D Lipsker

Centre Hospitalier Régional Universitaire de Lille, Lille, Nord-Pas-de-Calais, France

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Publications (206)532.02 Total impact

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    ABSTRACT: Skin involvement is reported during primary parvovirus B19 infection in adults. We sought to describe the cutaneous presentations associated with parvovirus B19 primary infection in adults. We conducted a descriptive, retrospective, multicenter study. The patients included (>18 years old) had well-established primary infections with parvovirus B19. Twenty-nine patients were identified between 1992 and 2013 (17 women, 12 men). The elementary dermatologic lesions were mostly erythematous (86%) and often purpuric (69%). Pruritus was reported in 48% of cases. The rash predominated on the legs (93%), trunk (55%), and arms (45%), with a lower frequency of facial involvement (20%). Four different but sometimes overlapping patterns were identified (45%): exanthema, which was reticulated and annular in some cases (80%); the gloves-and-socks pattern (24%); the periflexural pattern (28%); and palpable purpura (24%). The limitations of this study were its retrospective design and possible recruitment bias in tertiary care centers. Our findings suggest that primary parvovirus B19 infection is associated with polymorphous skin manifestations with 4 predominant, sometimes overlapping, patterns. The acral or periflexural distribution of the rash and the presence of purpuric or annular/reticulate lesions are highly suggestive of parvovirus B19 infection.
    Journal of the American Academy of Dermatology 04/2014; · 4.91 Impact Factor
  • M Freysz, L Mertz, D Lipsker
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    ABSTRACT: The treatment of cerebral lesions using endovascular radiological procedures is becoming a standard of care. Radiation-induced alopecia, a type of acute radiodermatitis, is a frequent complication. Between 2009 and 2010, a number of patients reported hair loss after embolization of a cerebral arteriovenous malformation at the Neuroradiology Department of the Strasbourg University Hospital. We therefore retrospectively investigated 18 cases to better delineate the circumstances and the risk factors associated with radiation-induced alopecia. We reviewed the records of 35 patients reporting hair loss among the 347 patients undergoing embolization of cerebral arteriovenous malformations between January 2008 and May 2010. Only patients with photographically documented complete circumscribed alopecia were included. Patients were examined and interviewed by a dermatologist and/or a radiologist at the time of hair loss and at a later point. The cumulative dose of radiation delivered to the skin in the 3 months preceding onset of alopecia, then over the entire period 2008-2010, was calculated. These doses included the diagnostic (angiography) and therapeutic (embolization) procedures. Definite circumscribed alopecia was noted in 18 patients. Alopecia occurred between two and four weeks after embolization; it was complete and in no cases cicatricial. Complete recovery as attested by examination or photography was observed in 12 patients. The cumulative dose over the preceding three months was between 2.5Gy and 12.3Gy (mean: 5Gy). The total cumulative dose since January 2008 was between 3.2 and 17Gy (mean: 7Gy). We describe a series of 18 patients with radio-induced alopecia occurring after diagnostic and therapeutic procedures for cerebral arteriovenous malformations. This series is particularly interesting because it includes the largest patient sample reported to date with an uncommon large area of alopecia, and also because we were able to calculate the cumulative dose of radiation delivered to the skin. In addition, we underline the importance of the cumulative dose in interventional radiology since radio-induced alopecia probably results from the number of interventional procedures during a given time period. Moreover, analysis of these doses provided us with a new perspective on the radiobiology of the hair growth cycle. Indeed, whereas previously reported data considered alopecia as definitive where doses higher than 7Gy were delivered, we noticed regrowth of hair with doses of up to 12Gy. These observations underline the specific findings of radiation-induced alopecia and underline the importance of the cumulative radiation dose delivered during the 3 months preceding alopecia.
    Annales de Dermatologie et de Vénéréologie 01/2014; 141(1):15-22. · 0.60 Impact Factor
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    ABSTRACT: Background: Blaschko-Linear Manifestations of Multifactorial Polygenic Diseases (BLMMPD) are rare. Their underlying pathogenesis is not known but genetic mosaicism is supposed to be involved. Objectives: To describe a series of patients with BLMMPD and to establish a meaningful classification of these manifestations. Materials & Methods: We retrospectively retrieved the records of all the patients with Blaschko-linear lesions followed at our institution between 1994 and 2007. Only well-documented cases of BLMMPD were included. Results: 17 cases were reviewed (11 men and 6 women, mean age 42 years), and the following diagnoses were established: psoriasis (4 cases), lupus erythematosus (1 case), lichen planus (4 cases), dermatomyositis (1 case), adult-onset lichen striatus (4 cases) and adult-onset blaschkitis (3 cases). Careful analysis allowed us to individualize 4 distinct nosological situations: in "type A" manifestations, patients had isolated Blaschko-linear lesions, either of a disease nosologically characterized in a non-segmental manner ("type Aα", e.g. Blaschko-linear psoriasis) or of a disease defined by its Blaschko-linearity ("type Aβ, e.g. lichen striatus); while in "type B" manifestations, patients had other signs of disease, i.e. either non-segmental skin lesions of the same type ("type Bα", e.g. Blaschko-linear psoriasis plus non Blaschko-linear psoriatic lesions), or distinct cutaneous or extra-cutaneous manifestations ("type Bβ", e.g. Blaschko-linear calcinosis cutis in a patient with otherwise typical dermatomyositis). Conclusions: We propose a comprehensive classification of BLMMPD in well distinct nosological situations, which should be of help if we wish to elucidate the pathogeny of those complex disorders.
    European journal of dermatology : EJD. 11/2013;
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    ABSTRACT: IMPORTANCE Cockayne syndrome (CS) and cerebro-oculo-facial-skeletal (COFS) syndrome are autosomal recessive diseases that belong to the family of nucleotide excision repair disorders. Our aim was to describe the cutaneous phenotype of patients with these rare diseases. OBSERVATIONS A systematic dermatologic examination of 16 patients included in a European study of CS was performed. The patients were aged 1 to 28 years. Six patients (38%) had mutations in the Cockayne syndrome A (CSA) gene, and the remaining had Cockayne syndrome B (CSB) gene mutations. Fourteen patients were classified clinically as having CS and 2 as having COFS syndrome. Photosensitivity was present in 75% of the patients and was characterized by sunburn after brief sun exposure. Six patients developed symptoms after short sun exposure through a windshield. Six patients had pigmented macules on sun-exposed skin, but none developed a skin neoplasm. Twelve patients (75%) displayed cyanotic acral edema of the extremities. Eight patients had nail dystrophies and 7 had hair anomalies. CONCLUSIONS AND RELEVANCE The dermatologic findings of 16 cases of CS and COFS syndrome highlight the high prevalence of photosensitivity and hair and nail disorders. Cyanotic acral edema was present in 75% of our patients, a finding not previously reported in CS.
    JAMA dermatology (Chicago, Ill.). 10/2013;
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    ABSTRACT: IMPORTANCE Life expectancy is increasing in most developed countries, and elderly people have the highest incidence of melanoma. OBJECTIVE To identify characteristics of melanoma and its management in the elderly compared with younger patients. DESIGN, SETTING, AND PARTICIPANTS Retrospective population-based study of incident cases of primary melanoma in 1621 patients with stage I or II melanoma in 2004 and 2008. Questionnaires administered to physicians and a survey of cancer registries and pathology laboratories were used to obtain data. The study was conducted in 5 regions in northeastern France. MAIN OUTCOMES AND MEASURES Characteristics of patients and tumors, circumstances of diagnosis, and further management in older patients (≥70 years, 487 patients [30.0%]) compared with younger ones (<70 years, 1134 [70.0%]). RESULTS Older patients had more frequent melanomas of the head and neck (29.4% vs 8.7%; P < .001) and of the nodular, lentigo maligna, or acral lentiginous histologic subtypes. They had thicker and more frequently ulcerated tumors, categorized as T3 or T4 in 36.7% of cases vs 20.1% in younger patients. Diagnosis of melanoma occurred more frequently in a general practice setting and less frequently in direct consultation with a dermatologist or regular screening for skin cancer. Time to definitive excision was longer in older patients, and 16.8% of them compared with 5.0% of the younger population had insufficient excision margins (P < .001). A sentinel lymph node biopsy was performed in 23.3% of the older patients with melanoma thicker than 1 mm vs 41.4% in the younger patients (P < .001). Adjuvant therapy was less frequently started in older patients and was prematurely stopped in a higher proportion of that population. CONCLUSIONS AND RELEVANCE Age-related variations are observed at every step of melanoma management. The most important concerns are access of elderly people to settings for early diagnosis and excision with appropriate margins.
