1
|
Welfringer-Morin A, Barroil M, Fraitag S, Szablewski V, Boccara O, Lacour JP, Chiaverini C, Bagot M, Ram-Wolff C, Vignon-Pennamen MD, Dalle S, D'incan M, Amatore F, Beylot-Barry M, Vergier B, Mazereeuw-Hautier J, Tedbirt B, Quereux G, Carpentier O, Skowron F, Bertrand Y, Van Eeckhout P, Dekeuleneer V, Nardin C, Adamski H, Ingen-Housz-Oro S, Dereure O, Bodemer C. Clinical Features, Histological Characteristics, and Disease Outcomes of Mycosis Fungoides in Children and Adolescents: A Nationwide Multicentre Cohort of 46 Patients. Dermatology 2022; 239:132-139. [PMID: 36349768 DOI: 10.1159/000526788] [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: 05/02/2022] [Accepted: 06/21/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Our objective was to describe the clinical, histological characteristics, and disease outcome of a cohort of mycosis fungoides (MF) diagnosed during childhood including disease status at adulthood. METHODS This is a retrospective multicentre survey of patients aged under 18 years at diagnosis with histologically confirmed MF. Patients' clinical and histological characteristics, treatments, and disease outcome (for patients followed for more than 12 months) were analysed. RESULTS Forty-six patients were included (median age at diagnosis: 11 years; M:F sex ratio: 3:1) with 39 (85%) followed for at least 12 months. Thirty-nine patients (85%) had stage I MF. Hypopigmented patches were observed in 48% and folliculotropism in 43% patients. Immunophenotype of the skin infiltrate was predominantly CD8+ in 17% of patients. Initial management included a wait-and-see strategy in 6/39 (15%), skin-directed treatment in 27 (69%), and systemic treatment in 6 (15%) patients, respectively, with partial or complete clinical response (PR or CR) observed in 28 patients (72%). 14/39 patients (36%) relapsed after initial response. After a median follow-up period of 54 months, disease status at last news was PR or CR in 31/39 (79%), stable disease in 6 (15%), and progression in 2 (5%) patients. Histological transformation was observed in 3/39 (8%). Of the 15 patients followed until adulthood, 13 (87%) had persistent MF. DISCUSSION This survey confirms the high frequency of hypopigmented and folliculotropic lesions and of CD8+ immunophenotype compared to adult MF patients. The long-term course is usually indolent but transformation may occur sometimes long after disease onset and the disease may persist during adulthood.
Collapse
Affiliation(s)
- Anne Welfringer-Morin
- Department of Dermatology, Hospital Necker-Enfants Malades, APHP. Centre-Université de Paris, Paris, France,
| | - Marion Barroil
- Department of Dermatology, University of Montpellier and INSERM U1058, Montpellier, France
| | - Sylvie Fraitag
- Department of Pathology, Hospital Necker-Enfants Malades, APHP. Centre-Université de Paris, Paris, France
| | | | - Olivia Boccara
- Department of Dermatology, Hospital Necker-Enfants Malades, APHP. Centre-Université de Paris, Paris, France
| | - Jean-Philippe Lacour
- Department of Dermatology, CHU de Nice, Université Nice Côte d'Azur, Nice, France
| | - Christine Chiaverini
- Department of Dermatology, CHU de Nice, Université Nice Côte d'Azur, Nice, France
| | - Martine Bagot
- Department of Dermatology, Hospital Saint Louis, APHP. Université de Paris, INSERM UMR 976, Paris, France
| | - Caroline Ram-Wolff
- Department of Dermatology, Hospital Saint Louis, APHP. Université de Paris, INSERM UMR 976, Paris, France
| | | | - Stéphane Dalle
- Department of Dermatology, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre Bénite, France
| | - Michel D'incan
- Department of Dermatology, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Florent Amatore
- Department of Dermatology, Hospital la Timone, Université Aix-Marseille, Assistance Publique des Hôpitaux de Marseille, Marseille, France
| | - Marie Beylot-Barry
