A Phan

Hospices Civils de Lyon, Lyons, Rhône-Alpes, France

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Publications (35)50.72 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The specific anatomy of the glabrous skin, characterized by marked orthokeratosis and the presence of furrows and ridges, results in peculiar dermoscopic patterns of acral melanocytic lesions. Most frequently, acral nevi are typified by a parallel furrow pattern and acral melanoma (AM) by a parallel ridge pattern (PRP). Although the dermoscopic patterns of AM have been extensively investigated, little attention has been paid to site-related differences between palmar and plantar AM. The current study aimed to compare patients' characteristics, melanoma thickness, and the morphologic variability of AM depending on the localization on palms or soles. Patients demographics and dermoscopic images of 118 AM, including 99 (83.9%) plantar and 19 (16.1%) palmar lesions (mean thickness, 2.1 mm), were extracted from the databases of seven pigmented skin lesion clinics and were evaluated for the presence of predefined criteria. Palmar melanomas were remarkably more frequent in women (male-to-female ratio, 1/3.8) and thinner than plantar melanomas (1.3 vs. 2.2 mm). Dermoscopically, no significant differences were found between plantar and palmar melanomas, with PRP scored in 64.6 and 68.4% of plantar and palmar lesions, respectively. Non-site-specific melanoma criteria were detected in 83.9% of lesions and, among melanomas not exhibiting a PRP, 95.1% showed at least one non-site-specific melanoma criterion. In conclusion, plantar and palmar AMs show sex-related and thickness-related differences, but do not differ with respect to their dermoscopic features. For cases lacking the PRP, non-site-specific melanoma criteria may be considered as helpful additional clues for the correct diagnosis.
    Melanoma research 11/2013; · 2.06 Impact Factor
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    ABSTRACT: Although dermoscopy reflects the anatomy, skin anatomy is different on facial and acral skin as well as in the nail unit. Malignant patterns on acral sites include the parallel ridge pattern and irregular diffuse pigmentation, whose presence should lead to a biopsy. Malignant patterns on the face include features of follicular invasion (signet-ring images, annular granular images, and rhomboidal structures) and atypical vessels. Malignant patterns on the nail unit include the micro-Hutchinson sign and irregular longitudinal lines.
    Dermatologic clinics 10/2013; 31(4):615-24. · 1.29 Impact Factor
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    ABSTRACT: We report a case of an immunocompetent child who developed parvovirus B19 infection complicated by auto-inflammatory disease with myocarditis, tamponade and macrophage activation syndrome. He recovered with immunotherapy including prednisone, immunoglobulins, cyclosporin and anakinra (anti-IL1). The report shows that parvovirus can provoke severe systemic inflammation with acute heart injury and that anti-IL1 might be considered in such parvovirus-related inflammation.
    The Pediatric Infectious Disease Journal 02/2013; · 3.57 Impact Factor
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    ABSTRACT: Los nevos pigmentarios, también denominados nevos melanocíticos, son tumores melanocíticos benignos que se caracterizan por una proliferación de melanocitos en las cercanías de la unión dermoepidérmica, con un reagrupamiento en cúmulos o tecas que permite distinguirlos de los melanocitos normales. Aparte de los nevos adquiridos comunes, algunos nevos adquiridos son notables por sus características clínicas y/o sus variantes evolutivas. Los problemas principales que plantean los nevos pigmentarios son el diagnóstico diferencial con el melanoma y, en algunos casos, el riesgo evolutivo de transformación maligna. La dermatoscopia permite mejorar los resultados diagnósticos en manos de un operador experimentado y, en consecuencia, proponer una clasificación de los nevos centrada en la observación clínica. Los nevos congénitos plantean problemas específicos y se deben tratar por separado.
    EMC - Dermatología. 12/2012; 46(4):1–16.