    JAMA dermatology (Chicago, Ill.). 08/2013;
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    ABSTRACT: The follow-up of a man from birth to adulthood, presenting with features both of RAPADILINO and Rothmund-Thomson syndrome (RTS), is described. Molecular studies confirmed the presence of two different mutations, c.2767_2768delTT and c.3061C>T, in the RECQL4 gene. This gene is known to be causative of a spectrum including Baller-Gerold syndrome, RAPADILINO syndrome and RTS. New and rare features such as oral leukoplakia and very prominent hyperkeratotic verrucous papules on both soles are shown. This patient has to date no cancer history despite bearing a truncating mutation at the age of 21 years, which is also unusual. © 2013 S. Karger AG, Basel.
    Dermatology 07/2013; · 2.02 Impact Factor
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    ABSTRACT: INTRODUCTION: Blastic plasmacytoid Dentritic Cell Neoplasm (BPDCN) is, as defined in the new 2008 World health Organized (WHO) classification of tumors of hematopoietic and lymphoid tissue, a rare disease characterized by malignant proliferation of a contingent blastic plasmacytoid dendritic cell. This rare entity is mostly revealed and diagnosed on cutaneous spreading associated d'emblée or not with a leukaemic component .The prognosis is very poor. We herein studied a large cohort of 90 patients with BPDCN and try to define additional clues to coin earlier the correct diagnosis and manage such patients accordingly. MATERIALS AND METHOD: We retrospectively reviewed BPDCN cases registered in the French Study Group on Cutaneous Lymphoma (GFELC) database from November 1995 to January 2012. Ninety patients were studied. Demographic data, clinical presentation, initial staging, and outcome were recorded. RESULTS: The studied group contained 62 male and 28 female patients (sex ratio 2.2). Age ranged from 8 to 103 years at the time of diagnosis (mean age: 67.2 years).Three major different clinical presentations were identified: Sixty six patients (73.2%) presented with nodular lesions only, 11 patients with "bruise-like» patches (12.2%).The remaining 13 ones showed disseminated lesions (patches and nodules). Mucosal lesions were seen in five patients (5.6%) The median survival in patients with BPDCN was at 12 months . CONCLUSIONS: We here distinct three different clinical presentation of BPDCN. Nodular pattern is actually a more common feature than the originally reported "bruise-like" pattern. Despite the fact that BPDCN may initially appear as a localized skin tumor an aggressive management including allogenic bone marrow transplantation should be considered d'emblée since it is so far the only one option associated with long term survival. This article is protected by copyright. All rights reserved.
    British Journal of Dermatology 05/2013; · 3.76 Impact Factor
  • M Freysz, B Cribier, D Lipsker
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    ABSTRACT: Port-wine stains or capillary malformations are generally congenital. Very few cases of acquired port-wine stains in adults have been described, and these occur particularly after trauma. We report three cases of acquired port-wine stains and we performed a review of the literature using the keywords "port-wine stain", "capillary malformation", "angioma" and "acquired" in the Medline database PubMed. All relevant articles were included. Two male patients and one female patient consulted for one or more angiomatous lesions, located respectively on the upper rear part of the right thigh (case 1), the left leg (case 2) and the right side of the face, skull and chest (case 3). Each patient's skin biopsy was consistent with port-wine stain. The three patients asserted the acquired nature of the lesions: the male patients were respectively 17 and 38 years old, and the female patient was 11 years old. No causative factors were evident preceding the lesion, and there was no family history of port-wine stain. The topography was systematic in patients 2 and 3. The lesions were light red in patient 1, dark red in patient 2 and pale pink in patient 3. The remainder of the physical examination was unremarkable, except for benign angiokeratoma of the scrotum in case 1 and pigmented leucoderma-type macules in case 3. LITERATURE RESULTS: Sixty-six cases of acquired port-wine stains were reported in the literature. The average age was 25 years (3-69) with a sex-ratio of 0.88. Generally, no causative factor was given. However, trauma (30.5%), estrogenic impregnation (16.5%), and more rarely, medication, solar damage, frostbite, cluster headache, herpes zoster and acoustic neuroma were reported as causatives factors. Acquired port-wine stain is rare. Although often idiopathic, it can result from spinal trauma, which must be explored if suggested by the history. In our series, the clinical presentation suggested a latent congenital vascular malformation of late onset, in particular in patients 2 and 3, because of the segmental distribution.
