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Bastos S, Masmoudi W, Pinard C, Duval-Modeste AB, Joly P, Hébert V. Efficacy of nivolumab in the treatment of metastatic cutaneous squamous cell carcinoma in a kidney-transplant patient with a history of allograft rejection. Ann Dermatol Venereol 2022; 149:198-199. [PMID: 35181155 DOI: 10.1016/j.annder.2022.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 06/11/2021] [Accepted: 01/04/2022] [Indexed: 12/20/2022]
Affiliation(s)
- S Bastos
- Department of Dermatology, Rouen University Hospital, 76000 Rouen, France.
| | - W Masmoudi
- Department of Dermatology, Rouen University Hospital, 76000 Rouen, France
| | - C Pinard
- Department of Dermatology, Rouen University Hospital, 76000 Rouen, France
| | - A-B Duval-Modeste
- Department of Dermatology, Rouen University Hospital, 76000 Rouen, France
| | - P Joly
- Department of Dermatology, Rouen University Hospital, 76000 Rouen, France
| | - V Hébert
- Department of Dermatology, Rouen University Hospital, 76000 Rouen, France
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Hébert V, Bastos S, Drenovska K, Meijer J, Ingen-Housz-Oro S, Bedane C, Lunardon L, Debarbieux S, Jedlickova H, Caux F, Chaby G, D'Incan M, Feliciani C, Boulard C, Schumacher N, Schmidt E, Roussel A, Richard MA, Gottlieb J, Ferranti V, Guérin O, Bénichou J, Joly P. International multicentre observational study to assess the efficacy and safety of a 0·5 mg kg -1 per day starting dose of oral corticosteroids to treat bullous pemphigoid. Br J Dermatol 2021; 185:1232-1239. [PMID: 34173243 DOI: 10.1111/bjd.20593] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND European guidelines propose a 0·5 mg kg-1 per day dose of oral prednisone as initial treatment for bullous pemphigoid (BP). We assessed the safety and efficacy of this regimen depending on BP extent and general condition of the patients. METHODS In a prospective international study, we consecutively included all patients diagnosed with BP. Patients received a 0·5 mg kg-1 per day dose of prednisone, which was then gradually tapered 15 days after disease control, with the aim of stopping prednisone or maintaining minimal treatment (0·1 mg kg-1 per day) within 6 months after the start of treatment. The two coprimary endpoints were control of disease activity at day 21 and 1-year overall survival. Disease severity was assessed according to the Bullous Pemphigoid Disease Area Index (BPDAI) score. RESULTS In total, 198 patients were included between 2015 and 2017. The final analysis comprised 190 patients with a mean age of 80·9 (SD 9·1) years. Control of disease activity was achieved at day 21 in 119 patients [62·6%, 95% confidence interval (CI) 55·3-69.5]; 18 of 24 patients (75%, 95% CI 53·3-90·2), 75 of 110 patients (68·8%, 95% CI 59·2-77·3) and 26 of 56 patients (46.4%, 95% CI 33·0-60·3) had mild, moderate and severe BP, respectively (P = 0·0218). A total of 30 patients died during the study. The overall Kaplan-Meier 1-year survival was 82·6% (95% CI 76·3-87·4) corresponding to 90·9%, 83·0% and 80·0% rates in patients with mild, moderate and severe BP, respectively (P = 0·5). Thresholds of 49 points for BPDAI score and 70 points for Karnofsky score yielded maximal Youden index values with respect to disease control at day 21 and 1-year survival, respectively. CONCLUSIONS A 0·5 mg kg-1 per day dose of prednisone is a valuable therapeutic option in patients with mild or moderate BP whose general condition allows them to be autonomous.
