DHEA et intracrinologie de jouvence pour la peau? Entre raison et magie.

in Revue Médicale de Liège (2002), 57(7), 438-42

Slowing down ageing is a goal for a large part of the population. Some mercantile claims hold out bright prospects to DHEA. The effects of this hormone manifest themselves after intracrine conversion. In ... [more ▼]

Slowing down ageing is a goal for a large part of the population. Some mercantile claims hold out bright prospects to DHEA. The effects of this hormone manifest themselves after intracrine conversion. In the skin, sebaceous glands enlarge and seborrhoea increases in post-menopausal women. No other effect is clinically discernable on the skin. At this level, DHEA does not show efficacy comparable to that of other anti-ageing compounds. [less ▲]

Comment je traite.... Un pityriasis rubra pilaire.

in Revue Médicale de Liège (2002), 57(6), 363-5

Pityriasis rubra pilaris is a syndrome of unknown etiology. Six distinct clinical types have been described in infancy and adulthood. Oral retinoids have proven their efficacy. Emollients and topical ... [more ▼]

Pityriasis rubra pilaris is a syndrome of unknown etiology. Six distinct clinical types have been described in infancy and adulthood. Oral retinoids have proven their efficacy. Emollients and topical calcipotriol may improve the clinical presentation. [less ▲]

Euclidean and fractal computer-assisted corneofungimetry: a comparison of 2% ketoconazole and 1% terbinafine topical formulations.

in Dermatology : International Journal for Clinical & Investigative Dermatology (2002), 204(3), 222-7

BACKGROUND: The corneofungimetry bioassay was designed as a unique model predicting the efficacy of topical and oral antifungals in dermatomycoses. OBJECTIVE: In this 2-step study performed in two groups ... [more ▼]

BACKGROUND: The corneofungimetry bioassay was designed as a unique model predicting the efficacy of topical and oral antifungals in dermatomycoses. OBJECTIVE: In this 2-step study performed in two groups of 15 volunteers, corneofungimetry was used to compare the effect of 5-day b.i.d. treatments with 2% ketoconazole and 1% terbinafine creams. METHODS: The bioassay was performed using 10 isolates of each of the 3 fungi Trichophyton rubrum, T. mentagrophytes var. interdigitale and Candida albicans put to grow on human stratum corneum. Controls were stratum corneum either untreated or enriched in propylene glycol contained in an unmedicated vehicle. Quantitative assessments were made using both Euclidean and fractal geometry parameters. RESULTS: In comparison with untreated stratum corneum, the fungitoxic activity of the 2% ketoconazole and 1% terbinafine formulations was obvious and similar against dermatophytes. By contrast, 2% ketoconazole was significantly more active against C. albicans than 1% terbinafine. The propylene-glycol-containing vehicle did not exhibit a significant effect upon the dermatophyte growth. Positive linear correlations were yielded between the extent area and the fractal dimension D of dermatophyte mycelia. By contrast, D appeared unrelated to the relative area of dermatophyte growth compared to controls. CONCLUSION: The combination of Euclidean and fractal analyses improves the information provided by the corneofungimetry bioassay. Creams containing 2% ketoconazole and 1% terbinafine appear equally effective against dermatophytes while the former is more potent against Candida albicans. [less ▲]

The beneficial toxicity paradox of antimicrobials in leg ulcer healing impaired by a polymicrobial flora: a proof-of-concept study.

in Dermatology : International Journal for Clinical & Investigative Dermatology (2002), 204 Suppl 1

BACKGROUND: Some of the views contrasting the beneficial and toxic effects of antimicrobials upon wound healing remain controversial. OBJECTIVE: To assess the clinical relevance of histological findings ... [more ▼]

