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Colas M, Bentz MH, Raffoul J, Devalland C, Dupond AS. [Atypical purpuric oedema of the nose during granulomatosis with polyangiitis]. Ann Dermatol Venereol 2020; 147:542-546. [PMID: 32305238 DOI: 10.1016/j.annder.2020.01.022] [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: 12/21/2018] [Revised: 09/28/2019] [Accepted: 01/28/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Granulomatosis with polyangeitis or Wegener's disease is a necrotizing vasculitis of small and medium vessels associated with antineutrophil cytoplasmic autoantibodies (ANCA). The most frequent sites are lung, ear, nose and throat and kidney. PATIENTS AND METHODS We report the case of a 47-year-old woman presenting purpuric oedematous plaque with bullous detachment of the nose and hospitalised for the assessment of two suspicious neoplastic lung lesions discovered as a result of a recent stroke and repeated seromucosal otitis. Granulomatosis with polyangeitis was suspected because of multiple systemic lesions. The histopathology of skin lesions and laboratory investigation results were consistent with this diagnosis. A favourable outcome was achieved with corticosteroids and rituximab. DISCUSSION The diagnosis of GPA is based on criteria established by the American College of Rheumatology. The cutaneous clinical aspect described in our case confirms the polymorphism of the cutaneous lesions possibly associated with this disease. They are rarely isolated but, in some cases, allow early diagnosis with improved prognosis, which remains severe in the absence of treatment.
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Affiliation(s)
- M Colas
- Service de dermatologie, hôpital Nord Franche Comté (Belfort), 100, route de Moval, 90400 Trévenans, France.
| | - M-H Bentz
- Service de pneumologie, hôpital Nord Franche Comté (Belfort), 100, route de Moval, 90400 Trévenans, France
| | - J Raffoul
- Service d'anatomopathologie, Hôpital Nord Franche Comté (Belfort), 100, route de Moval, 90400 Trévenans, France
| | - C Devalland
- Service d'anatomopathologie, Hôpital Nord Franche Comté (Belfort), 100, route de Moval, 90400 Trévenans, France
| | - A-S Dupond
- Service de dermatologie, hôpital Nord Franche Comté (Belfort), 100, route de Moval, 90400 Trévenans, France
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Affiliation(s)
- C Nardin
- Dermatologie, Centre Hospitalier de Belfort Montbéliard, Montbéliard
- Dermatologie, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France
| | - A S Dupond
- Dermatologie, Centre Hospitalier de Belfort Montbéliard, Montbéliard
| | - F Pelletier
- Dermatologie, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France
| | - E Puzenat
- Dermatologie, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France
| | - F Aubin
- Dermatologie, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France
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Affiliation(s)
- C Nardin
- Dermatologie, Centre Hospitalier de Belfort Montbéliard, Montbéliard
- Dermatologie, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France
| | - A S Dupond
- Dermatologie, Centre Hospitalier de Belfort Montbéliard, Montbéliard
| | - F Pelletier
- Dermatologie, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France
| | - E Puzenat
- Dermatologie, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France
| | - F Aubin
- Dermatologie, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France
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Castagna J, Clerc J, Dupond AS, Laresche C. [Multiple granular cell tumours in a patient with Noonan's syndrome and juvenile myelomonocytic leukaemia]. Ann Dermatol Venereol 2017; 144:705-711. [PMID: 28728859 DOI: 10.1016/j.annder.2017.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 12/15/2016] [Revised: 02/16/2017] [Accepted: 06/12/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Granular cell tumour (GCT) is a rare form of tumour comprising Schwann cells. Herein, we report a case of a child presenting Noonan syndrome complicated by juvenile myelomonocytic leukaemia (JMML) and who also developed a multiple form of GCT. We discussed the molecular mechanisms that might account for this association. PATIENTS AND METHODS A six-year-old boy with Noonan syndrome complicated by JMML presented three asymptomatic subcutaneous nodules on his back, forearm and neck. Histological analysis revealed GCT. A literature review revealed seven cases of Noonan syndrome presenting GCT, none of which were associated with JMML. Mutation of gene PTPN11, via hyperactivation of intracellular Ras signalling may cause the development of GCT and JMML in children presenting Noonan syndrome. DISCUSSION Detailed clinical examination is recommended in children presenting GCT to screen for multiple forms and for signs of malformation suggestive of a genetic syndrome. Ours is the first case to be described of Noonan syndrome complicated by JMML associated with multiple GCT. This association once again raises the important question of the role of the Ras-MAPK signalling pathway in the development of benign and malignant tumours of solid organs or blood, associated with genetic syndromes.
