S Ingen-Housz-Oro

Assistance Publique – Hôpitaux de Paris, Lutetia Parisorum, Île-de-France, France

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Publications (135)235.68 Total impact

  • S Ingen-Housz-Oro · E Sbidian · N Ortonne · E Poirier · O Chosidow · P Wolkenstein
    Journal of the European Academy of Dermatology and Venereology 08/2015; DOI:10.1111/jdv.13257 · 3.11 Impact Factor
  • The Lancet Infectious Diseases 08/2015; 15(8):986. DOI:10.1016/S1473-3099(15)00173-5 · 19.45 Impact Factor
  • Caroline Lacoste · Saskia Ingen-Housz-Oro · Nicolas Ortonne
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    ABSTRACT: Skin manifestations associated with monoclonal gammapathy are common and can present with various clinical and pathological aspects. They can be the first events leading to the diagnosis of monoclonal gammapathy. They may be present either as specific lesions, including lymphoplasmacytic or pure plasma cell neoplastic infiltrates and monoclonal immunoglobulin deposits, or as non-specific dermatitis, such as leukocytoclastic vasculitis, neutrophilic dermatoses, mucinoses or xanthomatosis, giving little clues for the diagnosis of the underlying disease. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
    Annales de Pathologie 07/2015; DOI:10.1016/j.annpat.2015.05.001 · 0.29 Impact Factor
  • S Ingen-Housz-Oro · N Ortonne
    Annales de Dermatologie et de Vénéréologie 07/2015; DOI:10.1016/j.annder.2015.04.167 · 0.67 Impact Factor
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    ABSTRACT: Monoclonal T-cell receptor (TCR) rearrangement is detected in 57% to 75% of early-stage mycosis fungoides (MF) at diagnosis. A retrospective study showed molecular residual disease (MRD) in 31% of patients in complete clinical remission (CR) after 1 year of treatment. To confirm the frequency of MRD at 1 year and to determine its prognostic value for further relapse. Patients with T1-, T2- or T4-stage MF were prospectively included in this multicenter study. At diagnosis, clinical lesions and healthy skin were biopsied. After 1 year of topical treatment, previously involved skin (PIS) of patients in CR was biopsied for histology and analysis of TCR-γ gene rearrangement. Results were compared to the clinical status each year for 4 years. We included 214 patients, 133 at T1, 78 T2, and 3 T4 stage. At diagnosis, 126/204 cases (61.8%) showed TCR clonality in lesional skin. After 1 year, 83/178 patients (46.7%) still being followed up were in CR and 13/63 (20.6%) showed MRD. At 4 years, 55/109 (50.5%) patients still being followed up were in CR and 44/109 were in T1 stage (40.4%). MRD did not affect clinical status at 4 years (CR vs. T1/T2, p=1.0, positive predictive value 36.4%, negative predictive value 67.6%). T-cell clonality at diagnosis and MRD at 1 year are not a prognostic factor of clinical status at 4 years. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    British Journal of Dermatology 07/2015; DOI:10.1111/bjd.14017 · 4.10 Impact Factor
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    ABSTRACT: Invasive aspergillosis (IA) has poor prognosis in immunocompromised patients. Skin manifestations, when present, should contribute to an early diagnosis. The authors aimed to provide prevalence data and a clinical and histologic description of cutaneous manifestations of primary cutaneous IA (PCIA) and secondary CIA (SCIA) in a unique clinical series of IA and present the results of an exhaustive literature review of CIA. Cases of proven and probable IA with cutaneous manifestations were retrospectively extracted from those registered between 2005 and 2010 in a prospective multicenter aspergillosis database held by the National Reference Center for Invasive Mycoses and Antifungals, Pasteur Institute, France. Patients were classified as having PCIA (i.e., CIA without extracutaneous manifestations) or SCIA (i.e., disseminated IA). Among the 1,410 patients with proven or probable IA, 15 had CIA (1.06%), 5 PCIA, and 10 SCIA. Hematological malignancies were the main underlying condition (12/15). Patients with PCIA