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Biomedical subjects

L Machet

Publications and source records attributed to L Machet.

At least 19 recordsLinked to original sources

[Photobiological study of lupus erythematosus].

BACKGROUND: Although cutaneous photosensitivity is one of the major criteria used for the diagnosis of systemic lupus erythematosus, this criterion is not precise. OBJECTIVE: To evaluate the interest of photobiological exploration in patients with cutaneous lupus erythematosus, and to compare the results to clinical photosensitivity. METHODS: Nineteen patients consecutively seen in one year, have been tested using a standardized method. RESULTS: Clinical photosensitivity was present in 16 cases. The clinical presentation of cutaneous disease was classified in 3 groups: acute, subacute, and chronic. One patient with no history of photosensitivity had positive photobiological tests, and five patients had negative tests though they experienced clinical photosensitivity. Positive phototests with UVA and UVB were present in 6/8 subacute lupus cases, 3/6 acute lupus cases, 3/5 chronic lupus cases. Histological aspect of cutaneous biopsies from phototest was not characteristic of lupus. Minimal erythematous doses was comparable in lupus group and in controls. No correlation between positivity of phototests and the presence of systemic involvement or anti-Ro/SSA antibodies was established. CONCLUSION: Phototesting is useful to assess photosensitivity in lupus patients.

Adult

Levels of fusidic acid in skin blister fluid and serum after repeated administration of two dosages (250 and 500 mg).

The fusidic acid steady-state concentrations in serum (S) and skin suction blister fluid (SBF) after oral doses of 250 and 500 mg administered twice daily for 6 days, as film-coated tablets of sodium fusidate, were studied in eight healthy subjects. The mean peak serum concentrations after the 250- and 500- mg regimens were 39 +/- 5 and 102 +/- 11 mg/l, respectively, obtained between 2 and 3 h after drug intake. The corresponding values for SBF, obtained later, between 2 and 12 h after drug intake, were 21 +/- 5 and 79 +/- 11 mg/l. As measured by the ratio of area under the concentration vs. time curve (SBF/S), fusidic acid penetration is 69-75%, whatever the dose. With either regime, the fusidic acid SBF and serum levels exceed the minimal inhibitory concentration of bacteria usually found in skin infections, especially Staphylococcus species. A dose of 250 mg twice a day appears sufficient to treat these infections and could be tested in clinical studies.

Adult

Contact and photocontact allergy to oxybenzone.

The purpose of this study was to determine the frequency of contact allergy and photocontact allergy to sunscreens. A consecutive series of 54 patients with suspected clinical photosensitivity were assessed. All had the same standardized photobiological investigation from January 1989 to December 1990, including patch tests and photopatch tests with 6 sunscreen agents. Oxybenzone was found to cause 4 cases of allergic contact dermatitis (with photoaggravation in 2), and 3 cases of photocontact dermatitis (13% of patients). This is probably due to the wide distribution of oxybenzone in sunscreens and other cosmetics, 2 patients with polymorphic light eruption and persistent light reactivity, respectively, were regular sunscreen users. Photobiological investigation is necessary to ensure accurate diagnosis, since sunscreen contact or photocontact allergy may simulate other photosensitivity eruptions.

Adult

Carpal tunnel syndrome and systemic sclerosis.

Carpal tunnel syndrome (CTS) was observed in 4 cases of a consecutive series of 16 patients admitted for the initial diagnosis or follow-up of systemic scleroderma from 1986 to 1990. We also observed one case of ulnar nerve compression. Neurological involvement was confirmed by electromyogram, and motor and sensory nerve conduction studies. The neurological signs appeared at the beginning of the disease in two cases and preceded the discovery of scleroderma in two. CTS is not rare in scleroderma and must be carefully sought, both clinically and electrophysiologically. Patients with 'idiopathic' CTS might need clinical follow-up for early diagnosis of scleroderma.

Adult

Schnitzler's syndrome (urticaria and macroglobulinemia) associated with pseudoxanthoma elasticum.

Schnitzler's syndrome, first described in 1974, is defined by chronic non-pruritic urticaria, osteocondentation, and a monoclonal IgM dysproteinemia, but without criteria of lymphoproliferative disease. We report a patient with chronic urticaria and macroglobulinemia. In addition, he had double monoconal dysproteinemia IgM kappa (31.3 g/l) and IgA lambda, osteocondensation, and some cutaneous lesions of pseudoxanthoma elasticum. Only 20 cases of Schnitzler's syndrome have been reported hitherto. This is the first case associated with pseudoxanthoma elasticum, which was localized and discovered at the same time as Schnitzler's syndrome. We discuss the possible role of monoclonal immunoglobulin in the occurrence of localized elastorrexhis.

Aged

[Persistent photosensitivity: treatment with puvatherapy and prednisolone (corticopuvatherapy)].

Eight patients, six men and two women, had chronic photosensitivity of 2.0 +/- 1.1 years' duration. The clinical and photobiological signs were consistent with a diagnosis of chronic actinic dermatitis syndrome. Photosensitivity was extremely severe, and the minimal erythematous dose (MED) in polychromatic light was dramatically decreased in all eight patients (82 +/- 20 mJ/cm2; range: 25-200 for a normal MED range of 1.000 to 2.000 mJ/cm2). Photopatchtests were positive to phenothiazine in four patients, to fragrance mix and oxybenzone in two patients, to balsam of Peru and musk ambrette in one patient each. Seven patients were treated with corticopuvatherapy. They all were markedly improved after one month of treatment, recovering normal MED and outdoor activities. Corticosteroid therapy was gradually reduced and stopped after 3 months, while puvatherapy was continued for several months. Treatment was withdrawn in three patients. The minimal erythematous dose was monitored after discontinuation of therapy: a progressive decrease of MED was observed, accompanied by a relapse in two of the three patients. This relapse was well controlled by another course of corticopuvatherapy. Four other patients had, after discontinuation of treatment, another course of corticopuvatherapy reinstituted in the early spring. Puvatherapy was stopped at the end of october. One patient did not receive corticopuvatherapy because she was living far from a puvatherapy centre. She was treated with azathioprine for 6 months without improvement, then with azathioprine+prednisolone 20 mg daily during 2 years with slight improvement. Corticopuvatherapy is a very efficient means of treating severe chronic actinic dermatitis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult