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Biomedical subjects

M Jeanmougin

Publications and source records attributed to M Jeanmougin.

At least 19 recordsLinked to original sources

[Polymorphic light eruption: prophylaxis using a topical combination of antioxidants and UVA protection formulations].

BACKGROUND: In a recent randomized, double-blind, placebo-controlled clinical study, the efficacy of a combination consisting of 0.25% alpha-glucosyl-rutin, 1% vitamin E and a broad-spectrum, highly UVA-protective sunscreen (sun protector factor 15 - persistent pigmentation darkening 6) regarding prevention of polymorphous light eruption was well demonstrated. We evaluated this combination under real solar exposure conditions. PATIENTS AND METHODS: Patients with three previous typical polymorphous light eruptions (including one in the last year) were included in an open prospective multicenter study. The preparation was applied every two hours after the first summer exposure. No topical or systemic treatments presumed to be effective against polymorphous light eruption were given concomitantly. Evaluation was performed after the summer by a dermatologist. RESULTS: Two of the 54 patients dropped out of the study, one for an adverse effect (contact dermatitis). At the end of the study following application of the test preparation, no eruption was seen for 35 patients (67%), with minor eruption for 10 patients (19%) and an marked eruption for 7 patients (13%). Pruritus (present in all patients the year before) was not seen in 36 patients (69%), was considered bearable for 36 patients and unbearable for only 3 patients compared to 27 before inclusion. For the dermatologists, efficacy was excellent for 35 patients and good for 7 patients, giving global efficacy of around 80%, with inadequate results in 10% of cases (5 patients). Concerning protection against erythema, the test product reduced sunburn by 60% compared with the previous year. DISCUSSION: Because of the high clinical efficacy of the product noted after UVA challenge tests and verified by this clinical study under actual conditions of exposure, it may be proposed as a new prophylactic treatment for polymorphous light eruption.

Administration, Topical↗

Efficacy of photochemotherapy on severe pruritus in polycythemia vera.

Pruritus may cause severe chronic discomfort to PV patients. Most of the usual treatments are not at all or only weakly efficient. Photochemotherapy using psoralen and ultraviolet A light may largely improve the clinical symptom of intractable itching, as observed in ten of the 11 cases presented, but maintenance therapy is generally necessary. The treatment may then improve the patient's quality of life.

Aged↗

[Contact photoallergic eczema caused by ketoprofen].

INTRODUCTION: Since 1983, several cases of allergy and photoallergic contact dermatitis to ketoprofen gel have been reported in Italy and Spain. In France, this drug has been available for topic applications since 1989 and no cases of photoallergy have been reported. CASE REPORT: We observed two cases of photoallergic contact dermatitis to ketoprofen (Profenid gel, Ketum gel). Imputability was suggested by clinical history and proven by patch-tests showing evidence of crossed photoallergy with fenofibrate in both cases. Photoallergic dermatitis to oxybenzone was associated in one case. COMMENTS: Ketoprofen is the predominant nonsteroid anti-inflammatory drug responsible for allergic and/or photoallergic contact dermatitis resulting from topic applications. Its prevalence is probably underestimated in France in light of the number of cases reported in certain Mediterranean countries. Cross reactive photoallergy to ketoprofen and fenofibrate can be explained by the common benzoly-ketone structure of these compounds. In case of skin reaction, the other drug should not be prescribed and benzophenone-containing cosmetics discouraged.

Adult↗

[Fenofibrate photoallergy].

Photosensitization to lipid-lowering fibric acid derivatives are rare. We report a case of photoallergy induced by fenofibrate, proved by a positive UVA photo-patch-test. Evolution towards persistent photosensitization is probable, since photobiological abnormalities persisted during four months after fenofibrate was discontinued. The fact that patch-tests to various benzophenones were negative is not in favour of the benzophenone group being responsible for the photosensitization reaction.

Dermatitis, Photoallergic↗

Photoallergy to hexamidine.

This report details the case of an atopic patient showing a photosensitivity caused by a hexamidine solution. Patch tests were negative but photopatch tests to hexamidine in water solution were positive, after irradiation by ultraviolet A (UVA); all control tests were negative. It is well-known that hexamidine can induce contact allergy but this case was the first reported in which UVA was implicated. This photoallergy can be explained by the structure of the hexamidine molecule, but the question is: why has there never been such a case reported before?

Adult↗

[Diagnosis of photodermatitis].

Detailed questioning and careful analysis of a skin eruption usually lead to the diagnosis of photodermatitis on two major criteria: the eruption is clearly related to a period of exposure to sunlight, and it is localized to, or predominant on, uncovered regions. However, the differential diagnosis with contact eczema of the face or air borne dermatitis due to irritation or allergy is sometimes difficult. The skin lesions of photosensitization result from two physiopathological mechanisms: phototoxicity, a photo-chemical reaction, and photoallergy, an immunoallergic reaction to an antigen formed in the skin after light irradiation. In the evaluation of photodermatitis, photobiological exploration ranks first as it confirms the diagnosis, informs on the mechanism and identifies a possible photosensitizing agent. It is useful in the nosological classification of light eruptions and permits to adjust the treatment according to the responsible photons. Depending on the presumed nature of the photodermatitis studied, various phototests are performed, including Saidman's tests, photochallenge tests, photopatch tests and phototest after reintroduction of a drug.

Humans↗

[External photoprotection].

Sunscreens go beyond the field of cosmetology to enter that of preventive or curative medicine. The anti-sun product is a preparation in which "filters" selective for UVB and/or UVA are associated with mineral powders called "screens" that are either dissolved or dispersed in an excipient. Modern products also contain compounds protecting against free radicals, anti-inflammatory agents, biosynthetic melanin or topical psoralens. Sunscreen efficacy tests provide "protection factors" against UVA and/or UVB, and/or infrared radiations. Testing the resistance of these indices to time and to immersion or sudation is necessary to evaluate the substantiality and remanence of sunscreens. These parameters enable sunscreens to be classified into four families with increasing activities: weak, fair, high and major protection. Protecting healthy subjects against solar radiation requires "common sense" and the choice of a sunscreen based on its dermatological risk depending on the phototype, the circumstances of exposure to sun, the regions exposed and the chemical formula of the compound.

Humans↗