    Annales de Dermatologie et de Vénéréologie 05/2013; 140(5):341-6. · 0.60 Impact Factor
  • M. Freysz, B. Cribier, D. Lipsker
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    ABSTRACT: Background Port-wine stains or capillary malformations are generally congenital. Very few cases of acquired port-wine stains in adults have been described, and these occur particularly after trauma. Patients and method We report three cases of acquired port-wine stains and we performed a review of the literature using the keywords “port-wine stain”, “capillary malformation”, “angioma” and “acquired” in the Medline database PubMed. All relevant articles were included. Results Two male patients and one female patient consulted for one or more angiomatous lesions, located respectively on the upper rear part of the right thigh (case 1), the left leg (case 2) and the right side of the face, skull and chest (case 3). Each patient's skin biopsy was consistent with port-wine stain. The three patients asserted the acquired nature of the lesions: the male patients were respectively 17 and 38 years old, and the female patient was 11 years old. No causative factors were evident preceding the lesion, and there was no family history of port-wine stain. The topography was systematic in patients 2 and 3. The lesions were light red in patient 1, dark red in patient 2 and pale pink in patient 3. The remainder of the physical examination was unremarkable, except for benign angiokeratoma of the scrotum in case 1 and pigmented leucoderma-type macules in case 3. Literature results Sixty-six cases of acquired port-wine stains were reported in the literature. The average age was 25 years (3−69) with a sex-ratio of 0.88. Generally, no causative factor was given. However, trauma (30.5%), estrogenic impregnation (16.5%), and more rarely, medication, solar damage, frostbite, cluster headache, herpes zoster and acoustic neuroma were reported as causatives factors. Discussion Acquired port-wine stain is rare. Although often idiopathic, it can result from spinal trauma, which must be explored if suggested by the history. In our series, the clinical presentation suggested a latent congenital vascular malformation of late onset, in particular in patients 2 and 3, because of the segmental distribution.
    Annales de Dermatologie et de Vénéréologie 05/2013; 140(5):341–346. · 0.60 Impact Factor
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    ABSTRACT: Schnitzler's syndrome is characterized by recurrent urticarial rash and monoclonal gammopathy, associated with clinical and biological signs of inflammation and a long-term risk of AA amyloidosis and overt lymphoproliferation. An extensive literature review was performed, and the following questions were addressed during an expert meeting: In whom should Schnitzler's syndrome be suspected? How should the diagnosis of Schnitzler's syndrome be established? How should a patient with Schnitzler's syndrome be treated? How should a patient with Schnitzler's syndrome be followed up?. A diagnosis of Schnitzler's syndrome is considered definite in any patient with two obligate criteria: a recurrent urticarial rash and a monoclonal IgM gammopathy, and two of the following minor criteria: recurrent fever, objective signs of abnormal bone remodeling, elevated CRP level or leukocytosis, and a neutrophilic infiltrate on skin biopsy. It is considered probable, if only 1 minor criterion is present. In patients with monoclonal IgG gammopathies, diagnosis is definite if three minor criteria are present and possible if two are present. First-line treatment in patients with significant alteration of quality of life or persistent elevation of markers of inflammation should be anakinra. Follow-up should include clinical evaluation, CBC and CRP every 3 months and MGUS as usually recommended.
