C Beylot

Hôpital Européen Georges-Pompidou (Hôpitaux Universitaires Paris-Ouest), Lutetia Parisorum, Île-de-France, France

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Publications (322)367.98 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: In recent years, significant progress has been made in the understanding of the pathophysiological mechanisms of acne and the role of Propionibacterium acnes. With this review, the authors aim to provide an update on the current understanding of the role of P. acnes in the development of acne lesions and analysing the potential implications for future treatments. A total of 188 articles published between January 1980 and March 2013 were searched using key words such as acne, P. acnes, microbiology, Corynebacterium acnes, acne vulgaris, pathogenesis, antibiotic, vaccination and a combination of those key words. From those articles, 77 were analysed in depth. Recent data confirm that P. acnes has a strong proinflammatory activity and targets molecules involved in the innate cutaneous immunity, keratinocytes and sebaceous glands of the pilosebaceous follicle and leads to the development of comedones. Furthermore, the profile of its different strains may differ between healthy subjects and acne patients. The better understanding of the role of P. acnes may allow for new perspectives in the treatment of acne. Novel therapies should target molecules implicated in the activation of innate immunity, including toll-like receptors, protease-activated receptors and topical antimicrobial peptides; the latter may be an alternative to topical antibiotics and thus a solution for limiting bacterial resistance induced by topical macrolides. Vaccines may also be promising. However, the most appropriate candidate remains to be selected.
    Journal of the European Academy of Dermatology and Venereology 08/2013; · 2.69 Impact Factor
  • C. Beylot
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    ABSTRACT: Alla luce della loro maggiore efficacia, è un peccato che i laser ablativi Erbium e soprattutto CO2 siano abbandonati a favore dei laser frazionati, di utilizzo più facile, che li soppiantano sempre di più oggi. Questi laser ablativi impulsionali, il cui bersaglio è l’acqua, distruggono per effetto fototermico, in una singola seduta, in modo perfettamente programmato e riproducibile, la porzione superficiale di cute, epidermide e derma papillare. A ciò si aggiunge, soprattutto per il laser CO2, un danno termico controllato, proporzionale alla neocollagenesi, fattore essenziale del miglioramento. È vero che, con i laser ablativi, è necessaria un’anestesia generale o locoregionale, che i postumi sono più pesanti che con i laser frazionati e che il rischio di complicanze è maggiore in caso di errore tecnico. Tuttavia, quando il fotoinvecchiamento, indicazione principale di questi laser ablativi, è molto marcato, i risultati sono ben superiori, soprattutto con il laser CO2, con un effetto tensore che si ottiene in misura molto minore o non si ottiene assolutamente con i laser frazionati. Per le rughe profonde del labbro superiore, questi laser restano insostituibili. In altre indicazioni, quando occorre essere molto destruenti, i risultati sono migliori con questi laser ablativi tradizionali. Essi sono stati utilizzati in molte affezioni acquisite o genetiche. Per alcune di esse, subiscono oggi la concorrenza delle tecniche alternative come la chirurgia e la fototerapia dinamica. Tuttavia, essi restano la tecnica di elezione nel rinofima, negli angiofibromi della sclerosi tuberosa di Bourneville, nei nevi epidermici, in alcuni xantelasmi e nella balanopostite di Zoon e sono sempre validi per le cheratosi multiple, per i carcinomi basocellulari superficiali del volto e per alcune malattie di Bowen.
    EMC - Cosmetologia Medica e Medicina degli Inestetismi Cutanei. 01/2013; 10(1):1–13.
  • Source
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    ABSTRACT: Acne can have an important psychological impact. We surveyed 852 adolescents aged 12-25 years about their knowledge of acne and its treatment in a non-medical context. The study involved a questionnaire administered to callers to a youth telephone helpline in France. Callers were categorized into those who currently had acne, those who had had acne previously, and those who had never had acne. Most respondents (66.2%) had experienced acne symptoms, which were mild in 50.2% of cases and severe in 16% of cases. Often, acne had been long-lasting (>12 months in 49.6% of cases). Many thought that gender, excess weight, eating dairy products, and physical activity did not influence acne, and that frequent washing could improve acne. Eating chocolate and snacks, smoking cigarettes, sweating, not washing, touching/squeezing spots, eating fatty foods, using make-up, pollution, and menstruation were thought to worsen acne. The majority (80.8%) did not believe acne to be a disease, but rather a normal phase of adolescence, yet 69.3% agreed it should be treated. There was a preference for topical vs. systemic treatment. Many (38.6%) of the respondents with acne had not consulted a physician. Almost two-thirds of respondents wanted more information about acne. Providing more information about acne might increase the likelihood of them consulting a physician and getting better treatment for the condition.
