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Ingen-Housz-Oro S, Guichard E, Milpied B, Bensaid B, Collet E, Barbaud A, Le Duff F, Tétart F, Soria A, Machet L, Descamps V, Monestier S, Pasteur J, Morice C, Chaby G, Colin A, Grégoire L, Allanore L, Giraudeau B, Chosidow O. Topical versus oral corticosteroids in moderate drug reaction with eosinophilia and systemic symptoms (DRESS): a multicenter randomized clinical trial. J Am Acad Dermatol 2024:S0190-9622(24)00745-X. [PMID: 38754628 DOI: 10.1016/j.jaad.2024.04.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/04/2024] [Accepted: 04/22/2024] [Indexed: 05/18/2024]
Affiliation(s)
- Saskia Ingen-Housz-Oro
- Dermatology department, Henri Mondor hospital, AP-HP, Créteil, France; French Investigators for Skin Adverse Reactions to Drugs (FISARD) group, Paris, France; Refence center for toxic bullous diseases and severe drug reactions TOXIBUL, Créteil, France; Univ Paris Est Créteil EpiDermE, Créteil, France
| | | | - Brigitte Milpied
- French Investigators for Skin Adverse Reactions to Drugs (FISARD) group, Paris, France; Dermatology department, CHU Bordeaux, Bordeaux, France
| | - Benoit Bensaid
- French Investigators for Skin Adverse Reactions to Drugs (FISARD) group, Paris, France; Dermatology department, CHU Edouard Herriot, Lyon, France
| | - Evelyne Collet
- French Investigators for Skin Adverse Reactions to Drugs (FISARD) group, Paris, France; Dermatology department, CHU Dijon, Dijon, France
| | - Annick Barbaud
- French Investigators for Skin Adverse Reactions to Drugs (FISARD) group, Paris, France; Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Tenon, Département de dermatologie et allergologie, Paris France
| | | | - Florence Tétart
- French Investigators for Skin Adverse Reactions to Drugs (FISARD) group, Paris, France; Dermatology department, CHU Charles Nicolle, Rouen, France
| | - Angèle Soria
- French Investigators for Skin Adverse Reactions to Drugs (FISARD) group, Paris, France; Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Tenon, Département de dermatologie et allergologie, Paris France
| | | | - Vincent Descamps
- French Investigators for Skin Adverse Reactions to Drugs (FISARD) group, Paris, France; Dermatology department, Bichat hospital, APHP, Paris, France
| | | | - Justine Pasteur
- French Investigators for Skin Adverse Reactions to Drugs (FISARD) group, Paris, France; Dermatology department, Hôpital Estaing, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Cécile Morice
- French Investigators for Skin Adverse Reactions to Drugs (FISARD) group, Paris, France; Dermatology department, CHU Caen, Caen, France
| | | | - Audrey Colin
- Dermatology department, Henri Mondor hospital, AP-HP, Créteil, France
| | - Laëtitia Grégoire
- Unité de Recherche Clinique, Henri Mondor hospital, APHP, Créteil, France
| | - Laurence Allanore
- Dermatology department, Henri Mondor hospital, AP-HP, Créteil, France; French Investigators for Skin Adverse Reactions to Drugs (FISARD) group, Paris, France
| | - Bruno Giraudeau
- INSERM CIC1415, CHRU de Tours, Tours, France; Université de Tours, Université de Nantes, INSERM, SPHERE U1246, Tours, France
| | - Olivier Chosidow
- French Investigators for Skin Adverse Reactions to Drugs (FISARD) group, Paris, France; Facial Dermatosis Clinic, ENT Department Hôpital Universitaire Pitié-Salpêtrière, AP-HP, Paris, France.
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2
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Stefanski M, Le Guern A, Visseaux L, Ehret M, Colomb M, Jeudy G, Le Duff F, Vourc'h M, Baroudjian B, Perea-Villacorta R, Bernigaud C, Mallet S, Norberciak L, Debarbieux S, Perrot JL, Grange F, Modiano P, Monnier J, Bahadoran P. Real-life practice of reflectance confocal microscopy in France: A prospective multicenter study. J Am Acad Dermatol 2024:S0190-9622(24)00383-9. [PMID: 38387851 DOI: 10.1016/j.jaad.2024.01.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/03/2023] [Accepted: 01/10/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Studies demonstrating the potential utility of reflectance confocal microscopy (RCM) have been performed under experimental conditions. OBJECTIVE To provide an overview of RCM practice in real-life. METHODS A multicenter, prospective study carried out in 10 university dermatology departments in France. RESULTS Overall, 410 patients were enrolled. One-half of the patients (48%) were referred by private practice dermatologists. They were referred for diagnosis (84.9%) or presurgical mapping (13%). For diagnosis, the lesions were located on the face (62%), arms and legs (14.9%), and trunk (13.6%), and presurgical mapping was almost exclusively on the face (90.9%). Among those referred for diagnosis, the main indication was suspicion of a skin tumor (92.8%). Of these, 50.6% were spared biopsies after RCM. When RCM indicated surgery, histology revealed malignant lesions in 72.7% of cases. The correlation between RCM and histopathology was high, with a correlation rate of 82.76% and a kappa coefficient of 0.73 (0.63; 0.82). LIMITATIONS This study was performed in the settings of French tertiary referral hospitals. CONCLUSION This study shows that in real-life RCM can be integrated into the workflow of a public private network, which enables a less invasive diagnostic procedure for patients.
