Bruno Sassolas

• Doctor of Medicine
• Consultant at Centre Hospitalier Universitaire de Brest, French Institute of Health and Medical Research

This cohort study examines the safety and efficacy of rituximab for patients with pempigus foliaceus.

Importance The Ritux 3 trial demonstrated the short-term efficacy and safety of first-line treatment with rituximab compared with a standard corticosteroid regimen in pemphigus. No data on the long-term follow-up of patients who received rituximab as first line are available. Objective To assess the long-term efficacy and safety of the Ritux 3 tre...

Background The interest of omalizumab in bullous pemphigoid (BP) in the event of resistance or contraindication to conventional therapies is currently based on limited evidence. Objectives To assess the effectiveness and safety of omalizumab in BP and to identify predictive factors of response to treatment. Methods We conducted a French national...

Introduction Le traitement de la pemphigoïde bulleuse (PB) est bien codifié mais peut poser problème (contre-indication aux immunosuppresseurs (IS) ; corticorésistance/dépendance). Nous présentons la 1re grande série évaluant l’intérêt de l’omalizumab (OMZ) dans cette indication. Matériel et méthodes Étude rétrospective, multicentrique incluant de...

Introduction L’hémophilie acquise (HA) est une maladie auto-immune rare liée à des anticorps (Ac) contre le facteur VIII. Dans les registres prospectifs, 3 % d’HA étaient secondaires aux dermatoses bulleuses auto-immunes (DBAI). Le taux de mortalité à 1 an de l’HA est à 33 % et augmente en cas de retard diagnostique. Il n’existe pas d’étude évaluan...

Introduction Le lupus érythémateux systémique est une affection auto-immune systémique responsable de manifestations cliniques variées qui évolue par poussées. Le lupus cutané est quant à lui isolé à l’atteinte du derme, avec trois catégories de lésions : aiguës, subaiguës et chroniques. Les syndromes paranéoplasiques (SPN) sont définis par un ense...

Background: Scleromyxedema (SME) is a rare mucinosis associated with monoclonal gammopathy. Several biochemical peculiarities of monoclonal immunoglobulins (Ig) in SME patients were reported in case reports or short series, such as IgGλ over-representation, cationic migration, and partial deletion. Methods: Monoclonal immunoglobulins (Ig) from t...

Introduction Le dupilumab, anti-IL-4/IL-13, a été récemment approuvé pour le traitement de la dermatite atopique (DA) modérée à sévère. Au-delà de sa remarquable efficacité, des cas de psoriasis apparaissent sous traitement. Notre objectif était de les caractériser cliniquement pour mieux les identifier. Matériel et méthodes Les cas de psoriasis s...

Atopic dermatitis (AD) and psoriasis are T cell‐mediated inflammatory diseases : a Th2‐component with interleukin (IL)‐4 and IL‐13 production in AD, a Th17/IL‐23 and TNF response in psoriasis. Although the coexistence of both diseases is rare, they can be seen as parts of a same spectrum (1). Dupilumab, an anti‐IL‐4/IL‐13 monoclonal antibody, has r...

Importance Rituximab and short-term corticosteroid therapy are the criterion standard treatments for patients with newly diagnosed moderate to severe pemphigus. Objective To examine factors associated with short-term relapse in patients with pemphigus treated with rituximab. Design, Setting, and Participants This post hoc analysis of a randomized...

Scleromyxedema is a rare skin and systemic mucinosis that is usually associated with monoclonal gammopathy (MG). In this French, multicenter, retrospective study of 33 patients, we investigated the clinical and therapeutic features of MG-associated scleromyxedema. Skin molecular signatures were analyzed using a transcriptomic approach. Skin symptom...

Introduction L’étude RITUX3 a montré l’efficacité du traitement de 1ere intention par rituximab (RTX) (2 g initialement puis 500 mg à M12 et M18) au cours du pemphigus. Le taux de rechute à 2 ans était de 24 % (11 sur 46 patients). Le but de l’étude était d’évaluer le taux de rechute à long terme des patients traités dans l’étude RITUX3. Matériel...