    Acta Dermato-Venereologica 05/2011; 91(5):531-6.
  • Annales de Dermatologie et de Vénéréologie 01/2011; 138(1):23-9. · 0.60 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Many acne grading methods exist; however, there is no agreed-upon standard. Our objective was to create and validate a reproducible acne assessment scale for rating the severity of juvenile facial acne suitable for use in France and Europe. The scale we created described the different types of acne lesions in a manner similar to global assessment scales used in clinical trials. The scale was then validated by seven expert dermatologists in the field of acne [the Global Evaluation Acne (GEA) group] first on 34 photographic cases of Caucasian acne patients and second by clinical examination of 22 acne patients. There was good agreement in Investigators' assessments of acne both on photographs and patients (R = 0.8057; P < 0.0001, and R = 0.8437; P = 0.0015). The GEA Scale is a global scale validated both on photographs and acne patients which can be used either in clinical research or by the dermatologist in his office.
    Journal of the European Academy of Dermatology and Venereology 04/2010; 25(1):43-8. · 2.69 Impact Factor
  • C Beylot
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    ABSTRACT: Skin aging various considerably between individuals and depends on intrinsic factors such as age, oestrogen deficiency during menopause, and on extrinsic factors such as exposure to UV light and tobacco addiction. The clinical and histological characteristics of these different types of aging are described as well as the principle highly complex mechanisms that are involved. Treatment for skin aging has become the main reason why patients consult in cosmetic dermatology. For this reason, dermatologist should know how to analyse this condition and offer suitable therapeutic care that takes into account the aging of the subcutaneous tissue.
    Annales de Dermatologie et de Vénéréologie 10/2009; 136 Suppl 6:S263-9. · 0.60 Impact Factor
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    ABSTRACT: In most cases, acute generalized exanthematous pustulosis (AGEP) is a drug reaction. Even if several systemic drugs have been reported to be a causative agent, this clinical case has rarely been observed with a topical treatment. We report here a case of AGEP after topical application of Algipan. A 51-year-old man consulted us for a skin rash with fever which started 72 h earlier. His personal history consisted only of lumbar pain and he was not under any oral medication. The skin rash was initially limited to the left hand and the back but quickly spread to the entire skin with multiple non-follicular pustules emerging on widespread and inflamed erythema. No systemic treatment was being taken prior the eruption. Nevertheless, 3 days before the skin rash appeared, the patient had applied Algipan to the lumbar area with his left hand. The whole clinical presentation leads us to diagnose Algipan-induced AGEP. The clinical signs improved rapidly. Patch tests performed 3 months later were positive for the whole product, thereby confirming our diagnosis. AGEP is drug-induced in more than 90% of cases, mostly after antibiotics, especially beta-lactams and macrolides. Algipan is a topical treatment containing mephenesin used for its analgesic and anti-inflammatory properties in adult muscular pain. No severe skin drug reactions due to this drug have been reported to date. Cases of AGEP induced by topical agents are rarely reported and our case is the first involving mephenesin. Our study suggests that topical mephenesin should be noted as a drug that may cause AGEP.
    Annales de Dermatologie et de Vénéréologie 10/2009; 136(10):709-12. · 0.60 Impact Factor
  • C Beylot, C Grognard, T Michaud
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    ABSTRACT: The use of pulsed or scanning Carbon Dioxide, and pulsed Erbium-YAG lasers allows the programmable and reproducible photocoagulation of thin layers of the epidermis and superficial dermis. Thermal damage depends on the type of laser and is greater with CO(2) lasers. The degree of neocollagenesis is proportional to the thermal damage and is better with CO(2) lasers. Their main indication is the correction of photoaged facial skin but they can also be used for corrective dermatology, e.g. for scars and genodermatosis. Results are highly satisfactory but the technique is invasive and the patient experiences a social hindrance of around two weeks. Fractionated techniques treat 25% of the defective skin area at each session in noncontiguous microzones; four sessions are therefore necessary to treat the entire cutaneous surface. The treatment is given under topical anesthesia and is much less invasive, particularly with nonablative fractional laser treatment in which photothermolysis does not penetrate below the epidermis and/or the effects are slight, with no or very little social isolation. However, the results are much less satisfactory than the results of ablative laser and there is no firming effect. Other zones than the face can be treated. With the fractional CO(2) and Erbium ablative lasers, which have multiplied over the past 2 years, the much wider impacts cause perforation of the epidermis and there is a zone of ablation by laser photovaporization, with a zone of thermal damage below. The results are better in correcting photoaging of the face, without, however, achieving the efficacy of ablative lasers, which remain the reference technique. However, the effects are not insignificant, requiring at least 5 days of social isolation.
