Publications by authors named "Brigitte Milpied"

61 Publications

Assessment of Treatment Approaches and Outcomes in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: Insights From a Pan-European Multicenter Study.

JAMA Dermatol 2021 Aug 25. Epub 2021 Aug 25.

ToxiTEN group, European Reference Network for Rare Skin Diseases, Paris, France.

Importance: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe drug reactions associated with a high rate of mortality and morbidity. There is no consensus on the treatment strategy.

Objective: To explore treatment approaches across Europe and outcomes associated with the SJS/TEN disease course, as well as risk factors and culprit drugs.

Design, Setting, And Participants: A retrospective pan-European multicenter cohort study including 13 referral centers belonging to the ToxiTEN ERN-skin subgroup was conducted. A total of 212 adults with SJS/TEN were included between January 1, 2015, and December 31, 2019, and data were collected from a follow-up period of 6 weeks.

Main Outcomes And Measures: Risk factors for severe acute-phase complications (acute kidney failure, septicemia, and need for mechanical ventilation) and mortality 6 weeks following admission were evaluated using a multivariable-adjusted logistic regression model. One tool used in evaluation of severity was the Score of Toxic Epidermal Necrolysis (SCORTEN), which ranges from 0 to 7, with 7 the highest level of severity.

Results: Of 212 patients (134 of 211 [63.7%] women; mean [SD] age, 51.0 [19.3] years), the mean (SD) body surface area detachment was 27% (32.8%). In 176 (83.0%) patients, a culprit drug was identified. Antibiotics (21.2%), followed by anticonvulsants (18.9%), nonsteroidal anti-inflammatory drugs (11.8%), allopurinol (11.3%), and sulfonamides (10.4%), were the most common suspected agents. Treatment approaches ranged from best supportive care only (38.2%) to systemic glucocorticoids (35.4%), intravenous immunoglobulins (23.6%), cyclosporine (10.4%), and antitumor necrosis factor agents (3.3%). Most patients (63.7%) developed severe acute-phase complications. The 6-week mortality rate was 20.8%. Maximal body surface area detachment (≥30%) was found to be independently associated with severe acute-phase complications (fully adjusted odds ratio [OR], 2.49; 95% CI, 1.21-5.12; P = .01) and SCORTEN greater than or equal to 2 was significantly associated with mortality (fully adjusted OR, 10.30; 95% CI, 3.82-27.78; P < .001). Cyclosporine was associated with a higher frequency of greater than or equal to 20% increase in body surface area detachment in the acute phase (adjusted OR, 3.44; 95% CI, 1.12-10.52; P = .03) and an increased risk of infections (adjusted OR, 7.16; 95% CI, 1.52-33.74; P = .01). Systemic glucocorticoids and intravenous immunoglobulins were associated with a decreased risk of infections (adjusted OR, 0.40; 95% CI, 0.18-0.88; P = .02). No significant difference in 6-week mortality was found between treatment groups.

Conclusions And Relevance: This cohort study noted differences in treatment strategies for SJS/TEN in Europe; the findings suggest the need for prospective therapeutic studies to be conducted and registries to be developed.
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http://dx.doi.org/10.1001/jamadermatol.2021.3154DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8387938PMC
August 2021

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Series of 49 French Pediatric Cases.

J Allergy Clin Immunol Pract 2021 Jul 29. Epub 2021 Jul 29.

Service de Dermatologie, Hôtel Dieu, Centre Hospitalier Universitaire de Nantes, Nantes, France. Electronic address:

Background: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare and potentially fatal adverse reaction. It can be difficult to diagnose, even more so among children, because symptoms may mimic other commonly encountered pediatric conditions.

Objective: To describe clinical and laboratory features of DRESS syndrome in the pediatric population (age ≤18 years) and establish causative agents and treatment modalities.

Methods: This was a multicenter retrospective study of probable and definite DRESS cases (Registry of Sever Cutaneous Adverse Reaction score ≥ 4) in children hospitalized in 15 French university hospitals between 2000 and 2020.

Results: We included 49 cases. All children had fever and rash, 69.4% had lymphadenopathy, and 65.3% had facial edema. The most common organ affected was the liver (83.7%). Treatment consisted of topical corticosteroid in only 30.6% and systemic corticosteroid in 55.1%; 12.2% received intravenous immunoglobulin. Among probable and likely culprit drugs, 65% were antibiotics and 27.5% were antiepileptics, median time to DRESS symptom onset after initiation of 15 days (13 days with antibiotics and 21 days with antiepileptics). Twenty-seven children had allergy assessment for causative agents, 65.4% of whom had positive tests.