    Allergy 03/2013; · 5.88 Impact Factor
  • C Lenormand, B Cribier, D Lipsker
    British Journal of Dermatology 02/2013; · 3.76 Impact Factor
  • E Levy, J Godet, B Cribier, D Lipsker
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    ABSTRACT: Cutaneous pseudolymphomas (CPL) are diseases that simulate cutaneous lymphomas both clinically and histologically but have a benign course. It can be very difficult, if not impossible, to differentiate pseudolymphoma from lymphoma and there is some semantic ambiguity about the term pseudolymphoma. The aim of this study was to determine the exact meaning attributed to the term pseudolymphoma by a representative sample of French dermatologists and pathologists. We designed two types of questionnaire, one for dermatologists and the other for pathologists, and sent them out to 274 dermatologists and to 110 pathologists. We received responses from 122 dermatologists (44.5%) and 64 pathologists (58.1%). In the dermatologist group, 56% consider that CPL is not a clearly defined entity, while 58% consider it a benign disease and only 18% feel that most CPLs are related to a precise cause; 72% of dermatologists perform a routine checkup, 58% initiate treatment and 84% conduct follow-up in the case of CPL. Among pathologists, 61% consider that CPL is not a clearly defined entity, 82% feel that cutaneous pseudolymphoma, cutaneous lymphoid hyperplasia and cutaneous lymphocytoma are the same entity, and 75% consider that CPL are benign; 92% perform routine immunohistochemistry studies and only 26% screen for clonality. Bivariate statistical analysis showed that pathologists consider pseudolymphomas as benign entities frequently than dermatologists (χ(2) test: P=0.02; Fisher's exact test: P=0.01) and that there are more pathologists than dermatologists who see more than four pseudolymphomas per year (χ(2) test: P<0.001; Fisher's exact test: P<0.001). Multivariate analysis clearly identified a tendency among doctors viewing pseudolymphomas as a distinct entity to also consider them benign (Odds Ratio 0.29, CI 97.5% 0.14-0.58), irrespective of speciality or type of practice (hospital practice, private practice or both). This study demonstrates that, in France, the term pseudolymphoma is an ambiguous notion. We believe that cases in which it is impossible to differentiate pseudolymphoma from cutaneous lymphoma should be referred to as lymphoproliferations of undetermined significance, since more than 50% of physicians consider that the term pseudolymphoma designates a resolutely benign entity.
    Annales de Dermatologie et de Vénéréologie 02/2013; 140(2):105-11. · 0.60 Impact Factor
  • E. Levy, J. Godet, B. Cribier, D. Lipsker
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    ABSTRACT: Background Cutaneous pseudolymphomas (CPL) are diseases that simulate cutaneous lymphomas both clinically and histologically but have a benign course. It can be very difficult, if not impossible, to differentiate pseudolymphoma from lymphoma and there is some semantic ambiguity about the term pseudolymphoma. The aim of this study was to determine the exact meaning attributed to the term pseudolymphoma by a representative sample of French dermatologists and pathologists. Materials and methods We designed two types of questionnaire, one for dermatologists and the other for pathologists, and sent them out to 274 dermatologists and to 110 pathologists. Results We received responses from 122 dermatologists (44.5%) and 64 pathologists (58.1%). In the dermatologist group, 56% consider that CPL is not a clearly defined entity, while 58% consider it a benign disease and only 18% feel that most CPLs are related to a precise cause; 72% of dermatologists perform a routine checkup, 58% initiate treatment and 84% conduct follow-up in the case of CPL. Among pathologists, 61% consider that CPL is not a clearly defined entity, 82% feel that cutaneous pseudolymphoma, cutaneous lymphoid hyperplasia and cutaneous lymphocytoma are the same entity, and 75% consider that CPL are benign; 92% perform routine immunohistochemistry studies and only 26% screen for clonality. Bivariate statistical analysis showed that pathologists consider pseudolymphomas as benign entities frequently than dermatologists (χ2 test: P = 0.02; Fisher's exact test: P = 0.01) and that there are more pathologists than dermatologists who see more than four pseudolymphomas per year (χ2 test: P < 0.001; Fisher's exact test: P < 0.001). Multivariate analysis clearly identified a tendency among doctors viewing pseudolymphomas as a distinct entity to also consider them benign (Odds Ratio 0.29, CI 97.5% 0.14–0.58), irrespective of speciality or type of practice (hospital practice, private practice or both). Discussion This study demonstrates that, in France, the term pseudolymphoma is an ambiguous notion. We believe that cases in which it is impossible to differentiate pseudolymphoma from cutaneous lymphoma should be referred to as lymphoproliferations of undetermined significance, since more than 50% of physicians consider that the term pseudolymphoma designates a resolutely benign entity.