    Annales de Dermatologie et de Vénéréologie 10/2009; 136 Suppl 6:S311-9. · 0.60 Impact Factor
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    ABSTRACT: We report a retrospective study of 14 patients with pityriasis rubra pilaris (PRP) referred to our department from 1973 to 1997. Four of them were children. The purpose of this study was to determine their response to several treatments in order to be able to define the best management of PRP. Nine patients were treated with retinoids (etretinate or acitretin) for an average period of 18.8 months. This treatment achieved in seven of them a partial or complete clearing without major side-effects. All five patients treated with methotrexate were adults. The mean duration of treatment was 12.1 months. All the methotrexate-treated patients improved, even though two of them had not responded to retinoids. The other therapies, including systemic steroids, topical treatments and psoralens-UVA therapy, produced inconsistent results. Our results suggest that retinoids should be considered a first-line treatment at an initial dosage of 0.5 mg/kg per day. Methotrexate has to be the second-line treatment, at an initial dosage between IS and 25 mg/week, in cases of inefficacy of retinoids, or the first alternative treatment when retinoids are contraindicated, especially in older patients.
    07/2009; 10(2):113-117.
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    ABSTRACT: A multicentre randomized double-blind study of 143 patients was conducted to compare terbinafine (250 mg/day) and micronized griseofulvin (1 g/day) in the treatment of dermatophyte onychomycosis. The duration of treatment was up to 12 months, but the treatment could be interrupted in the event of complete cure, i.e. clinical disappearance of the pathological zone of the nail combined with mycological cure. The percentage of nails cured was significantly higher in the terbinafine than in the griseofulvin group (77.1% versus 45.7%, P=0.0001). Clinical and biological tolerability were good in both groups. Only 7.4% of patients treated with terbinafine showed one or more adverse events, but 31.5% with griseofulvin (P<0.001).
    07/2009; 8(2):93-97.
  • C Beylot, V Gassia
    Annales de Dermatologie et de Vénéréologie 06/2009; 136 Suppl 4:S53-4. · 0.60 Impact Factor
  • C Beylot
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    ABSTRACT: Botulinum neurotoxin A was the first developed for therapeutic and then esthetic uses, Botox first and then Dysport. These two products differ on a few points, explaining their nonequivalence of units: American and British tests of the mouse LD50 units based on solutions that were not identical and 500microg vs 150microg serum albumin dose in the excipient. The neurotoxin- accessory protein complexes were also different: 900 kDa homogeneous for Botox, 500 kDa heterogeneous for Dysport, giving greater diffusion for Dysport, but this is under debate and could result from an excessive conversion ratio. Clinical comparative studies, often with weak methodology, have defined an ideal ratio between these two products, guaranteeing efficacy, but without an overly pronounced diffusion. In the first publications for neurological and ophthalmological indications, the conversion ratio between Dysport and Botox was high, 4:1, and sometimes higher. However, today, particularly for cosmetic indications, the trend is toward a much lower ratio, 2.5:1, or perhaps less for dyshidrosis. This lower ratio has an economic incidence: Dysport is less expensive and therefore more competitive. The price of Dysport's cosmetic product, Azzalure, compared to the price of Vistabel, which is Botox's cosmetic presentation, has not yet been defined in France. The other A toxins, Xeomin, and the Asian toxins, MyoBloc (botulinum toxin type B), tested compared to Botox, have a slightly lower efficacy.
    Annales de Dermatologie et de Vénéréologie 06/2009; 136 Suppl 4:S77-85. · 0.60 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The three-grade acne classification (mild, moderate, severe) is widely used to define the licensed indications of acne treatments, and for therapeutic decision-making in clinical practice, but its reproducibility has never been assessed. Ten photographs of facial acne were scored independently by eight experts using the three-grade acne classification. We conducted a descriptive analysis of the results, based on graphical representation of the scores for each photograph. Inter-observer agreement on acne severity based on the three-grade acne classification was very poor. The classical three-grade acne classification is poorly reproducible. A new rating tool accompanied by a clinical description of each severity level would be extremely useful.
