E Maubec

Publications (24)27.18 Total impact

• Article: [Melanoma in HIV patients: 14 cases].

  S Qasmi, C Sutra-Loubet, E Maubec, F Boitier, P Duvillard, A Carlotti, E Marinho, S Jacobelli, N Franck, I Gorin, M C Vacher-Lavenu, F Bouscarat, B Crickx, N Dupin, M F Avril
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  ABSTRACT: a clinical study of 14 patients presenting both malignant melanoma and HIV infection, and analysis of the literature to determine the frequency and specific features of this association. ten men and four women of median age 43 years were included. In 50% of cases, the primary melanoma consisted of spreading superficial melanoma with a mean Breslow thickness of 2.83 mm. In two cases, regional lymph node metastasis was discovered but with no primary melanoma being identified. HIV infection was already documented on diagnosis of melanoma in 11 cases, and it was discovered in three cases at the time of surgery for melanoma (treatment of the primary melanoma in two cases, and in one case, regional lymph node dissection two years after the initial diagnosis). Eight patients died within a mean period of 39 months, with melanoma being the cause of death in six cases. Following relapse of melanoma, the course of the disease was severe, with mean stage IV survival of 3.6 months. No response to chemotherapy was observed where such treatment was feasible. the presence of HIV appears to be an aggravating factor for the outcome of metastatic melanoma. our study suggests the importance of clinical examination of pigmented lesions in HIV patients in order to ensure early identification of melanoma.
  Annales de Dermatologie et de Vénéréologie 12/2010; 137(12):769-74. · 0.72 Impact Factor
• Article: [Tumour regression is not predictive for higher risk of sentinel node involvement in thin melanomas (Breslow thickness < or = 1 mm)].

  N Kramkimel, E Maubec, F Boitier, A Cavalcanti, M Beldi, G Mamelle, F Kolb, P Duvillard, M-F Avril
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  ABSTRACT: Thin melanomas (Breslow thickness < or = 1 mm) are considered highly curable. The aim of this study was to evaluate the correlation between histological tumour regression and sentinel lymph node (SLN) involvement in thin melanomas. This was a retrospective single-centre study of 34 patients with thin melanomas undergoing SLN biopsy between April 1998 and January 2005. The study included 14 women and 20 men of mean age 56.3 years. Melanomas were located on the neck (n=3), soles (n=4), trunk (n=13) and extremities (n=14). Pathological examination showed 25 SSM, four acral lentiginous melanomas, three in situ melanomas, one nodular melanoma and one unclassified melanoma with a mean Breslow thickness of 0.57 mm. Histological tumour regression was observed in 26 over 34 cases and ulceration was found in one case. Clark levels were as follows: I (n=3), II (n=20), III (n=9), IV (n=2). Growth phase was available in 15 cases (seven radial and eight vertical). Mitotic rates, available in 24 cases, were: 0 (n=9), 1 (n=11), 2 (n=2), 3 (n=1), 6 (n=1). One patient with histological tumour regression (2.9% of cases and 3.8% of cases with regressing tumours) had a metastatic SLN. One patient negative for SLN had a lung relapse and died of the disease. Mean follow-up was 26.2 months. The results of the present study and the analysis of the literature show that histological regression of the primary tumour does not seem predictive of higher risk of SLN involvement in thin melanomas. This suggests that screening for SLN is not indicated in thin melanomas, even those with histological regression.
  Annales de Dermatologie et de Vénéréologie 04/2010; 137(4):276-80. · 0.72 Impact Factor
• Article: [Long-term efficacy of autologous stem cell transplantation for stage IV mycosis fungoides].

  J Di Lucca-Chrisment, E Maubec, M Grossin, E Marinho, B Varet, H Maillard, B Crickx
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  ABSTRACT: Mycosis fungoides during large cell transformation to lymphoma has a poor prognosis with mean survival of 36 months. Autologous stem cell transplantation is rarely proposed in this indication. We report the case of a young man still in complete remission for transformed mycosis fungoides 14 years after autologous stem cell transplantation. A 25-year-old man presenting eczema-like patches since childhood was treated by chemotherapy for multiple lymphadenopathies considered as Hodgkin's lymphoma. He was referred with diffuse skin tumours and infiltrated patches. Histology of tumour samples revealed atypical T-cell infiltrate with epidermotropism and presence of more than 25% of large CD30-positive cells. Non-infiltrated patches showed small T-cell lymphoma with epidermotropism. Histological verification of a previous lymphadenopathy confirmed the diagnosis of transformed mycosis fungoides. Despite multiple courses of chemotherapy, the disease progressed, with neurological involvement in particular. Because of tumour aggressiveness, autologous stem cell transplantation was performed and resulted in rapid regression of the tumours, lymphadenopathy and neurological symptoms. Non-transformed mycosis fungoides patches persisted but were controlled with topical mechlorethamine. This patient is still in complete remission for tumour and extracutaneous lesions 14 years after the autograft. This was probably a case of juvenile mycosis fungoides diagnosed and transformed in adult age. Neurological involvement by mycosis fungoides is rare and usually carries a drastic prognosis. To our knowledge, this is the longest remission of transformed mycosis fungoides seen after autograft. It highlights the value of this method in aggressive transformed mycosis fungoides, especially in patients ineligible for allograft.
  Annales de Dermatologie et de Vénéréologie 11/2009; 136(11):800-5. · 0.72 Impact Factor
• Article: Management and outcome of metastatic melanoma during pregnancy.