- Department of Dermatology, CHU de Bordeaux, INSERM U1053 Oncogenèse des lymphomes cutanés, Université de Bordeaux, Bordeaux, France
| | - Béatrice Vergier
- Department of Pathology, CHU de Bordeaux, INSERM U1053 Oncogenèse des lymphomes cutanés, Université de Bordeaux, Bordeaux, France
| | | | | | - Gaelle Quereux
- Department of Dermatology, Hotel Dieu, CHU de Nantes, Nantes, France
| | - Olivier Carpentier
- Department of Dermatology, Hospital Claude Huriez, CHRU Lille, Lille, France
| | | | - Yves Bertrand
- Department of Hematology, Institut d'hématologie et oncologie pediatrique, Lyon, France
| | - Pascal Van Eeckhout
- Department of Pathology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Valérie Dekeuleneer
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Charlee Nardin
- Department of Dermatology, CHU de Besancon, INSERM UMR 1098, Université de Franche-Comté, Besancon, France
| | - Henri Adamski
- Department of Dermatology, CHU Pontchaillou, Rennes, France
| | - Saskia Ingen-Housz-Oro
- Department of Dermatology, Hospital Henri Mondor, APHP, University Paris Est Créteil EpiDermE, Creteil, France
| | - Olivier Dereure
- Department of Dermatology, University of Montpellier and INSERM U1058, Montpellier, France
| | - Christine Bodemer
- Department of Dermatology, Hospital Necker-Enfants Malades, APHP. Centre-Université de Paris, Paris, France
| |
Collapse
|
2
|
Devers É, Courouge-Dorcier D, Arpajou G, Chevenet C, Chevaleyre A, Grobost V, D'incan M. Ischaemic skin lesions with multi-organ failure due to cocaine intake. Eur J Dermatol 2020; 30:ejd.2020.3703. [PMID: 32229431 DOI: 10.1684/ejd.2020.3703] [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] [Indexed: 06/10/2023]
Affiliation(s)
- Élodie Devers
- Department of Dermatology, CHU Clermont-Ferrand, Clermont-Ferrand
| | | | - Gauthier Arpajou
- Department of Reanimation, University Clermont-Auvergne, CHU Clermont-Ferrand, Clermont-Ferrand
| | - Carole Chevenet
- Department of Anatomopathology, University Clermont-Auvergne, CHU Clermont-Ferrand, Clermont-Ferrand
| | | | - Vincent Grobost
- Department of Internal medicine, University Clermont-Auvergne, CHU Clermont-Ferrand, Clermont-Ferrand
| | - Michel D'incan
- Department of Dermatology, University Clermont-Auvergne, CHU Clermont-Ferrand, Clermont-Ferrand, France
| |
Collapse
|
3
|
Jelti L, Cordel N, Gillibert A, Lacour JP, Uthurriague C, Doutre MS, Delaporte E, Duvert-Lehembre S, Quereux G, Dupuy A, Adamski H, Bedane C, Misery L, Abasq Thomas C, Fleuret C, Bernard P, Chaby G, D'incan M, Verneuil L, Litrowski N, Joly P. Incidence and Mortality of Pemphigus in France. J Invest Dermatol 2019; 139:469-473. [DOI: 10.1016/j.jid.2018.07.042] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 07/13/2018] [Accepted: 07/27/2018] [Indexed: 10/28/2022]
|
4
|
Almugairen N, Hospital V, Bedane C, Duvert-Lehembre S, Picard D, Tronquoy AF, Houivet E, D'incan M, Joly P. Assessment of the rate of long-term complete remission off therapy in patients with pemphigus treated with different regimens including medium- and high-dose corticosteroids. J Am Acad Dermatol 2013; 69:583-8. [DOI: 10.1016/j.jaad.2013.05.016] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 05/17/2013] [Accepted: 05/22/2013] [Indexed: 01/26/2023]
|
5
|
Leger S, Picard D, Ingen-Housz-Oro S, Arnault JP, Aubin F, Carsuzaa F, Chaumentin G, Chevrant-Breton J, Chosidow O, Crickx B, D'incan M, Dandurand M, Debarbieux S, Delaporte E, Dereure O, Doutre MS, Guillet G, Jullien D, Kupfer I, Lacour JP, Leonard F, Lok C, Machet L, Martin L, Paul C, Pignon JM, Robert C, Thomas L, Weiller PJ, Ferranti V, Gilbert D, Courville P, Houivet E, Benichou J, Joly P. Prognostic factors of paraneoplastic pemphigus. ACTA ACUST UNITED AC 2013; 148:1165-72. [PMID: 22801794 DOI: 10.1001/archdermatol.2012.1830] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To identify the prognostic factors of overall survival in a series of