    Annales de Dermatologie et de Vénéréologie 02/2013; 140(2):105–111. · 0.60 Impact Factor
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    ABSTRACT: Recurrent fever can be the sole or leading manifestation of a variety of diseases including malignancies, autoimmune diseases and infections. Because the differential diagnoses are manifold, no formal guidelines for the approach of patients with recurrent fever exists. The newly recognized group of autoinflammatory diseases are often accompanied by repetitive fever attacks. As these episodes are frequently associated by a variety of divergent presentations, the differentiation of other causes for febrile illnesses can be difficult. In this article, we first review disease entities, which frequently present with the symptom of recurrent fever. In a next step, we summarize their characteristic pattern of disease presentation. Finally, we analyse key features of autoinflammatory diseases, which are helpful to distinguish this group of diseases from the other causes of recurrent fever. Recognizing these symptom patterns can provide the crucial clues and, thus, lead to the initiation of targeted specific diagnostic tests and therapies.
    Allergy 01/2013; · 5.88 Impact Factor
  • M. Freysz, D. Lipsker, L. Mertz
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    ABSTRACT: Background The treatment of cerebral lesions using endovascular radiological procedures is becoming a standard of care. Radiation-induced alopecia, a type of acute radiodermatitis, is a frequent complication. Between 2009 and 2010, a number of patients reported hair loss after embolization of a cerebral arteriovenous malformation at the Neuroradiology Department of the Strasbourg University Hospital. We therefore retrospectively investigated 18 cases to better delineate the circumstances and the risk factors associated with radiation-induced alopecia. Patients and methods We reviewed the records of 35 patients reporting hair loss among the 347 patients undergoing embolization of cerebral arteriovenous malformations between January 2008 and May 2010. Only patients with photographically documented complete circumscribed alopecia were included. Patients were examined and interviewed by a dermatologist and/or a radiologist at the time of hair loss and at a later point. The cumulative dose of radiation delivered to the skin in the 3 months preceding onset of alopecia, then over the entire period 2008–2010, was calculated. These doses included the diagnostic (angiography) and therapeutic (embolization) procedures. Results Definite circumscribed alopecia was noted in 18 patients. Alopecia occurred between two and four weeks after embolization; it was complete and in no cases cicatricial. Complete recovery as attested by examination or photography was observed in 12 patients. The cumulative dose over the preceding three months was between 2.5 Gy and 12.3 Gy (mean: 5 Gy). The total cumulative dose since January 2008 was between 3.2 and 17 Gy (mean: 7 Gy). Discussion We describe a series of 18 patients with radio-induced alopecia occurring after diagnostic and therapeutic procedures for cerebral arteriovenous malformations. This series is particularly interesting because it includes the largest patient sample reported to date with an uncommon large area of alopecia, and also because we were able to calculate the cumulative dose of radiation delivered to the skin. In addition, we underline the importance of the cumulative dose in interventional radiology since radio-induced alopecia probably results from the number of interventional procedures during a given time period. Moreover, analysis of these doses provided us with a new perspective on the radiobiology of the hair growth cycle. Indeed, whereas previously reported data considered alopecia as definitive where doses higher than 7 Gy were delivered, we noticed regrowth of hair with doses of up to 12 Gy. Conclusion These observations underline the specific findings of radiation-induced alopecia and underline the importance of the cumulative radiation dose delivered during the 3 months preceding alopecia.
    Annales de Dermatologie et de Vénéréologie 01/2013; 140(12):S365. · 0.60 Impact Factor
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    ABSTRACT: Background. Primary Sjögren's syndrome (PSS) is a frequent systemic autoimmune disease. In this study, we aimed to explore the cognitive impairment and the correlations with brain MRI. Methods. Twenty-five patients (mean age 55 ± 11.8 years, 21 females) with PSS were prospectively selected and tested with a French translation of the Brief Repeatable Battery for Neuropsychological Examination. The results were compared with the scores for 25 matched patients with multiple sclerosis (MS) and 25 controls. Brain lesions were assessed by brain MRI using the Wahlund classification. Results. Fifteen of the 25 PSS patients (60%) presented with cognitive disorders versus 19/25 MS patients (76%). Five patients had dementia in the PSS group. Speed of information processing, attention, immediate and long-term memory, and executive functions were frequently impaired. The mean duration of cognitive complaints was 5.6 ± 6.1 years, and the mean duration of PSS was 15.8 ± 14.0 years. A trend towards a correlation was found between the severity of cognitive impairment and the degree of white matter lesions (WML) (P = 0.03, rho = 0.43). Conclusion. Cognitive impairment-mild or dementia-exists in patients with PSS. Further MRI studies are needed to better understand the precise neural basis of cognitive impairment in PSS patients.
