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J-J Grob

Publications and source records attributed to J-J Grob.

14 recordsLinked to original sources
PubMed2007

Multiple large solar lentigos on the upper back as clinical markers of past severe sunburn: a case-control study.

BACKGROUND: Multiple solar lentigos commonly seen on the upper back and shoulders of adults are classically considered as a sign of photodamage, although epidemiological studies are scarce. AIM: To assess whether these lesions are clinical markers of past severe sunburn. METHODS: A case-control study in two outpatient dermatology clinics in French university hospitals. Past episodes of moderate and severe sunburn were compared between 145 adult patients with multiple solar lentigos on the upper back and 145 matched controls. RESULTS: In multivariate analysis adjusted for potential confounders, recalled episodes of sunburn during childhood, adolescence and adulthood were independently associated with the presence of multiple solar lentigos (adjusted odds ratios, 95% confidence intervals: 2.3 (1.1-5.2) and 28.1 (10.4-75.6) for moderate and severe sunburn, respectively). CONCLUSION: Multiple solar lentigos on the upper back and shoulders of adults are potential clinical markers of past severe sunburn which may thus be used to identify a population at higher risk of developing cutaneous malignant melanoma.

Adolescent↗
PubMed2006

[Surgical management of cutaneous malignant melanoma. Review].

Nowadays managing a cutaneous malignant melanoma can concern different kind of physicians: dermatologists, general or plastic surgeons The primary surgical procedure is a major step of the treatment. Biopsy must be total to properly determine the thickness of the tumor in case of malignancy. Wide local excision of the scar is often necessary to decrease the local and general recurrence rates. Wide local excision must be performed conforming to its own surgical rules. Managing tumor located on the face or limb extremities is a matter of plastic surgery. Sentinel node biopsy has succeeded to elective lymph node dissection. This procedure allows research of lymphatic spreading of the disease. Practice of sentinel node biopsy must be achieved in a protocolar way. Topography of the lesion can modified achievement and results of this procedure. Prognosis benefit of sentinel biopsy is now clear. Elective lymph node dissection is only performed in case of invaded sentinel node or clinically invaded lymph nodes. Local or locoregional recurrences mainly respond to surgical treatment using wide excision. However, alternative solutions are being evaluated (isolated limb perfusion).

Humans↗
PubMed2005

[Treatment of cutaneous metastases of a squamous cell carcinoma of the leg with topical miltefosine].

INTRODUCTION: Miltefosine (Hexadecylphosphocholine) is a chemotherapy, which when applied locally, has demonstrated efficacy in the treatment of cutaneous metastases of breast cancer. CASE REPORT: A 79 year-old woman developed recurrent in transit cutaneous metastases of a squamous cell carcinoma on her left leg. All lesions completely resolved after topical applications of miltefosine. Tolerance was excellent and the patient remained disease-free 24 months after the end of the treatment. DISCUSSION: Miltefosine, which might prove to be a simple and effective alternative for the usually heavy treatments proposed, warrants further assessment in this context.

Administration, Topical↗
PubMed2005

[Anti-H1 in dermatological practice].

INTRODUCTION: Histamine is an inflammation mediator that is fundamental for the development of some allergic reactions and is also implied in several common dermatological affections. Anti-H1s are molecules capable of couteracting the effect of histamine on its specific receptors. There are two types: first generation anti-H1 and second generation anti-H1. OBJECTIVE: To assess the efficacy of anti-H1 in the treatment of skin diseases. PATIENTS AND METHODS: A reference search was made using the Pubmed data bank. Critical analysis was made of the articles selected based on their evidence. RESULTS AND CONCLUSION: Demonstration of the efficacy of anti-H1 was only confirmed in a few dermatitis. Urticaria is the indication of choice. The symptomatic use of anti-H1 may be justified within the context of other dermatitis. The second rather than the first generation molecules should be preferred because of the lesser side effects and improved pharmacokinetic profile.

Dermatitis↗
PubMed2003

[Muscle granuloma: anatomoclinical correlation and immunohistochemistry in seven cases].

Granulomatous inflammation is infrequently observed in muscle biopsy. We report a series of 7 patents presenting with granulomas in muscle. Two of them had a history of sarcoidosis In 4 other cases, muscle Involvement revealed systemic sarcoidosis. Among the 6 cases of sarcoidosis, we observed 2 with acute myositis and 4 chronic forms. The last patient presented with polymyositis in association with melanoma. In sarcoidosis, muscle biopsy showed a granulomatous inflammation of varying intensity, which was generally associated with mononuclear inflammatory cells. Most of granulomas were located in the perimysium and the endomysium and necrosis was absent. Inflammatory cells were predominantly macrophages and CD4 positive lymphocytes. On the contrary, in the case of paraneoplastic polymyositis,granulomas were rare, most of inflammatory cells were CD8 positive lymphocytes and numerous areas of necrosis were observed. Class I MHC molecules were expressed on the membrane of muscle fibers. As a general rule, requisite examinations must be performed to search for sarcoidosis in patients exhibiting granulomas on muscle biopsy.