patients with paraneoplastic pemphigus (PNP). DESIGN Multicenter retrospective cohort study. SETTING Twenty-seven dermatology departments in France. PATIENTS A total of 53 patients (31 men and 22 women; median age, 59 years; age range, 30-88 years) were diagnosed as having PNP between 1992 and 2010. MAIN OUTCOME MEASURES Overall Kaplan-Meier survival rates were estimated, and features associated with survival were assessed using univariate (log-rank test) and multivariate (Cox regression) analyses. RESULTS The study included 53 patients with PNP. Thirty-six patients (68%) died during the study. The 1-, 3-, and 5-year overall survival rates were 49%, 41%, and 38%, respectively. The main causes of death were infections (n=21) and evolution of neoplasia (n=6). In univariate analysis, the main detrimental prognostic factors identified were erythema multiforme–like skin lesions (P=.05) and histologic keratinocyte necrosis (P=.03). None of the 5 patients with Castleman disease died during the study. After adjustment for age and sex in multivariate analysis, erythema multiforme–like skin lesions remained predictive of fatal outcome, with a 2-fold increase in death rate (hazard ratio [HR], 2.3; 95% CI, 1.05-5.03; P=.04). The prognosis of patients with PNP was even poorer when erythema multiforme–like skin lesions were associated with severe skin or mucosal involvement at presentation (HR of death, 3.0; 95% CI, 1.01-8.92; P=.049). CONCLUSION Patients with PNP with erythema multiforme–like skin lesions and histologic keratinocyte necrosis, especially when associated with extensive lesions at presentation, are likely to have a more severe and rapid fatal outcome and should be managed very carefully.
Collapse
Affiliation(s)
- Sandy Leger
- Departments of Dermatology, Institut National de la Santé et de la Recherche Médicale (INSERM) U905, Institute for Research and Innovation in Biomedicine, Rouen University Hospital, University of Normandy, Rouen, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Alquier-Bouffard A, Da Costa CM, Roger H, Franck F, Taïeb A, Souteyrand P, D'incan M. [Chronic actinic dermatitis: treatment with topical tacrolimus (two cases)]. Ann Dermatol Venereol 2007; 134:555-8. [PMID: 17657183 DOI: 10.1016/s0151-9638(07)89268-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Chronic actinic dermatitis is usually controlled under systemic immunosuppressive drugs. We report herein two patients successfully treated with topical tacrolimus. CASE REPORTS Two men aged 60 and 70 years were treated for chronic actinic dermatitis for two years using systemic immunosuppressive drugs. Due to drug intolerance and treatment resistance, systemic treatment was substituted by topical tacrolimus. Cutaneous lesions improved dramatically within two months but withdrawal of daily application was immediately followed by recurrence of the lesions. DISCUSSION Our cases, together with the 10 others reported in the literature, confirm the efficacy of topical tacrolimus in the treatment of chronic actinic dermatitis. Since tacrolimus chiefly targets activated T lymphocytes, it has been successfully deployed in various inflammatory dermatoses and its use is logical in the treatment of chronic actinic dermatitis. While dramatic improvement is achieved within a few weeks in this indication with twice-daily applications of tacrolimus ointment 0.1%, symptoms recur rapidly on dosage reduction, and extremely long-term, or even lifelong, treatment is thus probably needed. Topical tacrolimus application has been shown to be safe for periods of three years. However, the peculiar mechanism of chronic actinic dermatitis with a pronounced imbalance in T-cell subsets raises the question of theoretical risk of carcinogenicity of tacrolimus applications, and this, together with the prolonged duration of treatment, calls for long-term follow-up of chronic actinic dermatitis patients.
