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J M Bonnetblanc

Publications and source records attributed to J M Bonnetblanc.

At least 91 records · Page 5Linked to original sources
PubMed1995

[Principal skin manifestations and occupational allergy].

Cutaneous manifestations of occupational allergic diseases are mainly represented by contract dermatitis and less frequently recognized for mucous localizations. Contact erythema multiforme is often a severe disease. Rarely, contact dermatitis mimics a lymphoma. Irritant contact dermatitis usually differs clinically, but the diagnosis may required skin testing and a biopsy. The allergens or the irritants are sometimes transferred by air, and there is an ingrowing literature about airborne dermatoses. Modifications of the eruptions by physical factors such as the sun, or by infections such as dermatophytes may delay the diagnosis and the cure of the eruption. Cancers may occur as occupational diseases, and the event of lymphoma is always discussed.

Air Pollutants, Occupational↗
PubMed1995

Incidence and distribution of subepidermal autoimmune bullous skin diseases in three French regions. Bullous Diseases French Study Group.

BACKGROUND AND DESIGN: The incidence and distribution of autoimmune subepidermal bullous diseases were estimated from prospective data (including immunoelectron microscopy) obtained from 100 cases during a mean period of 35 months in three university dermatologic centers in Amiens, Limoges, and Tours, France, that correspond to a cumulative reference population of 3.55 x 10(6). RESULTS: Using data from these regions, we found a mean annual incidence of autoimmune subepidermal bullous diseases to be 10.4 per million people and, therefore, estimated the overall number of new cases of these disorders in France to be about 590 cases per year. According to clinical and immunoelectron microscopic criteria, a precise diagnosis was established in 94 cases, distributed as follows: bullous pemphigoid, 69 cases; cicatricial pemphigoid, 12 cases; linear IgA dermatosis, five cases; herpes gestationis, four cases; epidermolysis bullosa acquisita, two cases; and vesiculobullous systemic lupus erythematosus, two cases. CONCLUSION: Our prospective study is the first assessing the incidence and distribution of autoimmune subepidermal bullous disorders that systematically included immunoelectron microscopic data. Our estimated incidence of bullous pemphigoid (seven new cases per million people per year) is large enough to establish bullous pemphigoid as the major autoimmune subepidermal bullous disease for the purpose of therapeutic trials. On the contrary, all other disorders, particularly epidermolysis bullosa acquisita (estimated annual incidence, 0.17 to 0.26 per million people), were very rare and reflect the paucity of patients available for short-term clinical studies in France.

Adult↗
PubMed1995

[Bacterial dermo-hypodermatitis in adults. Incidence and role of streptococcal etiology].

INTRODUCTION: The frequency of bacterial dermohypodermal infections would appear to be increasing in western countries, particularly severe necrotizing forms. PATIENTS AND METHODS: We attempted to determine: (1) the incidence of the two most well-defined forms of bacterial dermohypodermal infections (erysipelas and necrotizing fasciitis) in a retrospective study of hospitalized cases seen over a period of 13 years in the Limoges University Hospital and (2) the role of streptococci as causative agents in bacterial dermohypodermal infections in the adult by collecting bacteriological data in 174 cases of erysipelas and 31 cases of necrotizing fasciitis. RESULTS: This retrospective analysis confirmed that the annual incidence of erysipelas was constantly increasing over the study period (1978-1991) while the annual incidence of necrotizing fasciitis was much lower and more constant. The two incidence curves were not parallel. Bacteriology, detection of streptococci (groups A, B, C or G) in skin specimen was better with direct immunofluorescence (64 p. 100) than with latex agglutination (47 p. 100) or classic culture techniques (28 p. 100) for erysipelas. Streptococci were determined to be the causative agent in 79 p. 100 (137/174) of the cases of erysipelas using at least one of the 3 bacteriological tests and/or serology. Group A streptococci predominated (67 p. 100 of the cases). For necrotizing fasciitis, streptococci was identified with classical culture technique, latex agglutination and/or serology in 12/131 cases (39 p. 100), again with a group A predominance (7 cases). In the other cases, multiple microbial flora (12 cases) were found including Staphylococcus aureus (3 cases) and Serratia liquefaciens (1 case). CONCLUSION: These results show that streptococci (group A predominantly and group G to a lesser extent) were the major, though not exclusive, causative agents in bacterial dermohypodermal infections in the adult, including necrotizing forms.

Adult↗
PubMed1995

[Inguinal mastocytosis with histiocytic infiltrate].

