D Lipsker

Hopitaux Civils De Colmar, Kolmar, Alsace, France

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Publications (236)573.24 Total impact

  • M. Huther, C. Gronier, D. Lipsker
    Annales de Dermatologie et de Vénéréologie 06/2015; DOI:10.1016/j.annder.2015.04.164 · 0.67 Impact Factor
  • A Kieny, C Wettlé, D Lipsker, B Cribier
    Annales de Dermatologie et de Vénéréologie 06/2015; DOI:10.1016/j.annder.2015.04.015 · 0.67 Impact Factor
  • M. Freysz, G.B.E. Jemec, D. Lipsker
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    ABSTRACT: The diagnosis of Hidradenitis Suppuratva (HS) is clinical and relatively straightforward for an experienced clinician. However, the terminology needed for a detailed and precise description of the lesions is more problematic. The aim of this study was to identify, enumerate and clearly define the primary lesions described in HS so as to compile a glossary that can be used to define clinical patient profiles. A review of the literature in English was performed on Medline (Pubmed), extending from 1949 to October 2013. This review targeted semantic aspects. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    British Journal of Dermatology 06/2015; DOI:10.1111/bjd.13940 · 4.10 Impact Factor
  • C. Moulinas, H. Dollfus, D. Lipsker
    Annales de Dermatologie et de Vénéréologie 05/2015; 142(6-7). DOI:10.1016/j.annder.2015.01.028 · 0.67 Impact Factor
  • Annales de Dermatologie et de Vénéréologie 04/2015; DOI:10.1016/j.annder.2015.03.012 · 0.67 Impact Factor
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    ABSTRACT: Some authors consider that morphoea and systemic sclerosis (SSc) could be part of the same disease spectrum. The aim of this study was to analyse the prevalence of signs indicative of SSc in a cohort of patients with morphoea. This is a prospective multi-centre study performed in four French academic dermatology departments: 76 patients with morphoea and 101 age- and sex-matched controls, who underwent complete clinical examination, were enrolled. A systemic search for signs indicative of SSc (e.g. Raynaud's phenomenon, reflux) was performed with the help of a standardised questionnaire. There were 58 women and 18 men (ration =3/1) with a median age of 59 years. Mean age at diagnosis was 54 years (extremes, 13-87). 49 subjects had plaque morphoea, 9 had generalised morphoea and 18 had linear morphoea. Mean duration of morphoea was 7.9 years. Signs possibly indicative of SSc were noted in four patients of the control group and in 8 patients with morphoea. This difference was not statistically significant (p=0.129). Further investigations ruled out SSc in all patients. Signs indicative of SSc are statistically not more frequently present in patients with morphoea than in controls and this study does not support the view that those 2 entities are part of a common disease spectrum.
    Clinical and experimental rheumatology 03/2015; · 2.97 Impact Factor
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    ABSTRACT: Lyme disease is the most important vector-borne disease in the Northern hemisphere and represents a major public health challenge with insufficient means of and reliable diagnosis. Skin is rarely investigated in proteomics but constitutes in the case of Lyme disease the key interface where the pathogens can enter, persist and multiply. Therefore, we investigated proteomics on skin samples to detect Borrelia proteins directly in cutaneous biopsies in a robust and specific way. We first set up a discovery Ge-LC-MS/MS approach on a murine model infected by B. burgdorferi sensu stricto that allowed the identification of 25 Borrelia proteins among more than 1300 mouse proteins. Then we developed a targeted Ge-LC-SRM assay to detect 9/33 Borrelia proteins/peptides in mice skin tissue samples using heavy labeled synthetic peptides. We successfully transferred this assay from the mouse model to human skin biopsies - naturally infected by Borrelia - and we were able to detect two Borrelia proteins: OspC and flagellin. Considering the extreme variability of OspC, we developed an extended SRM assay to target a large set of variants. This assay afforded the detection of nine peptides belonging to either OspC or flagellin in human skin biopsies. We further shortened the sample preparation and showed that Borrelia is detectable in mouse and human skin biopsies by directly using a liquid digestion followed by LC-SRM analysis without any prefractionation. This study thus shows that a targeted SRM approach is a promising tool for the early direct diagnosis of Lyme disease with high sensitivity (<10 fmol OspC per mg of human skin biopsy). Copyright © 2015, The American Society for Biochemistry and Molecular Biology.
    Molecular &amp Cellular Proteomics 02/2015; 14(5). DOI:10.1074/mcp.M114.046540 · 7.25 Impact Factor
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    N. Boulanger, Dan Lipsker
    Annales de Dermatologie et de Vénéréologie 01/2015; 142(4). DOI:10.1016/j.annder.2014.11.018 · 0.67 Impact Factor