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Affiliation(s)
- Marion Stefanski
- Department of Oncodermatology, Reims University Hospital, Reims France; Department of Dermatology, Saint Vincent de Paul Hospital, Hospital Group of the Catholic Institute of Lille, Lille, France
| | - Aurore Le Guern
- Department of Dermatology, Saint Vincent de Paul Hospital, Hospital Group of the Catholic Institute of Lille, Lille, France
| | | | - Marine Ehret
- Department of Dermatology, Emile Muller Hospital, Mulhouse, France
| | - Michel Colomb
- Department of Oncodermatology, Reims University Hospital, Reims France
| | - Géraldine Jeudy
- Department of Dermatology, Dijon University Hospital, Dijon, France
| | - Florence Le Duff
- Department of Dermatology, Nice University Hospital, Nice, France
| | - Morgane Vourc'h
- Department of Dermatology, Nantes University Hospital, Nantes, France
| | | | - Rosa Perea-Villacorta
- Department of Dermatology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | | | - Stéphanie Mallet
- Department of Dermatology and Skin Cancers, La Timone Hospital, AP-HM, Aix-Marseille University, Marseille, France
| | - Laurène Norberciak
- Delegation of Clinical Research and Innovation, Biostatistics, Saint Philibert Hospital, Catholic University of Lille, Lille, France
| | | | - Jean-Luc Perrot
- Department of Dermatology, Saint Etienne University Hospital et Laboratoire Hubert Curien UMR CNRS 5516, Saint Etienne, France
| | - Florent Grange
- Department of Dermatology, Valence Hospital, Valence, France
| | - Philippe Modiano
- Department of Dermatology, Saint Vincent de Paul Hospital, Hospital Group of the Catholic Institute of Lille, Lille, France
| | - Jilliana Monnier
- Department of Dermatology and Skin Cancers, La Timone Hospital, AP-HM, Aix-Marseille University, Marseille, France
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3
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Daude M, Dinulescu M, Nguyen JM, Maillard H, Le Duff F, Machet L, Beylot-Barry M, Legoupil D, Wierzbicka-Hainaut E, Bedane C, Leccia MT, Debarbieux S, Meyer N, Monestier S, Bens G, Denis MG, Bossard C, Vergier B, Khammari A, Dréno B. Efficacy of imiquimod in the management of lentigo maligna. J Eur Acad Dermatol Venereol 2023; 37:1785-1791. [PMID: 37114291 DOI: 10.1111/jdv.19141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 04/07/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND Lentigo maligna (LM) is a melanocytic proliferation occurring on photo-exposed skin that may progress to LM melanoma. Surgery is recommended as first-line treatment. Excision margins of 5-10 mm remain, without international consensus. Several studies have shown that imiquimod, an immunomodulator, induces LM regression. This study investigated the effect of imiquimod versus placebo in neoadjuvant settings. PATIENTS AND METHODS We performed a prospective, randomized, multicentre, phase III clinical study. Patients were randomly assigned in 1:1 ratio to receive imiquimod or placebo for 4 weeks, followed by LM excision 4 weeks after the last application of imiquimod or placebo. The primary endpoint was extra-lesional excision, with a 5 mm margin from the residual pigmentation after imiquimod or vehicle. Secondary endpoints included the gain on the surface removed between the two groups; number of revision surgeries to obtain extra-lesional excisions; relapse-free time; and number of complete remissions after treatment. RESULTS A total of 283 patients participated in this study; 247 patients, 121 patients in the placebo group and 126 in the imiquimod group, accounted for the modified ITT population. The first extralesional extirpation was performed in 116 (92%) imiquimod patients and in 102 (84%) placebo patients; the difference was not significant (p = 0.0743). Regarding the surface of LM, imiquimod reduced the LM surface (4.6-3.1 cm2 ) significantly (p < 0.001) more compared to the placebo (3.9-4.1 cm2 ). CONCLUSION Imiquimod reduces the lentigo maligna surface after 1 month of treatment, without a higher risk of intralesional excision and with a positive aesthetic outcome.