INTRODUCTION: The diagnosis of mastocytosis is usually not difficult in cases with typical skin lesions. Intertrigo is exceptional. CASE REPORT: An 83-year-old patient developed inguinal intertrigo bilaterally. The lesions contained maculopapulous elements without Darier's sign. The histology examination revealed a mixed mast cell infiltration predominated by histiocytes. The ultrastructure confirmed the diagnosis of cutaneous mastocytosis. No extension was observed. DISCUSSION: Skin folds are rarely involved in infiltrating diffuse mastocytosis. Two cases have been reported in the literature including one doubtful case. Mastocytosis should thus be included in the possible diagnoses in patients with macupopapulous intertrigo. In addition, the mastocytic and histiocytic polymorphism observed here is rare.

Aged↗
PubMed1995

[Survival prognosis in pemphigoid. A cohort analysis of 78 patients].

INTRODUCTION: Bullous pemphigoid (BP) is the most frequent autoimmune bullous skin disease and usually affects elderly patients. Despite some conflicting data, vital prognosis is poor in BP, of which mortality rate after one year of treatment varies between 10 and 40 p. 100. To date, the factors influencing this prognosis remain to be determined. PATIENTS AND METHODS: A cohort of 78 consecutive patients with BP (mean age: 80 +- 4 years) has been prospectively selected on a six-year period (1987-1992) in Limoges. The diagnosis of BP was made on clinical criteria (using a standardized questionnaire), direct immunofluorescence (IF) findings (linear deposits of IgG and/or C3 along the basement membrane zone) and confirmed by direct immunoelectron microscopy and/or Western immunoblotting on epidermal extracts. RESULTS: The follow-up analysis (mean duration of follow-up: year of treatment (22 p. 100 in the first three months) with an actuarial survival curve inclined to be horizontal by the end of this first year of treatment. Therefore, we have studied the clinical or immunologic factors susceptible to influence the vital prognosis of BP according to this main criterion: death (or survival) at the end of the first year of treatment. None of the following factors has been found to be significantly linked to the vital prognosis in BP: age, sex, extent of skin lesions at presentation, presence of mucosal lesions, blood eosinophilia, presence of circulating basement membrane zone autoantibodies by indirect IF. The clinical factors of bad prognosis were an altered general condition and a history of coronaropathy. The presence of circulating autoantibodies against BP180 antigen (but not the one of autoantibodies against BP230) as detected by immunoblotting on epidermal extracts was found to be significantly more frequent (50 vs 22 percent) in BP patients who died within the first year of treatment (p < 0.02). DISCUSSION: Although modestly discriminating, the presence of circulating autoantibodies against BP180 represents the first vital prognosis factor demonstrated in BP. This result confirms the growing pathophysiologic importance of the anti-BP180 autoantibodies of which the pathogenic role has been recently formally demonstrated in BP using an animal model.

Aged↗
PubMed1995

[Hydroxychloroquine-puvatherapy photoinduced acute generalized exanthematous pustulosis].

INTRODUCTION: Acute generalized exanthematous pustulosis usually occurs as a typical skin reaction to drugs. We observed a case with a photodistribution induced by hydroxychloroquine and/or PUVA. CASE REPORT: A male subject had been treated for actinic pseudolymphoma since 1988. General corticosteroids had been given initially and were followed by PUVA and azathioprine. A new episode with erythema involving the trunk and the proximal portion of the limbs was treated with corticosteroids and hydroxychloroquine. The symptomatology regressed but pustular erythema developed in exposed areas two days after a PUVA session on the upper part of the body. The eruption did not involve the zones of the phototests one month earlier. The lesions resolved rapidly after withdrawal of hydroxychloroquine and PUVA. DISCUSSION: Photo-induced acute generalized exanthematous pustulosis with a photodistribution has not been reported previously. The imputability of hydroxychloroquine and PUVA, and their association is suggested. The appearance of pustular lesion on exposed areas and the protection resulting from the phototests would lead to several hypotheses. General corticosteroids were ineffective in preventing and in treating acute generalized exanthematous pustulosis.

Acute Disease↗
PubMed1994

Simvastatin-induced lichenoid drug eruption.

Cutaneous drug eruptions have a variety of clinical features. Lichenoid drug eruptions are rare and may be difficult to diagnose. A case of a simvastatin-induced lichenoid eruption with skin and mucosal involvement is reported.

Anticholesteremic Agents↗
PubMed1994

[Cutaneous reactions to gold salts].