  C Pagès, C Robert, L Thomas, E Maubec, B Sassolas, F Granel-Brocard, C Chevreau, S De Raucourt, M-T Leccia, D Fichet, A Khammari, F Boitier, P-E Stoebner, S Dalac, P Celerier, F Aubin, M Viguier
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  ABSTRACT: Although metastatic melanoma occurrence during pregnancy challenges the physician in several ways, only a few studies have been published. Our aim was to investigate therapeutic management together with maternal and fetal outcomes in pregnant women with advanced melanoma. A French national retrospective study was conducted in 34 departments of Dermatology or Oncology. All patients with American Joint Committee on Cancer (AJCC) stage III/IV melanoma diagnosed during pregnancy were included. Data regarding melanoma history, pregnancy, treatment, delivery, maternal and infant outcomes were collected. Twenty-two women were included: 10 AJCC stage III and 12 stage IV. Abortion was performed in three patients. Therapeutic abstention during pregnancy was observed in three cases, 14 patients underwent surgery, four patients received chemotherapy and one patient was treated with brain radiotherapy alone. The median gestational age was 36 weeks amenorrhoea. Neither neonatal metastases nor deformities were observed. Placenta metastases were found in one case. Among 18 newborns, 17 are currently alive (median follow up, 17 months); one died of sudden infant death. The 2-year maternal survival rates were 56% (stage III) and 17% (stage IV). Faced with metastatic melanoma, a majority of women chose to continue with pregnancy, giving birth, based on our samples, to healthy, frequently premature infants. Except during the first trimester of pregnancy, conventional melanoma treatment was applied. No serious side effect was reported, except one case of miscarriage after surgery. Mortality rates do not suggest a worsened prognosis due to pregnancy but larger prospective controlled studies are necessary to assess this specific point.
  British Journal of Dermatology 05/2009; 162(2):274-81. · 3.67 Impact Factor
• Article: [Orange facial skin discolouration].

  N Brahimi, E Maubec, E Palazzo, E Larger, K Mohammedi, J Landry, V Descamps, B Crickx
  Annales de Dermatologie et de Vénéréologie 05/2009; 136(4):377-8. · 0.72 Impact Factor
• Article: [Pyoderma gangrenosum with aseptic spleen abscess].

  N Brahimi, E Maubec, O Boccara, E Marinho, L Valeyrie-Allanore, C Lecaille, V Sebban, B Hersent, C Picard-Dahan, V Descamps, B Crickx
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  ABSTRACT: Pyoderma gangrenosum is a neutrophilic dermatosis in which systemic involvement is rare. It may be associated with systemic disease. We report a case of pyoderma gangrenosum in the spleen. A 68-year-old man presenting pyoderma gangrenosum with pustules and stage I multiple myeloma was admitted for asthenia and abdominal pain. There were no skin lesions. Laboratory tests showed inflammatory syndrome with polynuclear leucocytes of 25,000/mm(3). CAT scans and abdominal ultrasound revealed a splenic abscess. A spleen biopsy was performed and histological examination showed polynuclear leukocyte infiltration, while cultures were negatives. Diagnosis of pyoderma gangrenosum with splenic involvement was made. Increased systemic corticosteroid therapy produced a successful outcome. Haematological findings remained unchanged. Spleen involvement in pyoderma gangrenosum is very rare and can mimic an infectious process. In such cases, routine screening is essential for associated diseases, particularly haematological malignancies.
  Annales de Dermatologie et de Vénéréologie 02/2009; 136(1):46-9. · 0.72 Impact Factor
• Article: [Melanoma in invisible naevus spilus].

