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Biomedical subjects

P Quatresooz

Publications and source records attributed to P Quatresooz.

At least 19 recordsLinked to original sources
PubMed2006

Delayed reepithelialization and scarring deregulation following drug-induced toxic epidermal necrolysis.

A 51-year-old Caucasian woman developed severe drug-induced toxic epidermal necrolysis (TEN) due to allopurinol. The withdrawal of the culprit drug was unfortunately delayed, and dramatic retardation of reepithelialization was observed. At that stage of disease evolution, an inflammatory cell infiltrate was present in the dermis. Coverage of eroded lesions by frozen cultured keratinocyte allografts failed to hasten reepithelialization compared to ungrafted sites. This unusual protracted TEN evolution was followed by the development of extensive hypertrophic and keloid scars. Several biopsies were taken over 6 months. The histologic presentation of the grafted and ungrafted eroded scar tissues looked similar. Both the number and size of the Factor XIIIa-positive dermal dendrocytes, as well as the number of alpha-actin-positive myofibroblasts showed a marked increase between weeks 2 and 12 after grafting. They were reduced after 6 months when the scarring process was stabilized. alpha1 [IV] collagen was never expressed over the eroded scars. Similar to burn patients, delayed reepithelialization might be a risk factor for abnormal scarring in TEN. Cultured keratinocyte allograft apparently offered no improvement in reepithelialization and did not prevent abnormal scarring in this TEN patient.

Allopurinol↗
PubMed2006

Skin immunoglobulin deposition following intravenous immunoglobulin therapy in toxic epidermal necrolysis.

Human intravenous immunoglobulins (IVIg) which contain anti-CD95 antibodies have been proposed to treat toxic epidermal necrolysis (TEN). Presently, there is no evidence that IVIg reach the keratinocytes in TEN patients. The aim of this study was to assess the Ig distribution in the serum, blister fluid and skin of six consecutive TEN patients treated with IVIg (1 g/kg/day) for 3 days. They were compared with five TEN patients who only received supportive therapy. In all patients, IgA, IgM and IgG concentrations were measured in the serum and blister fluid using an immuno-nephelometric method. Immunohistochemistry was performed on skin biopsies taken from both TEN clinically involved and uninvolved skin to search for IgG deposits. On admission, the IgG concentrations were significantly higher in both TEN serum and TEN blister fluid compared with their respective IgA and IgM contents. The IgG, IgA and IgM concentrations in blister fluid were significantly lower than their respective serum concentrations. The serum and blister fluid IgG concentrations, but not that of IgA and IgM, were markedly increased at the completion of the IVIg treatment. By contrast, they remained unchanged in the TEN patients that were untreated with IVIg. In the IVIg-treated patients, the IgG intraepidermal deposits raised markedly in both TEN-involved and uninvolved skin. This was not the case in patients who did not receive IVIg. These results suggest that IVIg perfusions brought a prominent increase in IgG concentration in the serum, blister fluid and epidermis of both TEN-involved and clinically uninvolved skin. The presence of potentially protective IgG in TEN epidermis following IVIg treatment could help limiting the disease progression.

Adolescent↗
PubMed2006

Healing effect of ketanserin on chronic leg ulcers in patients with diabetes.

BACKGROUND: The treatment of chronic leg ulcers remains a stubborn problem in many patients. Topical 2% ketanserin ointment, a 5HT2-serotoninergic blocking agent, has been reported to improve healing of decubitus, venous, diabetic and ischaemic ulcers. METHOD: The present double-blind intra-individual comparative study was performed in 12 women with diabetes presenting with at least two similar leg ulcers. In each subject, the two lesions were randomly assigned to be treated for 8 weeks by 2% ketanserin ointment or its unmedicated vehicle. OBJECTIVE: assessments of the dynamics of wound healing were performed using computerized morphometry. Evaluations were performed at 2-week intervals for 8 weeks. RESULTS: A significant decrease in relative wound area was observed on the ketanserin-treated ulcers compared with the placebo group. CONCLUSION: Topical ketanserin is a valuable therapy for difficult-to-treat leg ulcers.

Administration, Cutaneous↗
PubMed2006

Cutaneous myospherulosis and membranous lipodystrophy: extensive presentation in a patient with severe steroid-induced dermal atrophy.

Myospherulosis is a rare disorder that may develop in various organs including the skin. It is characterized by a typical histological presentation resulting from the interaction between erythrocytes and lipids. We present a case of cutaneous myospherulosis associated with membranous lipodystrophy. The lesions were supervening on severe steroid-induced skin atrophy upon which ointments had been applied.

Atrophy↗
PubMed2006

[Hic et Nunc. Naevus or melanoma?].

In Wallonia, the incidence of cutaneous melanoma has steadily increased over the past decades. Hopefully, the early diagnosis made at the premetastatic stage has benefited from great advances both in the clinical and laboratory fields. Thanks to the "Groupement Oncologique Universitaire Wallonie-Liège" (GOUWL) organization, some efforts are currently made in order to better frame and normalize the management of cancer patients. Some medical staffs involved in prospective clinical research bring by their own experience further practical insights for the benefit to the patients. In this field, Belgium is not destituted. We report a brief review of the contribution of the Mosan Study Group of Pigmentary Tumors (GMETP) at the University Hospital of Liège.

Belgium↗
PubMed2006

[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↗
PubMed2006

[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↗
PubMed2005

Tensegrity and type 1 dermal dendrocytes in acromegaly.