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Affiliation(s)
- V Hébert
- Department of Dermatology, Rouen University Hospital, Center for Autoimmune Bullous Diseases, and INSERM U1234, Normandie University, Rouen, France
| | - S Bastos
- Department of Dermatology, Rouen University Hospital, Center for Autoimmune Bullous Diseases, and INSERM U1234, Normandie University, Rouen, France
| | - K Drenovska
- Department of Dermatology, Medical University of Sofia, Sofia, Bulgaria
| | - J Meijer
- Center for Blistering Diseases, Department of Dermatology, University Medical Center Groningen, Groningen, the Netherlands
| | - S Ingen-Housz-Oro
- Department of Dermatology, Henri Mondor University Hospital, (AP-HP), Creteil, France
| | - C Bedane
- Department of Dermatology, Limoges University Hospital, Limoges, France
| | - L Lunardon
- Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - S Debarbieux
- Department of Dermatology, Hospices Civils de Lyon, Lyon, France
| | - H Jedlickova
- Department of Dermatology, St. Anne's Faculty Hospital, Brno, Czech Republic
| | - F Caux
- Department of Dermatology, Avicenne Hospital, University Paris 13, Bobigny, France
| | - G Chaby
- Department of Dermatology, Amiens University Hospital, Amiens, France
| | - M D'Incan
- Department of Dermatology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - C Feliciani
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - C Boulard
- Department of Dermatology, Monod General Hospital, le Havre, France
| | - N Schumacher
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - A Roussel
- Department of Dermatology, Orleans Hospital, Orléans, France
| | - M A Richard
- Department of Dermatology, Hôpital la Timone, Assistance Publique des Hôpitaux de Marseille, Marseille, France
| | - J Gottlieb
- Department of Dermatology, Saint Louis Hospital, (AP-HP), Paris, France
| | - V Ferranti
- Department of Biostatistics, Rouen University Hospital, Rouen, France
| | - O Guérin
- Department of Biostatistics, Rouen University Hospital, Rouen, France
| | - J Bénichou
- Department of Biostatistics, Rouen University Hospital, Rouen, France
| | - P Joly
- Department of Dermatology, Rouen University Hospital, Center for Autoimmune Bullous Diseases, and INSERM U1234, Normandie University, Rouen, France
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Bastos S, Hebert V, Vassileva S, Patsatsi A, Meijer J, Quéreux G, Bedane C, Prost-Squarcioni C, Debardieux S, Oro S, Chaby G, D’Incan M, Litrowski N, Boulard C, Lunardon L, Kiritsi D, Jedlickova H, Feliciani C, Roussel A, Kottler D, Plantin P, Richard MA, Friedrichsen L, Abasq C, Duvert Lehembre S, Gottlieb J, Zebrowska A, Hofmann S, Joly P. Efficacité et tolérance de la prednisone à 0,5 mg/kg/j en traitement initial de la pemphigoïde bulleuse. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Barreirinho MS, Teixeira J, Moreira NC, Bastos S, Gonçalvez S, Barbot MC. [Joubert's syndrome: report of 12 cases]. Rev Neurol 2001; 32:812-7. [PMID: 11424029] [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: 02/20/2023]
Abstract
INTRODUCTION Joubert syndrome is a rare autosomal recessive disorder whose main clinical signs are hypotonia, ataxia, mental retardation, abnormal eye movements and a respiratory pattern of alternating tachypnea-apnea during first months of life. The most characteristic imaging features are elongation and thinning of the pontomesencephalic junction with deepening of the interpeduncular fosse, thickening of the superior cerebellar peduncles, hypoplasia of the vermis and incomplete fusion of the halves of the vermis, creating a sagittal vermic cleft. The first three findings are components of the molar tooth sign . OBJECTIVES Our aim was to review the clinical features and the neuroradiological findings in 12 children with clinical diagnosis of Joubert syndrome, along with the attempt to correlate clinical and radiological findings. PATIENTS AND METHODS We performed a retrospective study, and cerebral magnetic resonance imaging was achieved in all cases. RESULTS All the children have mental retardation, hypotonia, ataxia and oculomotor abnormalities. Other clinical findings are respiratory rhythm abnormalities, abnormal retinal pigmentation, mouth-tongye-facial dyskinesias, ptosis, polydactyly, scoliosis, congenital heart defects, polycystic kidneys and seizures. All patients have agenesis of the vermis and the molar tooth sign is present in nine patients. Five children have other associated cerebral malformations. CONCLUSIONS In the absence of a biochemical or genetic marker for the Joubert syndrome, we need to have a group of patients with homogeneous clinical and neuroradiological characteristics, in order to avoid an overlap with other syndromes. According to our experience and the review of the literature, we believe that the following should be considered as major diagnostic criteria for Joubert syndrome: hypotonia, ataxia, mental retardation, oculomotor apraxia and the molar tooth sign . Supporting clinical features are: abnormal respiratory pattern, retinal pigmentation, renal abnormalities and facial dysmorphism.
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Affiliation(s)
- M S Barreirinho
- Servicio de Neuropediatría; Hospital de Crianças Maria Pia, Porto, 4050, Portugal.
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