent although treated anogenital lesions were identified as 10 viral condylomas, 3 bowenoid papulosis and 1 basal cell carcinoma. The inflammatory cell densities and distributions were similar in the untreated and imiquimod-resistant condylomas with the exception of Factor XIIIa-positive dendrocytes. These dermal dendritic cells were slim and rare in all imiquimod-resistant lesions. In contrast, about two-thirds of the untreated condylomas were enriched in these cells. CONCLUSION: As dermal dendritic cells play a role in the immune surveillance, their low densities in some lesions might be a key feature responsible for low cytokine local production and failure of imiquimod treatment. The combined apparent lack of Langerhans cell activation might suggest that both intraepidermal and intradermal compartments of antigen-presenting cells are affected in imiquimod-resistant lesions.

Adjuvants, Immunologic↗

Onychomycosis and other superficial fungal infections of the foot in the elderly: a pan-European survey.

BACKGROUND: The escalating ageing population in the western world has led to an increased incidence of superficial fungal infections. The most common infections include onychomycosis, tinea pedis and tinea cruris. With the increasing life expectancy, the prevalence of onychomycosis and other superficial fungal infections is likely to increase further without adequate prevention and treatment. OBJECTIVE: To study the prevalence of foot mycoses in Europe. METHOD: The Achilles project represents a survey of 90,085 subjects from 16 European countries. RESULTS: Approximately half of the total screened population had evidence of fungal foot infection, with tinea pedis and onychomycosis affecting one quarter of these individuals. Advancing age showed an unfavourable effect on the prevalence of these infections. CONCLUSION: As the number of aged people in developed countries continues to increase, skin diseases will constitute a greater pharmaco-economic concern of worldwide healthcare. Better recognition by clinicians and patients of mycotic foot disease will help prevent direct morbidity and further complications.

Adolescent↗

Diagnosing dermatomycosis in general practice.

BACKGROUND: Diagnosing dermatomycosis from a clinical image is not always easy. Microscopy of a potassium hydroxide preparation (KOH-test) and culturing are seldomly used in general practice. Cyanoacrylate surface skin scraping (CSSS) is a new diagnostic tool that may be useful and simple. OBJECTIVES: We aimed to investigate the diagnostic value of signs and symptoms, the KOH-test and the CSSS, in patients with erythematosquamous skin lesions, using the culture as the gold standard. Our goal is to formulate an optimal algorithm for the diagnosis of mycosis, based on one or more of these tests and including both optimal accuracy and costs. METHODS: Scales from 148 consecutive general practice patients were tested using a KOH-test, CSSS and culture. Clinical data were collected using a questionnaire. RESULTS: Twenty-six (18%) positive fungal cultures were identified. The sensitivity of the clinical diagnosis was 81% and its specificity 45%; for the KOH-test, these figures were 12 and 93% respectively; and for the CSSS, 62 and 88%, respectively. The positive predictive value of the clinical diagnosis was 24% and the negative predictive value 92%; for the KOH-test these figures were 25 and 83%, respectively, and for the CSSS, 52 and 92%, respectively. Determining CSSS in all patients proved to be the most accurate policy (accuracy = 83%). The likelihood ratio of CSSS in all patients was 5.17 for a positive test result and 0.43 for a negative test result. An approach in which CSSS is obtained in only those patients whom the physician considers by clinical examination to have dermatomycosis, with no testing in other patients, results in positive and negative likelihood ratios of 4.69 and 0.56, respectively. Such a policy would result in an overall sensitivity of 50%, a specificity of 89%, a positive predictive value of 50% and a negative predictive value of 89%. DISCUSSION: The clinical picture of dermatomycosis is not very reliable. The combination of a clinical judgement if this is negative and an additional CSSS in the case of a positive clinical judgement provides us with the best cost-benefit ratio, if both diagnostic accuracy and logistic considerations are taken into consideration.

Belgium↗

Recurrent pleomorphic solitary angiomyxoma of the face.