BACKGROUND: Skin is enlarged and doughy in acromegaly. Alterations have been reported in the structure of the extracellular matrix (ECM) and in the mechanical properties of the dermis. It is recognized that internal tensions in the dermis give rise to active cell-ECM and cell-cell mechanical interactions. This mechanobiological aspect can lead to functional and conformational changes in the cells. Such alterations in connective tissue cells have not been explored so far in acromegaly. The aim of the study was to assess structural changes in the dermal ECM, and in the number and shape of factor XIIIa-positive type I dermal dendrocytes (DDs) in acromegaly. MATERIALS AND METHOD: A total of 32 patients with acromegaly (three untreated, 17 with active disease under somatostatin analogues and 12 cured) were examined. Both the maximum and the most recent IGF-1 (insulin-like growth factor) dosages recorded in the patients' files were retrieved. Skin biopsies were taken from their forearms. Histochemistry, immunohistochemistry, morphometry and electron microscopy were used. RESULTS: Collagen-bundle coarsening and acidic glycosaminoglycan deposits were found irrespective of the current endocrine status. Dermal dendrocytes were often markedly reduced in numbers, but those present were plump with few dendrites. A negative correlation was found between DD numbers and the maximum IGF-1 dosages recorded in the patients' files. A similar although weaker trend was found with the most recent IGF-1 dosages. CONCLUSIONS: Collagen, glycosaminoglycans and DDs appeared affected in acromegaly, even when the hormonal status was controlled after surgery and/or somatostatin analogue treatment. The persisting conformational change of DDs suggests a modification in cellular tensegrity, perhaps initiated by hormonal effects and probably maintained by alterations in the ECM interactions.

Acromegaly↗
PubMed2005

[How I explore...a disorder with an apparently healthy microscopic aspect of the skin].

Some dermatologic disorders named "Invisible dermatoses" are defined by obvious clinical signs while histologic alterations remain discrete. This situation may lead to clinico-pathological discrepancies impeding the establishment of a diagnosis. In other cases, the skin looks clinically normal but the histological examination allows to disclose some systemic diseases. Systematic analysis of the skin biopsy complemented by histochemical and immunohistochemical techniques may help reach the diagnosis.

Biopsy↗
PubMed2005

[How I treat ... atopic dermatitis by topical pimecrolimus (Elidel). The emerging paradigm of calcineurin inhibitors].

Topical calcineurin inhibitors, also called topical immunomodulators or downregulators, represent an innovative class of non-steroidal anti-inflammatory agents. Pimecrolimus 1% cream (Elidel) is one representative drug available for the treatment of atopic dermatitis. Unlike topical steroids, this drug does not affect collagen synthesis and does not alter the dendritic cell functions and the barrier function of the skin.

Calcineurin Inhibitors↗
PubMed2005

[Cellular photobiology].

The various cell lines of the epidermis and dermis can be activated or conversely altered by actinic irradiations. Keratinocytes, melanocytes, Langerhans cells and connective tissue cells are the main targets.

Humans↗
PubMed2005

[Helioderma, heliophiles and heliophobes].

The cumulative effect of lifelong sun exposures induces skin alterations which are coined helioderma. The manifestations of helioderma vary according to the body site. This is particularly the case for the prominent differences in the expression of solar elastosis. This condition is commonly more severe on the face and nape of the neck than on the forearms and back of the hands. The age, phototype and behaviour regarding sun exposure are cofactors responsible for the severity of solar elastosis.

Elastin↗
PubMed2005

[Skin cancer and sunlight].

Most of the cutaneous carcinomas and melanomas are photo-induced cancers. By contrast, some cutaneous lymphomas are inhibited by light exposure. The annual incidence of photo-induced cancers is steadily on the rise.

Carcinoma↗
PubMed2005

[How I treat ... basal cell carcinoma by imiquimod].

Basal cell carcinoma is the most frequent cancer in humans. Several clinical types are distinguished. They are bound to distinct evolutive prognosis. The surgical excision is the treatment of choice which is rarely followed by recurrence. However, when the lesion is superficial and non aggressive and when the body site is adequate, topical applications of imiquimod can provoke the neoplastic regression. This type of immunotherapy brings 70 to 90% complete remission. A medical follow-up of the treated site is mandatory for a couple of years.

Adjuvants, Immunologic↗
PubMed2005

[How I treat ... lentigo maligna by topical imiquimod].

Lentigo maligna is a special form of in situ cutaneous melanoma that develops on the face of sun worshipers. The topic immunostimulator imiquimod can destroy the neoplasm before it expresses its invasive potential. A strict clinical follow-up of the treated zone must be observed at least 5 years to detect any early sign of recurrence.

Administration, Topical↗
PubMed2004

[How I treat... the critical bacterial colonization of a leg ulcer. The Yin and the Yang features of silver-based dressings].

The critical bacterial colonizaion of leg ulcers can impair their healing rate, aggravate the patient discomfort and increase the medical and nursing costs. In recent times, the dressings designed for leg ulcers have followed a pace of conceptual revolution. Some of them are now offered containing an antiseptic of the silver salt family. The silver concentraton delivered into the wound bed is important to consider when assessing treatment efficacy. The diversity of the silver-based dressings currently on the European market is as large as their differences in activity. Only a minority of these dressings adequately control the wound biocenosis. Their cost which is high for the patient, must be compared to that of nursing care that may become less important. The expected beneficit is a reduction in healing time.

Anti-Infective Agents, Local↗
PubMed2004

[Anatomo-clinical confrontation. Vulvar melanosis].

Vulvar melanosis is a benign disorder that may suggest a malignant melanoma. We report the case of a woman in whom partial vulvectomy was performed to eradicate the melanotic macule. The lesion corresponds to increased accumulation of melanin inside keratinocytes in the absence of any melanocytic neoplasm.

Female↗