[Benefit of topical steroids in necrotic angiodermatitis].
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Administration, Topical↗
Biomedical subjects
K Faguer
Publications and source records attributed to K Faguer.
Early surgical treatment of Cyrano-nose haemangiomas with Rethi incision.
Nasal haemangiomas may cause great social distress. Complete involution of these haemangiomas does not usually result in a return to normality. The subcutaneous tumour infiltrates the alar cartilages, resulting in a globular aspect of the nasal tip. In this location, haemangiomas are slow to regress, and contour deformities result from the fibrofatty tissue that remains after total involution and also from definitive deformation of the nasal cartilages. Surgery to remove the affected tissue and preserve the anatomy seems to be the best treatment for these tumours. We report six cases of nasal haemangiomas removed using the Rethi incision and a double rim incision. This procedure allows complete dissection of the tumour, and leaves only a small scar. The alar cartilages are returned to their anatomical position to allow normal growth. Surgery is performed at around 2 years of age; skin excision is not necessary because spontaneous skin retraction occurs. Our patients were evaluated by their parents, the surgeon and members of the dermatology staff not involved in their treatment. Pain, scar and final aspect were evaluated using statistical analysis. The parents and surgeon rated the postoperative results as very satisfactory or satisfactory. The dermatology staff also reported improvement after surgery. The scar is nearly invisible and the procedure allows excision of large nasal haemangiomas.
Child, Preschool↗
Polychromatic phototest as a prognostic tool for polymorphic light eruption.
BACKGROUND: Diagnosis of polymorphic light eruption (PLE) is based on the patient's history, the morphology of the lesions and the results of phototesting. Skin lesions of PLE can be provoked by repetitive UVB or UVA irradiation. However, about 20% of the patients with PLE have negative phototests. As 24% of the patients with PLE go into remission, it was of interest to search for a link between the results of the phototests and the evolution of the photodermatosis. METHODS: Forty patients with PLE were recruited and repetitive phototests were performed. To ensure a good reproducibility of the phototests, one to three phototests were performed on each patient at different stages of the disease including the period when the PLE had gone into remission. RESULTS: Except for one patient, there was a good reproducibility of the repetitive polychromatic phototests: in each patient, the tests remained positive or negative throughout the disease. After long-term follow-up, two different subgroups were identified: 30 patients with active PLE and 10 patients in remission. There were no clinical differences between these two groups apart from the age of onset and the clinical lesions of the PLE. PLE began at an earlier age in the patients in remission and presented mainly with a plaque-type eruption. In total, 52.5% of the patients had at least one positive polychromatic phototest. Phototests were positive only in patients with active disease. All the patients in remission had negative phototests. CONCLUSIONS: Repetitive phototests could be a prognostic marker for PLE. Two subtypes of PLE were identified on the basis of phototest results: the benign form of PLE with negative phototests, which tends to go into remission, and the more severe and more chronic PLE, with positive phototests.
Adult↗
Photo(chemo)therapy in private practice in Belgium, France and The Netherlands.
Photo(chemo)therapy is used widely, and ultraviolet (UV) sources, protocols and indications are numerous. A survey was carried out to examine how photo(chemo)therapy is employed in private practice and to determine whether safety guidelines are respected. A questionnaire survey sent to Belgian, French and Dutch dermatologists generated 593 useful responses. UV sources, doses of UV and 8-methoxypsoralen (8-MOP), as well as the frequency of the treatment, were all different in the three countries. UV starting doses were rarely chosen according to the minimal phototoxic dose (MPD) or to the minimal erythema dose (MED). Total cumulative UV doses were not always determined. Maintenance PUVA therapy for psoriasis was still performed by 15 to 40% of dermatologists in the respective countries. Another striking fact was that genital protection is not universal. On the other hand, the irradiance of tubes is checked regularly, and contraindications are respected. Despite the availability of guidelines, clinicians seem to be inconstant in their assessment of the carcinogenic risk of UV radiation.
Belgium↗
[Does benign summer light eruption exist?].
BACKGROUND: Contrary to other countries, in which a unique entity is recognized, two sub-groups of light eruption, benign summer light eruption and polymorphous light eruption, are identified in France. Benign summer light eruption was individualized with a few criteria: age at onset between 25-35 years old, female predominance, onset within 12 hours after an intensive exposure to sun, presence of lesions on areas which have not been regularly exposed to sunlight such as the upper chest, absence of lesions on the face, improvement during the summer period and negativity of the polychromatic phototest. In fact patients usually presenting with benign summer light eruption do not have all the criteria and they gradually develop a polymorphous light eruption. The aim of this study was to quantify, among the patients presenting with a light eruption, the population with three main criteria of benign summer light eruption. PATIENTS AND METHOD: Eighty-seven patients presenting with a light eruption, a polymorphous light eruption or a benign summer light eruption, were selected by a dermatologist. For each patient the presence or absence of the 3 main criteria were noted: a) no lesion of the face, b) improvement of the eruption during the summer period, c) negative polychromatic phototest. RESULTS: Among the 87 patients, 9 of them (10 p. 100) had the three main criteria of benign summer light eruption. DISCUSSION: Benign summer light eruption is either rare or defined with wrong criteria. The polychromatic phototest was gradually replaced by the UVA phototest. In fact, provocation UVA phototests do not individualize benign summer light eruption from polymorphous light eruption. Individualization of the benign summer light eruption is not justified because there is a continuous spectrum of light eruptions, ranging from the benign eruption which improves during the summer period and the chronic eruption with a high photosensitivy and lesions of the face.
Adult↗
[Polychromatic phototest sensibility is superior to UVA phototest in polymorphic light eruptions].
BACKGROUND: The phototest is used to confirm the diagnosis of polymorphous light eruption and to evaluate the different treatments. The different light sources in the different countries explains the lack of standardization. In France, we use a polychromatic source emitting a radiation close to the solar spectrum. The study compared the efficacy of a polychromatic source with a UVA source in the photo-induction of lesions. PATIENTS AND METHOD: Sixty-four patients presenting with a polymorphous light eruption were selected by a dermatologist. Polychromatic and UVA phototests were performed on each patient. At day 8, the phototest was considered positive if there were papules. RESULTS: Polychromatic and UVA phototests were positive in respectively 56 p. 100 and 23 p. 100 of the patients. Forty-one per cent of the patients had both polychromatic and UVA negative phototests. DISCUSSION: Polychromatic phototest seems to be more sensitive than UVA phototest. Induction of the lesions with a polychromatic source is so easy that it proves the significant role for UVB in the genesis of polymorphous light eruption. The percentage of negative phototests is identical to those published in the literature. Negative phototests are not necessarily secondary a bad methodology, they can individualize patients with those lower photosensitivity who present with a polymorphous light eruption that may resolve spontaneously.
Diagnosis, Differential↗