Collapse
Affiliation(s)
- A Alquier-Bouffard
- Service de Dermatologie, Université Clermont-Ferrand 1, CHU, Clermont-Ferrand
| | | | | | | | | | | | | |
Collapse
|
7
|
Alquier-Bouffard A, Franck F, Joubert-Zakeyh J, Barthélémy I, Mansard S, Ughetto S, Aublet-Cuvelier B, Déchelotte PJ, Mondié JM, Souteyrand P, D'incan M. Absence de valeur prédictive des signes de régression histologique sur l’envahissement du ganglion sentinelle. Ann Dermatol Venereol 2007; 134:521-5. [PMID: 17657177 DOI: 10.1016/s0151-9638(07)89262-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The predictive value of regression in melanoma is debated. AIM OF THE STUDY A retrospective single-centre study to evaluate the correlation between regression in primary skin tumor and the presence of micrometastases in sentinel lymph nodes. PATIENTS AND METHODS Histological signs of regression in 84 melanomas (>1 mm) with corresponding sentinel lymph nodes were studied by two independent pathologists. RESULTS Regression was seen in 40 skin melanoma tumors while micrometastasis was seen in 24. Of the tumors with micrometastasis, only 10 were regressive (RR: 0.47, p=0.49). Breslow value>2 mm and male sex were predictive for node micrometastasis (RR: 4.6, p=0.03 and RR: 7.6, p=0.006, respectively). On multivariate analysis, these two factors were independent. COMMENTS These data suggest that regression in primary cutaneous melanoma is not predictive for lymph node metastasis.
Collapse
Affiliation(s)
- A Alquier-Bouffard
- Service de Dermatologie, Université d'Auvergne Clermont-Ferrand 1, CHU, Hôtel-Dieu, Clermont-Ferrand
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
|
9
|
D'incan M, Roger H, Gabrillargues J, Mansard S, Parent S, Chazal J, Irthum B, Souteyrand P. [Radiation-induced temporary hair loss after endovascular embolization of the cerebral arteries: six cases]. Ann Dermatol Venereol 2002; 129:703-6. [PMID: 12124512] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
BACKGROUND Intraoperative fluoroscopy imaging during coronaroplasty or transjugular intrahepatic portosystemic shunt may induce chronic radiodermatitis. Temporary hair loss is a peculiar form of radiodermatitis following endovascular surgery of the cerebral arteries. CASE REPORTS Six patients (2 women, 4 men, age range: 27-47 years old) were seen for a solitary plaque of alopecia. In all of the cases, the plaque had appeared two weeks after a neuroradiologically guided embolization procedure. No other skin lesions were seen. Alopecia spontaneously and completely regressed within three to four months. However, it reappeared after a subsequent embolization (one case) but not after arteriographies (five cases). DISCUSSION Five similar cases have been reported in the literature. Transient alopecia often occurs after neurologically guided endovascular surgery of the cerebral arteries. This side-effect is well known by neurosurgeons and thus, these patients are rarely referred to a dermatologist. Two differential diagnoses must be evoqued: alopecia aerata and anticonvulsant - induced alopecia. The role played as cofactor by carbamazepine which is a photosensitivant drug, is discussed.