Conclusions: Culprit drugs are frequently antibiotics and antiepileptic drugs, and onset is often less than 2 weeks after treatment starts, especially with antibiotics. Treatment with topical corticosteroids appears to be sufficient in the least severe cases. Treatment by systemic corticosteroid therapy remains the reference treatment in case of severe organ damage.
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http://dx.doi.org/10.1016/j.jaip.2021.07.025DOI Listing
July 2021

DRESS and AGEP Reactions to Iodinated Contrast Media: A French Case Series.

J Allergy Clin Immunol Pract 2021 Aug 20;9(8):3041-3050. Epub 2021 Mar 20.

Service de Dermatologie, Hôpital Henri Mondor, APHP, Créteil, France.

Background: Drug reactions with eosinophilia and systemic symptoms (DRESSs) and acute generalized exanthematous pustulosis (AGEP) are potentially severe cutaneous adverse drug reactions.

Objective: To describe the clinical findings and sensitization profiles of DRESS and AGEP patients who had been administered iodinated contrast media (ICM).

Methods: All adult patients in the dermatologist's French Investigators for Skin Adverse Reactions to Drugs (FISARD) network diagnosed with a DRESS or AGEP highly suspected to have been caused by an ICM were included retrospectively.

Results: Thirteen DRESS patients and 19 AGEP patients who had been administered ICM were included, and the median delay in DRESS and AGEP occurrence after ICM administration was short, 4 and 1 days, respectively. Five AGEP patients had systemic involvement. A high cosensitization rate (46%) was observed among the DRESS patients, mainly with beta-lactam antibiotics. Overall, 77% of our patients were sensitized to several ICM. Patch tests identified the suspected ICM for 21 cases (72%). The retrospective nature, the limited number of subjects, the absence of a control group of healthy individuals, and the lack of detailed information on previous exposure to sensitizing drugs are limitations of this study.

Conclusions: We report a large series of DRESSs and AGEPs related to ICM administration. Skin tests appear useful for diagnosis and potentially to identify alternative ICM.
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http://dx.doi.org/10.1016/j.jaip.2021.02.060DOI Listing
August 2021

Linear immunoglobulin A bullous dermatosis associated with disseminated tuberculosis.

Int J Dermatol 2021 Sep 20;60(9):e361-e362. Epub 2021 Mar 20.

Department of Dermatology, Hôpital Saint André, CHU de Bordeaux, France.

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http://dx.doi.org/10.1111/ijd.15526DOI Listing
September 2021

Allergic contact dermatitis from a disposable blood pressure cuff containing isobornyl acrylate and 2-phenoxyethyl acrylate.

Contact Dermatitis 2021 Jun 25;84(6):462-464. Epub 2021 Jan 25.

Department of Dermatology, Hôpital Saint-André, CHU de Bordeaux, Bordeaux, France.

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http://dx.doi.org/10.1111/cod.13761DOI Listing
June 2021

Response to low-dose intravenous immunoglobulin in a case of recalcitrant Darier disease.

JAAD Case Rep 2020 Mar 19;6(3):189-191. Epub 2020 Feb 19.

Department of Dermatology, National Reference Center for Rare Skin Diseases, Bordeaux University Hospitals, Bordeaux, France.

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http://dx.doi.org/10.1016/j.jdcr.2020.01.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7033304PMC
March 2020

Local Management of Anogenital Warts in Non-Immunocompromised Adults: A Network Meta-Analysis of Randomized Controlled Trials.

Dermatol Ther (Heidelb) 2020 Apr 6;10(2):249-262. Epub 2020 Feb 6.

EA 4537, Antilles-Guyane University, Martinique, France.

Introduction: No hierarchy of first-line treatments for anogenital warts (AGWs) is provided in international guidelines. This study aimed to determine the efficacy of topical treatments and ablative procedures for the management of AGWs.

Methods: Twelve electronic databases were systematically searched from inception to August 2018. All randomized controlled trials (RCTs) comparing immunocompetent adults with AGWs who received at least 1 provider-administered or patient-administered treatment in at least 1 parallel group were included. Risk of bias assessment followed the Cochrane Handbook. The study endpoint was complete lesion response after clearance and recurrence assessment. A network meta-analysis was performed.

Results: A network geometry was constructed based on 49 of the 70 RCTs included in our systematic review. All but 4 RCTs had a high risk of bias. The most efficacious treatments compared to placebo were surgery (RR 10.54; CI 95% 4.53-24.52), ablative therapy + imiquimod (RR 7.52; CI 95% 4.53-24.52), and electrosurgery (RR 7.10; CI 95% 3.47-14.53). SUCRA values confirmed the superiority of surgery (90.9%), ablative therapy + imiquimod (79.8%), and electrosurgery (77.1%). The most efficacious patient-administered treatments were podophyllotoxin 0.5% solution (63.5%) and podophyllotoxin 0.5% cream (62.2%).

