Anticorps monoclonaux thérapeutiques En dermatologie aussi

International audienceTherapeutic monoclonal antibodies are henceforth commonly used in the management of psoriasis but have been also used more recently in chronic spontaneous urticaria and atopic dermatitis. Three examples are developed herein: dupilumab, omalizumab and lanadelumab. The specificity of their mechanism of action results from a better understanding of the inflammatory pathways in these chronic diseases, which previously shared either the same targeted topical or systemic treatments. However, their high costs should be put into perspective with the epidemiology, the precise evaluation of the severity, the optimization of first line treatments and the long-term benefit/risk ratio

Évaluation de l'intérêt de nouveaux marqueurs du métabolisme cellulaire en dermatologie

MONTPELLIER-BU Médecine UPM (341722108) / SudocPARIS-BIUM (751062103) / SudocMONTPELLIER-BU Médecine (341722104) / SudocSudocFranceF

Lethal anaplastic large-cell lymphoma occurring in a patient treated with dupilumab

International audienceNo abstract availabl

Merkel cell polyomavirus: Its putative involvement in a particular subset of cutaneous lymphoma with possibly unfavorable outcome

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High Expression of Fas/CD95 on CD4+ Circulating T Cells: An Exclusion Criterion in the Diagnosis of Mycosis Fungoides?

International audienceThe aim of this 10-year monocentric prospective study was to determine a cut-off value of Fas/CD95 expression by peripheral blood CD4+ T lymphocytes in discriminating patients with mycosis fungoides from controls with cutaneous benign lymphocytic conditions. CD95 expression in peripheral blood CD4+ T lymphocytes was measured using flow cytometry in 330 patients referred for diagnosis: 104 with mycosis fungoides and 226 with eczema, psoriasis, drug reaction, etc. The sensitivity and specificity of different thresholds of CD95 expression were calculated regarding the final diagnosis of patients with mycosis fungoides or controls. CD95 expression higher than 30% reached a specificity of 91% in ruling out a diagnosis of mycosis fungoides, although overall CD95 expression was not significantly different from that of controls (p = 0.309) and sensitivity was very low (5%). Thus, peripheral CD95 expression higher than 30% could be used among the exclusion criteria in a multicomponent score for mycosis fungoides diagnosis

Allergic contact dermatitis caused by Magnolia officinalis bark extract in a facial anti-ageing cream

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Evolution of Bullous Pemphigoid Clinical Pattern over Time: A 17-Year Single-Centre Retrospective Survey of 312 Cases

International audience&lt;b&gt;&lt;i&gt;Background and Objectives:&lt;/i&gt;&lt;/b&gt; Bullous pemphigoid (BP) clinical profile may have evolved during the last 2 decades. A retrospective, single-centre analysis investigated a possible shift of clinical presentation of the disease over time regarding both lesions’ clinical pattern and locations and more particularly an increased frequency of characteristics considered as less classical regarding the usual clinical description of BP. &lt;b&gt;&lt;i&gt;Patients and Methods:&lt;/i&gt;&lt;/b&gt; Initial clinical data from all BP patients treated between January 2001 and April 2017 in a reference centre were collected and compared between four 4-year successive chronological subsets (G1 to G4). &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; 213/312 patients retained for final analysis (68.3%) displayed at least one initial non-classical characteristic, mainly head and neck, palmo-plantar, and/or mucosal involvement. Chronological analysis confirmed a significant increase over time of the percentage of patients displaying such features (G1 57.9% vs. G4 73.7%, &lt;i&gt;p&lt;/i&gt; = 0.041). &lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; Changes in BP clinical pattern may have occurred over the last two decades with the progressive emergence of forms with a number of less classical features. No significant clinical difference was observed between patients receiving or not DPP4 inhibitors at the time of diagnosis. </jats:p

Place des traitements innovants du mélanome métastatique chez le sujet âgé

International audienceThe mortality rate for malignant melanoma is higher in elderly patients aged 75 years or more, with over 25% of melanomas being diagnosed in this population. This poorer prognosis might perhaps be improved by emerging targeted therapies and immunotherapy, although these agents must be prescribed with care in this rather fragile population. The purpose of our review of the literature concerning phase-2 and -3 published trials of these innovative molecules was to examine their optimal use in elderly patients presenting metastatic malignant melanoma. Most of the trials examined included elderly patients and some were analyzed by age sub-groups. In conclusion, elderly patients with ECOG 0/1 status can be given ipilimumab or vemurafenib as first-line therapy depending on tumoral BRaf mutation status. The benefit of combined targeted therapies does not seem to apply consistently in elderly patients and their use must be discussed. Further specific data must be collected in elderly patients concerning anti-PD1 molecules. For more fragile patients, risk scales or scores should enable more accurate use of innovative therapies in metastatic melanoma. Moreover, physicians must be aware of the common drug interactions with targeted therapies, since elderly patients are often taking several concomitant drugs

Clostridium difficile infection may loom behind ipilimumab-induced auto-immune colitis.

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