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    ABSTRACT: Neutrophilic urticarial dermatosis (NUD) resembles urticaria clinically but is a neutrophilic dermatosis histopathologically. The majority of patients with NUD have an underlying systemic condition, mainly, autoinflammatory disorders such as cryopyrin-associated periodic syndromes, Schnitzler syndrome, and adult-onset Still disease, but a few also have systemic lupus erythematosus (LE). Here, we confirm these data and we report relevant clinical and histopathological data of 7 patients with LE and NUD.We retrospectively retrieved the medical records of all patients with LE in whom skin biopsy showed NUD in registers of Strasbourg and Montpellier University hospitals since 2000.All were female and aged between 13 and 45 years. Skin lesions were typically rose or red macules or slightly elevated papules occurring in a wide distribution. Individual lesions resolved within 24 hours and were not or only slightly itchy. Every patient had associated signs, most of the time polyarthritis and/or fever. NUD was the presenting mode of LE in 2 patients. NUD was misdiagnosed as a classic lupus flare and led to therapeutic intensification with the introduction of immunosuppressive drugs in 4 patients. Histopathological findings consisted of intense neutrophilic interstitial and perivascular infiltrate with leukocytoclasia and without fibrinoid necrosis of vessel walls. Direct immunofluorescence testing showed a lupus band in 4 patients. Antinuclear antibodies were always positive, anti-dsDNA antibodies were positive in 5 patients, and anti-Ro/SSA antibodies in 6 patients. Immunosuppressive drugs such as prednisone, hydroxychloroquine, mycophenolate mofetil, and methotrexate were never effective to treat NUD. Antihistamines were effective in 1 patient and dapsone or colchicine was effective in 5 patients.NUD is not exceptional in patients with systemic LE and is easily misdiagnosed as an acute LE flare. Furthermore, we show that conventional immunosuppressive LE treatments are not efficient and we underline the major interest of dapsone and colchicine, classic neutrophil migration inhibitors, in those patients.
    Medicine 12/2014; 93(29):e351. DOI:10.1097/MD.0000000000000351 · 4.87 Impact Factor
  • Dan Lipsker, Cédric Lenormand
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    ABSTRACT: Introduction: Schnitzler’s syndrome is a paradigm of an acquired autoinflammatory disorder, involving IL-1, which can now be pharmacologically targeted.Areas covered: Management of Schnitzler’s syndrome is covered in detail, by reviewing all published papers on this topic until May 2014. Schnitzler’s syndrome usually affects adult patients in their fifties. The main symptoms are an urticarial rash, fever, joint and/or bone pain, elevated CRP and leukocytosis in a patient with a monoclonal IgM (or rarely IgG) gammopathy. It is a chronic/recurrent disorder and spontaneous remissions are exceedingly rare. Patients are at specific risk of inflammatory anemia and AA-amyloidosis. The risk of associated lymphoid malignancy seems to be comparable to the one associated to monoclonal gammopathy of undetermined significance in general. Diagnosis relies on the Lipsker or the Strasbourg criteria.Expert opinion: Treatment relies on IL-1 inhibitors which allow a rapid and complete control of all signs. The IL-1 receptor antagonist anakinra, which has a short half-life and necessitates daily injections, is the treatment of choice in patients with Schnitzler’s syndrome who have alteration in their quality of life or persistent elevation of markers of inflammation. The other IL-1 inhibitors with longer half-lives need further investigation.
    08/2014; 2(9). DOI:10.1517/21678707.2014.939170
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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; 71(1). DOI:10.1016/j.jaad.2014.02.044 · 5.00 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. DOI:10.1016/j.annder.2013.09.655 · 0.67 Impact Factor
  • Annales de Dermatologie et de Vénéréologie 12/2013; 140(12):S492-S493. DOI:10.1016/j.annder.2013.09.298 · 0.67 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 12/2013; 140(12):S365. DOI:10.1016/j.annder.2013.09.014 · 0.67 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.
    11/2013; 23(5). DOI:10.1684/ejd.2013.2150
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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.
    10/2013; 149(12). DOI:10.1001/jamadermatol.2013.6683
  • Dan Lipsker
    10/2013; 149(10):1244-5. DOI:10.1001/jamadermatol.2013.5480
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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.
    09/2013; 2013:501327. DOI:10.1155/2013/501327
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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.
    08/2013; 149(10). DOI:10.1001/jamadermatol.2013.706
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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; 226(4). DOI:10.1159/000351311 · 1.69 Impact Factor

Publication Stats

2k Citations
573.24 Total Impact Points

Institutions

  • 2015
    • Hopitaux Civils De Colmar
      Kolmar, Alsace, France
  • 2000–2015
    • University of Strasbourg
      • Faculty of Medicine
      Strasburg, Alsace, France
  • 2012
    • Centre Hospitalier Universitaire de Dijon
      Dijon, Bourgogne, France
  • 2009
    • Universidad de La Punta
      La Punta, San Luis, Argentina
    • Assistance Publique – Hôpitaux de Paris
      Lutetia Parisorum, Île-de-France, France
  • 2008
    • Hôpital Tenon (Hôpitaux Universitaires Est Parisien)
      • Service de Dermatologie - Allergologie
      Paris, Ile-de-France, France
    • CHRU de Strasbourg
      Strasburg, Alsace, France
  • 2005
    • University of Geneva
      Genève, Geneva, Switzerland
  • 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