OBJECTIVE: Evaluate the clinical features of skin reactions to gold salts. INTRODUCTION: Gold dermatitis is described in the literature as a group of reactions non-specifically associated with these drugs. PATIENTS AND METHODS: Ten patients (7 males, 3 females, mean age 59.6 years [corrected] with a skin reaction were studied over a 6 year period. All were treated with Allochrysine for rheumatoid arthritis (n = 8), rhizomelic pseudopolyarthritis (n = 1) or arthropathic psoriasis (n = 1). RESULTS: The delay to the first signs was from 2 weeks to 8 months. Three lichenoid eruptions (including two with buccal lesions and two which followed an autonomous course), 2 pityriasis rosea (one with eosinophilia and one with liver disease), 2 eczematoid dermatoses and one urticaria were observed. Pathology examinations (8/10) were in agreement with clinical diagnosis. Imputability was 14 (1 case), 13 (8 cases) and 12 (1 case). DISCUSSION: The clinical features observed were variable and in agreement with a particular clinical situation. They were not specific to gold salts and cannot be qualified as "gold dermatitis". Two autonomous and severe lichenoid eruptions were observed. Generalized lesions were associated with biological signs. This situation must be considered as a marker of severity.

Adult↗
PubMed1994

[Multocida Pasteurella and leg ulcer].

INTRODUCTION: We observed two cases of Pasteurella and discuss the role of bacterial sampling in ulcerations of the lower limb. CASE REPORTS: In the first case, Pasteurella was discovered in an ulceration of the lower limb and was cured with no particularly specific care. In the second case, Pasteurella had been inoculated by scratching an ulceration and could not be cured without specific treatment. DISCUSSION: No specific pathological consequence in chronic carriers could be possible, a situation which has often been reported in the literature. Pasteurella is an unusual specific cause of ulcerations of the lower limb.

Aged↗
PubMed1994

[Fixed pigmented erythema caused by levamisole administration].

INTRODUCTION: Description of a case of fixed drug eruption induced by levamisole. OBSERVATION: Fixed toxic erythema with pigmentation was observed in a patient taking levamisole as an adjuvant to 5 fluorouracil chemotherapy for cancer of the colon. The imputability of levamisole was highly likely. Epicutaneous skin tests were negative. DISCUSSION: Several types of skin eruptions have been described after intake of levamisole. It was highly likely that levamisole was implicated here and fixed pigmented erythema should be added to the list.

Adenocarcinoma, Mucinous↗
PubMed1994

[Disulone hypersensitivity syndrome].

Hypersensitivity to dapsone (Disulone) is a rare side effect of sulfone therapy. The diagnosis is based on variable clinical manifestations and laboratory findings dominated by hyperthermia, skin eruptions and a mixed form of hepatitis. We observed a case of hypersensitivity to dapsone in a 57-year-old woman who was treated with Disulone for cicatricaial pemphigoid. Clinical manifestations and laboratory results returned to normal 3 weeks after drug withdrawal. This case is interesting because the skin eruptions classically described were not observed. In addition this is apparently the first case reported of such a hypersensitivity syndrome occurring during treatment of autoimmune bullous dermatosis.

Chemical and Drug Induced Liver Injury↗
PubMed1994

[Ehlers-Danlos type IV syndrome presenting as renovascular hypertension].

The association of Ehlers-Danlos type IV syndrome and acrogeria with renovascular hypertension is reported. Ultrastructural abnormalities observed in our case were different of those associated with acrogeria. We propose that acrogeria associated with Ehlers-Danlos type IV syndrome be a different disease of acrogeria of Gottron. The occurrence of renovascular hypertension in Ehlers-Danlos is unusual.

Adult↗
PubMed1993

Dermatomyositis and malignancy.

During the past 12 years, many studies applying strict diagnostic criteria have been published that have attempted to settle the controversy about the reality of the association between dermatomyositis and malignancy. Although retrospective, recent studies have shown an increased incidence of malignancy among patients with dermatomyositis when compared with controls without myositis. In contrast, an increased frequency of malignancy in dermatomyositis as compared to polymyositis still has to be demonstrated. In most cases, malignant disease precedes or occurs concurrently with dermatomyositis and is discovered on the basis of clinical signs, symptoms, and routine screening laboratory tests. The types of neoplasms found in association with dermatomyositis parallel those observed in the general population. A possible link between dermatomyositis and an underlying malignancy remains largely hypothetical at a biologic level, although cellular immunity abnormalities may provide a direction for future investigations. Prospective epidemiologic studies using the case-control methods and cohort analysis remain necessary 1) to rigorously demonstrate the reality and to study the nature of the association between dermatomyositis and malignancy, and 2) to clarify the optimal screening strategies for malignant neoplasms in patients with dermatomyositis.

Dermatomyositis↗