RISQUES CUTANES DU SOLEIL (PLACE DU PHARMACIEN DANS LA PREVENTION)

ANGERS-BU Médecine-Pharmacie (490072105) / SudocSudocFranceF

Intoxication chronique à l'arsenic

Un homme de 75 ans est hospitalisé en Dermatologie pour une pigmentation cutanée diffuse du tronc avec des petites taches achromiques et des papules kératosiques palmaires dans un contexte d'altération de l'état général. Le diagnostic clinique d'arsenicisme chronique est confirmé par des dosages d'arsenic (arsenic inorganique et métabolites) dans le plasma, l'urine et les phanères et ceci par spectrophotométrie d'absorption atomique avec four graphite et correction Zeeman (GFAAS). L'acide monométhylarsonique (MMA) et l'acide diméthylarsinique (DMA) sont dosés dans l'urine par chromatographie liquide couplée à la spectrométrie de masse en tandem avec ionisation par électrospray (LC-ES-MS-MS). La consommation d'un vin fabriqué par le patient est à l'origine de l'intoxication. Une concentration élevée d'arsenic y est retrouvée (7 mg/l). Il semblerait qu'une erreur dans la manipulation d'un fongicide à l'arsénite de sodium utilisé pour le traitement de la vigne, le Pyralesca®, soit la cause de la contamination du vin

Omalizumab in patients with severe and refractory solar urticaria: A phase II multicentric study

International audienceno abstrac

Photodermatitis from topical phenothiazines A case series

International audienceBackground - In Europe, contact photosensitivity to phenothiazines is well-known, particularly in southern countries. Topical phenothiazines are widely used and sold over-the-counter (OTC) for the treatment of mosquito bites and pruritus in France. Objective - To report a series of cases with photodermatitis following use of topical phenothiazines. Method - A retrospective study of cases of contact dermatitis from phenothiazines seen in French photodermatology centers was performed. Results - In all, 14 patients with a diagnosis of contact dermatitis from phenothiazines were included. These patients developed eczema on the application sites, and in 13 the eruption spread to photodistributed sites. Topical products containing isothipendyl were the most common cause of photodermatitis. One patient had photoaggravated eczema due to promethazine cream. All patients stopped using topical phenothiazines and were treated successfully with topical corticosteroids. One patient relapsed and developed persistent light eruption. In all of the nine cases tested, photopatch testing to the topical phenothiazine used "as is" was positive. Isothipendyl, chlorproethazine, and the excipients were not tested. Photopatch tests to chlorpromazine and promethazine were positive in 8 of 12 and 7 of 13 tested, respectively. Conclusion - Use of isothipendyl and promethazine as OTC (or even prescribed) drugs needs to be limited due to severe reactions and sensitization to other phenothiazines that consequently will have to be avoided

A high neutrophil-to-lymphocyte ratio as a potential marker of mortality in patients with Merkel cell carcinoma: A retrospective study

The prognostic relevance of a high blood neutrophil-to-lymphocyte ratio (NLR) has been reported in many cancers, although, to our knowledge, not investigated in patients with Merkel cell carcinoma (MCC) to date.We assessed whether the NLR at baseline was associated with specific survival and recurrence-free survival in MCC.We retrospectively included MCC cases between 1999 and 2015 and collected clinical data, blood cell count at baseline, and outcome. A Cox model was used to identify factors associated with recurrence and death from MCC.Among the 75 patients included in the study, a high NLR at baseline (NLR ≥4) was associated with death from MCC in univariate (hazard ratio 2.76, 95% confidence interval 1.15-6.62, P = .023) and multivariate (hazard ratio 3.30, 95% confidence interval 1.21-9.01, P = .020) analysis, but not with recurrence.Because of the retrospective design, we excluded patients with missing data and not all confounding factors that may influence the NLR were available.A high NLR at baseline was independently associated with specific mortality in patients with MCC. The NLR seems to constitute an easily available and inexpensive prognostic biomarker at baseline

Somatostatin Receptors 2A and 5 Are Expressed in Merkel Cell Carcinoma with No Association with Disease Severity

Merkel cell carcinoma (MCC) is a rare high-grade neuroendocrine tumour of the skin. It has been speculated that MCCs express somatostatin receptors (SSTRs), but this has never been assessed in a large series of MCCs. The main aim of this study was to assess the expression of SSTR2A and SSTR5 in MCC tumours. The secondary aims were to assess whether expression of SSTR was associated with the Ki67 proliferative index, Merkel cell polyomavirus (MCPyV) status, clinical characteristics and outcome.Clinical data and tumours were collected from an ongoing cohort of French patients with MCC. Immunohistochemistry was performed with anti-SSTR2A and anti-SSTR5 monoclonal antibodies, and tumours were classified into 3 groups: 'no expression', 'low expression' and 'moderate expression' using an SSTR staining score.SSTR expression was assessed for 105 MCC tissue samples from 98 patients, and clinical characteristics were available for 87 of them. SSTR expression was consistent between the primary skin tumour and the corresponding metastases for SSTR2A and SSTR5 in 3/7 and 6/7 cases, respectively. SSTR2A and SSTR5 were expressed in 58 cases (59.2%) and in 44 cases (44.9%), respectively. Overall, at least one SSTR was expressed in 75 tumours (76.5%). SSTR expression was not associated with clinical characteristics, Ki67 proliferative index, recurrence-free survival or MCC-specific survival. Expression of SSTR2A was associated with MCPyV status in MCC tumours but not SSTR5.SSTRs were expressed in a high proportion of MCCs, although expression was heterogeneous between tumours and was not associated with disease severit

Marqueurs tumoraux et sériques dans les carcinomes à cellule de Merkel

National audienc