BACKGROUND: Some of the views contrasting the beneficial and toxic effects of antimicrobials upon wound healing remain controversial. OBJECTIVE: To assess the clinical relevance of histological findings following antimicrobial applications on chronic leg ulcers. METHOD: The present study was performed in three parallel groups of 17 patients suffering from at least 2 similar chronic leg ulcers. Clinical planimetric assessments were performed before and after 3 and 6 weeks of treatment using hydrocolloid dressings. In addition, 1 ulcer in each patient received applications of povidone-iodine (PVP-I), silver sulfadiazine or chlorhexidine digluconate. Histological examinations were made at inclusion and after the 6-week therapy. Time to healing was also recorded. RESULTS: At entry in the study, fibroblasts, macrophages, neutrophils and vessels were abundant in the ulcers. In addition, focal necrotizing vasculitis was related to the microbiological load. Compared to the control lesions, both the healing rate and time to healing of the leg ulcers showed a modest improvement at the sites receiving silver sulfadiazine (2-7%) or chlorhexidine digluconate (-1 to 5%). By contrast, PVP-I increased significantly the healing rate (4-18%, p < 0.01), and time to healing was reduced by 2-9 weeks (p < 0.01). The 3 antimicrobials decreased the bacterial density, and the vascular margination and migration of inflammatory cells, thus abating the vasculitic changes. PVP-I applications did not alter the microvessels and did not significantly reduce the density in dendrocytes and fibroblasts. By contrast, both silver sulfadiazine and chorhexidine digluconate appeared to alter the superficial microsvasculature including the dendrocyte population. CONCLUSION: Although topical antimicrobials may apparently achieve almost similar activity on the bacterial load inside chronic leg ulcers, the toxicity upon host cells was different among these agents. PVP-I appeared to be an efficient compound in these respects exhibiting a positive and relevant clinical effect. [less ▲]

Pharma clinics. Comment je traite ... un herpes labial récurrent.

in Revue Médicale de Liège (2002), 57(2), 67-71

Recurrent herpes labialis is a frequent disorder. It occurs following the reactivation of the Herpesvirus (HSV1 and more rarely HSV2) inside the Gasser ganglion. Treatment and prevention of recurrent ... [more ▼]

Recurrent herpes labialis is a frequent disorder. It occurs following the reactivation of the Herpesvirus (HSV1 and more rarely HSV2) inside the Gasser ganglion. Treatment and prevention of recurrent labial herpes are targeted by specific antiviral agents. Spectacular benefits obtained in the immunocompromised patients are less convincing in otherwise healthy subjects. Other prospective ways of therapy are under consideration, including lipopeptides and physical means aiming at modifying the cutaneous pH. [less ▲]

Postmenopausal aging of the sebaceous follicle: a comparison between women receiving hormone replacement therapy or not.

in Dermatology : International Journal for Clinical & Investigative Dermatology (2002), 204(1), 17-22

BACKGROUND: The endocrine control of sebaceous follicles is complex in women. During aging, a decline in sebum output is often experienced. However, some women report increased seborrhea after the ... [more ▼]

BACKGROUND: The endocrine control of sebaceous follicles is complex in women. During aging, a decline in sebum output is often experienced. However, some women report increased seborrhea after the menopause. OBJECTIVE: In this study, the follicular reservoir function was studied during the first decade following the menopause. METHODS: Four evaluations were made at 3-week intervals in two parallel age-matched groups of 50 postmenopausal women receiving hormone replacement therapy (HRT) or not. The Sebumeter served to measure the casual sebum level and the sebum excretion rate on the forehead. In addition, a Visioscan equipped with an ultraviolet-recording camera was used with and without lipid-sensitive tapes interposed between the camera and the skin surface. Follicular openings and sebum pore patterns were studied by image analysis. RESULTS: There was enormous diversity among individual values of sebum output at the skin surface. In untreated women, a significant decline in sebum excretion rate accompanied by an increase in both the sebum replacement time and the mean pore size were evidenced during the first decade after the menopause. The sebum excretion rate and casual level showed a wide range of interindividual differences early after the menopause. These physiological changes were less prominent in women receiving HRT. CONCLUSION: Postmenopausal aging affects the sebum production, but HRT does not significantly control the complex process of seborrhea. However, HRT mitigates the progressive enlargement of the openings of the sebum follicular reservoir. [less ▲]

Assessment of topical hypopigmenting agents on solar lentigines of Asian women.

in Dermatology : International Journal for Clinical & Investigative Dermatology (2002), 204(4), 281-6

BACKGROUND: So-called darkened age spots encompass distinct pathological processes. The efficacy of topical depigmenting agents is difficult to objectivate. OBJECTIVE: To assess the hypopigmenting effect ... [more ▼]

BACKGROUND: So-called darkened age spots encompass distinct pathological processes. The efficacy of topical depigmenting agents is difficult to objectivate. OBJECTIVE: To assess the hypopigmenting effect of three cosmetic formulations using objective biometrological methods. METHODS: 50 women of South-East Asian ancestry were enrolled in this pilot study. They had solar lentigines according to dermoscopic criteria. The lesions were treated by topical hypopigmenting formulations. Products were applied twice daily for 2 or 3 months. Assessments at 1-month intervals were made using narrow-band reflectance spectrophotometry, image analysis of video-recorded ultraviolet light reflection and photodensitometry- and image-analysis-assisted corneomelametry. RESULTS: A 20% azelaic acid formulation and another one containing 5% ascorbyl glucosamine, 1% kojic acid and alpha-hydroxyacid esters appeared inefficacious on solar lentigines. A stabilized soy extract showed a better although modest lightening effect when assessed by corneomelametry. The subclinical or faint mottled skin revealed by ultraviolet light examination better responded (p < 0.05) to treatments. CONCLUSION: Focal epidermal hyperpigmentation is better controlled by topical whitening agents when the increase in melanin content reflects a modest functional hyperactivity of melanocytes. [less ▲]

