J P Lacour

University of Nice-Sophia Antipolis, Nice, Provence-Alpes-Côte d'Azur, France

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Publications (224)399.18 Total impact

  • Annales de Dermatologie et de Vénéréologie 11/2014; · 0.60 Impact Factor
  • Annales de Dermatologie et de Vénéréologie 08/2014; · 0.60 Impact Factor
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    ABSTRACT: Acral nevi are peculiar subtype of nevus with specific dermoscopic patterns. Little is known about congenital melanocytic nevi affecting acral volar skin in children.
    British Journal of Dermatology 06/2014; · 3.76 Impact Factor
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    ABSTRACT: Background Pigmented purpuric dermatosis (or Schamberg's disease) is characterized by chronic macular purpura and capillaritis. It is more common in young adult males and adolescents and is generally localized on the lower limbs. In this article, we report on five young children with generalized Schamberg's disease. Patients and methods Five children (aged 13 months to 5 years) were included in this retrospective study. Time to consultation delay ranged from 15 days to 1 year. Results All patients presented asymptomatic generalized macular purpura. Skin biopsies were performed in 4 cases and were characteristic. The results of coagulation tests and complete blood counts were within the normal range in all patients. The clinical course was chronic, with periods of improvement and worsening. No treatment was prescribed. Discussion Schamberg's disease is uncommon in childhood. Our observations suggest that this diagnosis is not exceptional. Clinical appearance, setting and normal blood count values are sufficient to enable a diagnosis to be made. The clinical course is generally chronic, and as yet no treatments have demonstrated efficacy.
    Annales de Dermatologie et de Vénéréologie 05/2014; · 0.60 Impact Factor
  • Journal of the European Academy of Dermatology and Venereology 03/2014; · 2.69 Impact Factor
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    ABSTRACT: Background Histiocytoma (HC) is a very common benign tumour generally seen in the lower limbs of adults, particularly women. There are, however, atypical forms of HC that behave like locally aggressive tumours, occasionally with relapse or even metastasis. Herein we report a case of locally aggressive HC in a child, which, on account of its clinical extension, required seven surgical procedures to achieve complete excision. Patients and methods A 13-year-old child consulted for a hard purplish papule measuring 8 mm in diameter located in the right lumbar region. Punch biopsy revealed a poorly delineated dermal-hypodermic tumour comprising randomly distributed moderately pleomorphic fusiform cells, arranged in bands or with storiform architecture, certain of which were multi-nucleated. The mitotic index was high (11 mitoses in 10 fields at high magnification). There was no expression by the tumour of melanocytic markers (PS100, Melan-A), histiocytic markers (CD68) or CD34. FISH analysis showed the absence of COL1A1-PDGFB fusion gene. Based on these immunohistochemical and molecular findings, a diagnosis was made of atypical HC with high cellular density. Since the lower margins of the section showed tumoural foci, surgical excision was performed with 5-mm margins. Because the lateral and vertical limits were reached in all cases, a series of five further procedures (the last of was preceded by multiple peripheral biopsies) was necessary to achieve complete excision. These multiple excision procedures resulted in total excision of 25 cm across the longest side. No clinical relapse was seen after 25 months. Discussion Cellular or atypical forms of HC carry a high likelihood of post-surgical relapse. They are characterised by marked pleomorphism and high cellular density. In our patient, the extent of the lesion had been greatly underestimated initially, resulting in the need for several surgical procedures in order to achieve complete excision. It is thus important to highlight the predictive factors for this type of tumour in order to enable sufficiently extensive excision, or excision guided by previous biopsies, to be contemplated from the outset. These predictive factors are: young patient age, unusual location (trunk, face, neck), high cellularity, marked mitotic activity and deep extension.
    Annales de Dermatologie et de Vénéréologie 01/2014; · 0.60 Impact Factor
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    ABSTRACT: Although most mucosal pigmented macules are benign, it can be clinically challenging to rule out an early melanoma. Reflectance confocal microscopy (RCM) is a non-invasive imaging technique useful to discriminate between benign and malignant skin lesions. To describe the confocal aspects of benign and malignant mucosal pigmented macules with histopathological correlations. We retrospectively reviewed the confocal images of 56 labial or genital pigmented macules including 10 macular melanoma. According to the retrospective nature of the study, we evaluated the recorded images chosen by the physicians that performed the RCM examination for each case. In benign macules, the most frequently observed pattern was a ringed pattern characterized by round or polycyclic papillae, with a hyperreflective basal layer; another pattern was characterized by sparse bright dendritic cells in the basal layer, the basal epithelial cells being otherwise usually less reflective. The presence of roundish cells, a high density dendritic cells with atypias, intraepithelial bright cells were clues in favour of malignancy. RCM seems to be a valuable tool to non invasively differentiate benign from malignant mucosal pigmented macules and target biopsies in cases of equivocal features. This article is protected by copyright. All rights reserved.