  M Livory, V Descamps, F Pelletier, E Maubec, B Faivre, E Marinho, P Humbert, B Crickx, F Aubin
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  ABSTRACT: Diagnosis of naevus lesions may be complex where they contain little or no pigmentation. Naevus spilus (or naevus on naevus) is, generally, readily identified by the difference in pigmentation between overlying and underlying naevi and healthy skin. Malignant transformation of naevus spilus is rare. We report two cases of melanoma in which surgical procedures revealed underlying melanocyte lesions, diagnosed at histology but undetectable on clinical examination. Two patients were operated for melanoma in which surgery, at a site remote from the melanoma, suggested incomplete relapse despite the fact that previous clinical examination had indicated healthy skin. A diagnosis was made of melanoma in invisible naevus spilus. Diagnosis of melanoma in invisible naevus spilus may be suspected where several naevi are found together in a specific area. The main problem is the therapeutic stance to be adopted since complete excision of the underlying naevi is difficult in practice. Wood's light examination may be helpful.
  Annales de Dermatologie et de Vénéréologie 02/2008; 135(1):48-52. · 0.72 Impact Factor
• Article: [Panniculitis induced by interferon beta-1a vascular toxicity].

  A Soria, E Maubec, M-C Henry-Feugeas, E Marinho, P Le Bozec, M-G Huisse, M-A Pocidalo, V Descamps, B Crickx
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  ABSTRACT: Interferon-beta-1b is a valuable first-line therapy for patients with relapsing-remitting multiple sclerosis. Many non-severe cutaneous reactions to recombinant interferon beta are described at injection sites. Panniculitis after subcutaneous injection of beta interferon is a rare adverse event; we describe two such cases at beta interferon injection sites. Two women aged 22 years and 45 years with severe multiple sclerosis receiving immunotherapy with beta interferon were admitted to an emergency department following the appearance of extremely painful induration at injection sites rendering walking impossible after several months of interferon injections. One of the patients had fever. Histology tests showed vasculitis and capillary thrombosis in one-woman and dermal oedema in the other. MRI scanners showed extensive avascular necrosis of soft tissue without fasciitis in both patients. Interferon withdrawal and surgical debridement was carried out in one case and beta interferon was successfully reintroduced in both cases. Only two cases have been reported of panniculitis induced by subcutaneous beta interferon injection. Clinically, such cases may mimic infectious processes. The present cases show that MRI may be useful in diagnosis and that the vascular toxicity of interferon beta probably plays a role in panniculitis. Temporary withdrawal of treatment, rotation of several injection sites and alternative routes of administration may all be proposed.
  Annales de Dermatologie et de Vénéréologie 05/2007; 134(4 Pt 1):374-7. · 0.72 Impact Factor
• Article: [Haemolytic uremic syndrome and acute mesenteric ischemia caused by interferon-alpha-2b in the treatment of Kaposi's sarcoma in an AIDS patient].

  I Zaraa, E Maubec, L Valeyrie-Allanore, M Essig, A Charachon, D Chosidow, M-P Debray, E Marinho, C Picard-Dahan, V Descamps, B Crickx
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  ABSTRACT: Interferon alpha is approved for the treatment of Kaposi's sarcoma in HIV infected patients. Hemolytic and uremic syndrome (HUS) is a rare side-effect of interferon alpha and has been reported primarily in chronic myelogenous leukemia. A 44-year-old HIV-infected woman from Cameroon was admitted for treatment of cutaneous Kaposi's sarcoma. Two days later, she presented severe HUS. Abdominal pains subsequently revealed non-occlusive mesenteric ischemia. The patient rapidly improved after interferon withdrawal. To our knowledge this is the first case of HUS induced by interferon alpha given for Kaposi's sarcoma. Further, no cases of acute mesenteric ischemia have been reported with interferon alpha. It is possible that the condition may have been induced or aggravated by HUS or a low infusion rate. Interferon can exert vascular toxicity on both the mesenteric vessels and the renal vessels in a setting of microangiopathy.
  Annales de Dermatologie et de Vénéréologie 02/2007; 134(1):65-7. · 0.72 Impact Factor
• Article: Anévrysmes aortiques multiples au cours d’une polychondrite atrophiante

  G. Monsel, E. Maubec, C. Picard-Dahan, I. Brocheriou, M.-C. Henry Feugeas, E. Kieffer, C. Francès, B. Crickx
  Annales De Dermatologie Et De Venereologie - ANN DERMATOL VENEREOL. 01/2007; 134(6):552-554.
• Article: [Multinucleate cell angiohistiocytoma].