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Affiliation(s)
- Marie Daude
- Nantes Université, INSERM, CNRS, CHU Nantes, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302/EMR6001, Nantes, France
| | | | - Jean-Michel Nguyen
- Biostatistics and Epidemiology, Hôpital Saint Jacques - CHU Nantes, Nantes, France
| | | | - Florence Le Duff
- Department of Dermatology, CHU Nice, Centre de recherche Clinique, Nice, France
| | | | | | | | | | | | | | - Sébastien Debarbieux
- Department of Dermatology, Hospices Civiles de Lyon, Hôpital Lyon Sud, Pierre Bénite, France
| | - Nicolas Meyer
- Department of Dermatology, CHU Toulouse, Toulouse, France
| | | | - Guido Bens
- Department of Dermatology, CHU Orléans, Orléans, France
| | - Marc G Denis
- Nantes Université, INSERM, CNRS, CHU Nantes, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302/EMR6001, Nantes, France
| | | | | | - Amir Khammari
- Department of Dermatology, Nantes Université, Univ Angers, CHU Nantes, CIC 1413, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302, Nantes, France
| | - Brigitte Dréno
- Nantes Université, INSERM, CNRS, CHU Nantes, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302/EMR6001, Nantes, France
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4
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Martinez DA, Bertold C, Le Duff F, Bahadoran P, Passeron T. Laser-assisted depigmentation for vitiligo universalis: A retrospective monocentric study comparing nano- and picosecond lasers. J Eur Acad Dermatol Venereol 2022; 37:e708-e710. [PMID: 36541248 DOI: 10.1111/jdv.18822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022]
Affiliation(s)
- David Alvarez Martinez
- Service de Dermatologie, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France
| | - Clémence Bertold
- Service de Dermatologie, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France
| | - Florence Le Duff
- Service de Dermatologie, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France
| | - Philippe Bahadoran
- Service de Dermatologie, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France
| | - Thierry Passeron
- Service de Dermatologie, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France.,INSERM U1065, C3M, Nice, France
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5
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Kenani Z, Le Duff F, Hachem JP, Le Pillouer-Prost A, Martin-Chico R, Patarin M, Laubach H, Ducamp I, Cante V, Perillat Y, Toubel G, Passeron T, Bahadoran P. Scarring after chemical tattoo removal: a retrospective study. Eur J Dermatol 2022; 32:131-132. [PMID: 35653091 PMCID: PMC9170555 DOI: 10.1684/ejd.2022.4205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Zied Kenani
- Department of Dermatology, Nice Hospital, Nice, France
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6
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Le Duff F, Fontas E, Guardoli D, Lacour JP, Passeron T. HeaLED: Assessment of skin healing under light-emitting diode (LED) exposure-A randomized controlled study versus placebo. Lasers Surg Med 2021; 54:342-347. [PMID: 34529859 DOI: 10.1002/lsm.23480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/03/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Light-emitting diodes (LEDs) in the visible or near-infrared spectrum have been reported to promote wound healing. However, despite being frequently proposed in daily clinical practice, the efficacy of photobiomodulation treatment after a laser procedure relies on very limited clinical data. OBJECTIVE To compare the relative efficacy of LED versus placebo treatment in decreasing erythema and transepidermal water loss (TEWL) after a fractional CO2 session. METHODS We conducted an open prospective intraindividual randomized controlled study with 10 healthy volunteers. An ablative fractional laser was performed on the seven forearm areas. Three consecutive daily sessions of LED (590, 630, and 850 nm [two tested irradiances each] and placebo) were applied after randomization. Physical measures (colorimetry, TEWL), photography, and clinical evaluation were performed on Days 1, 2, 3, 7, and 21. The main criterion of evaluation was the variation of parameter a* (erythema) at 72 hours for each LED parameter compared to placebo treatment. RESULTS No significant differences in the variation of the parameter a* or any of the other studied parameters were found for the different LEDs compared to the placebo area. CONCLUSION Photobiomodulation failed to improve healing after laser ablation compared to placebo.
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Affiliation(s)
- Florence Le Duff
- Dermatology Department, Archet Hospital-CHU, University Côte d'Azur, Nice, France
| | - Eric Fontas
- Délégation à la Recherche Clinique et à l'innovation (DRCI), Université Côte D'Azur, CHU Nice, Nice, France
| | - Davide Guardoli
- Dermatology Department, Archet Hospital-CHU, University Côte d'Azur, Nice, France
| | - Jean-Philippe Lacour
- Dermatology Department, Archet Hospital-CHU, University Côte d'Azur, Nice, France
| | - Thierry Passeron
- Dermatology Department, Archet Hospital-CHU, University Côte d'Azur, Nice, France.,INSERM U 1065, C3M, University Côte d'Azur, Nice, France
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7
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Lemasson J, Frumholtz L, Jachiet M, Lenormand C, Lipsker D, Moulin S, Chiaverini C, Le Duff F, Passeron T, Cordoliani F, Bagot M, Monfort JB, Senet P, De Masson A, Cassius C, Petit A, Misery L, Moguelet P, Cordel N, Fardet L, Begon E, Frances C, Bessis D, Bouaziz JD, Chasset F. Male sex, discoid lupus erythematosus, and lower limb involvement are associated with systemic lupus in lupus panniculitis patients: A multicenter case series of 74 patients. J Am Acad Dermatol 2021; 87:219-221. [PMID: 34352346 DOI: 10.1016/j.jaad.2021.07.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 07/16/2021] [Accepted: 07/20/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Juliette Lemasson
- Université de Paris, AP-HP, Service de dermatologie, Hôpital Saint-Louis, Paris, France.
