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L Verneuil

Publications and source records attributed to L Verneuil.

18 recordsLinked to original sources
PubMed2003

Acute fungal pustulosis on a bedridden patient's back.

We report a particular dermatophytosis due to Trichophyton rubrum. A 61-year-old woman presented an eruption which quickly evolved within 48 h, consisting of papular annular patches surrounded by creamy white pustules, which sometimes coalesced. The eruption was exclusively located on the back. The rest of the body and skin examination was normal, and the patient had no temperature. The mycological sample revealed mycelial filaments in the direct microscopic examination and T. rubrum in the mycological culture. Only a few cases of pustular lesions due to T. rubrum are reported in the literature. The extensive character, the site and the inflammatory aspect of the lesions were very surprising. This clinical presentation is more frequent with geophilic and zoophilic organisms than with anthropophilic dermatophytes such as T. rubrum.

Acute Disease↗
PubMed2001

Improvement of nonviral p53 gene transfer in human carcinoma cells using glucosylated polyethylenimine derivatives.

Polyethylenimine (PEI) derivatives are potent polycationic nonviral vectors for gene transfer. The gene transfer efficiency of glucosylated and galactosylated PEI derivatives was optimized using green fluorescent protein gene as reporter gene in FaDu and PANC3 human carcinoma cell lines. Glucosylated or galactosylated PEI derivatives were found to be slightly less cytotoxic than unsubstituted PEI. Gene transfer efficiency was found to be related to DNA/cell number ratio and optimal gene transfer efficiency was achieved at 4 microg DNA/10(5) cells. PEI-DNA complexes were found to enter cells rapidly and were detected into cytoplasmic vesicles 2 hours post-transfection. Green fluorescent protein gene expression was detected 4-6 hours after transfection and reached maximal value 24 hours post-transfection. The results achieved demonstrated that glucosylated PEI yield higher and longer gene transfer efficiency than unsubstituted PEI. Using glucosylated PEI allowed to achieve significant gene transfer in more than 10% of the total cell population for more than 4 days. These data were then applied to p53 gene transfer in PANC3 cells bearing p53 gene deletion and consequently unable to initiate apoptosis. Using glucosylated PEI, p53 gene transfer was successfully achieved with subsequent recovery of p53 mRNA expression and transient P53 protein expression. P53 protein functionality was further demonstrated because transfected cells underwent apoptosis.

Apoptosis↗
PubMed2001

Interstitial granulomatous dermatitis with cutaneous cords and arthritis: a disorder associated with autoantibodies.

Interstitial granulomatous dermatitis with arthritis is a new entity characterized by linear or arciform subcutaneous cords. We describe a patient presenting with typical cutaneous lesions extending from the anterior and posterior part of the axillae to the flank. The lesions had been present for 6 years with flares and remission. Histopathologic examination revealed a bandlike infiltrate of histiocytes in the reticular dermis with focal areas of palisading around necrotic collagen bundles. A few atypical histiocytes were also present. As previously described, it was associated with serologic findings of an autoimmune disease, especially high titers of anti-DNA antibodies. The possible inclusion of the interstitial granulomatous dermatitis in the continuous spectrum of the palisaded neutrophilic and granulomatous dermatitis of immune complex disease is also discussed.

Aged↗
PubMed2000

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↗
PubMed2000

Photoscratch testing in systemic drug-induced photosensitivity.

Because of numerous false-negative results, photopatch testing is seldom relevant in systemic drug-induced photosensitivity. These false-negative photopatch test results can be attributed to the inability of the drug to penetrate into the epidermis. In order to enhance the penetration of the tested drug into the epidermis, some authors proposed to breach the cutaneous barrier. We performed a prospective study comparing photopatch and photoscratch testing. Fifteen patients presenting with a systemic drug-induced photosensitivity, proved by a favourable outcome after discontinuing the drug, were tested. For each drug, photopatch and photoscratch tests were performed. Two-thirds of the patients had negative photopatch and photoscratch tests with the suspected drugs. Photopatch and photoscratch tests were positive and relevant, respectively, in 3 and 4 patients. Photoscratch tests induced more false-positive results due to irritation confirmed on control subjects. Our study proves that photoscratch tests do not change the sensitivity of phototesting.

Adult↗
PubMed2000

[Localized bullous pemphigoid following radiotherapy].

BACKGROUND: Bullous pemphigoid is the most frequent autoimmune blistering dermatologic disease. Induction of pemphigoid has been observed after administration of certain drugs but also after various irradiation procedures. We report a case of pemphigoid strictly confined to the irradiated area. CASE REPORT: A 66-year-old woman had been irradiated 16 years before because of a breast carcinoma. She presented with a blistering rash strictly confined to the irradiated area. The diagnosis of pemphigoid was confirmed with pathologic examination, direct immunofluorescence, direct immunofluorescence of sodium chloride-separated skin, electron microscopy and immunoelectron microscopy. Indirect immunofluorescence and serum immunoblot were also positive. The patient was successfully treated with topical steroids. DISCUSSION: The location on the area of radiotherapy and the limited character of lesions were unusual. A few cases of pemphigoid strictly localized to the area of radiotherapy have been published. However, in our case, only direct immunofluorescence and immunoelectron microscopy reliably confirmed the diagnosis. The unusual location of this pemphigoid is not due to the regional variation in the expression of the antigen. Other hypotheses concerning the pathogenesis of localized pemphigoid should be examined.

