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J L Perrot

Publications and source records attributed to J L Perrot.

At least 19 recordsLinked to original sources
PubMed2004

Sentinel lymph node detection in primary melanoma with preoperative dynamic lymphoscintigraphy and intraoperative gamma probe guidance.

BACKGROUND: This study assessed the value of the radioisotopic method used alone, and factors influencing relapse rates, for sentinel lymph node (SLN) mapping in primary melanoma. METHODS: One hundred and thirty-three patients with a diagnosis of melanoma (thickness greater than 0.75 mm) underwent gamma probe-directed lymphatic mapping in a prospective single-centre study. RESULTS: Mean Breslow thickness was 3 mm. At least one SLN was identified in 132 patients (mean 1.8 nodes per patient); the success rate was 99.2 per cent. Twenty-two patients (16.7 per cent) had a metastasis within the SLN. The mean tumour thickness in patients with a metastatic SLN was 4.4 mm compared with 2.7 mm for patients with a negative SLN (P < 0.001). The median time to recurrence was 20.4 months in SLN-negative patients compared with 8.5 months in those with SLN metastasis (P < 0.001). Ten (9.1 per cent) of the 110 SLN-negative patients developed recurrence. Three patients relapsed in the previously mapped lymphatic basin after a median follow-up of 27.1 months. CONCLUSION: This study confirmed the reliability and accuracy of SLN mapping using a radioisotope technique, and also the importance of the SLN as a predictive factor for survival. There was a low risk of locoregional recurrence when the SLN was not involved.

Adolescent↗
PubMed2002

[Increased serum and urinary levels of silver during treatment with topical silver sulfadiazine].

BACKGROUND: Argyria, induced by prolonged absorption, is often of professional or medical origin. We report two cases of per cutaneous intoxication with topical silver sulfadiazine. CASE REPORTS: A 64 year-old hypertensive, diabetic woman presented bilateral venous ulcers on the legs. She had applied 100 g of silver sulfadiazine 1 p. 100 cream per week for the past 18 months. Silver concentration in blood high: 38 microgram/l (N<0.5) and led to renal dysfunction, without ocular or hepatic abnormality. A 19 year-old woman was treated with topical silver sulfadiazine for thermic cutaneous burns on legs. Renal and hepatic function was normal but silver concentration in blood was high at 440 microgram/l (N<0) with urinary excretion of silver at 12 microgram/l (N=0). DISCUSSION: Silver, from prolonged and excessive use of topical silver sulfadiazine, deposits in large amounts throughout the body: skin, labial mucosa, gingiva, kidney, liver and cornea. Monitoring concentration of silver in blood and/or urine is necessary, especially in patients treated with silver sulfadiazine cream for cutaneous burns. Indeed, silver is rapidly absorbed through the burn wound. It provokes hepatic, renal and neurologic tissue toxicity. Renal and hepatic function tests are not correlated with serum silver levels. CONCLUSION: The potential for silver toxicity is a direct consequence of applying silver sulfadiazine to extensive burn wounds. Hence monitoring concentrations of silver in blood and/or urine of patients receiving this treatment is recommended.

Adult↗
PubMed2001

[Is anticoagulant therapy useful when treating erysipelas?].

INTRODUCTION: Low or high dosage heparin adjuvant therapy for Erysipelas (E) has become frequent, especially in France. MATERIAL AND METHODS: Publications on erysipelas complications were reviewed, and 2 studies were found in which the detection of deep venous thrombosis (DVT) was systematically performed: Mahe A (6DVT/40E), and Perrot JL (4DVP/155E). We calculated the relative incidence (CRI) at 4.9 p. 100, for all studies systematically detecting the DVT (whether symptomatic or not). The other studies reported clinical DVT. CRI was at 0.7 p. 100 without heparin adjuvant therapy. CRI was at 0, not statistically significant, with low or high dosage heparin adjuvant therapy. The most frequent complications for heparin treatment were: thrombocytopenia (5.7 and 0.9 p. 100 respectively with standard and low weight heparin), and hemorrhage (less than 3 p. 100 for DVT treatment). DISCUSSION: The risk of DVT associated with E is inferior to 10 p. 100 (the level of risk for DVT is small according to consensus conferences on thromboembolism). The incidence of asymptomatic DVT is superior to that of symptomatic DVT. But we do not know if asymptomatic DVT is equivalent to symptomatic DVT. Consensus conferences on thromboembolism do not recommend the preventive administration of heparin to bedfast patients with a low risk of DVT. CONCLUSION: There is no indication of adjuvant anticoagulant therapy for erysipelas. There is no indication for systematic prophylactic anticoagulant therapy for erysipelas. Prophylactic anticoagulant therapy is used depending on other risk factors of DVT. Wearing stockings may be another indication for patients.