| | - Laure Frumholtz
- Université de Paris, AP-HP, Service de dermatologie, Hôpital Saint-Louis, Paris, France
| | - Marie Jachiet
- Université de Paris, AP-HP, Service de dermatologie, Hôpital Saint-Louis, Paris, France
| | - Cédric Lenormand
- Faculté de Médecine, Université de Strasbourg et Clinique Dermatologique, Hôpitaux Universitaires, Strasbourg, France
| | - Dan Lipsker
- Faculté de Médecine, Université de Strasbourg et Clinique Dermatologique, Hôpitaux Universitaires, Strasbourg, France
| | - Sophie Moulin
- Université Côte d'Azur, Dermatologie, CHU de Nice, Nice, France
| | | | | | | | - Florence Cordoliani
- Université de Paris, AP-HP, Service de dermatologie, Hôpital Saint-Louis, Paris, France
| | - Martine Bagot
- Université de Paris, AP-HP, Service de dermatologie, Hôpital Saint-Louis, Paris, France
| | - Jean-Benoît Monfort
- Sorbonne Université, Faculté de Médecine Sorbonne Université, AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Paris, France
| | - Patricia Senet
- Sorbonne Université, Faculté de Médecine Sorbonne Université, AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Paris, France
| | - Adèle De Masson
- Université de Paris, AP-HP, Service de dermatologie, Hôpital Saint-Louis, Paris, France
| | - Charles Cassius
- Université de Paris, AP-HP, Service de dermatologie, Hôpital Saint-Louis, Paris, France
| | - Antoine Petit
- Université de Paris, AP-HP, Service de dermatologie, Hôpital Saint-Louis, Paris, France
| | | | - Philippe Moguelet
- Anatomie et cytologie pathologiques, AP-HP, Hôpital Tenon, Paris, France
| | - Nadège Cordel
- Dermatologie-Immunologie clinique, CHU de la Guadeloupe, Point-à-Pitre, France
| | | | | | - Camille Frances
- Sorbonne Université, Faculté de Médecine Sorbonne Université, AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Paris, France
| | - Didier Bessis
- Dermatologie, CHU de Montpellier, Montpellier, France
| | - Jean-David Bouaziz
- Université de Paris, AP-HP, Service de dermatologie, Hôpital Saint-Louis, Paris, France
| | - François Chasset
- Sorbonne Université, Faculté de Médecine Sorbonne Université, AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Paris, France
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8
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Le Duff F, Bouaziz JD, Fontas E, Ticchioni M, Viguier M, Dereure O, Reygagne P, Montaudié H, Lacour JP, Monestier S, Richard MA, Passeron T. Low-Dose IL-2 for Treating Moderate to Severe Alopecia Areata: A 52-Week Multicenter Prospective Placebo-Controlled Study Assessing its Impact on T Regulatory Cell and NK Cell Populations. J Invest Dermatol 2021; 141:933-936.e6. [DOI: 10.1016/j.jid.2020.08.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 07/13/2020] [Accepted: 08/03/2020] [Indexed: 01/31/2023]
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9
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Hubiche T, Cardot-Leccia N, Le Duff F, Seitz-Polski B, Giordana P, Chiaverini C, Giordanengo V, Gonfrier G, Raimondi V, Bausset O, Adjtoutah Z, Garnier M, Burel-Vandenbos F, Dadone-Montaudié B, Fassbender V, Palladini A, Courjon J, Mondain V, Contenti J, Dellamonica J, Leftheriotis G, Passeron T. Clinical, Laboratory, and Interferon-Alpha Response Characteristics of Patients With Chilblain-like Lesions During the COVID-19 Pandemic. JAMA Dermatol 2021; 157:202-206. [PMID: 33237291 DOI: 10.1001/jamadermatol.2020.4324] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Importance Chilblain-like lesions have been reported during the coronavirus 2019 (COVID-19) pandemic. The pathophysiology of such manifestations remains largely unknown. Objective To perform a systematic clinical, histologic, and biologic assessment in a cohort of patients with chilblain-like lesions occurring during the COVID-19 pandemic. Design, Setting, and Participants In this prospective case series carried out with a COVID-19 multidisciplinary consultation group at the University Hospital of Nice, France, 40 consecutive patients presenting with chilblain-like lesions were included. Main Outcomes and Measures Patients underwent a thorough general and dermatologic examination, including skin biopsies, vascular investigations, biologic analyses, interferon-alpha (IFN-α) stimulation and detection, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) and serologic analysis. Results Overall, 40 consecutive patients with chilblain-like lesions were included. Most patients were young, with a median (range) age of 22 (12-67) years; 19 were male and 21 were female. The clinical presentation was highly reproducible with chilblain-like lesions mostly on the toes. Bullous and necrotic evolution was observed in 11 patients. Acrocyanosis or cold toes were reported in 19 (47.5%) cases. Criteria compatible with COVID-19 cases were noted in 11 (27.5%) within 6 weeks prior to the eruption. The real-time PCR (rt-PCR) testing results were negative in all cases. Overall, SARS-CoV-2 serology results were positive in 12 patients (30%). D-dimer concentration levels were elevated in 24 (60.0%) cases. Cryoglobulinemia and parvovirus B19 serologic results were negative for all tested patients. The major histologic findings were features of lymphocytic inflammation and vascular damage with thickening of venule walls and pericyte hyperplasia. A significant increase of IFN-α production after in vitro stimulation was observed in the chilblain population compared with patients with mild-severe acute COVID-19. Conclusions and Relevance Taken together, our results suggest that chilblain-like lesions observed during the COVID-19 pandemic represent manifestations of a viral-induced type I interferonopathy. Trial Registration ClinicalTrials.gov Identifier: NCT04344119.