Introduction Trois biothérapies ont obtenu une autorisation de mise sur le marché (AMM) pour le traitement du psoriasis en plaques modéré à sévère de l’enfant, l’étanercept, l’adalimumab et l’ustekinumab. La majorité des données d’efficacité et de tolérance de ces biothérapies sont issues d’essais cliniques de phase III conçus pour une population s...

Background: Corticosteroids (CS) with or without adjuvant immunosuppressant agents are standard treatment for pemphigus vulgaris (PV). The efficacy of adjuvant therapies in minimising steroid-related adverse events (AEs) is unproven. Objective: To utilise data collected in a French investigator-initiated, phase 3, open-label, randomized, control...

Background Phase III clinical trials of biotherapies for childhood psoriasis are designed for a selected population, which can differ from real-life patients. Objective Our objective was to assess the proportion of children with psoriasis that received biotherapy in the biological treatments for pediatric psoriasis (BiPe) cohort that would be excl...

e21009 Background: In 2016, Nivolumab (N) and Pembrolizumab (P) have been registred for first line ECOG PS 0-1 adult patients with non-resecable or metastatic melanoma. The Brittany and Pays de la Loire Cancer Observatory has collected data on their real-life indications, current management, safety, efficacy and medico-economics Methods: All non op...

Introduction L’essai Ritux3 a montré la supériorité du rituximab (RTX) associé à une corticothérapie orale (CO) courte en termes d’efficacité et de tolérance dans le traitement de 1re intention du pemphigus par rapport à la CO longue. Malgré ces résultats, le coût élevé du RTX peut être un frein à son remboursement par les différents systèmes de sa...

The Pemphigus Disease Area Index (PDAI) and Autoimmune Bullous Skin Disorder Intensity-Score (ABSIS) scores have been proposed to provide an objective measure of pemphigus activity. These scores have been evaluated only on already treated patients mainly with mild to moderate activity. The objective was to assess the interrater reliability of ABSIS...

Introduction Le scléromyxœdème est une mucinose systémique responsable d’un syndrome sclérodermiforme souvent associée à une gammapathie monoclonale de signification indéterminée (MGUS). Le dermatoneurosyndrome (DNS), une encéphalopathie aiguë, est sa complication la plus grave. Les données de la littérature sur les caractéristiques clinicobiologiq...

Backgroud: The proportion of severe cutaneous adverse reactions (SCARs) that could be avoided if medication use was consistent with good medical practice is unknown. Objectives: To estimate the proportion of SCARs related to inappropriate medication use. Methods: Retrospective study of all validated SCARs collected in a French registry between...

Introduction L’intérêt de la corticothérapie locale forte (CLF) a été démontré dans la pemphigoïde bulleuse (PB) mais elle pose des problèmes pratiques et n’est pas dénuée d’effets adverses notamment cutanés. Le méthotrexate (MTX) a montré son efficacité à visée d’épargne cortisonique. Pour pallier ces inconvénients de la CLF, un essai de non-infér...

Introduction Le groupe SJS-NET (syndrome de Stevens-Johnson–nécrolyse épidermique toxique) et le syndrome d’hypersensibilité médicamenteuse (DRESS) sont des toxidermies sévères qui peuvent engager le pronostic vital. L’objectif de ce travail était d’évaluer la proportion de ces toxidermies qui était facilement évitable. Matériel et méthodes Il s’a...

Introduction Le scléromyxœdème est une mucinose systémique souvent associée à une gammapathie monoclonale de signification indéterminée (MGUS). Le dermato-neurosyndrome (DNS), une encéphalopathie aiguë, est sa plus grave complication. Les données de la littérature sur les caractéristiques clinicobiologiques, pronostiques, et l’impact des immunoglob...

Linked Comment: Tan. Br J Dermatol 2017; 177: 892–893

Background: Since 2011, the management of advanced melanoma has radically changed with the availability of new therapies (immunotherapy and BRAF-targeted therapy) and with BRAF testing. Objectives: Following the introduction of these new therapies, the objectives of this AMEL study were to describe treatment patterns and evaluate overall surviva...