Anticoagulants↗
PubMed2000

Safety and efficacy of 1 year of tacrolimus ointment monotherapy in adults with atopic dermatitis. The European Tacrolimus Ointment Study Group.

OBJECTIVE: To investigate the safety and efficacy of using 0.1% tacrolimus ointment for long-term treatment of atopic dermatitis. DESIGN: Open-label, noncomparative study with 6 to 12 months of follow-up. SETTINGS: Outpatient departments in 30 study centers in 11 European countries. PATIENTS: We enrolled 316 patients aged 18 years and older with moderate to severe atopic dermatitis, 200 for 6 months and 116 for 12 months; 77.5% of patients completed the study. INTERVENTION: Twice-daily application of 0.1% tacrolimus ointment on all affected skin. Visits were scheduled on day 1; after 1, 2, and 4 weeks of treatment; and monthly thereafter. MAIN OUTCOME MEASURES: Safety assessments included monitoring of adverse events, clinical laboratory values, and tacrolimus blood concentrations. Efficacy end points included a combined score (modified Eczema Area and Severity Index) and an investigator's global assessment. RESULTS: Local irritation, adverse events such as burning sensation (47% of patients), pruritus (24% of patients), and erythema (12% of patients) were common but tended to occur only when initiating treatment. Laboratory values showed no marked changes over time. Systemic absorption was minimal, with the maximum tacrolimus blood concentration being less than 1 ng/mL in 76% of patients. All efficacy end points showed improvement. The mean (SD) modified Eczema Area and Severity Index score was 23.7 (12.6) at day 1, 13.5 (11.3) at week 1, 6.1 (9.2) at month 6, and 6.1 (8.1) at month 12. Marked or excellent improvement or clearance of disease was reported in 54%, 81%, and 86% of patients at week 1, month 6, and month 12, respectively. CONCLUSION: Up to 1 year of tacrolimus ointment use was safe and effective in patients with atopic dermatitis. Arch Dermatol. 2000;136:999-1006

Administration, Topical↗
PubMed2000

[Detection of lymphatic metastasis from malignant melanoma after identification of the sentinel node by preoperative lymphoscintigraphy and intraoperative radioisotopic detection].

OBJECTIVES: The aim of this study was to evaluate the detection of the first lymph node draining the primary tumour site, using a radioisotopic mapping alone and to determine whether a preoperative lymphoscintigraphy using technetium sulfur colloid and a hand-held gamma detecting probe could improve the detection of the sentinel lymph node (SLN) in melanoma. PATIENTS AND METHOD: From January to December 1998, 36 patients with a cutaneous melanoma larger than 0.75 mm, stage I TNM were included in this prospective study. Mean Breslow was 1.85 mm. The distribution of melanoma was head and neck (n = 9), trunk (n = 7), upper extremities (n = 4), lower extremities (n = 16). Preoperative lymphoscintigram and intraoperative detection were used. The first hot lymph node was supposed to be the SLN. RESULTS: In all cases, a lymph node was found and nine patients had more than one SLN (average number of SLN per patient: 1.25). Aberrant drainages were found in seven patients (19.4%): 1 in-transit lymph node, three paradoxical bassins, three bypasses). Four out of 36 patients had lymph node metastases and underwent elective lymph node dissection. CONCLUSION: The radio-isotopic technique used alone for the identification of the SLN is efficient in melanoma with a 100% detection rate in this short series.

Adult↗
PubMed2000

[Solar urticaria: one case treated by intravenous immunoglobulin].