  I Zaraa, E Maubec, M-D Vignon-Pennamen, E Marinho, E Matichard, V Descamps, B Crickx
  Annales de Dermatologie et de Vénéréologie 06/2006; 133(5 Pt 1):496-7. · 0.72 Impact Factor
• Article: [Immunohistochemical analysis of EGFR and HER-2 in patients with metastasizing melanoma, Merkel carcinoma and squamous cell carcinoma of the skin].

  E Maubec, P Duvillard, V Velasco, B Crickx, M F Avril
  Annales de Dermatologie et de Vénéréologie 04/2006; 133(3):274-6. · 0.72 Impact Factor
• Article: Common skin cancers in porokeratosis.

  E Maubec, P Duvillard, A Margulis, B Bachollet, G Degois, M-F Avril
  British Journal of Dermatology 07/2005; 152(6):1389-91. · 3.67 Impact Factor
• Article: [Subcutaneous inflammatory edema induced by MINE chemotherapy].

  E Maubec, O Oberlin, K Belhadj, J C Roujeau
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  ABSTRACT: The MINE regimen (mitoguazone, ifosfamide, vinorelbine and etoposide) is a salvage chemotherapy for relapsed and refractory Hodgkin's disease. We report the cases of a 16-year-old girl and a 17-year-old boy who had Hodgkin's disease and developed painful and massive subcutaneous inflammatory edema after MINE chemotherapy. Morphine was unable to control pain leading to major functional disability of joint movement. One patient had an elevated creatine kinase level, hypoalbuminemia, hypodermic and muscular edema at magnetic resonance imaging and diffuse hemorrhagic hypodermic edema at skin biopsy. The other patient was found to have only hypoalbuminemia. The clinical course was favorable in both cases within a few weeks, but with recurrent episodes of pain and localized areas of fat necrosis five months later in one case. This side effect of MINE chemotherapy - subcutaneous inflammatory edema, myalgia and skin pain - has not been described previously for the different components of the regimen. Three clinicopathological hypotheses could be put forward: capillary leak syndrome, panniculitis, toxic fasciitis. The causal drug remains undetermined, but the most likely would be vinorelbine because of the chronology of the eruptions during the first and last days of chemotherapy and because of the known vascular toxicity of vinorelbine which could explain a capillary leak syndrome.
  Annales de Dermatologie et de Vénéréologie 05/2001; 128(4):534-7. · 0.72 Impact Factor
• Article: Immune recovery inflammatory folliculitis.

  F Bouscarat, E Maubec, S Matheron, V Descamps
  AIDS 04/2000; 14(5):617-8. · 6.24 Impact Factor
• Article: [Multiple aortic aneurysms in chronic atrophic polychondritis].

  G Monsel, E Maubec, C Picard-Dahan, I Brocheriou, M-C Henry Feugeas, E Kieffer, C Francès, B Crickx
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  ABSTRACT: Although rare, cardiovascular involvement is the second most frequent cause of mortality in chronic relapsing polychondritis behind tracheobronchial tree chondritis. The most frequent cardiovascular complications are valvulopathy and aortic aneurysm. We report a case of chronic relapsing polychondritis with multiple aortic aneurysms that were clinically silent but continued to progress despite systemic corticosteroids and immunosuppressive therapy. Progression of aortic aneurysms and extravascular disease do not appear to be correlated. Although the disease may appear to be in remission, vascular lesions can continue to progress independently. This case shows that medical treatment has little effect on the progression of these aneurysms. Consequently, it is necessary to opt for surgical therapy at the opportune moment.
  Annales de Dermatologie et de Vénéréologie 134(6-7):552-4. · 0.72 Impact Factor
• Article: [Kimura's disease associated with extracapillary glomerulonephritis].

  C Chauvel, L Valeyrie-Allanore, M Essig, F Vrtovsnik, F Walker, E Marinho, E Maubec, V Descamps, B Crickx
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  ABSTRACT: Kimura's disease is a rare and benign chronic inflammatory soft-tissue disorder of unknown origin. Most cases involve young Asian males. The typical presentation consists of painless papules or nodules with a predilection for the head and neck region, associated with lymphadenopathy, parotid gland involvement, peripheral blood eosinophilia and raised immunoglobulin E. A 49-year-old Mauritian man was hospitalized for nephrotic syndrome. Examination revealed a painless 3 cm nodule in the left pre-auricular region and multiple enlarged left cervical lymph nodes. Histopathologic examination of a nodule confirmed the diagnosis of Kimura's disease, which was associated with necrotic extracapillary glomerulonephritis. Corticosteroids were initiated, resulting in rapid improvement of renal function and partial regression of the patient's cutaneous nodules and lymph node disorder. Renal manifestations are the only visceral localization of Kimura's disease, and proteinuria is seen in 12% of cases, of which 50% are accompanied by nephrotic syndrome. Many different histologic types of renal involvement may be observed with potentially severe lesions. To our knowledge, this is the first case of Kimura's disease associated with extracapillary glomerulonephritis.
  Annales de Dermatologie et de Vénéréologie 133(8-9 Pt 1):689-92. · 0.72 Impact Factor
• Article: [Chloroquine cardiotoxicity in long-term lupus therapy in two patients].