Introduction Le purpura thrombopénique immunologique (PTI) est une pathologie hématologique bénigne due à un phénomène immunologique aboutissant à la destruction périphérique des plaquettes et touchant principalement l’enfant et l’adulte jeune. Un épisode infectieux bactérien ou viral peut favoriser une poussée de PTI. Observation Une patiente de...

Background: High doses of corticosteroids are considered the standard treatment for pemphigus. Because long-term corticosteroid treatment can cause severe and even life-threatening side-effects in patients with this disease, we assessed whether first-line use of rituximab as adjuvant therapy could improve the proportion of patients achieving compl...

Introduction Dans un contexte croissant de traitements initiés en secteur hospitalier et dispensés en ville, le pharmacien d’officine doit connaître ces médicaments et les pathologies associées afin d’accompagner au mieux les patients concernés, même s’ils sont peu nombreux. Matériel et méthodes Depuis 2012, Roche a coordonné un groupe de clinicie...

Table of contents Oral Abstracts O1 Functionally distinct HMGB1 isoforms correlate with physiological processes in drug-induced SJS/TEN Daniel F. Carr, Wen-Hung Chung, Rosalind E. Jenkiins, Mas Chaponda, Gospel Nwikue, Elena M. Cornejo Castro, Daniel J. Antoine, Munir Pirmohamed O2 Hypersensitivity reactions to beta-lactams, does the t cell recogni...

Introduction Deux scores de sévérité du pemphigus, l’ABSIS et le PDAI ont été récemment proposés afin de grader la sévérité au moment du diagnostic et faciliter le suivi des patients. Le but de cette étude a été d’étudier la corrélation de ces scores entre eux et avec d’autres marqueurs de sévérité : score de sévérité global (PGA), DLQI et taux d’A...

Introduction Jusqu’en 2011, le traitement des mélanomes avancés (stade III et IV inopérables) reposait principalement sur les chimiothérapies conventionnelles (CC) à base de dacarbazine, fotemustine ou temozolomide. La mise à disposition successive de l’ipilimumab (IPI) et des inhibiteurs de BRAF (iBRAF) a bouleversé la prise en charge de ces patie...

Introduction L’ABSIS et le PDAI ont ete proposes comme scores d’evaluation de la severite des lesions cutanees et muqueuses pemphigus. Leur interet depend de la reproductibilite entre differents observateurs, pour comparer des populations de malades entre differentes etudes. Notre objectif a ete d’etudier la concordance des scores ABSIS et PDAI ent...

NRAS and BRAF mutational status has become mandatory to treat patients with metastatic melanomas. Mutation-specific immunohistochemistry (IHC) can help analyze challenging tumor samples. We report our experience integrating NRASQ61R (SP174) and BRAFV600E (VE1) IHC in routine practice in a cancer molecular genetic platform. All samples screened for...

Hyperhidrosis is a disorder that can impair quality of life. Localized treatments may be cumbersome and ineffective, and no systemic treatments have proven to be significantly beneficial. To evaluate the effectiveness and tolerance of low-dose oxybutynin for hyperhidrosis. We conducted a prospective, randomized, placebo-controlled trial. From June...

Objectives: The incidence of skin cancers, melanoma in particular, is increasing rapidly. Consequently, specific recommendations for sun-protection measures now exist. This survey set out to assess the compliance of the general population with these guidelines. Methods: The French nationwide observational survey, EDIFICE Melanoma, was conducted...

Background Melanoma incidence is increasing worldwide thus justifying information campaigns aimed at reducing ultraviolet exposure levels and promoting early diagnosis.Objectives We set out to assess awareness, knowledge and attitudes of the French population with regard to melanoma prevention and early diagnosis, following more than 15 years of na...

Background Routine sun protection is recommended to prevent skin cancer. The aims of the present analysis were to assess and compare modalities of sun protection in parents and their children.MethodsEDIFICE Melanoma is a French nationwide observational survey. It was conducted through phone interviews among a representative sample of 1502 individua...

Background The prevention of melanoma can be significantly improved by targeting information directly towards the subpopulation of children and, as a means to achieve it, towards young parents.Objectives The objective of this analysis was to determine the evolution over time of the sun-protection measures adopted by parents for their young children...