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    ABSTRACT: Merkel cell carcinoma (MCC) is an aggressive cutaneous tumor whose clinical presentation, usually a pink nodule, is not specific. We aimed in this study to determine the dermoscopic criteria encountered in MCC. From our image database we selected the patients diagnosed with MCC and scored the dermoscopic criteria shown by these tumors. Ten patients coming from three different academic hospitals were studied. Vascular structures were the more relevant dermoscopic features. In 8 out of 10 (80%) patients a polymorphic vascular pattern was seen, composed of milky-red clods/areas in association with one or more additional vascular structures. Although an overlap existed between the dermoscopic features observed in MCC and amelanotic melanoma, the presence of a polymorphous vascular pattern may constitute an additional clinical clue to accurately diagnose this rare tumor.
    Dermatology 04/2012; 224(2):140-4. · 2.02 Impact Factor
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    ABSTRACT: Subungual melanoma (SUM) is a rare entity, comprising approximately 0·7-3·5% of all melanoma subtypes. SUM histopathologically belongs to the acral lentiginous pathological subtype of malignant melanoma. Its diagnosis is helped by dermoscopy but pathological examination of doubtful cases is required. Classical management of SUM is based on radical surgery, namely distal phalanx amputation. Conservative treatment with nonamputative wide excision of the nail unit followed by a skin graft has been insufficiently reported in the medical literature even though it is performed in many centres. To report a series of patients with in situ or minimally invasive SUM treated by conservative surgery, to investigate the postoperative evolution and to evaluate the outcome with a review of the literature. We performed a retrospective extraction study from our melanoma register of all patients with in situ and minimally invasive SUM treated with conservative surgery in the University Hospital Department of Dermatology, Lyon, France from 2004 to 2009. The patient demographics, disease presentation, delay to diagnosis, histopathology and postoperative evolution were reviewed. Seven cases of SUM treated as such were identified in our melanoma database. All cases had a clinical presentation of melanonychia striata. The mean delay to diagnosis was 2years. Surgical excision of the entire nail unit with a 5-10mm safety margin without bone resection followed by full-thickness skin graft taken from the arm was performed in all cases. No recurrence was observed with a mean follow-up of 45months. Functional results were found satisfactory by all patients and their referring physicians. Sixty-two other cases have been found in the literature and are also discussed. Conservative surgical management in patients with in situ or minimally invasive SUM is a procedure with good cosmetic and functional outcome and, in our cases as well as in the literature, the prognosis is not changed.
    British Journal of Dermatology 08/2011; 165(4):852-8. · 3.76 Impact Factor
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    ABSTRACT: Epidermal nevus syndrome is a rare congenital sporadic neuro-ectodermic disorder, characterized by the presence of epidermal nevi in association with various developmental abnormalities of the skin, eyes, nervous, skeletal, cardiovascular and urogenital systems. We describe a 5-year-old boy with conjunctival lipodermoid, cervical and facial sebaceous nevi who presented at 3 years of age with hypertension due to bilateral renal artery stenosis together with multiple vascular anomalies (aorta, celiac trunk, superior mesenteric artery) as shown by magnetic resonance angiography. Systemic arterial hypertension was difficult to control despite combined anti-hypertensive drugs and the surgical repair of the aortic coarctation.
    Pediatric Nephrology 07/2011; 26(11):2081-4. · 2.94 Impact Factor
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    ABSTRACT: The parallel ridge pattern (PRP) is a volar dermoscopic pattern that is characterized by an accentuated pigmentation on the ridges of the skin markings, while the furrows are hypopigmented or unpigmented. It has been demonstrated to be highly specific for acral melanoma, and its presence must be considered a warning sign of melanoma. However, rare cases of benign acral melanocytic nevus can exhibit the PRP, as in the edge of the compound melanocytic nevus shown in Figure 1A. The acral blue nevus (Figure 1B) usually shows a bluish, quite homogeneous pigmentation involving the ridges.