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Affiliation(s)
- Thomas Hubiche
- Department of Dermatology, Université Côte d'Azur, CHU Nice, Nice, France
| | | | - Florence Le Duff
- Department of Dermatology, Université Côte d'Azur, CHU Nice, Nice, France
| | - Barbara Seitz-Polski
- Department of Immunology, Université Côte d'Azur, UPR 01, UR2CA, CHU Nice, Nice, France
| | - Pascal Giordana
- Department of Vascular Medicine, Université Côte d'Azur, CHU Nice, Nice, France
| | | | - Valérie Giordanengo
- Department of Virology, Université Côte d'Azur, CHU Nice, Nice, France.,Université Côte d'Azur, INSERM, U1065, C3M, Nice, France
| | | | | | | | | | - Margaux Garnier
- Department of Dermatology, Université Côte d'Azur, CHU Nice, Nice, France
| | | | - Bérengère Dadone-Montaudié
- Department of Pathology, Université Côte d'Azur, CHU Nice, Nice, France.,Laboratory of Solid Tumors Genetics, Université Côte d'Azur, CHU Nice, Nice, France.,Institute for Research on Cancer and Aging of Nice (IRCAN), Université Côte d'Azur, CNRS UMR 7284/INSERM U1081, Nice, France
| | - Véréna Fassbender
- Department of Vascular Medicine, Université Côte d'Azur, CHU Nice, Nice, France
| | - Aurélia Palladini
- Department of Dermatology, Université Côte d'Azur, CHU Nice, Nice, France
| | - Johan Courjon
- Department of Infectiology, Université Côte d'Azur, CHU Nice, Nice, France
| | - Véronique Mondain
- Department of Infectiology, Université Côte d'Azur, CHU Nice, Nice, France
| | - Julie Contenti
- Emergency Department, Université Côte d'Azur, CHU Nice, Nice, France
| | - Jean Dellamonica
- Medical Intensive Care Unit, Université Côte d'Azur, UPR 01, UR2CA, CHU Nice, Nice, France
| | | | - Thierry Passeron
- Department of Dermatology, Université Côte d'Azur, CHU Nice, Nice, France.,Université Côte d'Azur, INSERM, U1065, C3M, Nice, France
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10
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Alkhalifah A, Fransen F, Le Duff F, Lacour JP, Wolkerstorfer A, Passeron T. Laser treatment of epidermal nevi: A multicenter retrospective study with long-term follow-up. J Am Acad Dermatol 2020; 83:1606-1615. [DOI: 10.1016/j.jaad.2019.06.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 05/30/2019] [Accepted: 06/08/2019] [Indexed: 10/26/2022]
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11
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Hubiche T, Le Duff F, Chiaverini C, Giordanengo V, Passeron T. Negative SARS-CoV-2 PCR in patients with chilblain-like lesions. Lancet Infect Dis 2020; 21:315-316. [PMID: 32563281 PMCID: PMC7302762 DOI: 10.1016/s1473-3099(20)30518-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 06/10/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Thomas Hubiche
- Department of Dermatology, Université Côte d'Azur, Nice 06200, France
| | - Florence Le Duff
- Department of Dermatology, Université Côte d'Azur, Nice 06200, France
| | | | - Valérie Giordanengo
- Department of Pathology, Université Côte d'Azur, Nice 06200, France; Department of Virology, Université Côte d'Azur, Nice 06200, France
| | - Thierry Passeron
- Department of Dermatology, Université Côte d'Azur, Nice 06200, France; Department of Virology, Université Côte d'Azur, Nice 06200, France; Centre Hospitalier Universitaire de Nice, and INSERM U1065, Université Côte d'Azur, Nice 06200, France.