presented infiltrated and/or suppurative lesions of various localizations not related to a catheter site (4/5), whereas SCIA was mainly characterized by disseminated papules and nodules but sometimes isolated nodules or cellulitis. Histologic data were available for 11 patients, and for 9, similar for PCIA and SCIA, showed a dense dermal polymorphic inflammatory infiltrate, with the epidermis altered in PCIA only. Periodic acid Schiff and Gomori-Grocott methenamine silver nitrate staining for all but 2 biopsies revealed hyphae compatible with Aspergillus. Aspergillus flavus was isolated in all cases of PCIA, with Aspergillus fumigatus being the most frequent species (6/10) in SCIA. Two out 5 PCIA cases were treated surgically. The 3-month survival rate was 100% and 30% for PCIA and SCIA, respectively. Our study is the largest adult series of CIA and provides complete clinical and histologic data for the disease. Primary cutaneous IA should be recognized early, and cases of extensive necrosis should be treated surgically; its prognosis markedly differs from that for SCIA. Any suppurative, necrotic, papulonodular, or infiltrated skin lesion in an immunocompromised patient should lead to immediate biopsy for histologic analysis and mycological skin direct examination and culture.
    Medicine 07/2015; 94(26):e1018. DOI:10.1097/MD.0000000000001018 · 4.87 Impact Factor
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    ABSTRACT: Sézary syndrome is a cutaneous T-cell lymphoma characterized by erythroderma and leukemic involvement. We sought to define the clinical, biologic, and histopathologic features of Sézary syndrome without erythroderma. Features of patients with Sézary syndrome and normal-appearing skin or stage-T1 patches, fulfilling Sézary syndrome hematologic criteria and with histologically documented disease in normal-appearing skin were collected. Expression of Sézary syndrome molecular biomarkers in peripheral blood and skin lymphocytes were studied. Five women and 1 man (median age: 71 years) were all referred for generalized pruritus. Four had no specific lesions; 2 had T1-stage patches. Histologic examination of normal-appearing skin from all patients showed lesions compatible with Sézary syndrome. Peripheral blood lymphocytes from 3 of 4 patients tested strongly expressed PLS3, Twist-1, and KIR3DL2. All normal-appearing skin biopsy specimens expressed programmed death-1. Median follow-up was 9 years. Although no patient developed erythroderma, tumors, or abnormal lymph nodes, specific skin lesions appeared in all patients during follow-up. Only 1 death, unrelated to Sézary syndrome, occurred. Retrospective design and small sample size are limitations. Sézary syndrome without erythroderma is a rare entity that may have a better prognosis than classic Sézary syndrome. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
    Journal of the American Academy of Dermatology 06/2015; 72(6). DOI:10.1016/j.jaad.2014.11.015 · 5.00 Impact Factor
  • 06/2015; DOI:10.1001/jamadermatol.2015.1357
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    ABSTRACT: ELISA-BP180 values and direct immunofluorescence (DIF) are prognostic factors for relapse after treatment cessation in bullous pemphigoid (BP). To determine the relevance of ELISA-BP230 antibodies for predicting relapse 6 months after treatment cessation. We retrospectively selected patients with BP and available data from ELISA-BP180 and -BP230 and DIF performed at treatment cessation. The rate of relapse was calculated at 6 months. We compared ELISA-BP180 and -BP230 values and DIF in patients with relapse and remission. We included 97 patients. At 6 months, 25.6% of patients showed relapse. The proportion of patients with an ELISA-BP230 value ≥27 UA/ml was higher, but not significantly, for those with relapse than for those with remission (p = 0.11). The frequency of positive DIF findings was significantly higher for patients with relapse (p = 0.005). DIF is of better value than ELISA-BP180 and -230 tests to predict relapse after treatment cessation in BP. © 2015 S. Karger AG, Basel.