    British Journal of Dermatology 12/2013; · 3.76 Impact Factor
  • Annales de Dermatologie et de Vénéréologie 12/2013; 140:S25. · 0.60 Impact Factor
  • Journal of the European Academy of Dermatology and Venereology 05/2013; · 2.69 Impact Factor
  • Journal of the European Academy of Dermatology and Venereology 02/2013; · 2.69 Impact Factor
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    ABSTRACT: BACKGROUND: Genetic mutations in the plectin gene (PLEC) cause autosomal recessive forms of epidermolysis bullosa simplex associated with either muscular dystrophy (EBS-MD) or pyloric atresia (EBS-PA). Phenotype-genotype analysis suggested that EBS-MD is mostly due to genetic mutations affecting the central rod domain of plectin and EBS-PA to mutations outside this domain. OBJECTIVES: This study was aimed at describing new phenotypes of EBS-MD and EBS-PA patients, identifying novel PLEC mutations and contributing to establish genotype-phenotype correlations. METHODS: Seven patients with suspicion of EBS linked to PLEC mutations were included. A standardized clinical questionnaire was send to physicians in charge of each patient. Immunofluorescence studies of skin biopsies followed by molecular analysis of PLEC were performed in all patients. RESULTS: We report the first case of non-lethal EBS-PA improving with age, the first multisystemic involvement in a lethal EBS-PA patient, the first EBS-MD patients with either bladder or oesophagus involvement. Eleven novel PLEC mutations are also reported. CONCLUSIONS: Our results confirm that EBS-PA is linked to mutations in the distal exons 1-30 and 32 of PLEC. Long term survival is possible with skin improvement but delayed muscular dystrophy onset is probable. While EBS-MD is linked to PLEC mutations in all exons, in most cases usually one of the mutations affects exon 31. The precocity of muscular dystrophy seems to be linked to type/localization of the PLEC mutation(s) but no correlation with mucosal involvement has been found.
    British Journal of Dermatology 01/2013; · 3.76 Impact Factor
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    ABSTRACT: Background Juvenile xanthogranuloma (JXG) is a non-Langerhans histiocytosis of young children characterized by solitary or multiple yellowish cutaneous nodules. Atypical skin lesions such as lichenoid eruptions, and pedunculated, maculopapular, plaque-like or linear lesions have been described. We report a case of eruptive XGJ en plaque in the left leg in an infant. Patients and methods A 13-month-old child presented asymptomatic eruptive, yellowish papules of the leg measuring 5 to 10 mm since the age of 2 months. There was no cutaneous infiltration between the lesions. Darier's sign was negative. Histological examination confirmed the diagnosis of JXG. The course of the disease comprised a gradual decrease in the number of active lesions with slight residual pigmentation. Discussion Our case was suggestive of JXG en plaque. Only 7 cases have been reported in the literature, all appearing before the age of 5 months. The lesions corresponded mostly to an asymptomatic erythematous plaque studded with small yellowish/red nodules of variable localisation. Spontaneous involvement was noted in all cases. No systemic involvement was found. Herein we present a unique case of localised multiple JXG without evident clinical infiltrating plaque progressing with self-resolving flares.
    Annales de Dermatologie et de Vénéréologie 01/2013; · 0.60 Impact Factor
  • J.-P. Lacour
    Annales de Dermatologie et de Vénéréologie 01/2013; 140(12):S712. · 0.60 Impact Factor
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    ABSTRACT: Background Sneddon-Wilkinson disease (SWD) is a rare chronic neutrophilic dermatosis. The first-line treatment is dapsone but resistance to treatment may sometimes pose a challenge. Case Report We report a multidrug-resistant patient who responded dramatically before gradually losing response to infliximab and then etanercept. Complete remission was again obtained with adalimumab. Discussion Our case confirms the previously reported dramatic efficacy of anti-TNF biological agents in recalcitrant SWD but highlights the possibility of subsequent loss of response. Furthermore, it illustrates the efficacy of adalimumab in this indication.
    Annales de Dermatologie et de Vénéréologie 01/2013; 140(12):797–800. · 0.60 Impact Factor
  • Annales de Dermatologie et de Vénéréologie 12/2012; 139(12):B74. · 0.60 Impact Factor