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Dréno B, Dinulescu M, NGuyen JM, Maillard H, Le Duff F, Machet L, Beylot-Barry M, Legoupil D, Wierzbicka-Hainaut E, Bedane C, Leccia MT, Debarbieux S, Meyer N, Monestier S, Bens G, Denis MG, Bossard C, Vergier B, Khammari A. Efficacy of imiquimod in the management of lentigo maligna. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.10074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10074 Background: Lentigo maligna (LM), a melanocytic proliferation occurring on photoexposed skin, might progress to LM melanoma. Surgery is recommended as first-line treatment. However, the main challenge is the size of the excision inducing often-aesthetic injuries on the face and thus often refused by patients. The excision margins of 5 to 10 mm remain without international consensus. Several studies have shown that imiquimod induced LM regression, acting by enhancing IFN-γ production and effector function of T cells. The main goal of this study is to investigate the effect of imiquimod versus placebo in neoadjuvant setting to decrease the excision size as from the first surgical procedure. Methods: We performed a prospective, randomized, open, multicenter, phase III clinical study (NCT01720407). The health authority and ethics committee approvals were obtained and all subjects signed an informed consent. The primary endpoint was to demonstrate that in neoadjuvant situation, imiquimod could reduce the surgical excision size of LM with a healthy tissue margin of 5 mm. The main inclusion criteria were: Patients > 18 years fit for surgery. LM of the head histologically confirmed and not previously treated. Surface lesion ≥ to 1cm² and ≤ to 20cm². The two treatment arms were imiquimod or placebo followed by LM excision. Imiquimod or placebo were applied once daily, 5 days/week for 4 weeks followed by 5 mm margin surgery performed four weeks after the last treatment application. For sample size, 268 patients were expected to demonstrate a difference of 15% between the two arms in a bilateral situation with an alpha risk of 5% and a beta risk of 20%. Results: The trial involved 273 patients, 238 (105 men (44%) and 133 women (56%), mean age of 71 ± 10.2 years, were analyzed in modified ITT. Statistical analysis was performed on 122 patients in the imiquimod arm and 116 patients in the placebo arm. For the primary endpoint, the first extralesionnal excision has been achieved for 112 (91.8%) patients in the imiquimod arm and for 98 (84.5%) placebo patients group. There was no significant difference (p value = 0.1067) between the two arms. However, regarding the surface of LM, imiquimod allowed a highly significant reduction (4.2 cm² ± 4.6 to 2.3 cm² ± 3.3) compared to LM treated by placebo (4.0 cm² ± 3.5 to 4.0 cm² ±3.3; p < 0.0001). Conclusions: This randomized prospective study shows that imiquimod reduces the LM area (-50%) after one month of treatment. Reducing the surface of LM with imiquimod is not associated with a higher risk of intralesional excision (marge 5mm), with a significant esthetic result (less excised surface). Clinical trial information: NCT01720407.
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Affiliation(s)
- Brigitte Dréno
- Department of Dermatology-Oncology, Nantes University, CHU Nantes, CIC1413, CRCINA, Nantes, France
| | | | | | | | | | - Laurent Machet
- Dermatology department, CHRU, Inserm U-1253, University of Tours, France, Tours, France
| | - Marie Beylot-Barry
- Dermatology, Hôpital Saint-André, CHU de Bordeaux, Université de Bordeaux, Bordeaux, France
| | | | | | | | - Marie Thérèse Leccia
- Dermatology department, CHU Albert Michalon, Grenoble; Université de Grenoble, Grenoble, France
| | | | | | | | - Guido Bens
- Dermatology department, CHR Orleans., Orleans, France
| | - Marc G. Denis
- Department of Biochemistry, Nantes University Hospital, Nantes, France
| | - Celine Bossard
- Pathology Department, CHU Hotel Dieu and CRCINA, INSERM U1232, Nantes, France
| | - Beatrice Vergier
- CHU Bordeaux-Université Bordeaux, INSERM U1053, Team 3, Bordeaux, France
| | - Amir Khammari
- Dermato-Oncology Department, Nantes University, Nantes, France
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Abstract
Importance Hailey-Hailey disease (HHD) is a rare, autosomal-dominant acantholytic dermatosis characterized clinically by development of recurrent blisters and erosions in friction areas. Despite progression in our understanding of the molecular genetics of HHD, therapy remains suboptimal and there is no known cure. Objective To determine whether the novel phosphodiesterase-4 inhibitor apremilast is effective in the treatment of HHD. Design, Setting, and Participants Clinical case series of 4 patients with severe, treatment-resistant HHD at an outpatient clinic in the Department of Dermatology of Nice University Hospital, Nice, France. The patients were treated with apremilast; after the initial titration, the dose was 30 mg, twice daily. Main Outcomes and Measures Objective clinical response was assessed by the treating dermatologist using the physician global assessment score; recorded adverse effects were monitored throughout the treatment at intervals of 2 to 3 months. Results Three women and 1 man, with a mean age of 56 years, were treated and followed up for 6 to 10 months. Family history of the disease was noted in 3 (75%) of the cases. The lesions affected the axillary regions (75%), submammary regions (75%), inguinal regions (100%), and back and neck areas (50%). An improvement in the symptoms was reported by all of the patients after a treatment period of 1 month. After 6 months, the improvement of HHD lesions was reported as moderate to almost cleared among the patients. However, 2 patients developed some flares after 6 to 10 months of treatment and stopped apremilast therapy. One of the patients developed uncontrolled diffuse lesions and apremilast was reintroduced, resulting in partial control of her disease. Conclusions and Relevance Apremilast appears to offer a low-risk therapeutic alternative or adjunct in resistant and severe forms of HHD. A prospective controlled trial with long-term follow-up is required to confirm these preliminary observations.