    Dermatology 04/2015; DOI:10.1159/000381143 · 1.69 Impact Factor
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    ABSTRACT: Ear, nose, and throat (ENT) lesions are frequently involved in Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN), although a detailed description is lacking in the literature. To describe ENT lesions at the acute stage and follow-up in a large series of patients with SJS/TEN and identify factors associated with the severe ENT form. Retrospective study of 49 patients with SJS/TEN hospitalized in a referral care center from 2005 to 2010. Patients who underwent a full ENT workup including examination and a nasal fiberoptic endoscopy by an otorhinolaryngologist in the acute phase and during follow-up at 2 and 12 months were included in the study. Recorded variables included maximal body surface area (BSA) detachment, SCORTEN (Score of Toxic Epidermal Necrosis [a severity of illness score]), sites and type of ENT mucosal lesions, intensive care unit transfer, pulmonary infection, and mortality. "Severe ENT form" was defined by the occurrence of laryngeal lesions with the risk of airways obstruction. Clinical characteristics associated with severe ENT form were analyzed in univariate and multivariable analysis. Of the 49 patients who underwent a full ENT workup (female to male ratio, 1.1:1), ENT symptoms (eg, odynophagia, dysphagia, dysphonia, dyspnea, earache, nasal obstruction) occurred in 48 (98%). Dyspnea or dysphonia were significantly associated with severe ENT form (21% [P = .03] and 50% [P < .001], respectively). Topographic frequencies of lesions were as followed: lips and oral cavity (n = 46 [93%]) and pharynx and vestibule of the nose (n = 26 [53%]). Fourteen patients (29%) had severe ENT form. Findings for other recorded variables for those with vs without ENT examination are as follows: maximal BSA detachment (20% [0%-95%] vs 5.5% [0%-95%]; P = .004), SCORTEN (1 [0-5] vs 1 [0-5]; P = .54), intensive care unit transfer (10 [20%] vs 9 [19%]; P = .80), pulmonary infection (9 [18%] vs 6 [13%]; P = .10), and mortality (3 [6%] vs 5 [10%]; P = .70). In multivariable analysis, pulmonary infection was significantly associated with severe ENT form (odds ratio, 5.9 [95% CI, 1.1-32.8] [P = .04]). After remission of SJS/TEN, a complete ENT mucosal healing occurred in 36 patients (74%) at 2 months and in nearly all patients (n = 48 [98%]) at 1 year of follow-up. Severe ENT form is associated with pulmonary infection and is easily detected by nasal fiberoptic endoscopy. ENT evaluation should be suggested when dysphonia or dyspnea is observed at the acute stage of SJS/TEN.
    JAMA Dermatology 02/2015; DOI:10.1001/jamadermatol.2014.4844 · 4.30 Impact Factor
  • S. Hüe · S. Ingen-Housz-Oro · L. Fardet
    Annales de Dermatologie et de Vénéréologie 01/2015; 142(2). · 0.67 Impact Factor
  • S Hüe · S Ingen-Housz-Oro · L Fardet
    Annales de Dermatologie et de Vénéréologie 01/2015; 142(2). DOI:10.1016/j.annder.2014.11.015 · 0.67 Impact Factor
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    ABSTRACT: Importance The main component of the first-line treatment of pemphigus vulgaris is high doses of systemic corticosteroids, but adverse effects of these drugs are frequent and sometimes severe. Rituximab has shown effectiveness as a corticosteroid-sparing agent or in case of relapse. To our knowledge, the effectiveness of rituximab as a first-line treatment without systemic corticosteroids has not been evaluated.Observations Five women in their 50s, 60s, or 70s with pemphigus vulgaris (Pemphigus Disease Area Index score, 15-84 at diagnosis) and contraindications to systemic corticosteroid treatment received rituximab with high-potency topical corticosteroids as first-line treatment. All patients experienced a favorable response, with a mean time to healing of skin and mucosal lesions of 15 weeks. Two patients, with 42- and 48-month follow-up evaluations, did not experience relapse. Three patients developed 2 to 4 relapses, with effective retreatment achieved using rituximab and topical corticosteroids. No severe adverse effects were observed.Conclusions and Relevance Considering the high rate of severe adverse effects induced by prolonged administration of high doses of systemic corticosteroids, new therapeutic options are warranted in the treatment of pemphigus vulgaris. The combination of rituximab and topical corticosteroids could be considered in mild to severe cutaneous disease. Larger long-term studies are needed to evaluate the optimal treatment strategies according to the severity of the disease and the benefit-risk ratio of rituximab.
