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Biomedical subjects

L Thirion

Publications and source records attributed to L Thirion.

9 recordsLinked to original sources

[Cutaneous vasculitis with necrotic ulcers in rheumatoid arthritis: treatment with anti-TNFalpha].

INTRODUCTION: Anti-TNFalpha has occasionally been used in the treatment of recalcitrant forms of systemic vasculitis such as Behçet's disease, Wegener's granulomatosis and Churg-Strauss syndrome. We report on the outcome of treatment in rheumatoid arthritis patients with cutaneous vasculitis lesions on anti-TNFalpha. OBSERVATIONS: Two patients with rheumatoid arthritis present for several years had necrotic ulcers of the lower limbs due to cutaneous vasculitis. After the failure of various immunosuppressive drugs (cyclophosphamide, azathioprine, methotrexate), the two patients were treated with anti-TNFalpha: infliximab in the first case and adalimumab in the second. Cutaneous ulcers healed within two to four months of the start of anti-TNFalpha treatment. Despite ongoing anti-TNFalpha treatment, these cutaneous ulcers relapsed four to six months after complete healing. CONCLUSION: Initially spectacular healing of cutaneous vasculitis ulcers under anti-TNF alpha treatment followed by relapse after several months of treatment is suggestive of an escape mechanism.

Adalimumab↗

A novel method of comparing the healing properties of two hydrogels in chronic leg ulcers.

Skin ulcers on the legs have a chronic, relapsing course and are often a significant management challenge. Novel methods of measuring and comparing the effects of different treatments can be of assistance in addressing this situation. A clinical pilot study using original methods was undertaken to compare the healing properties of the alginate gel Flaminal (test) and the hydrocolloid gel Intrasite (control) on chronic leg ulcers. The study was performed over a period of 28 days with two parallel groups of 10 patients. Both the surface (acetate tracing and planimetry) and the volume (Jeltrate mould impression and weighting) of each wound were measured at baseline and after 7, 14 and 28 days of treatment. On both parameters results were superior with the test product compared to the control, with volume reduction being the first parameter to change. Between groups, difference in wound volume reduction was detected as early as day 7 whereas difference in surface reduction was clearly apparent only at day 28. Correlation between wound surface and volume reductions was also better in the test group (r = 0.843 vs. 0.421) than in the control. In conclusion, this pilot study suggests that combining wound surface and volume evaluations allows a more precise analysis of the healing process in venous leg ulcers and that this method is able to detect very early differences in treatments even with limited sample size.

Administration, Cutaneous↗

[Cutaneous signs of endocrinopathies].

Some cutaneous lesions accompany or reveal endocrine disorders. Identifying the endocrinopathy is very important because it sometimes allows corrective rather than symptomatic treatment. The most frequenly involved diseases include thyrotoxicosis, hypothyroidism, the auto-immune disorders of thyroid, Cushing syndrome, Addison disease, acromegaly, androgen-dependent disorders, hypopituitarism, hypoparathyroidism, pseudohypoparathyroidism and diabetes mellitus.

Endocrine System Diseases↗

[The skin and menopause].

The estrogen deficit occurring at menopause manifests itself under various modalities in the diverse organs and their functions. Skin does not escape this global involutive process. In addition to the effects of chronological ageing, sunlight exposure and other environmental and endogenous stimuli, the climacteric appears to exert some dramatic consequences on skin biology and aspect. The epidermis, its adnexae and the dermis are altered by this process. The epidermis may become xerotic and exhibits altered functions. The dermis thins out and its elasticity decreases in concert with the decline in bone mass. The skin microcirculation is impaired. These aspects are some of the better-worked out skin climacteric changes of which in turn seem to be stabilized or in part reversible with hormone replacement therapy (HRT).

Female↗

[How I treat...diaper dermatitis].

Diaper dermatitis is the most frequent skin disorder of the newborn. Several clinical types are distinguished. The most frequent type results from increased fragility of the newborn buttock skin when covered by diapers. According to the mechanisms involved and the severity of the dermatitis, one can distinguish the intertrigo of the chubby baby, and the so-called "W", "Y" and "red panties" types of diaper dermatitis. When the effects of occlusion are not controlled by adequate absorption by the diapers maceration of the stratum corneum occurs. As a result, degradation of the skin barrier function takes place. In addition, the value of the coefficient of friction of the skin increases with epidermal weakening to rubbing. In addition, fecal enzymes alter urines and skin. Judicious hygiene measures and a correct choice of care and diapers are mandatory. Cutaneous colonisation by microorganisms, in particular the yeasts Candida spp, is the main complication. Adequate preventive and curative measures can combat diaper dermatitis with confidence. A miconazole paste allows to improve the tribological properties of the interface between diapers and the skin. It also corrects the degradation of the skin barrier function, reduces inflammation and abates the impact of Candida spp. in the pathogenesis of the skin disorder.

Antifungal Agents↗

[Pimecrolimus (Elidel) for a variety of skin diseases].

Pimecrolimus is an immune downregulator that belongs to the class of calcineurin inhibitors. Its efficacy is recognized for the topical treatment of the mild to moderate types of atopic dermatitis. In addition, the drug shows activity in a series of other dermatitides. We report a review of the international literature about this topic.

Dermatologic Agents↗

[Linear dermatosis].

Some typical distributions of skin lesions represent a helpful sign for the differential diagnosis in dermatology. Indeed, some dermatoses, affecting the skin, nails or mucosae, display an annular or linear disposition. The linear pattern can be explained by several factors. The dermatosis can follow either a nerve traject, vascular or lymphatic vessels, or embryological lines. Exogenous factors, including traumatisms or automutilations, can also contribute to this particular distribution. In this review, the principal linear dermatoses are discussed together with their pathogenesis.

Humans↗