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Affiliation(s)
- J Castagna
- Service de dermatologie, hôpital Nord Franche-Comté, 2, rue du Dr-Flamand, 25200 Montbeliard, France.
| | - J Clerc
- Service d'anatomie et cytologie pathologiques, hôpital Nord Franche-Comté, 2, rue du Dr-Flamand, 25200 Montbeliard, France
| | - A-S Dupond
- Service de dermatologie, hôpital Nord Franche-Comté, 2, rue du Dr-Flamand, 25200 Montbeliard, France
| | - C Laresche
- Service de dermatologie, hôpital Nord Franche-Comté, 2, rue du Dr-Flamand, 25200 Montbeliard, France
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Moreau J, Dupond AS, Dan N, Untereiner T, Vidal C, Aubin F. [Comparative evaluation of dermoscopy and capillaroscopy in Raynaud's phenomenon]. Ann Dermatol Venereol 2017; 144:333-340. [PMID: 28343718 DOI: 10.1016/j.annder.2017.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 08/23/2015] [Revised: 01/15/2017] [Accepted: 02/20/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Raynaud's phenomenon (RP) is a common cause for consultation. Capillaroscopy is a well-established technique to detect capillary abnormalities suggestive of a connective tissue disease, but it is sometimes unavailable. The aim of this study was to compare dermoscopy and capillaroscopy in the assessment of RP. METHODS This was a prospective single-centre observational study in adult patients consulting for RP at the Hôpital Nord Franche-Comté between January 2014 and June 2015. Dermoscopy was performed at dermatological consultations and capillaroscopy was prescribed. For each capillaroscopy and dermoscopy, the following parameters were examined: normal appearance, giant capillaries, avascular areas, dystrophic capillaries or tortuosity and haemorrhages. Kappa coefficients were calculated. RESULTS Twenty-six patients participated in this study. The kappa coefficient was 0.76 for "normal" status, 0.78 for tortuosity, 0.70 for giant capillaries, 0.48 for haemorrhage and 0.62 for avascular areas. The global kappa coefficient was 0.33. Detection of these abnormalities with capillaroscopy was significantly associated with abnormal dermoscopic status (P<0.05). The sensitivity of dermoscopy for the detection of "abnormal" capillaroscopic status was 0.87. CONCLUSION The correlation coefficients were good. Despite poor global concordance, 80% of patients had the same status, normal or abnormal, for both capillaroscopy and dermoscopy, which resulted in the same clinical management. Dermoscopy is thus a valuable tool screening for periungual anomalies and provides support for clinical examination by the dermatologist, although the reference method continues to be capillaroscopy.
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Affiliation(s)
- J Moreau
- Service de dermatologie, CHU de Besançon, 3, boulevard Fleming, 25000 Besançon, France.
| | - A-S Dupond
- Service de dermatologie néphrologie, CH Montbéliard, 2, rue du Dr-Flamand, 25200 Montbéliard, France
| | - N Dan
- Service de dermatologie, hôpital de jour, CH Montbéliard, 2, rue du Dr-Flamand, 25200 Montbéliard, France
| | - T Untereiner
- Service de radiologie, CH Montbéliard, 2, rue du Dr-Flamand, 25200 Montbéliard, France
| | - C Vidal
- Centre d'investigation clinique, CHU de Besançon, 3, boulevard Fleming, 25000 Besançon, France
| | - F Aubin
- Service de dermatologie, CHU de Besançon, 3, boulevard Fleming, 25000 Besançon, France
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Magy-Bertrand N, Dupond JL, Mauny F, Dupond AS, Duchene F, Gil H, Kantelip B. Incidence of amyloidosis over 3 years: the AMYPRO study. Clin Exp Rheumatol 2008; 26:1074-1078. [PMID: 19210872] [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: 05/27/2023]
Abstract
OBJECTIVES There is a lack of epidemiological information concerning amyloidosis, particularly in France. We started a 3-year prospective study (AMPYRO) to analyze the epidemiological features of amyloidosis in the eastern part of France. METHODS From 2003 to 2005, all patients with a tissue sample showing amyloid deposits, were included in this study. Immunohistochemistry using anti-P component, anti-SAA, anti-light chains immunoglobulins and anti-transthyretin was applied for each tissue sample. For each patient, past and present medical histories along with biological features were recorded. RESULTS Seventy-six patients with amyloid were identified over 3 years. The age-standardized incidence rate of amyloidosis was estimated at 14 cases per million person-years. The final entire population included in the AMYPRO study was composed of 66 patients with a mean age of 71.7+/-11.5 years old. The amyloid typing after clinical, biological and immunohistochemistry revealed senile amyloid in 40 cases (60.6%), AL amyloid in 13 (19.7%) and AA amyloid in 9 (13.6%). Neither clinical nor biological features differed significantly between the transthyretin-positive and transthyretin-negative populations. CONCLUSION Regarding only tissue samples, senile amyloid was the most prominent amyloid type identified. Therefore, the clinician needs to be aware that in most of the amyloid cases identified on the pathologic examination there is no need for additional examination unless there are clinical or biological signs of a primary or secondary amyloidosis.
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Affiliation(s)
- N Magy-Bertrand
- Department of Internal Medicine, University Hospital Jean Minjoz, Besançon, France.