Background The incidence of melanoma is increasing worldwide, causing significant economic burden at community and individual levels. Ultraviolet radiation, from natural sunlight or artificial sources, is the main environmental, modifiable risk factor for melanoma.Objectives The present analysis assesses the profile of sun exposure in the French po...

Background In addition to natural sunlight, indoor tanning has emerged as a common source of ultraviolet (UV) radiation associated with an increased risk of melanoma. It is classified as a class I human carcinogen by the World Health Organization.Objectives This analysis presents data on the prevalence of sunbed use in France, on factors associated...

Background The efficiency of skin cancer prevention programmes is strongly correlated with the information dispensed, and with the level of risk awareness, of the overall population on one hand, and on the other, of specific sub-populations, according to their risk profiles.Objectives The primary objective of this analysis was to establish a correl...

Introduction: The management of metastatic cutaneous melanoma is changing, marked by innovative therapies. However, their respective use and place in the therapeutic strategy continue to be debated by healthcare professionals. Objective: The French national cancer institute has led a national clinical practice guideline project since 2008. It ha...

Background: Thalidomide use in cutaneous sarcoidosis is based on data from small case series or case reports. The objective of this study was to evaluate the efficacy and safety of thalidomide in severe cutaneous sarcoidosis. Methods: This study consisted of a randomized, double-bind, parallel, placebo-controlled, investigator-masked, multicente...

Recent years have seen the emergence of new molecules for the treatment of patients with metastatic cutaneous melanoma, with significant benefits in terms of survival and the opening of new therapeutic perspectives. In addition, many techniques are currently being developed for locoregional treatment of metastatic sites. Management of metastatic me...

Introduction the emergence of new molecules for the treatment of metastatic cutaneous melanoma with a significant benefit on the survival brings new therapeutic perspectives. Nevertheless, their respective use and place in the therapeutic strategy are still debated by healthcare professionals. Objective: the French National Cancer Institute leads a...

Introduction: The last years are marked by the emergence of new molecules for the treatment of metastatic cutaneous melanoma with a significant benefit on the survival. Besides, some techniques are in development for the loco-regional treatment of the metastatic sites, bringing new therapeutic perspectives. However, their respective use and place...

Several case reports suggested that tumour necrosis factor-α (TNF) inhibitors might increase the incidence and/or alter the natural course of melanoma towards a more aggressive behaviour. Our objective was to point if history of melanoma in patients exposed to TNF inhibitors could present with a particular pattern at diagnosis or during follow-up....

Background: Melanoma is associated with high mortality and poor response to standard chemotherapy. In order to benchmark benefits of recently introduced treatments, outcome with standard chemotherapy in everyday practice should be documented. Objectives: To document treatment pathways in patients with advanced melanoma, to compare clinical outco...

The law gives patients the right to name a healthcare proxy to support them, guide them and communicate their needs and wishes. Healthcare professionals as well as the patients themselves must be familiar with and use this right in order to ensure the provision of high-quality medical and human support.

9069 Background: Intrinsic risk factors for melanoma include personal and family history of the condition, a high number of naevi and a light skin phototype (I or II). The objective of this study was to evaluate the correlation between personal awareness of melanoma risk and objective risk factors and to analyze the elements associated with under-o...

Background Generalized bullous fixed drug eruption (GBFDE) is a rare cutaneous adverse reaction to drugs, and may resemble Stevens–Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN), but is usually considered less severe. Objectives To compare the severity and mortality rate in cases of GBFDE and control cases of SJS or TEN of similar exten...

Objective To assess the added benefit of scanning lower limbs in addition to usual whole-body PET/CT scan in patients with no known or suspected primary or metastatic melanoma involving the lower limbs.Materials and methodsThis is a retrospective study of 133 consecutive patients (189 FDG PET/CT) who underwent FDG PET/CT for staging of melanoma at...

Aim: Both low-dose interferon (IFN) alfa-2b and pegylated interferon (Peg-IFN) alfa-2b have been shown to be superior to observation in the adjuvant treatment of melanoma without macrometastatic nodes, but have never been directly compared. Peg-IFN facilitates prolongation of treatment, which could provide additional benefit. This multicentre, ope...