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Affiliation(s)
- Julie Kieffer
- Department of Dermatology, Université Nice Côte d'Azur, Centre Hospitalier Universitaire Nice, Nice, France
| | - Florence Le Duff
- Department of Dermatology, Université Nice Côte d'Azur, Centre Hospitalier Universitaire Nice, Nice, France
| | - Henri Montaudié
- Department of Dermatology, Université Nice Côte d'Azur, Centre Hospitalier Universitaire Nice, Nice, France
| | - Christine Chiaverini
- Department of Dermatology, Université Nice Côte d'Azur, Centre Hospitalier Universitaire Nice, Nice, France
| | - Jean-Philippe Lacour
- Department of Dermatology, Université Nice Côte d'Azur, Centre Hospitalier Universitaire Nice, Nice, France
| | - Thierry Passeron
- Department of Dermatology, Université Nice Côte d'Azur, Centre Hospitalier Universitaire Nice, Nice, France.,INSERM U1065, C3M, team 12, Université Nice Côte d'Azur, Nice, France
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Montaudié H, Le Duff F, Butori C, Hofman V, Fontas E, Roger-Cruzel C, Bahadoran P, Perrot JL, Desmedt E, Legoupil D, Passeron T, Lacour JP. Ingenol mebutate to treat lentigo maligna of the head (face and scalp): A prospective, multicenter, single-arm phase 2 trial indicates no benefit. J Am Acad Dermatol 2019; 82:731-733. [PMID: 31325551 DOI: 10.1016/j.jaad.2019.07.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 07/10/2019] [Accepted: 07/11/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Henri Montaudié
- Department of Dermatology, Archet Hospital, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Nice, France; Team 12, Centre Méditerranéen de Médecine Moléculaire, INSERM, U1065, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Nice, France.
| | - Florence Le Duff
- Department of Dermatology, Archet Hospital, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Catherine Butori
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Véronique Hofman
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Eric Fontas
- Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Délégation à la Recherche et à l'Innovation, Nice, France
| | - Coralie Roger-Cruzel
- Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Délégation à la Recherche et à l'Innovation, Nice, France
| | - Philippe Bahadoran
- Department of Dermatology, Archet Hospital, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Nice, France; Clinical Research Center Archet Hospital, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Jean-Luc Perrot
- Department of Dermatology, University Hospital of Saint Etienne, Saint Etienne, France
| | - Eve Desmedt
- Department of Dermatology, University Hospital of Lille, INSERM U 1189, Lille, France
| | - Délphine Legoupil
- Department of Dermatology, University Hospital of Brest, Brest, France
| | - Thierry Passeron
- Department of Dermatology, Archet Hospital, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Nice, France; Team 12, Centre Méditerranéen de Médecine Moléculaire, INSERM, U1065, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Jean-Philippe Lacour
- Department of Dermatology, Archet Hospital, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Nice, France; Team 12, Centre Méditerranéen de Médecine Moléculaire, INSERM, U1065, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Nice, France
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Montaudié H, Le Duff F, Butori C, Hofman V, Fontas E, Roger C, Bahadoran P, Perrot JL, Desmedt E, Legoupil D, Passeron T, Lacour JP. Ingenol mebutate to treat lentigo maligna of the head (face and scalp): A prospective and multicenter single-arm phase 2 trial. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e21051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e21051 Background: Ingenol mebutate gel is indicated for the treatment of actinic keratoses. In vitro, it has been shown that ingenol mebutate can induce the apoptosis of melanoma cells, but robust clinical data are missing with only few case reports reported.The objectives of the current study was to assess the efficacy and safety of ingenol mebutate for the treatment of lentigo maligna (LM). Methods: We conducted a prospective, multicentre, and single-arm phase 2 trial (NCT02723721), from June 2016 to November 2017. This trial was planned according to Simon’s optimal two-stage design for a total sample size of 23 subjects. Adults with LM of the head were included. Ingenol mebutate gel 150 µg/g was applied daily for 3 consecutive days (one cycle). For patients having no remission or only partial remission at 2 months, a second cycle was done. Patients were evaluated 2 months after the (re)treatment and then every 3 months for 36 months if a complete response (CR) was obtained. The primary endpoint was the CR, defined as the complete clearing of the LM evaluated at 2 months clinically and histologically. Results: Twelve patients with a median age of 73 years were recruited. Only 2 achieved a CR; one patient relapsed during the first year following the treatment. Forty-seven adverse events related to ingenol mebutate were declared. Most were grade 3-4 (66%), but all were resolved without any sequelae. The mean maximum local skin reaction score was 12 (min: 3 – max: 22). These results should be interpreted with caution, because this study has limitations, such as the lack of a comparative arm and the heterogeneity of LM (size and localization). Conclusions: To our knowledge, we report the first prospective study evaluating the efficacy and safety of IM in patients with LM of the head. Unfortunately ingenol mebutate is not an effective treatment of LM in this indication at the concentration of 150 µg/g. Its use with a more intense regimen (more cycles and/or highest concentration (500 µg/g)) is also limited by a poor safety profile. Clinical trial information: NCT 02723721.
