UVA-1 phototherapy as adjuvant treatment for eosinophilic fasciitis: in vitro and in vivo functional characterization

Introduction: Eosinophilic fasciitis (EF) is a rare autoimmune disease causing progressive induration of dermal, hypodermal, and muscularis fascia. The exact pathogenesis is yet to be fully understood, and a validated therapy protocol still lacks. We here aimed to realize a clinical–functional characterization of these patients. Materials and methods: A total of eight patients (five males, 45 years average) were treated with adjuvant high-dose UVA-1 phototherapy (90 J/cm), after having received the standard systemic immunosuppressive protocol (oral methylprednisolone switched to methotrexate). Body lesion mapping, Localized Scleroderma Assessment Tool (LoSCAT), Dermatology Life Quality Index (DLQI), High-Resolution Ultrasound (HRUS) (13-17MHz), and ultra HRUS (55–70 MHz) were performed at each examination time taking specific anatomical points. Gene expression analysis at a molecular level and in vitro UVA-1 irradiation was realized on lesional fibroblasts primary cultures. Results: The LoSCAT and the DLQI showed to decrease significantly starting from the last UVA-1 session. A significant reduction in muscularis fascia thickness (−50% on average) was estimated starting from 3 months after the last UVA-1 session and maintained up to 12 months follow-up. Tissues was detected by HRUS. The UVA-1 in vitro irradiation of lesional skin sites cells appeared not to affect their viability. Molecular genes analysis revealed a significant reduction of IL-1ß and of TGF-ß genes after phototherapy, while MMPs 1,2,9 gene expression was enhanced. Comment: These preliminary in vivo and in vitro findings suggest that UVA-1 phototherapy is a safe and useful adjuvant therapy able to elicit anti-inflammatory effects and stimulate tissue matrix digestion and remodeling at lesional sites

The role of reflectance confocal microscopy and of optical coherence tomography in the diagnosis of pemphigus

7sinonenoneCouzan, Caroline; Perrot, jean Luc; Habougit, Cyril; Labeille, Bruno; Douchet, Catherine; Cambazard, Frédéric; Cinotti, ElisaCouzan, Caroline; Perrot, jean Luc; Habougit, Cyril; Labeille, Bruno; Douchet, Catherine; Cambazard, Frédéric; Cinotti, Elis

Role of reflectance confocal microscopy and optical coherence tomography as aids in the diagnosis of pemphigoid gestationis

7sinonenoneCouzan, C; Cinotti, E; Labeille, B; Habougit, C; Douchet, C; Cambazard, F; Perrot, J-LCouzan, C; Cinotti, Elisa; Labeille, B; Habougit, C; Douchet, C; Cambazard, F; Perrot, J. L

Aspect en microscopie confocale par réflectance in vivo des kératoses actiniques: Reflectance confocal microscopy features of actinic keratoses

Though the diagnosis of actinic keratoses is most often clinical, it is sometimes necessary to use non-invasive imaging methods to confirm this diagnosis. Reflectance confocal microscopic examination of actinic keratosis may reveal hyperkeratosis (i.e., detached, isolated or scaly corneocytes), parakeratosis (i.e., nucleated cells in the stratum corneum), dilated vessels and signs of solar elastosis, including clusters of moderately reflecting material and/or undulating shiny elastic fibres that are clearly visible in the superficial dermis. Hopefully, new in vivo microscopic imaging techniques such as line-field confocal optical coherence tomography will make it possible to obtain a three-dimensional examination of the skin and, thus, to further improve diagnostic accuracy of these lesions. © 2019 Elsevier Masson SAS. All rights reserved. Cet article fait partie du numéro supplément Kératoses actiniques : comprendre et traiter réalisé avec le soutien institutionnel de Galderma International

Contribution of reflectance confocal microscopy in the diagnosis of eyelid dermal nevus

7sinonenoneCinotti, E; Perrot, J-L; Labeille, B; Grivet, D; Habougit, C; Douchet, C; Cambazard, FCinotti, Elisa; Perrot, J. L; Labeille, B; Grivet, D; Habougit, C; Douchet, C; Cambazard, F