    Journal of the European Academy of Dermatology and Venereology 06/2009; 24(2):196-8. · 2.69 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Although correction of the dynamic wrinkles of the upper part of the face is the major indication for botulinum toxin, there are also many possibilities for the middle and lower thirds of the face and neck. However, these injections are more delicate and require an experienced operator who has excellent knowledge of the muscles of these regions, their functions, the antagonist actions exercised on other muscles, particularly in terms of the complex equilibrium of the mouth. An excessive dose, an inappropriate injection point, or a centering mistake can all easily be responsible for undesirable side effects. However, the results obtained, often with lower doses than in the superior part of the face, can be highly satisfactory, notably in erasing bunny lines, improvement of marionette lines, peau d'orange chin, attenuation of peribuccal lines, melomental folds, correction of a gummy smile, and facial asymmetries. In the neck it is possible to reduce platysmal bands, horizontal lines, and diagonal lines of the neck and décolleté. The face contours can also be improved by the Nefertiti lift. In the mid and lower regions of the face, botulinum toxin is often a complement to other esthetic techniques, particularly filling procedures.
    Annales de Dermatologie et de Vénéréologie 06/2009; 136 Suppl 4:S111-8. · 0.60 Impact Factor
  • C Beylot
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    ABSTRACT: In esthetic dermatology, filling and laser treatments are two essential techniques. Several recent studies on calcium hydroxyapatite in filling treatments and facial volumetry, in esthetics, but also in HIV patients, have been published. It was also tested in accentuated melomental folds where it is superior to hyaluronic acid. In aging of the skin of the dorsal aspect of the hands, hyaluronic acid provides slightly better results than collagen. Filler rhinoplasty can correct minor deformations of the nose. Lipofilling is advantageous for linear scleroderma of the face, at least in the forehead region, and adipocyte stem cells may be a future solution for facial aging or lipoatrophy. The risk of local and/or general sarcoid reactions related to interferon in patients having undergone filling injections has been reported. In the field of laser treatment, fractionated photothermolysis has motivated much more research and seem particularly valuable in treating acne scars, aging of the dorsal aspect of the hands, and, more anecdotally, in colloid milium and pearly penile papules. Laser is also useful in preventing surgical scars where a mini-diode can also be used. For axillary hyperhidrosis, subdermic Nd-YAG laser competes with botulinum toxin, with longer-lasting results. Solutions are appearing for treatment of red or white striae cutis distensae. Intense pulsed light is the reference technique for poikiloderma of Civatte, and seems effective, with new devices, for melasma. However, inappropriately used by nonphysicians, IPL can cause serious ocular accidents; one case of uveitis has been reported.
    Annales de Dermatologie et de Vénéréologie 06/2009; 136 Suppl 4:S152-9. · 0.60 Impact Factor
  • Source
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    ABSTRACT: Existing scoring systems for facial acne focus on the lesions themselves, but clinical decisions are based on a general assessment of severity, including the time since onset, the site(s) of involvement, the patient's history, and the response to prior treatments. The aim of this study was to investigate the influence of some of these factors on the global assessment of acne severity. Involvement of the trunk, prior systemic treatment and a positive family history of acne increased the severity score. Inclusion of these factors could help to compose more homogeneous groups for clinical trials.
    Acta Dermato-Venereologica 02/2009; 89(4):369-71.
  • C. Beylot
    [Show abstract] [Hide abstract]
    ABSTRACT: Skin aging various considerably between individuals and depends on intrinsic factors such as age, oestrogen deficiency during menopause, and on extrinsic factors such as exposure to UV light and tobacco addiction. The clinical and histological characteristics of these different types of aging are described as well as the principle highly complex mechanisms that are involved. Treatment for skin aging has become the main reason why patients consult in cosmetic dermatology. For this reason, dermatologist should know how to analyse this condition and offer suitable therapeutic care that takes into account the aging of the subcutaneous tissue.
    Annales De Dermatologie Et De Venereologie - ANN DERMATOL VENEREOL. 01/2009; 136.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Although correction of the dynamic wrinkles of the upper part of the face is the major indication for botulinum toxin, there are also many possibilities for the middle and lower thirds of the face and neck. However, these injections are more delicate and require an experienced operator who has excellent knowledge of the muscles of these regions, their functions, the antagonist actions exercised on other muscles, particularly in terms of the complex equilibrium of the mouth. An excessive dose, an inappropriate injection point, or a centering mistake can all easily be responsible for undesirable side effects. However, the results obtained, often with lower doses than in the superior part of the face, can be highly satisfactory, notably in erasing bunny lines, improvement of marionette lines, peau d’orange chin, attenuation of peribuccal lines, melomental folds, correction of a gummy smile, and facial asymmetries. In the neck it is possible to reduce platysmal bands, horizontal lines, and diagonal lines of the neck and décolleté. The face contours can also be improved by the Nefertiti lift. In the mid and lower regions of the face, botulinum toxin is often a complement to other esthetic techniques, particularly filling procedures.
