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P Célérier

Publications and source records attributed to P Célérier.

10 recordsLinked to original sources
PubMed1998

[Cutaneous Scedosporium infection revealed by bullous-necrotic purpura].

BACKGROUND: Non-mycetomatous cutaneous scedosprium is an uncommon mycosis observed in immunodepressed subjects. We report a case with an inaugural presentation of bullous and necrotic purpura. CASE REPORT: A 79-year-old man on intermittent corticosteroid therapy for bronchospasm was admitted for bullous and necrotic purpura and fever. Subcutaneous nodules with a sporotrichoid aspect developed despite wide-spectrum antibiotics. Microbiology samples cultured on Sabouraud medium evidenced Scedosporium apiospermum. The pathogenic nature of the infection was proven on a skin biopsy showing numerous myceleal filaments with Gomori-Grocott staining despite negative PAS. No pulmonary involvement was evidenced. The patient was treated unsuccessfully with itraconazole. A Pseudomonas lung infection was fatal. DISCUSSION: Scedosporium apiospermum, an ubiquitous ascomycetes anamorphous to Pseudallescheria boydii, is the cause of a growing number of human infections due to widespread use of immunosuppressors. Skin and lung localizations predominate. The inaugural bullous and necrotic purpural skin manifestations in this case are unusual. In addition, the patient was only minimally immunodepressed and despite demonstrated in vitro sensitivity, itraconazole was ineffective clinically. Treatment is not well defined, but surgery is essential in combination with empirically chosen antifungals.

Aged↗
PubMed1997

Keratinocyte-lymphocyte interaction in cutaneous T-cell lymphoma. Modulation of keratinocyte antigen My7 by a soluble factor produced by T lymphocytes.

OBJECTIVE: To test the hypothesis that the modulation of My7 antigen in the basal keratinocytes is directly related to the effect of dermal lymphocyte infiltrate of epidermotropic cutaneous T-cell lymphoma (CTCL). DESIGN: In vitro study with reconstituted skin model. SETTING: Department of Dermatology of University Hospital, Nantes, France. PATIENTS: Lymphocytes extracted from 11 skin samples with lesions of epidermotropic CTCL (mycosis fungoides, stages IIa to IV) and 6 skin samples with lesions of atopic dermatitis (control population) together with the supernatants of these infiltrating lymphocytes were incubated with normal reconstituted skin samples either alone or in the presence of interferon alfa-2a (10(2) IU/ mL). Moreover, normal peripheral blood mononuclear cells of 7 patients and 4 controls were incubated with reconstituted skin. INTERVENTION: None MAIN OUTCOME MEASURES: None. RESULTS: Ten of 11 samples of lymphocytes extracted from CTCL and 7 of 11 of their supernatants inhibited partially or completely My7 expression by basal cells. NO inhibition was noted for lymphocytes extracted from inflammatory skin or their supernatants. Addition of interferon alfa-2a in a culture medium of extracted lymphocytes or their supernatants blocked inhibition of My7 expression by keratinocytes in 8 of 10 reconstituted skin samples. No abrogation of My7 expression was noted with peripheral mononuclear cells. CONCLUSIONS: Our in vitro study demonstrated a direct and specific interaction between the tumor infiltrate of CTCL and keratinocytes. Moreover, this interaction appeared to be closely associated with a soluble factor produced by the tumor T-cell infiltrate and was at least partially blocked by interferon alfa-2a.

Antibodies, Monoclonal↗
PubMed1995

[Autochthonal leprosy].

INTRODUCTION: In continental France, Hansen's disease is now a strictly imported disease. Native contamination is rare since the foyers described early in the century have totally disappeared. CASE REPORT: A case of locally acquired diffuse lepromatous Hansen's disease was observed in a patient who developed acrocyanosis with distal necrosis over a period of several years. Late cutaneomucal signs led to the diagnosis of Hansen's disease after eliminating sarcoidosis and tuberculosis. Skin biopsy with Ziehl stain confirmed the lepromatous nature of the disease. In addition the patient had undergone splenectomy following trauma and also developed babesiasis (a rare protozoan disease in Europe--15 cases reported--similar to Texas fever). DISCUSSION: The source of infection in this case of Hansen's disease was not found. As in the other cases reported in the literature, late diagnosis due to lack of any suggestive context allowed the disease to develop into an advanced stage.

Amputation, Surgical↗
PubMed1993

[Combination of fotemustine-dacarbazine and interferon alpha in the treatment of metastatic malignant melanoma].

In the treatment of disseminated malignant melanoma (DMM), the results obtained with fotemustine associated or not with dacarbazine are promising and those obtained with interféron alpha are also interesting. Therefore, we have investigated the efficacy and the toxicity of a combined chemotherapy with fotemustine-dacarbazine and interferon alpha in DMM. We present in this work our results on 44 patients who entered into this opened study. 37 patients were evaluable. 29 (78.4 p. 100) had previously received one or more cytotoxic chemotherapy. The regimen consisted of an induction treatment with fotemustine (100 mg/m2) on days 1.8, and 60 dacarbazine (400 mg/m2) on days 1, and 60 and subcutaneous injections of interféron (9.10(6) UI) alpha three times weekly. Responding and stabilized patients were given maintenance treatment with a monthly infusion of fotemustine (100 mg/m2) and dacarbazine (400 mg/m2) and interferon alpha carried on at the same dose. The response rate was 10.8 p. 100 (3 PR + 1 CR). Responses have depended on metastatic sites (cerebral site 18,2 p. 100). The median duration of response was 28 weeks. Toxicity was mainly hematologic and was acceptable. These results are not as good as those reported before with fotemustine and dacarbazine. Even if reasons related to patients and protocol could be discussed, the association of interferon alpha, fotemustine and dacarbazine seems devoid of interest during induction treatment.

Adult↗