Adenocarcinoma↗
PubMed1999

Hypersensitivity syndrome due to 2 anticonvulsant drugs.

Drug-induced hypersensitivity syndrome is a multiorgan-system reaction characterized by fever, pleomorphic eruption, lymphadenopathy, eosinophilia, lymphocytosis and hepatitis. We report a drug hypersensitivity syndrome in a 6-year-old Tunisian child treated for epileptic absences with sodium valproate and ethosuximide. Imputability of these 2 drugs is probable because of the chronological and clinical features. Positive rechallenge with ethosuximide confirmed the toxicity of this drug. Sodium valproate was also responsible because patch testing was positive and followed by a generalized eruption. Human herpesvirus 6 (HHV6) antibody titers increased significantly within 15 days. There was a favourable outcome after discontinuation of the drugs and corticosteroid therapy. Our case is interesting because this drug hypersensitivity syndrome occurred with non-aromatic anticonvulsant drugs. It is the 1st case with ethosuximide and the 2nd with sodium valproate. We also observed a reactivation of HHV6 infection that may contribute to the development of this hypersensitivity syndrome.

Antibodies, Viral↗
PubMed1999

[Cutaneous sensitivity to histoplasmin in a Martinique hospitalized population].

OBJECTIVE: Histoplasma capsulatum infection is considered to be endemic in the West Indies. Nevertheless, few epidemiologic studies have been conducted in this area. The histoplasmin skin test reflects the frequency of asymptomatic forms of histoplasmosis. We studied the prevalence of positive skin tests in a population of the French West Indies (Martinique). MATERIALS AND METHODS: Forty one patients (24 females and 17 males), age range 29 to 90 years, were tested for histoplasmin skin sensitivity between August and October 1997, in the department of dermatology of Fort de France (French West Indies). Patients with immunosuppression or personal history of histoplasmosis were excluded. RESULTS: Five patients had a positive skin test (12 p. 100). No significative association was found between a positive skin test and diabetes, rural occupations or exposure to bats. DISCUSSION: Despite the small number of cases, related with difficulties in obtaining histoplasmin, our study showed a sensitivity level similar to medium endemic areas of the USA. The positive skin test rate is much higher than the rate reported before in West Indies, in a sample of the population under 25 years of age.

Adult↗
PubMed1995

[Cryptococcal whitlow in a HIV positive patient].

INTRODUCTION: Cutaneous cryptococcosis is a systemic fungal disease; it is commonly observed in immunocompromised patients. OBSERVATION: We report the case of a cryptococcal whitlow in an HIV positive patient. The mycologic culture of the cutaneous lesion was positive for Cryptococcus neoformans serotype D. The detection of the blood antigen was positive but there was no pulmonary nor central nervous system involvement. The lesions cured with fluconazole (400 mg/day during 2 months and 200 mg/day after). DISCUSSION: This unusual clinical presentation of cutaneous cryptococcosis has never been reported in an HIV positive patient. As the dermatologic manifestations of cryptococcosis are polymorphous mycologic examination of skin lesions is very important.

Aged↗
PubMedDate not supplied

Epidemiology of histoplasmosis in the French West Indies (Martinique).

The Caribbean islands are presumed to be an endemic zone for Histoplasma capsulatum infection, but no epidemiological studies have been done in this area. Our purpose was to report the epidemiology of histoplasmosis from 1991 to 1997 in the French West Indies (Martinique). Cases identified from the register of the mycology laboratory were analysed retrospectively. Ten cases (9 male and 1 female) were identified; 8 of the patients were infected with HIV (average T4 lymphocyte count in these 8 patients was 32/mm3). Eight patients had cutaneous involvement. The incidence in AIDS patients was 1.7%. The annual incidence in the general population was 0.34/100,000. Our data showed that histoplasmosis is endemic in Martinique, with an incidence in AIDS patients slightly inferior to that in endemic areas of the USA. The high rate of cutaneous forms (80%) is uncommon.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[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↗
PubMedDate not supplied

[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↗
PubMedDate not supplied

[An association of paraneoplastic syndromes in a patient].

BACKGROUND: Erythema gyratum repens is a rare cutaneous marker for internal malignancy and the association with other paraneoplastic syndromes is not unusual. CASE REPORT: We report the case of a 54 year-old man with a three-month history of erythroderma which evolved into erythema gyratum repens; a bronchial carcinoma was discovered. Erythema gyratum repens was associated with acquired ichthyosis, hyperkeratosis of the ears and eosinophilia. Improvement of the paraneoplastic dermatosis was achieved by treatment of the underlying carcinoma with chemotherapy, surgery and radiation. However, the lesions relapsed when metastases appeared. Another regimen of chemotherapy improved the carcinoma and the dermatosis. DISCUSSION: The parallel course of the carcinoma and the cutaneous eruption strongly supports the diagnosis of a cutaneous paraneoplastic syndrome. Three months prior to erythema gyratum repens, the patient developed a scaling erythroderma. This unusual early manifestation is misleading. Our case highlights the possible association of different paraneoplastic syndromes: initially scaling erythroderma, followed by erythema gyratum repens associated with acquired ichthyosis, hyperkeratosis of the ears and eosinophilia.

Adenocarcinoma↗