8601 Background: Routine sun protection is recommended to prevent skin cancer. Our aims were to examine and compare, in an observational survey, modalities of sun protection in parents and their children. Methods: This French nationwide observational survey, EDIFICE melanoma, was conducted through phone interviews among a representative sample of 1...

1566 Background: The main environmental risk factor for melanoma is related to UV-exposure. Our objective was to evaluate in a survey the profile of sun exposition in the French population as well as the level of knowledge about UV risk and UV protection. Methods: “Edifice Melanoma” a nationwide observational survey was conducted in France via phon...

La plaie chronique est définie comme une perte de substance cutanée de durée persistante, au-delà de 6 semaines. Ces ulcères, dont la topographie au membre inférieur est une des plus classiques et des plus fréquentes, représentent un problème majeur de santé publique en nombre de patients atteints, en coût de prise en charge et en retentissement su...

Connective tissue nevi (CTN) may be isolated, either sporadic or hereditary, or syndromic as in the Buschke-Ollendorff syndrome. Few publications have addressed the variable clinical and histopathologic expression of these benign hamartomas. We sought to characterize the clinical and histopathologic features of CTN and to highlight a spectrum of cl...

The treatment of stage I Merkel cell carcinoma (MCC) usually includes wide local excision (WLE) combined with irradiation of the tumor bed (ITB). No randomized study has ever been conducted in MCC. The purpose of this study was to assess the efficacy and safety of prophylactic adjuvant radiotherapy on the regional nodes. In this randomized open con...

ejd.2011.1398 Auteur(s) : Karen Talour1 laurent.misery@chu-brest.fr), Claire Abasq1, Bruno Sassolas1, Yves Le Ru2, Virginie Jannou1, Laurent Misery1 1 Brest University Hospital, Department of Dermatology, 29609 Brest cedex, France 2 Private practice, Brest, France Shiitake mushroom (Lentinus edodes) is the second most commonly produced edible mushr...

Background In recent years, a growing number of biological agents have been introduced for the treatment of various diseases, and their principal adverse events are known. We present nine cases of alopecia areata (AA) developed in patients treated with TNF-α blocking agents. Patients and methods Nine cases are described: five men and four women of...

Par son étendue (2 m2) et son poids (3,5 kg), la peau tient une place particulière parmi les organes d’un être vivant. La peau est un épithélium de revêtement continu, fin, souple et résistant, dont la fonction protectrice est essentielle au maintien de l’intégrité et à la survie de l’organisme : protection physique (UV, thermique), chimique (pénét...

In recent years, a growing number of biological agents have been introduced for the treatment of various diseases, and their principal adverse events are known. We present nine cases of alopecia areata (AA) developed in patients treated with TNF-α blocking agents. Nine cases are described: five men and four women of mean age 39.2 years (range: 29-5...

The management of drug-induced hypersensitivity syndrome or drug reaction with eosinophilia and systemic symptoms (DRESS) is not codified. Demonstration of the reactivation of Herpesviruses illustrates the specific pathophysiology of this syndrome. Proposals for the management of DRESS were elaborated by the cutaneous adverse drug reaction working...

Prevention of risk factors, early diagnosis and support are essential in melanoma and allow a significant improvement of its prognosis. Therefore the practitioners concerned by melanoma (general practitioners and dermatologists) need to have a very good knowledge of this disease and its management. E-learning is an innovative learning method which...

To assess the added benefit of scanning lower limbs in addition to the usual whole-body positron emission tomography/computed tomography (PET/CT) scan in patients with no known or suspected primary or metastatic melanoma involving the lower limbs. This is a retrospective study of 122 consecutive patients [174 2-[¹⁸F]-fluoro-2-deoxy-D-glucose (FDG)...

Skin diseases may be treated locally or generally. Skin can also be affected by treatments that are used for healing other diseased organs; thus opening the field of drug eruptions.

The constant increase in the incidence of malignant skin tumours is a public health problem. The main known causal agent of these tumours is sun exposure. Preventive action therefore consists in raising people's awareness of the dangers of the sun and promoting sun protection.