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Lamfichekh N, Dupond AS, Destrumelle N, Runser C, Humbert P, Mantion G. [Surgical treatment of Verneuil's disease (hidradenitis suppurativa): 15 cases]. Ann Dermatol Venereol 2001; 128:127-9. [PMID: 11275587] [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: 02/19/2023]
Abstract
INTRODUCTION Verneuil's disease (hidradenitis suppurativa) is a chronic inflammatory, suppurating and fistulizing disease of apocrine sweat gland-bearing skin. The aim of this study was to describe the surgical treatment, conducted in 15 patients suffering from this disease. PATIENTS AND METHODS We retrospectively analyzed 15 observations (9 men, 6 women, mean age 38.6). The mean delay between beginning of the symptoms and diagnosis was 55.5 months. Surgery was conducted at the stage of abscesses, fistulization and keloids in all patients. The first surgical step was wide and deep excision of affected skin and subcutaneous fat. The second step was secondary intention healing, or ideal suture, Z plasty or dorsalis major flap. RESULTS Only four patients had complications: two axillary strictures, one anal margin stenosis and one hypertrophic scarring. Three relapses occurred, treated by excision under local anesthesia. CONCLUSION Surgical treatment seems to be the only definitive treatment of Verneuil's disease.
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Affiliation(s)
- N Lamfichekh
- Service de Chirurgie Générale et Digestive, CHG "André Boulloche", Montbéliard
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Dupond AS, Magy N, Humbert P, Dupond JL. [Nail manifestations of systemic diseases]. Rev Prat 2000; 50:2236-40. [PMID: 11217125] [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] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
General diseases-associated nail disorders may be classified into 5 types according to their clinical impact. Type I refers to nail disorders considered as peculiar features among the various symptoms of general disease such as peri-ungueal vascular dilatation, onycholysis, Beau lines, opaque nails or melanonychia. Type II refers to nail disorders with a strong clinical value such as Terry's nails, Muerhrcke's lines or koilonychia. Type III refers to nails disorders presenting as significant syndromes of several diseases such as yellow-nail syndrome of subungueal splinter haemorrhages, and type IV to specific disorders considered as true keys for diagnosis such as digital hippocratism, Bazex's acrokeratosis, Koenen's tumor, or nail hypoplasia. In type V are included drug-induced nails disorders especially after chemiotherapy or antiretroviral therapy.
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Affiliation(s)
- A S Dupond
- Services de dermatologie et de médecine interne CHU-Hôpital Jean-Minjoz 25030 Besançon
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Berthier S, Jaeger F, Gil H, Dupond AS, Aubin F, Dupond JL. [The internist knows the music but not on microdisks]. Rev Med Interne 1999; 20 Suppl 2:279s-280s. [PMID: 10422169 DOI: 10.1016/s0248-8663(99)80464-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- S Berthier
- Service de médecine Interne, Centre Hospitalier, Besançon
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Dupond AS, Lacour JP, Lafont C, Ortonne JP. [Prevalence of hepatitis C virus in oral erosive lichen]. Ann Dermatol Venereol 1998; 125:676-8. [PMID: 9835954] [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: 02/09/2023]
Abstract
OBJECTIVE An increased prevalence of hepatitis C virus (HCV)-related hepatitis has been reported in patients with lichen planus. The aim of our retrospective study was to determine whether there is a relationship between the erosive form of oral lichen planus and HCV. PATIENTS AND METHODS A retrospective study was conducted in a consecutive sample of 28 patients suffering from oral erosive lichen planus and seen in our department between 1992 and 1996. Anti-HCV antibodies were detected in all cases by third generation recombinant immunoblot assay. PCR was performed to detect HCV RNA in the serum sample from 19 patients. RESULTS Eight patients (29 p. 100) tested positive for HCV antibodies. These results were compared with the rate of HCV chronic carriers which is between 1 and 2 p. 100 in our region (Southern France). Among these 8 patients, 7 had severe chronic liver disease, and 5 of them were actively replicating the virus. DISCUSSION Our results suggest a strong relationship between erosive oral lichen planus and HCV-related chronic hepatitis. We conclude that patients with the erosive form of oral lichen planus should be systematically evaluated for HCV infection.
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Affiliation(s)
- A S Dupond
- Service de Dermatologie, Hôpital Archet-2, Nice
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Abstract
We describe two brothers with eosinophilic pustular folliculitis. Both had recurrent crops of papules and pustules, primarily affecting the scalp. The eruption began in the neonatal period. Both children had a leucocytosis with eosinophilia. Histology revealed folliculitis, with an infiltrate in which eosinophils were predominant. Bacteriological and fungal cultures of pustules were negative. There was a good clinical response to treatment with a topical corticosteroid and dapsone. We review the 28 previously reported cases of eosinophilic pustular folliculitis in infancy. The occurrence of this disorder in brothers suggests that an inherited or contagious factor may be involved in its aetiology.
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Affiliation(s)
- A S Dupond
- Department of Functional Dermatology, University Hospital, Besançon, France
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