    JAMA Dermatology 10/2014; 151(2). DOI:10.1001/jamadermatol.2014.2421 · 4.30 Impact Factor
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    ABSTRACT: Background: The value of anti-desmoglein 1 and 3 (Dsg1, Dsg3) enzyme-linked immunosorbent assay (ELISA) is controversial in the follow-up of pemphigus. Objective: To evaluate anti-desmoglein ELISA (Dsg ELISA) in the follow-up of pemphigus and compare ELISA with direct and indirect immunofluorescence in complete remission (CR). Methods: We performed a retrospective monocenter study of patients with pemphigus and consecutive sera samples collected at baseline (M0), 12 months (M12) and 24 or 36 months after M0 (M24/36). Tests were compared in CR and in active disease. Direct immunofluorescence and circulating autoantibodies were compared for patients with stable CR. Results: We included 36 patients. At M12, ELISA values did not differ between CR and active disease. At M24/36, Dsg3 but not Dsg1 ELISA values were lower in CR (p = 0.07). For 5/8 patients with stable CR, direct immunofluorescence and ELISA findings remained positive. Conclusion: In routine practice, Dsg ELISA seems to be of little interest for immunological follow-up of pemphigus. © 2014 S. Karger AG, Basel.
    Dermatology 09/2014; 229(3). DOI:10.1159/000365079 · 1.69 Impact Factor
  • S Ingen-Housz-Oro · L Valeyrie-Allanore · J Chanal · O Chosidow · P Wolkenstein
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    ABSTRACT: We read with interest the letter by Fortuna et al.(1) about our paper "Linear IgA bullous dermatosis (LABD): comparison between the drug-induced and spontaneous forms".(2) In our study, we compared the clinical and histological aspects of drug-induced and "idiopathic" (in fact a better wording than "spontaneous" as previously used) forms of LABD. Drug-induced LABD was defined by two available imputability scores: the French method (modified Begaud score(3) ), based on intrinsic and extrinsic criteria, mostly used by French pharmacovigilance and in our routine practice, and the Naranjo score(4) , more often used in the international literature and based on intrinsic criteria only. This article is protected by copyright. All rights reserved.
    British Journal of Dermatology 06/2014; 171(6). DOI:10.1111/bjd.13174 · 4.10 Impact Factor
  • S Ingen-Housz-Oro · A Amiot · N Ortonne · S Hüe
    Annales de Dermatologie et de Vénéréologie 05/2014; 141(5):387-91. · 0.67 Impact Factor
  • S. Ingen-Housz-Oro · A. Amiot · N. Ortonne · S. Hüe
    Annales de Dermatologie et de Vénéréologie 05/2014; DOI:10.1016/j.annder.2014.03.013 · 0.67 Impact Factor
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    ABSTRACT: Background: Administrative bodies for compensating medical accidents were created in France in 2002. Objectives: To evaluate the knowledge patients with severe cutaneous adverse reactions (SCARs) have of procedures and to compare the rate of compensation for SCARs for France and for our referral center. Methods: A questionnaire was sent to 247 patients of our SCARs referral center and 225 patients with Stevens-Johnson syndrome and toxic epidermal necrolysis from the patient association AMALYSTE. We calculated the rate of compensation for France and our center. Results: Among the 123 respondents (26%), 28 (23%) knew the compensation procedure; 13 (11%) had received compensation. The Commission of Conciliation and Compensation had received 63 applications for SCARs since 2002 and proposed compensation for 56%. The estimated rate of compensation for France was 2.6% and 2.5% for our referral center (p = 0.9). Conclusions: The procedure of compensation for SCARs is misunderstood. Better information should be disseminated for patients with threshold disability conditions. © 2014 S. Karger AG, Basel.