Skin tensile properties in patients treated for acromegaly.

in Dermatology : International Journal for Clinical & Investigative Dermatology (2002), 204(4), 325-9

BACKGROUND: Somatotropic effects are described in the skin. Indeed, acromegaly is in part clinically recognized by cutaneous coarsening. The actual changes in tensile properties associated with the ... [more ▼]

BACKGROUND: Somatotropic effects are described in the skin. Indeed, acromegaly is in part clinically recognized by cutaneous coarsening. The actual changes in tensile properties associated with the cutaneous manifestations are largely unknown. OBJECTIVES: To study the relationships between the skin tensile properties and the severity of acromegaly as assessed by serum levels of growth hormone (GH) and insulin-like growth factor 1 (IGF-1). PATIENTS AND METHOD: Assessments were made in 13 patients with acromegaly treated by somatostatin agonists combined or not with surgery. A total of 39 age- and sex-matched healthy subjects served as controls. Skin tensile properties were measured on the forearm and nape of the neck using a computerized suction device. RESULTS: Significant differences were yielded between the skin tensile properties in patients and normal subjects. The highest IGF-1 values in the patients' medical records were positively correlated with both skin distensibility and biologic elasticity. The most recent IGF-1 serum levels were negatively correlated with the visco-elastic ratio. No correlations were yielded between any of the biomechanical parameters and GH levels, disease duration and treatment dosages, respectively. CONCLUSION: The skin in acromegaly appears to be functionally more redundant and elastic than normal skin. The biomechanical changes appear quite different from those observed in other diseases with collagen deposition such as diabetes mellitus and scleroderma. [less ▲]

Epidermal Calprotectin Expression in Lymphocyte-Depleted Cutaneous Graft-versus-Host Reaction

in Archivos Argentinos de Dermatologia (1998), 48

One of the most important complications associated with bone marrow transplantation (BMT) is graft-versus-host reaction (GVHR) altering different organs. The immunosuppressive regimen frequently abates ... [more ▼]

One of the most important complications associated with bone marrow transplantation (BMT) is graft-versus-host reaction (GVHR) altering different organs. The immunosuppressive regimen frequently abates the severity of cutaneous lesions to a peculiar lymphocyto-depleted GVHR (LD-GVHR) with scant recognizable inflammatory cells and almost absence of epidermal injury. The recently revisited histological criteria for cutaneous GVHR are of little help in diagnosing such LD-GVHR. As calprotectin (L1-protein) has been reported to be expressed in several types of stressed epithelia, we assessed the epidermal calprotectin expression during LD-GVHR. Calprotectin expression was studied by immuno-histochemistry using the Mac 287 moAb in 50 cases of LD-GVHR and 40 cases of toxic reactions due to the conditioning regimens or to post-transplant drugs. Calprotectin was evidenced in normal looking keratinocytes of all cutaneous LD-GVHR cases and in the vast majority of cytotoxic drug-induced dermatitis. It is concluded that calprotectin immunoreactivity appears to be a diagnostic clue in LD-GVHR. The epidermal calprotectin expression occurs early in GVHD, irrespective of the histological grading. However, it cannot be used alone to distinguish early LD-GVHR from drug-induced dermatitis. [less ▲]

Immunohistochemical expression of epidermal growth factor receptors in nuclei of a subpopulation of keratinocytes and sweat gland cells.

in Dermatologica (1991), 183(1), 7-9

We have raised a polyclonal antibody to the 170-kD epidermal growth factor receptor. We found an intercellular pattern of immunoreactivity in the epidermis as well as a positivity of the cytoplasm of ... [more ▼]

We have raised a polyclonal antibody to the 170-kD epidermal growth factor receptor. We found an intercellular pattern of immunoreactivity in the epidermis as well as a positivity of the cytoplasm of keratinocytes and eccrine secretory cells. In some samples, a nuclear labelling was evidenced in these type of cells. There is a close resemblance in the topographical distribution of these cells with nuclear labelling and those synthesizing DNA under phytohaemagglutinin stimulation. [less ▲]