BACKGROUND: Solar urticaria is a rare photodermatosis which often begins from the third to the fifth decade. Usual treatment consists of photoprotection measures and antihistamines although disease control is sometimes unsatisfactory with both. We report herein a very severe case of solar urticaria we treated with intravenous immunoglobulins. CASE-REPORT: A 55-year-old woman suffered for 3 years from very severe solar urticaria which resisted treatment. Phototests revealed two action spectra: the first in UVA near 380 nm with a minimal urticarian dose of 0.025 J/cm(2), the second near 500 nm in visible light. RESULTS: As last resort treatment, we gave our patient intravenous immunoglobulins. After the third course of treatment, the improvement was impressive as the patient could tolerate visible light and 15 minutes of intense solar exposure. The minimal urticarian dose was raised from 0.025 J/cm(2) to 27 J/cm(2) in UVA. One year after treatment, the solar urticaria has disappeared. CONCLUSIONS: We report herein the first case of solar urticaria treated with success with immunoglobulin. Intravenous immunoglobulin treatment is well for its effectiveness in many autoimmune diseases such as autoimmune thrombocytopenic purpura, and also, as recently proven, in some cases of severe idiopathic chronic urticaria.

Biopsy↗
PubMed1999

Quantitative zymography of matrix metalloproteinases by measuring hydroxyproline: application to gelatinases A and B.

Gelatinases A and B are metalloproteinases involved in the degradation of the extracellular matrix. Detection and quantification of these enzymes in physiological and pathological conditions such as rheumatoid arthritis, tumor invasion and metastasis may be clinically useful. Gelatin zymography is an electrophoretic technique specific for gelatinases. It can be used to detect the activity of both the active and latent forms. We have standardized this technique for the active and latent forms of gelatinase A and for the latent form of gelatinase B. We measured the extent of gelatin degradation with an EDC scanning densitometer (Helena). The value recorded was directly proportional to the amount of enzyme. Gelatinase activity was quantified from the gel by assaying hydroxyproline as an index of gelatin breakdown. Gelatin zymography was found to be useful in characterizing gelatinases A and B by their molecular weights and measuring their specific activity by a standardized analysis of the degraded gelatin substrate.

Animals↗
PubMed1999

[Psoriasis in childhood].

Psoriasis is a common chronic disease in childhood of yet unclear etiology. Thirty per cent of psoriatic patients experience onset of their disease before 15 years of age. Psoriasis is exceptionally congenital but may present in infancy as a napkin dermatitis. There are specific pediatric clinical forms, but at the beginning the eruption is usually discrete, and the diagnosis can be difficult. Pustular, erythrodermic and arthropathic forms are rare. Treatment must weigh the advantages and disadvantages of the possible therapies and be kept to the minimum compatible with asymptomatic control.

Adolescent↗
PubMed1999

[Granuloma annulare in the child].

Granuloma annulare is a benign, common, inflammatory skin lesion of unknown etiology that is seen in both adults and children. The typical lesions are single or multiple small cutaneous papules with an annular distribution. The histology is consistent with an area of fibrinoid degeneration of collagen, surrounded by palisading histiocytes and inflammatory cells. There are four clinically distinct subtypes: localized, generalized, subcutaneous and perforating. Usually a spontaneous resolution is expected. Many medical treatments have been proposed but without evidence of efficacy. The association with insulin dependent diabetes is still being discussed.

Adult↗
PubMed1999

[Exanthematic pustulosis of pregnancy: favorable evolution using calcium and vitamin D2].

A 26-year-old pregnant woman was hospitalized in an emergency setting for a skin eruption. She had developed pustules distributed on round patch-like areas of rash localized at the umbilicus and the larger skin folds. She was given calcitriol and calcium with good results. Systemic steroids are usually given for exanthematic pustulosis of pregnancy but with variable efficacy. Few cases of successful treatment with calcium and vitamin D have been reported. We suggest this alternative treatment could be useful in other cases.

Adult↗
PubMed1998

[Focal familial palmoplantar keratoderma with punctate hyperkeratosis of the palmar creases].

BACKGROUND: Keratosis punctata of the palmar creases is a variant of punctata palmoplantar keratoderma. CASE REPORT: Keratosis punctata of the palmar creases was observed in a 53 year-old North African male. The lesions presented as small keratotic papules confined exclusively to the flexion creases of the palms and digits, with a bilateral localization on the soles. The lesions were sensitive to pressure. The proband's 19 year-old son had similar lesions. DISCUSSION: Keratosis punctata of the palmar creases is characterized by the development of small round keratotic papules, electively and exclusively found in the palmar, digital, and uncommonly soles creases. The etiology is unknown. The frequency is higher in the black population. Although considered as an hereditary palmoplantar keratoderma with autosomal dominant transmission, familial cases with localizations on the soles is uncommon.

Adult↗