Conclusions: With low-level evidence of most included RCTs, surgery and electrosurgery were superior to other treatments after clearance and recurrence assessment. Podophyllotoxin 0.5% was the most efficacious patient-administered treatment. Combined therapies should be evaluated in future RCTs in view of their identified effectiveness. The results of future RCTs should systematically include clinical type, number and location of AGWs, and sex of the patient, to refine therapeutic indications.

Protocol Registration: PROSPERO-CRD42015025827.
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http://dx.doi.org/10.1007/s13555-020-00357-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7090115PMC
April 2020

Toxicological screening reveals toxic epidermal necrolysis likely carbamazepine-induced rather than idiopathic.

J Allergy Clin Immunol Pract 2020 Jun 28;8(6):2075-2076. Epub 2020 Jan 28.

Department of Adult and Pediatric Dermatology, Bordeaux University Hospitals, Bordeaux, France. Electronic address:

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http://dx.doi.org/10.1016/j.jaip.2020.01.028DOI Listing
June 2020

TNFα inhibitor-induced urticaria: a class effect.

Eur J Dermatol 2019 Oct;29(5):543-544

Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disease, Hôpital Saint André, University Hospital of Bordeaux, France.

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http://dx.doi.org/10.1684/ejd.2019.3625DOI Listing
October 2019

Local Management of Anogenital Warts in Non-immunocompromised Adults: A Systematic Review and Meta-analyses of Randomized Controlled Trials.

Dermatol Ther (Heidelb) 2019 Dec 13;9(4):761-774. Epub 2019 Oct 13.

EA 4537, Antilles University, Martinique, France.

Introduction: Several therapeutic options are available to manage anogenital warts (AGWs). However, no hierarchy of treatments is provided in the latest European and American recommendations. This study aimed to determine the efficacy and safety of local treatments for the management of AGWs.

Methods: A search was conducted through 12 databases from inception to August 2018. All randomized controlled trials (RCTs) in which at least one parallel treatment group composed of immunocompetent adults with AGWs received at least one provider-administered or patient-administered treatment were included. Risk of bias assessment and meta-analyses of aggregated study data were performed on the basis of the Cochrane Handbook, and quality of evidence evaluation followed the Grading of Recommendation Assessment, Development and Evaluation (GRADE) approach. Primary endpoints were complete clearance and recurrence at 3 months.

Results: Seventy RCTs (9931 patients) were included. All but four RCTs had a high risk of bias. CO laser was slightly more efficacious than cryotherapy [risk ratio (RR) 2.05; 95% confidence interval (CI) 1.61-2.62], with fewer recurrences at 3 months (RR 0.28; 95% CI 0.09-0.89). Electrosurgery was slightly more efficacious than cryotherapy. No differences in efficacy or side effects were found between cryotherapy and imiquimod or trichloroacetic acid. Podophyllotoxin gel was slightly more efficacious than podophyllotoxin cream. 5-Fluorouracil (5-FU) was slightly more efficacious and caused less erosion than CO laser (RR 1.37; 95% CI 1.11-1.70).

Conclusion: The vast majority of included RCTs had a low level of evidence, thereby preventing the establishment of a hierarchy of treatments. Nevertheless, our results provide an overview of the main AGW treatments available for general practitioners and specialists. While provider-administered treatments are superior, patient-administered treatments (e.g., imiquimod, podophyllotoxin) are useful solutions for compliant patients.

Protocol Registration: PROSPERO-CRD42015025827.
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http://dx.doi.org/10.1007/s13555-019-00328-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6828858PMC
December 2019

Drug reaction with eosinophilia and systemic symptoms may occur within 2 weeks of drug exposure: A retrospective study.

J Am Acad Dermatol 2020 Mar 25;82(3):606-611. Epub 2019 Sep 25.

Service de Dermatologie, Hôpital Saint André, Bordeaux, France.

Background: Diagnosing drug reaction with eosinophilia and systemic symptoms (DRESS) is challenging. Some clinicians reject this diagnosis when the delay of onset is less than 15 days after drug intake.

Objectives: To assess the delay of DRESS occurrence and culprit drugs.

Methods: All patients hospitalized in 3 dermatology departments with a first occurrence of DRESS for which a drug was highly suspected were included in this retrospective study. Based on the delay in DRESS occurrence, cases were classified into 2 groups: a rapid-onset group (≤15 days after exposure) and a delayed-onset group (>15 days).

Results: A total of 41 patients with DRESS were included: 14 in the rapid-onset and 27 in delayed-onset groups. In the rapid-onset group, antibiotics (n = 6/14) and iodinated contrast media (n = 5/5) were the predominant culprits. Carbamazepine (n = 4/4), lamotrigine (n = 6/6), allopurinol (n = 8/8), and sulfasalazine (n = 2/2) were exclusively found in the delayed-onset group.