    Dermatology 03/2014; 228(4). DOI:10.1159/000358295 · 1.69 Impact Factor
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    ABSTRACT: IMPORTANCE Primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL-LT), occurs in elderly patients and has been considered as a lymphoma with a poor prognosis, with estimated 5-year specific survival rates of approximately 50%. The hypothesis of an improvement in prognosis over time has not been studied. OBJECTIVES To evaluate this hypothesis in a large series of patients and investigate factors associated with prognosis as well as improvement in the prognosis. DESIGN, SETTING, AND PARTICIPANTS A retrospective multicenter study was conducted including dermatology departments belonging to the French Study Group on Cutaneous Lymphoma. Participants were 115 patients with PCDLBCL-LT diagnosed between 1988 and 2003 (period 1) or between 2004 and 2010 (period 2). MAIN OUTCOMES AND MEASURES Age, sex, period of diagnosis, number of skin lesions, tumor stage, tumor location (leg vs nonleg), lactate dehydrogenase level, type of therapy (with or without a combination of rituximab and polychemotherapy [PCT]), and outcome were recorded. Baseline characteristics and outcome were compared according to period of diagnosis and type of therapy. Prognosis factors were identified by univariate and multivariate survival analyses. RESULTS The mean age of the patients was 76.9 years, and 47% of the patients were older than 80 years. The 3- and 5-year specific survival rates improved between period 1 and period 2, from 55% to 74% and from 46% to 66%, respectively (P = .01). Patients had similar baseline characteristics during both periods, but rituximab-PCT regimens were administered to 88.5% of the patients in period 2 vs 16.7% in period 1 (P < .001). The 3- and 5-year specific survival rates were 80% and 74%, respectively, in patients who received a rituximab-PCT regimen compared with 48% and 38% in those who received less-intensive therapies. No significant difference was observed between both groups in age and baseline prognostic factors. In multivariate analysis, treatment without rituximab-PCT was the only adverse prognostic factor (odds ratio, 4.6 [95% CI, 2.4-9.1]; P < .001), whereas the number of skin lesions (P = .06) and location on the leg (P = .07) had only borderline significance. CONCLUSIONS AND RELEVANCE A major improvement in the survival of patients with PCDLBCL-LT has occurred over time in France, mainly as a result of the use of intensive rituximab-PCT regimens in most patients, including very elderly ones. Until further prospective clinical trials are conducted, such regimens should be considered as the standard of care in these patients.
    03/2014; 150(5). DOI:10.1001/jamadermatol.2013.7452
  • C Guillaud · S Hüe · S Ingen-Housz-Oro
    Annales de Dermatologie et de Vénéréologie 12/2013; 140(12):821-6. DOI:10.1016/j.annder.2013.08.001 · 0.67 Impact Factor

Publication Stats

490 Citations
235.68 Total Impact Points

Institutions

  • 2013–2015
    • Assistance Publique – Hôpitaux de Paris
      Lutetia Parisorum, Île-de-France, France
    • Centre Hospitalier Universitaire Rouen
      Rouen, Upper Normandy, France
    • Centre Hospitalier Universitaire de Nancy
      Nancy, Lorraine, France
  • 2009–2015
    • Hôpital Henri Mondor (Hôpitaux Universitaires Henri Mondor)
      • Service de Dermatologie
      Créteil, Île-de-France, France
  • 2011
    • Université Paris-Est Créteil Val de Marne - Université Paris 12
      • Faculty of medicine
      Créteil, Île-de-France, France
  • 2010
    • University of Paris-Est
      La Haye-Descartes, Centre, France
  • 2005–2009
    • Centre Hospitalier Victor Dupouy
      Argenteuil, Île-de-France, France
  • 2002
    • French Institute of Health and Medical Research
      • Unit of Immunology, Dermatology, Oncology
      Lutetia Parisorum, Île-de-France, France