Collapse
Affiliation(s)
- M D'incan
- Service de Dermatologie, Hôtel-Dieu/Polyclinique, Clermont-Ferrand, France.
| | | | | | | | | | | | | | | |
Collapse
|
10
|
Pinson S, Créange A, Barbarot S, Stalder JF, Chaix Y, Rodriguez D, Sanson M, Bernheim A, D'incan M, Doz F, Stoll CL, Combemale P, Kalifa C, Zeller J, Teillac-Hamel D, Lyonnet S, Zerah M, Lacour JP, Guillot B, Wolkenstein P. [Recommendations for the treatment of neurofibromatosis type 1]. J Fr Ophtalmol 2002; 25:423-33. [PMID: 12011750] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Affiliation(s)
- S Pinson
- Génétique Moléculaire, Hôpital Edouard Herriot, Lyon, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Pinson S, Créange A, Barbarot S, Stalder JF, Chaix Y, Rodriguez D, Sanson M, Bernheim A, D'incan M, Doz F, Stoll C, Combemale P, Kalifa C, Zeller J, Teillac-Hamel D, Lyonnet S, Zerah M, Lacour JP, Guillot B, Wolkenstein P. [Neurofibromatosis 1: recommendations for management]. Ann Dermatol Venereol 2001; 128:567-75. [PMID: 11395662] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Affiliation(s)
- S Pinson
- Génétique Moléculaire, Hôpital Edouard Herriot, Lyon
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
D'incan M, Souteyrand P. [Dacarbazine]. Ann Dermatol Venereol 2001; 128:517-25. [PMID: 11395650] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Affiliation(s)
- M D'incan
- Service de Dermatologie, Hôtel-Dieu, Polyclinique, 17, boulevard Léon Malfreyt, 63058 Clermont-Ferrand Cedex.
| | | |
Collapse
|
13
|
Joly P, Richard C, Gilbert D, Courville P, Chosidow O, Roujeau JC, Beylot-Barry M, D'incan M, Martel P, Lauret P, Tron F. Sensitivity and specificity of clinical, histologic, and immunologic features in the diagnosis of paraneoplastic pemphigus. J Am Acad Dermatol 2000; 43:619-26. [PMID: 11004616 DOI: 10.1067/mjd.2000.107488] [Citation(s) in RCA: 140] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Paraneoplastic pemphigus (PNP) is an autoimmune blistering disease characterized by the production of autoantibodies mainly directed against proteins of the plakin family. An overlapping distribution of autoantibody specificities has been recently reported between PNP, pemphigus vulgaris (PV), and pemphigus foliaceus (PF), which suggests a relationship between the different types of pemphigus. OBJECTIVE Our purpose was to evaluate the sensitivity and the specificity of clinical, histologic, and immunologic features in the diagnosis of PNP. METHODS The clinical, histologic, and immunologic features of 22 PNP patients were retrospectively reviewed and compared with those of 81 PV and PF patients without neoplasia and of 8 PV and 4 PF patients with various neoplasms. RESULTS One clinical and 2 biologic features had both high sensitivity (82%-86%) and high specificity (83%-100%) whatever the control group considered: (1) association with a lymphoproliferative disorder, (2) indirect immunofluorescence (IIF) labeling of rat bladder, and (3) recognition of the envoplakin and/or periplakin bands in immunoblotting. Two clinicopathologic and two biologic features had high specificity (87%-100%) but poor sensitivity (27%-59%): (1) clinical presentation associating erosive oral lesions with erythema multiforme-like, bullous pemphigoid-like, or lichen planus-like cutaneous lesions; (2) histologic picture of suprabasal acantholysis with keratinocyte necrosis, interface changes, or lichenoid infiltrate; (3) presence of both anti-epithelial cell surface and anti-basement membrane zone antibodies by IIF; and (4) recognition of the desmoplakin I and/or BPAG1 bands in immunoblotting. Interestingly, 45% of patients with PNP presented initially with isolated oral erosions that were undistinguishable from those seen in PV patients, and 27% had histologic findings of only suprabasal acantholysis, which was in accordance with the frequent detection of anti-desmoglein 3 antibodies in PNP sera. CONCLUSION The association with a lymphoproliferative disorder, the IIF labeling of rat bladder, and the immunoblotting recognition of envoplakin and/or periplakin are both sensitive and specific features in the diagnosis of PNP.