    ISRN neurology. 01/2013; 2013:501327.
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    British Journal of Haematology 12/2012; · 4.94 Impact Factor
  • Cedric Lenormand, Dan Lipsker
    Annals of internal medicine 10/2012; 157(8):599-600. · 13.98 Impact Factor
  • M Mohr, P Kanter, B Cribier, D Lipsker
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    ABSTRACT: Rosacea is a common dermatosis that can involve the bald area of the scalp. We report the case of a man presenting clinical symptoms of rosacea of the forehead and the scalp, but with a histological picture of familial chronic benign pemphigus. A 47-year-old man with a history of Hailey-Hailey disease had been presenting facial dermatosis for 5 years. The clinical features were erythema with pustules and scales located on the mid-forehead and the androgenic bald area of the frontal scalp. The histological aspect of the skin biopsy showed suprabasilar clefting and ancantholysis at all levels of the epidermis and sparse perivascular infiltrate. Direct immunofluorescence was negative. These findings were typical of Hailey-Hailey disease. Based on clinical findings, and without taking account of the skin biopsy results, treatment with doxycycline and a topical antifungal was administered for 3 months, leading to remission of symptoms. The site of rosacea on the bald area of the scalp in males is described in the literature, and when present, is probably enhanced by exposure to UV radiation. In this patient, the histological features were interpreted as histopathologically equivalent to Köbner phenomenon.
    Annales de Dermatologie et de Vénéréologie 10/2012; 139(10):626-30. · 0.60 Impact Factor
  • M. Mohr, P. Kanter, B. Cribier, D. Lipsker
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    ABSTRACT: Background Rosacea is a common dermatosis that can involve the bald area of the scalp. We report the case of a man presenting clinical symptoms of rosacea of the forehead and the scalp, but with a histological picture of familial chronic benign pemphigus. Patients and methods A 47-year-old man with a history of Hailey-Hailey disease had been presenting facial dermatosis for 5 years. The clinical features were erythema with pustules and scales located on the mid-forehead and the androgenic bald area of the frontal scalp. The histological aspect of the skin biopsy showed suprabasilar clefting and ancantholysis at all levels of the epidermis and sparse perivascular infiltrate. Direct immunofluorescence was negative. These findings were typical of Hailey-Hailey disease. Based on clinical findings, and without taking account of the skin biopsy results, treatment with doxycycline and a topical antifungal was administered for 3 months, leading to remission of symptoms. Discussion The site of rosacea on the bald area of the scalp in males is described in the literature, and when present, is probably enhanced by exposure to UV radiation. In this patient, the histological features were interpreted as histopathologically equivalent to Köbner phenomenon.
    Annales de Dermatologie et de Vénéréologie 10/2012; 139(10):626–630. · 0.60 Impact Factor

Publication Stats

1k Citations
532.02 Total Impact Points

Institutions

  • 2014
    • Centre Hospitalier Régional Universitaire de Lille
      Lille, Nord-Pas-de-Calais, France
  • 2013
    • Radboud University Medical Centre (Radboudumc)
      Nymegen, Gelderland, Netherlands
    • Centre Hospitalier Universitaire de Montpellier
      Montpelhièr, Languedoc-Roussillon, France
  • 2008–2013
    • CHRU de Strasbourg
      Strasburg, Alsace, France
    • Hôpital Tenon (Hôpitaux Universitaires Est Parisien)
      • Service de Dermatologie - Allergologie
      Paris, Ile-de-France, France
  • 1996–2013
    • University of Strasbourg
      • Faculty of Medicine
      Strasburg, Alsace, France
  • 2009–2011
    • Assistance Publique – Hôpitaux de Paris
      Lutetia Parisorum, Île-de-France, France
  • 2004
    • Institut Curie
      Lutetia Parisorum, Île-de-France, France
  • 2002–2003
    • Etablissement Français du Sang (EFS)
      Lutetia Parisorum, Île-de-France, France
    • French National Centre for Scientific Research
      Lutetia Parisorum, Île-de-France, France