Biomedical subjects

Jean-Marie Lachapelle

Publications and source records attributed to Jean-Marie Lachapelle.

6 recordsLinked to original sources

PubMed2006

[Diagnosis and treatment strategies in case of suspicion of contact dermatitis].

Contact dermatitis may be either irritant, allergic or both. The differential diagnosis is based on information from the patient, nature and concentration of chemicals involved and clinical examination. In case of suspicion of allergic contact dermatitis, the search for the responsible allergen(s) is built on patch testing. Positive patch test results, the current and/or past relevance of which has to be assessed, are confirmative. Additional tests, such as the repeated open application test, are sometimes recommended. Treatment which is symptomatic, is mainly based upon corticosteroids, either local or systemic; efficacy is rather limited. By any means, it cannot be substituted to the eviction of allergens. Primary and secondary prevention are linked with the complete eviction of allergens, but this caveat can be attenuated in some circumstances.

Dermatitis, Contact↗

PubMed2005

Allergic contact dermatitis from povidone-iodine: a re-evaluation study.

500 consecutive patients were patch tested with a 10% povidone-iodine (PVP-I) solution, diluted 10 times in water. Readings were made at 2 and 4 days. 14 of the 500 (2.8%) showed a positive test to PVP-I. The 14 positive patients to PVP-I were subjected to a repeated open application test (ROAT) with a PVP-I solution, as is; 2 of the 14 were recorded as positive. It was concluded that only 2 of the 500 patients had true allergic contact dermatitis from PVP-I (0.4%). This study emphasizes the need for more complete investigation, when testing with some allergens, when they share both irritant and allergenic properties, such as PVP-I. The approach is important to rule out false-positive patch test reactions and to assess true clinical relevance.

Allergens↗

PubMed2005

The management of dry skin with topical emollients--recent perspectives.

Dry skin (xerosis) is a common symptom of a number of chronic skin diseases, such as atopic dermatitis, but can also be caused by environmental factors, such as cold weather and frequent showering. The condition can cause unsightliness of the skin, discomfort, itching, and can have a negative impact on patients' quality of life. This article will cover recent developments in the understanding of xerosis and its management with emollients. The stratum corneum consists of corneocytes and lipid-enriched intercellular bilayers. These are both produced from keratinocytes in a process called epidermal differentiation. Disturbed epidermal differentiation, resulting in the impairment of stratum corneum intercellular lipid bilayers and natural moisturizing factor, is the root cause of xerosis. The constituent ingredients of emollients should, therefore, address the different factors that contribute to dry skin and, most importantly, attempt to restore epidermal differentiation. The use of lipids, physiological lipids, humectants and antipruritics will help to restore the lipid lamellae, improve skin hydration, skin elasticity and prevent itching. The ideal emollient will include these ingredients plus an agent to support epidermal differentiation. Selecting the correct emollient product and using it regularly are vital factors in the management of xerosis.

Cell Differentiation↗

PubMed2004

Drug-induced eosinophilia and multisystemic failure with positive patch-test reaction to spironolactone: DRESS syndrome.

We report the case of a 58-year-old man who suffered from a generalized and intolerable itching one month after starting treatment with colchicine, amiodarone, perindopril, allopurinol and spironolactone. From the start of treatment he had progressively developed erythroderma, fever, anorexia and prostration, oedema of both hands and face, hypereosinophilia (42%; 5810 eosinophils/mm3), hepatic failure (including cholestatic jaundice, cytolysis, coagulation abnormalities and hypoproteinaemia), exocrine pancreatic failure (with severe steatorrhoea), renal failure, metabolic acidosis, aggravation of pre-existing cardiac insufficiency and oedema of the lower extremities. All medications were stopped and the condition improved slowly until complete remission was reached 4 months later. Patch-testing was performed, including the various drugs. All the tests (including components of the vehicles) were negative, except for spironolactone, which gave a strong positive reaction. Ten controls in healthy volunteers were negative. The diagnosis of drug rash with eosinophilia and systemic symptoms (DRESS) induced by spironolactone was made. This is the first report of DRESS due to spironolactone.

Drug Eruptions↗

PubMed2004

High nickel release from 1- and 2-euro coins: are there practical implications?

PURPOSE: To determine the release of nickel from 1- and 2-euro coins and the ability to produce allergic contact dermatitis from the application of coins to the palmar skin of nickel-sensitized individuals. METHODS: Three experiments were conducted. Experiments 1 and 2 checked the release of nickel from 1- and 2-euro coins by using the dimethylglyoxime test. In experiment 3, the elicitation of positive reactions was checked by applying coins to the palmar skin for 48 h under occlusion in nickel-sensitized and non-sensitized individuals. RESULTS: The dimethylglyoxime test for release of nickel was positive in all cases. Positive patch test reactions to euro coins applied to the palmar skin of nickel-sensitized individuals were observed at 48 and 96 h. CONCLUSION: The results show that positive patch test reactions to euro coins can be obtained from nickel-sensitized individuals after 48 h of application to the palmar skin under occlusion. These results do not contradict other experiments in which repeated handling of coins was unable to provoke fingertip allergic contact dermatitis. A dose-response relationship is a credible explanation to support such potential discrepancies.

Belgium↗

PubMed2002

[Occupational dermatitis: irritation or allergy?].

Occupational dermatitis is a very frequent subject of consultation, as much in general practice as in dermatology. The most frequently found pathologies are linked to environmental factors. In these cases, irritant dermatitis and allergic contact dermatitis represent the majority of the cutaneous problems. Rigorous history taking associated with an attentive examination and a few investigations, essentially consisting of skin testing, form an incontestable tripod. The therapeutic approach, as much preventative as curative, can only be envisaged after having made a precise diagnosis, of which the conclusions should be pertinent and adapted to each patient presenting in consultation. In occupational disease, the distinction between irritant dermatitis and allergic contact dermatitis is primordial.

Dermatitis, Allergic Contact↗