Adult↗
PubMed2003

[Cutaneous metastasis of pleural mesothelioma: two cases].

INTRODUCTION: Cutaneous manifestations of pleural mesothelioma are rare, polymorphic, and occur at various stages of the disease. CASE REPORTS: Case 1. A 60 year-old man, 6 months after the initial diagnosis of a pleural mesothelioma, developed a right latero-thoracic subcutaneous nodule. The lesion resulted from an inoculation of tumoral cells to the wall at the time of the initial thoracoscopy. No specific treatment was proposed. Case 2. A 62 year-old man, with a history of pleural mesothelioma developed an inflammatory layer of the left chest wall. The lesion, laid out like an hemi-belt, was centred by the thoracotomy scar and was associated with retraction phenomena of the thoracic wall. The lesion corresponded to a direct extension of the mesothelioma to the wall. At the same time, the pleural disease was progressing. The patient died a few weeks later. COMMENTS: Cutaneous manifestations usually occur when the diagnosis of primitive pleural cancer has been already established. Distant cutaneous metastases are exceptional and involve with predilection the cephalic extremity. The majority of cutaneous lesions are distributed near the tumoral site and represent either a direct extension of the tumor to the thoracic wall, or a malignant seeding by diffusion of the pleural fluid at the time of the diagnostic and therapeutic procedures.

Cicatrix↗
PubMedDate not supplied

[The lentigoclast].

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Humans↗
PubMedDate not supplied

[Granulomatous hypodermitis revealing a cutaneous mucormycosis in an immunodepressed patient].

INTRODUCTION: Mucormycosis is an exceptional opportunist fungal infection, despite the ubiquitous nature of its pathogenic agents. It is sometimes revealed by primary cutaneous involvement and its prognosis is bad in the case of visceral dissemination. Our observation illustrates the need for early diagnosis and treatment of this infection. OBSERVATION: An immunodepressed, 45 year-old woman, had developed necrotic hypodermitis lesions on the lower limbs. The skin biopsy led to the diagnosis of mucormycosis. Despite treatment with liposomal amphotericin, the fungal infection worsened, spread to the organs (lungs and brain) and the patient died. DISCUSSION: This case report underlines the potential severity of mucormycosis, which is presently emerging in the onco-hematological field. The infection is sometimes revealed by inaugural ulcerated and/or necrotic cutaneous lesions. Its diagnosis must be evoked early so that salvage medical-surgical treatment can be initiated.

Brain Diseases↗
PubMedDate not supplied

[Treatment of Hailey-Hailey disease with carbon dioxide laser vaporization].

INTRODUCTION: Only ablative methods lead to long term remission of areas affected by Hailey-Hailey disease: excision/skin graft, cryosurgery, dermabrasion... The method using the CO2 laser is a recent addition in the management of this dermatitis. We report our experience with this technique in 4 patients. PATIENTS AND METHODS: Carbon dioxide laser vaporization was proposed to 4 patients exhibiting Hailey-Hailey disease resistant to classical treatments. A test under local anesthesia was performed beforehand in all the patients. A 60 year-old man had an immediate reaction and refused to continue treatment. In the other 3 cases, the result of the test at 6 months was considered satisfactory. These patients were treated under general anesthesia in a single area of 50 to 70 cm2, and a half-body for comparison. The CO2 laser was used in pulse mode, with successive irradiations, until a homogenous, whitish-yellow aspect with first retraction was obtained. RESULTS: Although the healing delays were long (a mean of 1 month) and required major analgesics over the first few days, the cosmetic results were satisfactory and no abnormal scarring was observed. After a median follow-up of 27 months, no relapse of the disease other than punctiform elements was noted. All the patients wanted treatment of the other remaining affected areas be continued. In 2 patients, CO2 laser vaporization permitted treatment of areas not easily accessible to other ablative methods (around the mouth, the anus and the vulva) with anatomy and normal function spared. DISCUSSION: These results are globally good. Although the time to healing was long, the cosmetic and functional results were always satisfactory, without abnormal scarring. Moreover, in 2 of the patients, CO2 laser was able to treat areas inaccessible to other methods. The reason for the efficacy of ablative methods is debated. Re-epidermization with keratinocytes of appendices and not expressing the molecular defect, and the constitution of dermal cicatricial tissue, are two currently proposed hypotheses.

Adult↗
PubMedDate not supplied

[Facial rash].

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Adult↗