    Annales De Dermatologie Et De Venereologie - ANN DERMATOL VENEREOL. 01/2009; 136.
  • C. Beylot
    [Show abstract] [Hide abstract]
    ABSTRACT: Botulinum neurotoxin A was the first developed for therapeutic and then esthetic uses, Botox® first and then Dysport®. These two products differ on a few points, explaining their nonequivalence of units: American and British tests of the mouse LD50 units based on solutions that were not identical and 500 μg vs 150 μg serum albumin dose in the excipient. The neurotoxin- accessory protein complexes were also different: 900 kDa homogeneous for Botox®, 500 kDa heterogeneous for Dysport®, giving greater diffusion for Dysport®, but this is under debate and could result from an excessive conversion ratio. Clinical comparative studies, often with weak methodology, have defined an ideal ratio between these two products, guaranteeing efficacy, but without an overly pronounced diffusion. In the first publications for neurological and ophthalmological indications, the conversion ratio between Dysport® and Botox® was high, 4: 1, and sometimes higher. However, today, particularly for cosmetic indications, the trend is toward a much lower ratio, 2.5: 1, or perhaps less for dyshidrosis. This lower ratio has an economic incidence: Dysport® is less expensive and therefore more competitive. The price of Dysport®’s cosmetic product, Azzalure®, compared to the price of Vistabel®, which is Botox®’s cosmetic presentation, has not yet been defined in France. The other A toxins, Xeomin®, and the Asian toxins, MyoBloc® (botulinum toxin type B), tested compared to Botox®, have a slightly lower efficacy.
    Annales De Dermatologie Et De Venereologie - ANN DERMATOL VENEREOL. 01/2009; 136.
  • C. Beylot
    [Show abstract] [Hide abstract]
    ABSTRACT: The use of pulsed or scanning Carobon Dioxide, and pulsed Erbium-YAG lasers allows the programmable and reproducible photocoagulation of thin layers of the epidermis and superficial dermis. Thermal damage depends on the type of laser and is greater with CO2 lasers. The degree of neocollagenesis is proportional to the thermal damage and is better with CO2 lasers. Their main indication is the correction of photoaged facial skin but they can also be used for corrective dermatology, e.g. for scars and genodermatosis. Results are highly satisfactory but the technique is invasive and the patient experiences a social hindrance of around two weeks. The fractional techniques such as Fraxel are used to treat non-adjacent microzones without ablation of the epidermis. Around 25 p. 100 of the affected region is treated per session without ablation of the epidermis. Each fraction is only mini-invasive and is performed under local anesthesia. Social hindrance is minimal. Nonetheless, the results are inferior to those obtained with ablative lasers, especially regarding deep wrinkles. The treatment is costly and four sessions are usually required to treat the whole affected area. Others regions of the face may also be treated. Encouraging results have been obtained with mélasma.
    Annales de Dermatologie et de Vénéréologie 01/2009; 135:189-194. · 0.60 Impact Factor

Publication Stats

2k Citations
367.98 Total Impact Points

Institutions

  • 2011
    • Hôpital Européen Georges-Pompidou (Hôpitaux Universitaires Paris-Ouest)
      Lutetia Parisorum, Île-de-France, France
  • 2009
    • CHU de Lyon - Groupement Hospitalier Edouard Herriot
      Lyons, Rhône-Alpes, France
  • 2001–2009
    • Université Victor Segalen Bordeaux 2
      • Unité Histologie et pathologie moléculaire des tumeurs
      Burdeos, Aquitaine, France
  • 2008
    • Hôpital Henri Mondor (Hôpitaux Universitaires Henri Mondor)
      • Service de Dermatologie
      Créteil, Ile-de-France, France
  • 2005
    • Groupe Hospitalier Saint Vincent
      Strasburg, Alsace, France
  • 1994–2004
    • Centre Hospitalier Universitaire de Bordeaux
      Burdeos, Aquitaine, France
  • 1985–2001
    • University of Bordeaux
      Burdeos, Aquitaine, France