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    ABSTRACT: Background  Blanching creams are used to depigment and to achieve uniform skin tone in widespread vitiligo. Length of the treatment and side-effects strongly limit their use in common practice. Objectives  To assess the long-term efficacy and tolerance of Q-Switched (QS) lasers for depigmenting the remaining unaffected skin in vitiligo. Methods  Retrospective study of vitiligo patients treated with QS lasers in the Department of Dermatology of the University Hospital of Nice, France, from 2002 to 2011. Localizations and the percentage of body surface area of treated lesions, the total number of sessions and the possible relapses and side-effects, were analysed. Global satisfaction of the patients was evaluated on a visual analogical scale. Results  Sixteen areas of normally pigmented skin were treated in six patients. The median number of sessions to achieve a complete depigmentation was 2 (1-6). The mean duration of follow-up was 36 months (19-120). One third of the patients had no relapse. A complete repigmentation was observed after 21 months in one patient; a 50% repigmentation was noted in one patient, 7 months after the end of the treatment. Two patients showed a minimal repigmentation (<25%), 18 months and 9 years after the first laser treatments. The repigmentations were effectively treated with a maintenance session. The mean total number of sessions performed during this period was 3 (1-20). Side-effects were limited to transient purpura and crusts. The satisfaction of the patients was excellent (mean 9/10). Conclusions  QS lasers appear as an efficient and safe modality for depigmenting normal skin in vitiligo.
    Journal of the European Academy of Dermatology and Venereology 11/2012; · 2.69 Impact Factor
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    ABSTRACT: Background  Most dermatological conditions can be evaluated using validate clinical scores, no such tool is available for irritant contact dermatitis (ICD). Objective  To create and validate a grid-based ICD severity score. Methods  Three dermatologists developed the SCOre de REparation de l'EPIderme (SCOREPI) grid. Two studies were conducted to validate the SCOREPI. A cross-sectional study assessed the intra- and inter-observer error associated with using the SCOREPI. Each investigator received 15 min of training on proper use of the SCOREPI. A computer displayed a series of 20 photos of ICD, each of which were repeated three times in a randomized order. The prospective study assessed the correlation between SCOREPI with the severity of clinical symptoms as well as the sensitivity of the score to changes in ICD in response to topical treatment. Results  The SCOREPI took an average of 35 ± 5 s to be completed and was characterized by an excellent intra-observer and moderate inter-observer reproducibility (intra-class correlation coefficient = 0.93 and 0.74, respectively). Significant divergence was observed between the physicians' assessment of estimated surface (P = 0.04), the presence of erythema (P < 0.0001) and the number of deep cracks (P = 0.0008). In the prospective analysis of patients, SCOREPI was correlated with tightness (r = 0.45; P < 0.0001), pain (r = 0.45; P < 0.0001), burning (r = 0.42; P < 0.0001), and pruritus (r = 0.28; P = 0.0055). SCOREPI decreased considerably during follow-up from 10.45 ± 4.61 to 4.82 ± 4.15 (P < 0.0001). Conclusion  The SCOREPI is easy to use, sensitive to change, and characterized by high intra- and moderate inter-observer reliability.
    Journal of the European Academy of Dermatology and Venereology 08/2012; · 2.69 Impact Factor
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    ABSTRACT: Background  Blastic plasmacytoid dendritic cell neoplasm (BPDCN), formerly known as agranular CD4(+) /CD56(+) haematodermic neoplasm (CD4/CD56 HN), is a rare distinct form of lymphoma-like entity known of dermatologists because of its marked predilection for cutaneous involvement, and its aggressive behaviour. Moreover, the association or the evolution to an acute leukaemia entity that still expresses CD4 and CD56 markers is almost systematic. This new described entity of 'CD4(+) /CD56(+) leukaemia' or 'leukaemia of plasmacytoid dendritic cell lineage' has a poor prognostic and may lead to include haematopoietic stem cell transplantation in the treatment strategy as early as possible. Report of cases  We report here four cases presenting with skin lesions and haematological signs. One of the patients underwent allogeneic stem cell transplantation, with a relapse-free survival of 40 months. We discuss the diagnosis features as well as the treatment options. Conclusion  A collaborative work between dermatologists and onco-haematologists is essential to give patients the best chance of complete and long-term response.
    Journal of the European Academy of Dermatology and Venereology 03/2012; · 2.69 Impact Factor
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    ABSTRACT: No abstract available.
    Dermatology 03/2012; 224(3):209-11. · 2.02 Impact Factor
  • Annales de Dermatologie et de Vénéréologie 12/2011; 139(s 6–7):H36–H37. · 0.60 Impact Factor

Publication Stats

1k Citations
399.18 Total Impact Points

Institutions

  • 1992–2012
    • University of Nice-Sophia Antipolis
      • Faculty of medicine
      Nice, Provence-Alpes-Côte d'Azur, France
  • 2002–2010
    • Centre Hospitalier Universitaire de Nice
      Nice, Provence-Alpes-Côte d'Azur, France
  • 2005
    • Centre Hospitalier Universitaire de Nantes
      Naoned, Pays de la Loire, France
  • 2001
    • Centre Hospitalier Intercommunal Fréjus Saint-Raphael
      Saint-Raphaël, Provence-Alpes-Côte d'Azur, France
  • 1996
    • French Institute of Health and Medical Research
      Lutetia Parisorum, Île-de-France, France
    • Centre Hospitalier de CAYENNE Andrée ROSEMON
      Cayenne, Guyane, French Guiana