The historical background of solitary and multiple myxoid tumors of the dermis is accompanied by a confusing conglomeration of names. We report a case whose histologic features do not fit exactly with previous classifications. It appeared as a solitary angiomyxoma of the face containing stellate pleomorphic cells and exhibiting a locally infiltrative behavior with tendency for recurrences over more than 25 years. This recurrent pleomorphic solitary angiomyxoma appears to be distinct from cutaneous myxomas that exhibit a very low local recurrence rate and from malignant tumors with myxoid deposits. The treatment consisted of a wide surgical excision.

Humans↗

[Necrolytic migratory erythema].

Necrolytic migratory erythema (NME) is generally associated with glucagonoma. It waxes and wanes by successive relapses and remissions. The clinical and microscopical diagnosis is complex. In addition to glucagonoma treatments, the administration of corticoids, aminoacids, zinc or essential fatty acids can be helpful. There exist several etiological hypotheses for NME. These are based on modifications of pancreatic enzyme activities and on variations of aminoacids, fatty acids, zinc or glucagon concentrations.

Adrenal Cortex Hormones↗

Interleukin-10 differentially regulates B7-1 (CD80) and B7-2 (CD86) expression on human peripheral blood dendritic cells.

Most of the immunosuppressive effects of interleukin-10 (IL-10) are related to functional inhibition of antigen-presenting cells (APC). Herein, we investigate the influence of recombinant (r)IL-10 on human dendritic cells (DC) purified from peripheral blood of healthy volunteers. First, we found that rIL-10 inhibited in a dose-dependent manner the proliferative responses as well as the production of IL-2 and interferon-gamma (IFN-gamma) in mixed lymphocyte reaction (MLR) between purified T cells and DC. This rIL-10 effect could be attributed to a direct effect on DC, as DC preincubated with rIL-10 were found to be deficient in the induction of alloreactive T cells even when anti-IL-10 neutralizing mAb was added at the time of MLR. Flow cytometric analysis indicated that rIL-10 did not modify the expression of ICAM-1 (CD54) and B7-1 (CD80), but decreased HLA-DR and B7-2 (CD86) expression at the DC surface. We conclude that the inhibitory effect of rIL-10 on primary alloreactive T cell responses involves down-regulation of class II MHC and B7-2 expression at the DC surface.

Antigens, CD↗

Clinical and biological significance of interleukin-10 plasma levels in patients with septic shock.

Interleukin-10 is a potent macrophage-deactivating cytokine that inhibits lipopolysaccharide-induced tumor necrosis factor production. We determined the plasma levels of immunoreactive interleukin-10 in 16 patients with septic shock and in 11 patients with circulatory shock of nonseptic origin. In septic shock, interleukin-10 levels peaked during the first 24 h (median: 48 pg/ml) and decreased progressively till Day 5. In nonseptic shock, interleukin-10 plasma levels also increased during the first 24 h but to a lesser extent (median: 17 pg/ml). In septic shock patients, interleukin-10 plasma levels were positively correlated with tumor necrosis factor (r = 0.8, p = 0.01) and with parameters of shock severity including lactate levels (r = 0.56, p < 0.05) and correlated negatively with blood platelet counts (r = -0.65, p < 0.05). The decreased production of tumor necrosis factor-alpha and interleukin-6 after in vitro incubation of whole blood from septic shock patients with lipopolysaccharide was not influenced by in vitro neutralization of interleukin-10. We conclude that interleukin-10 is produced in patients with circulatory shock of septic and nonseptic origin and that the production of this anti-inflammatory cytokine during septic shock correlates positively with the intensity of the inflammatory response.

Adult↗

The Sebutape technique for monitoring androgen dependent disorders.

Sebaceous gland function is androgen dependent in man and animals. Many studies have suggested a relationship between the rate of sebum excretion and the severity of androgen-dependent disorders. We present a review of a recently developed non-invasive method to accurately measure sebum excretion. The Sebutape technique provides information that may be used in monitoring androgen-dependent disorders and in screening the efficacy of antiandrogens.

Adolescent↗