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Affiliation(s)
| | | | - Catherine Butori
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, FHU OncoAge, University Côte d'Azur, Nice, France
| | - Veronique Hofman
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, FHU OncoAge, University Côte d'Azur, Nice, France
| | - Eric Fontas
- Université Côte d’Azur, Centre Hospitalier Universitaire de Nice, Délégation à la Recherche et à l’Innovation, Nice, France
| | - Coralie Roger
- Université Côte d’Azur, Centre Hospitalier Universitaire de Nice, Délégation à la Recherche et à l’Innovation, Nice, France
| | | | - Jena-Luc Perrot
- Department of Dermatology, University Hospital of Saint Etienne, Saint Etienne, France
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Kelati A, Lagrange S, Le Duff F, Lacour JP, Passeron T. Treatment of Elastosis Perforans Serpiginosa Using a Fractional Carbon Dioxide Laser. JAMA Dermatol 2017; 153:1063-1064. [PMID: 28746703 DOI: 10.1001/jamadermatol.2017.2223] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | | | | | | | - Thierry Passeron
- Department of Dermatology, CHU de Nice, France.,Université Côte d'Azur, INSERM U1065, Team 12, C3M, Nice, France
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Bahadoran P, Le Duff F, Pascual T, Petit L, Martel P, Lacour JP, Passeron T. Comparative Methods for Improving Transepidermal Methylaminolevulinate Delivery. JAMA Dermatol 2015; 151:1371-1373. [DOI: 10.1001/jamadermatol.2015.2234] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Philippe Bahadoran
- Department of Dermatology, University Hospital of Nice, Nice, France2Centre de Recherche Clinique, University Hospital of Nice, Nice, France
| | - Florence Le Duff
- Department of Dermatology, University Hospital of Nice, Nice, France2Centre de Recherche Clinique, University Hospital of Nice, Nice, France
| | - Thierry Pascual
- Galderma Research & Development, Clinical Unit for Tests and Imaging of Skin, Sophia Antipolis, France
| | - Laurent Petit
- Galderma Research & Development, Clinical Unit for Tests and Imaging of Skin, Sophia Antipolis, France
| | - Philippe Martel
- Galderma Research & Development, Clinical Unit for Tests and Imaging of Skin, Sophia Antipolis, France
| | | | - Thierry Passeron
- Department of Dermatology, University Hospital of Nice, Nice, France4Institut National de la Santé Et de la Recherche Médicale U1065, Team 12, C3M, University Hospital of Nice, Nice, France
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Toubel G, Lavogiez C, Le Duff F. Vasculaire et laser : quels dispositifs pour quelles indications ? Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.04.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Castela E, Le Duff F, Butori C, Ticchioni M, Hofman P, Bahadoran P, Lacour JP, Passeron T. Effects of low-dose recombinant interleukin 2 to promote T-regulatory cells in alopecia areata. JAMA Dermatol 2014; 150:748-51. [PMID: 24872229 DOI: 10.1001/jamadermatol.2014.504] [Citation(s) in RCA: 160] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE An impaired inhibitory function of circulating CD4+CD25+ regulatory T (Treg) cells was reported to play a key role in alopecia areata (AA). We report the first use to our knowledge of low-dose interleukin 2 for treating severe AA by promoting the recruitment of Treg cells. OBSERVATIONS We conducted a prospective open pilot study in 5 patients with severe AA resistant to previous systemic treatments. Subcutaneous interleukin 2 (1.5 million IU/d) was administered during 5 days, followed by three 5-day courses of 3 million IU/d at weeks 3, 6, and 9. The primary outcome was the evolution of the Severity of Alopecia Tool (SALT) score, evaluated by 2 independent investigators on standardized photographs. Lesional skin biopsy specimens and peripheral blood lymphocyte phenotype were analyzed. The median SALT score went from 82 (range, 63-100) at baseline to 69 (range, 28-100) at 6 months. Immunochemical analysis revealed the appearance or a notable increase in Treg cell count in 4 of 5 patients at the end of the treatment compared with baseline. No serious adverse event was reported. CONCLUSIONS AND RELEVANCE The partial regrowth achieved in 4 of 5 patients and the recruitment of Treg cells in lesional skin support the interest of promoting Treg cells for treating AA. Further investigations are now required to confirm and to optimize the design in order to enhance the Treg cell response. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01840046.
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Affiliation(s)
- Emeline Castela
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - Florence Le Duff
- Department of Dermatology, University Hospital of Nice, Nice, France2Centre de Recherche Clinique (CRC), University Hospital of Nice, Nice, France
| | - Catherine Butori
- Laboratory of Clinical and Experimental Pathology, University Hospital of Nice, Nice, France
| | - Michel Ticchioni
- Laboratory of Immunology, University Hospital of Nice, Nice, France
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, University Hospital of Nice, Nice, France
| | - Philippe Bahadoran
- Department of Dermatology, University Hospital of Nice, Nice, France2Centre de Recherche Clinique (CRC), University Hospital of Nice, Nice, France
| | | | - Thierry Passeron
- Department of Dermatology, University Hospital of Nice, Nice, France5Institut National de la Santé et de la Récherche Médicale (INSERM) U1065, Team 12, Mediterranean Centre of Molecular Medicine, Nice, France
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Bahadoran P, Allegra M, Le Duff F, Long-Mira E, Hofman P, Giacchero D, Passeron T, Lacour JP, Ballotti R. Major clinical response to a BRAF inhibitor in a patient with a BRAF L597R-mutated melanoma. J Clin Oncol 2013; 31:e324-6. [PMID: 23715574 DOI: 10.1200/jco.2012.46.1061] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Philippe Bahadoran
- Department of Dermatology, Archet Hospital-Centre Hospitalier Universitaire de Nice, Nice cedex 03, France
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