  A Saussine, M-A Loriot, C Picard, V Lecerf, J Landry, I Scheer, S Voicu, A Leenhardt, G Ducrocq, E Maubec, B Crickx
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  ABSTRACT: The antimalarial compounds chloroquine and hydroxychloroquine are widely used in the treatment of connective tissue diseases and are usually well tolerated. We report two cases of chloroquine cardiotoxicity. Two women (aged 43 and 48 years) were treated for 5 years for lupus. They developed severe conduction disturbances requiring a pacemaker. Plasma chloroquine concentrations were abnormally high in both cases. In one case, a genetic polymorphism modulating the activity of a cytochrome involved in chloroquine metabolism (CYP2C8) was identified. Since 1965, 60 cases of occasionally severe cardiotoxicity have been reported following long-term treatment with chloroquine in most cases, but also with hydroxychloroquine. This toxicity must be detected early and close cardiac assessment is required.
  Annales de Dermatologie et de Vénéréologie 136(6-7):530-5. · 0.72 Impact Factor
• Article: [Metastatic extraskeletal osteosarcoma revealed by an occipital mass].

  G Serac, E Maubec, J-P Laissy, E Marinho, S Abgrall, M-F Avril, A Le Cesne, B Crickx
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  ABSTRACT: Extraskeletal osteosarcoma is a rare mesenchymatous tumour occurring in adults aged over 50 years and is located mainly in the limbs or retroperitoneum. We report a case of metastatic extraskeletal osteosarcoma revealed by a cutaneous occipital tumour site. A 53-year-old woman was admitted for dyspnea and weight loss. An occipital tumour, noticed for one year by the patient, was discovered. It was freely movable on the bone, of hard consistency and responsible for alopecia. In addition to left-sided pleural effusion, a chest CAT revealed a large mass in the left lung, including areas of necrosis and calcifications with intracardiac extension. Histological examination of biopsies of the skin and of pulmonary and intracardiac lumps showed an osteosarcomatous proliferation. No primary osteosarcoma was found in the bones. A diagnosis was made of metastatic extraskeletal osteosarcoma. Intravenous chemotherapy was given followed by radiotherapy. After a six-month stabilization period, the disease progressed. Extraskeletal cutaneous locations of osteosarcoma are extremely rare. They may comprise either the primary tumour or a metastatic lesion. In this patient, the immediately metastatic nature of the disease was a poor prognostic factor for this high-grade sarcoma.
  Annales de Dermatologie et de Vénéréologie 135(6-7):499-502. · 0.72 Impact Factor
• Article: Syndrome hémolytique et urémique et ischémie mésentérique aiguë lors d’un traitement par interféron alpha-2b pour une maladie de Kaposi associée au VIH

  I. Zaraa, E. Maubec, L. Valeyrie-Allanore, M. Essig, A. Charachon, D. Chosidow, M.-P. Debray, E. Marinho, C. Picard-Dahan, V. Descamps, B. Crickx
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  ABSTRACT: Background Interferon alpha is approved for the treatment of Kaposi's sarcoma in HIV infected patients. Hemolytic and uremic syndrome (HUS) is a rare side-effect of interferon alpha and has been reported primarily in chronic myelogenous leukemia.Case reportA 44-year-old HIV-infected woman from Cameroon was admitted for treatment of cutaneous Kaposi's sarcoma. Two days later, she presented severe HUS. Abdominal pains subsequently revealed non-occlusive mesenteric ischemia. The patient rapidly improved after interferon withdrawal.DiscussionTo our knowledge this is the first case of HUS induced by interferon alpha given for Kaposi's sarcoma. Further, no cases of acute mesenteric ischemia have been reported with interferon alpha. It is possible that the condition may have been induced or aggravated by HUS or a low infusion rate. Interferon can exert vascular toxicity on both the mesenteric vessels and the renal vessels in a setting of microangiopathy.
  Annales de Dermatologie et de Vénéréologie 134(1):65-67. · 0.72 Impact Factor