    Archives of dermatology 05/2011; 147(5):634. · 4.76 Impact Factor
  • S Dalle, A Phan, L Thomas
    Annales de Dermatologie et de Vénéréologie 05/2011; 138(5):451-2. · 0.60 Impact Factor
  • S. Dalle, A. Phan, L. Thomas
    Annales De Dermatologie Et De Venereologie - ANN DERMATOL VENEREOL. 01/2011; 138(5):451-452.
  • A. Phan, S. Dalle, L. Thomas
    Annales De Dermatologie Et De Venereologie - ANN DERMATOL VENEREOL. 01/2011; 138(6):542-544.
  • Archives of dermatology 06/2010; 146(6):667-72. · 4.76 Impact Factor
  • A Phan, S Dalle, L Thomas
    Annales de Dermatologie et de Vénéréologie 04/2010; 137(4):334-5. · 0.60 Impact Factor
  • A Phan, S Dalle, L Thomas
    Annales de Dermatologie et de Vénéréologie 02/2010; 137(2):161-2. · 0.60 Impact Factor
  • A. Phan, S. Dalle, L. Thomas
    Annales De Dermatologie Et De Venereologie - ANN DERMATOL VENEREOL. 01/2010; 137(2):161-162.
  • A. Phan, S. Dalle, L. Thomas
    Annales De Dermatologie Et De Venereologie - ANN DERMATOL VENEREOL. 01/2010; 137(4):334-335.
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    ABSTRACT: Acral lentiginous melanoma (ALM) is a rare but distinctive subtype of melanoma. The diagnosis is often delayed and misdiagnosis is common, due to frequently unusual clinical presentation and a higher rate of amelanosis than in other melanoma subtypes. We aimed to investigate the dermoscopic features of a large series of ALM in a white-skinned population, in order to emphasize their diagnostic value. All recorded dermoscopic photographs of ALM, including nail unit variants, were collected from the files of the University Hospital Department of Dermatology (Lyons, France) and reviewed. In total 110 lesions, including 66 (60%) palmoplantar ALM and 44 (40%) ALM of the nail apparatus, were analysed for dermoscopic characteristics. The mean Breslow thickness was 2.6 mm. In volar skin melanomas, the two most prevalent patterns were irregular diffuse pigmentation (60%) and the parallel-ridge pattern (53%). Minor dermoscopic patterns, commonly noted in benign lesions, were also detected but only focally within the lesions. Among the 44 nail unit lesions, 31 (70%) presented irregular lines with variegations in colours, spacing, width and disruption of parallelism. Two cases of melanonychia striata had a triangular shape. Both corresponded to early ungual ALM. Association with subungual haemorrhage was not uncommon. The study included 37 (34%) amelanotic melanomas. However, dermoscopy enabled detection of microscopic remnants of pigmentation in most cases. The vascular pattern found in almost half of these lesions was polymorphous, with combinations of milky-red areas (95%), linear irregular vessels (49%), dotted vessels (43%) and hairpin vessels (41%). The presence of a parallel-ridge pattern and/or irregular diffuse pigmentation within the lesion is highly indicative of melanoma on volar skin. An irregular lines pattern is the most prominent dermoscopic feature of pigmented ALM of the nail apparatus. Amelanotic ALM either in volar skin or in nail apparatus is characterized by remnants of pigmentation and a polymorphic vascular pattern.
    British Journal of Dermatology 11/2009; 162(4):765-71. · 3.76 Impact Factor
  • Source
    A Phan, S Dalle, L Thomas
    Annales de Dermatologie et de Vénéréologie 06/2009; 136(5):477-8. · 0.60 Impact Factor
  • A. Phan, S. Dalle, L. Thomas
    Annales De Dermatologie Et De Venereologie - ANN DERMATOL VENEREOL. 01/2009; 136(5):477-478.
  • A. Phan, S. Dalle, L. Thomas
    Annales De Dermatologie Et De Venereologie - ANN DERMATOL VENEREOL. 01/2009; 136(6):562-563.

Publication Stats

197 Citations
50.72 Total Impact Points

Institutions

  • 2012
    • Hospices Civils de Lyon
      Lyons, Rhône-Alpes, France
  • 2009–2012
    • Centre Hospitalier Lyon Sud
      Lyons, Rhône-Alpes, France
  • 2006–2011
    • Claude Bernard University Lyon 1
      • Service de dermatologie
      Villeurbanne, Rhone-Alpes, France
  • 2007
    • CHU de Lyon - Hôpital Femme-Mère-Enfant
      Lyons, Rhône-Alpes, France