Collapse
Affiliation(s)
- P Joly
- Institut National de la Santé et de la Recherche Medicale U519, Institut Fédératif de Recherche Multidisciplinaire sur les Peptides, IFR23, Faculté Mixte de Médecine et de Pharmacie, Hôpital Charles Nicolle, Rouen, France
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
D'incan M, Kanold J, Halle P, De Lumley L, Souteyrand P, Deméocq F. [Extracorporeal photopheresis as an alternative therapy for drug-resistant graft versus host disease: three cases]. Ann Dermatol Venereol 2000; 127:166-70. [PMID: 10739974] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
BACKGROUND Graft versus host reaction is a life-threatening complication of allogenic bone marrow transplantation. Extracorporeal photopheresis has been used for some years in the treatment of graft versus host reaction. We report on three children treated with extracorporeal photopheresis for a graft versus host reaction resistant to immunosuppresive drugs. MATERIAL AND METHODS Three children with a graft versus host reaction were submitted to 18, 30 and 46 extracorporeal photopheresis courses respectively. In the same time, the other immunosuppressive treatments were tapered or definitively stopped (ciclosporin). RESULTS A dramatic improvement of cutaneous status and biological data was observed after the first courses. However, the extracorporeal photopheresis treatment did not improve the mucous lesions. No serious adverse effect was encountered. COMMENTS As published elsewhere, extracorporeal photopheresis was effective on the graft versus host reaction lichenoid cutaneous lesions and in case of visceral involvement. In all of our cases, the immunosuppressive drug could have been tapered. No adverse event was observed. Thus, extracorporeal photopheresis should be indicated in case of resistance to immunosuppressive drugs.
Collapse
Affiliation(s)
- M D'incan
- Service de Dermatologie, CHRU-Hôtel-Dieu, BP 69, 63001 Clermont-Ferrand Cedex 01, France
| | | | | | | | | | | |
Collapse
|
15
|
Cure H, Souteyrand P, Ouabdesselam R, Roche H, Ravaud A, D'incan M, Viens P, Fargeot P, Lentz MA, Fumoleau P, Hanauske A, Chollet P. Results of a phase II trial with cystemustine at 90 mg/m(2) as a first- or second-line treatment in advanced malignant melanoma: a trial of the EORTC Clinical Studies Group. Melanoma Res 1999; 9:607-10. [PMID: 10661773 DOI: 10.1097/00008390-199912000-00011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
From May 1991 to January 1996, 54 patients with advanced malignant melanoma were enrolled into a phase II trial testing the new nitrosourea cystemustine, administrated intravenously as a 15 min infusion every 2 weeks at 90 mg/m2 for three cycles followed by 60 mg/m2. Out of the 54 enrolled patients, 10 were Ineligible, leaving 44 fully evaluable patients (World Health Organization criteria). Twenty one patients had already received first-line palliative chemotherapy and/or immunotherapy. The median age was 62 years (range 30-74 years) and the median performance status was 0 (grade 0, 19 patients; grade 1, 21 patients; grade 2, 4 patients). Five patients with partial responses (lasting 16-29 weeks, mean duration 24 weeks), nine with stable disease and 28 showing progression were observed, giving an overall response rate of 11% (confidence interval 3.8-24.6%). Toxicity was mild and consisted mainly of neutropenia (39% grade III-IV), thrombocytopenia (42% grade III-IV); febrile aplasia was rare. Cystemustine administered to this schedule appears to have limited clinical activity and acceptable toxicity in untreated or second-line advanced malignant melanoma.
Collapse
Affiliation(s)
- H Cure
- Centre Jean Perrin, Hôtel Dieu, and Inserm U, Clermont-Ferrand, France
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Euvrard S, Noble CP, Kanitakis J, Ffrench M, Berger F, Delecluse HJ, D'incan M, Thivolet J, Touraine JL. Brief report: successive occurrence of T-cell and B-cell lymphomas after renal transplantation in a patient with multiple cutaneous squamous-cell carcinomas. N Engl J Med 1992; 327:1924-6. [PMID: 1454087 DOI: 10.1056/nejm199212313272706] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- S Euvrard
- Department of Dermatology, Edouard Herriot Hospital, Lyon, France
| | | | | | | | | | | | | | | | | |
Collapse
|