Background In basal cell nevus syndrome, basal cell carcinomas occur in early life. The treatment of basal cell carcinomas requires surgical excisions and may lead to unaesthetic scars. Photodynamic ...therapy (PDT) is a validated treatment of skin cancers, with good cosmetic outcomes.
Objectives The aim of the study was to evaluate patient’s satisfaction, cosmetic outcome and number of surgical excisions before and after PDT, in patients with basal cell nevus syndrome treated with PDT.
Methods A cross‐sectional evaluation of all patients with basal cell nevus syndrome, treated with PDT for basal cell carcinomas. A questionnaire evaluated satisfaction, cosmetic outcomes for surgery and PDT. The number of surgeries before and after PDT was noted and efficacy was evaluated.
Results Seven patients were evaluated; 85% of patients were satisfied with PDT vs. 55% for surgery. The average visual analogue score for the cosmetic result was 8.42/10 for PDT vs. 6.3/10 for surgery. The mean number of surgical excisions was 4.4 during the 6 months before the first session of PDT and 0.57 after.
Conclusion Methylaminolevulinate‐photodynamic therapy seems an interesting option for the treatment of basal cell carcinomas in patients with basal cell nevus syndrome.
Cytophagic histiocytic panniculitis (CHP) is a rare disease mostly caused by viral infections and/or lymphoproliferative diseases. We describe a case of CHP associated with H1N1 vaccine during the ...winter 2009-2010 vaccination campaign and discuss the cutaneous side effects of influenza vaccines. A 6-year-old child presented with inflammatory subcutaneous nodules, which had appeared 1 month after the first injection of H1N1 vaccine and 1 week after the second injection. There was no history of recent infection. The skin lesions spontaneously disappeared without scarring. In CHP the abnormal cytokine secretion from neoplastic or reactive T cells promotes monocyte-macrophage activation and haemophagocytosis. Vaccination is not a common cause of CHP, but it seems possible that, as in infectious diseases, reactive T cells to the vaccine antigen could trigger CHP.
A rise in the incidence of bullous pemphigoid (BP) was documented recently in Europe, and the main risk factors for BP remain unknown. We conducted a multicenter case–control study to evaluate risk ...factors for BP. We identified 201 incident BP cases and 345 controls individually matched for age, gender, center, and place of residence (home, nursing home, or extended-care facility). We used univariate and multivariate logistic regression analyses to compare drugs used for over 3 months, comorbidities, and physical and cognitive impairments between cases and controls. Mean age of BP patients was 84.2 (±8.7) years. Factors independently associated with BP by multivariate analysis were major cognitive impairment (odds ratio (OR), 2.19; 95% confidence interval (95% CI), 1.24–3.87), bedridden condition (OR, 2.19; 95% CI, 1.23–3.89), Parkinson's disease (OR, 2.16; 95% CI, 1.09–4.27), unipolar or bipolar disorder (OR, 5.25; 95% CI, 1.21–22.86), and chronic use of spironolactone (OR, 2.30; 95% CI, 1.20–4.46) or phenothiazines with aliphatic side chains (OR, 3.70; 95% CI, 1.21–11.34). Chronic analgesic use was associated with a lower risk of BP (OR, 0.49; 95% CI, 0.30–0.81). Thus, risk factors for BP include neurological disorders, particularly dementia and Parkinson's disease, psychiatric disorders (unipolar and bipolar disorders), bedridden condition, and chronic use of several drugs.
Paecilomyces lilacinus is an emerging pathogen in immunocompromised patients. We report here a case of cutaneous hyphomycosis in a 63‐year‐old heart transplant recipient caused by the simultaneous ...presence of 2 molds: Paecilomyces lilacinus and Alternaria alternata. The infection was successfully treated with local voriconazole followed by oral terbinafine.
Nonspecific low back pain is first cause of years lived with disability. An active disc disease is present in up to 58% of patients with low back pain. We aimed to describe patients with chronic low ...back pain and an active disc disease who respond and those who do not respond to intradiscal glucocorticoid or to intradiscal contrast.
We conducted a secondary analysis of the PREDID study, a randomized trial of 135 patients with chronic low back pain and an active disc disease. Overall, 61 participants received an intradiscal injection of glucocorticoid (25mg prednisolone acetate) during discography and 60 received discography alone. Fourteen participants did not receive the allocated treatment and were not included in this secondary analysis. The primary outcome was the description of clinical, demographical, psychological and social characteristics of responders and non-responders to intradiscal glucocorticoid and to intradiscal contrast at 1 month, as defined in the primary trial. Independent variables associated to clinical response were assessed by logistic regression.
Participants who responded to intradiscal corticosteroid injection were more often highly educated (18/34 52.9% vs. 6/26 23.1%, respectively), whereas participants who did not respond were more often on sick leave (14/27 51.9% vs. 5/34 14.7%). The independent variable most strongly associated with the absence of therapeutic response to intradiscal glucocorticoid was sick leave (OR=33.8, 95% CI=2.4 to 472.2). Similar results were observed with response to intradiscal contrast injection but the magnitude of differences was lower.
Patients with chronic low back pain and an active disc disease who respond to an intradiscal injection of corticosteroids or contrast have a social profile different from those who do not respond.
ClinicalTrials.gov number NCT00804531 (First received: December 8, 2008. Last updated: June 23, 2016).
French Ministry of Health (Programme Hospitalier de Recherche Clinique, project No. P070157).
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