Limitations: The retrospective nature, limited number of participants, and lack of detailed information on previous exposure to sensitizing drugs in some instances.

Conclusions: DRESS is frequently related to drugs introduced 15 or fewer days before the occurrence of cutaneous adverse reactions. The time of onset of DRESS may differ depending on the medications involved.
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http://dx.doi.org/10.1016/j.jaad.2019.09.036DOI Listing
March 2020

Characteristics, Associated Diseases, and Management of Gram-negative Toe-web Infection: A French Experience.

Acta Derm Venereol 2019 Nov;99(12):1121-1126

Department of Dermatology, Bordeaux University Hospital, 33000 Bordeaux, France.

Gram-negative toe-web infection can cause pain and disability, be complicated by a long healing time, management failure, and cellulitis, and recur due to persistent predisposing factors. To describe the clinical features and management of Gram-negative toe-web infection and evaluate predisposing factors and associated diseases, their management, and the effect of controlling them on the rate of recurrence, we conducted a retrospective real-life study of patients with Gram-negative toe-web infection. Among the 62 patients (sex ratio 9:1), 31 experienced more than one episode of Gram-negative toe-web infection. Pseudomonas aeruginosa was the most prominent bacteria. Predisposing factors/associated diseases were eczema (66%), suspected Tinea pedis (58%), humidity (42%), hyperhidrosis (16%), psoriasis (11%), and vascular disorders (40%). Patients in whom associated diseases, such as eczema or psoriasis, were controlled did not relapse, suggesting the benefit of management of such conditions. We suggest that management of Gram-negative toe-web infection be standardised, with a focus on diagnosis and treatment of associated diseases.
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http://dx.doi.org/10.2340/00015555-3315DOI Listing
November 2019

A child polysensitized to all constituents of Biseptine.

Contact Dermatitis 2020 Jan 25;82(1):65-66. Epub 2019 Nov 25.

Department of Dermatology, Hospital Saint-André, University Centre Hospital of Bordeaux, Bordeaux, France.

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http://dx.doi.org/10.1111/cod.13393DOI Listing
January 2020

Reintroduction of dabrafenib after previous vemurafenib-induced DRESS: Not always safe!

JAAD Case Rep 2019 May 28;5(5):422-423. Epub 2019 Apr 28.

Saint André Hospital, University Hospital Center of Bordeaux, Bordeaux, France.

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http://dx.doi.org/10.1016/j.jdcr.2019.02.033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6488678PMC
May 2019

Local management of anogenital warts in immunocompetent adults: Systematic review and pooled analysis of randomized-controlled trial data.

J Am Acad Dermatol 2019 11 9;81(5):1203-1204. Epub 2019 Apr 9.

EA 4537, Antilles University, Martinique, France; DRCI, Martinique University Hospital, Fort-de-France, Martinique, France.

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http://dx.doi.org/10.1016/j.jaad.2019.04.008DOI Listing
November 2019

Methodologic gaps and risk of bias in randomized controlled trials of local anogenital wart treatments.

J Am Acad Dermatol 2019 11 4;81(5):1197-1198. Epub 2019 Apr 4.

EA 4537, Antilles University, Martinique, France; DRCI, Martinique University Hospital, Fort-de-France, Martinique, France.

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http://dx.doi.org/10.1016/j.jaad.2019.03.080DOI Listing
November 2019

Allergic contact dermatitis in a child caused by isothiazolinones in a "noise putty".

Contact Dermatitis 2018 12 3;79(6):393-394. Epub 2018 Sep 3.

Dermatology Department, CHU de Bordeaux, Bordeaux, France.

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http://dx.doi.org/10.1111/cod.13096DOI Listing
December 2018

Aluminium sensitization in a French paediatric patch test population.

Contact Dermatitis 2018 12 19;79(6):382-383. Epub 2018 Aug 19.

Dermatology Department, Hôpital St André, CHU de Bordeaux, Bordeaux, France.

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http://dx.doi.org/10.1111/cod.13087DOI Listing
December 2018

Is a specific eyelid patch test series useful? Results of a French prospective study.

Contact Dermatitis 2018 Sep 8;79(3):157-161. Epub 2018 Jun 8.

Department of Dermatology, CHU Montpellier, Montpellier, France.

Background: Eyelids are frequent sites of contact dermatitis. No prospective study focused on eyelid allergic contact dermatitis (EACD) has yet been published, and this topic has never been studied in French patients.

Objectives: To prospectively evaluate the usefulness of an eyelid series in French patients patch tested because of EACD, and to describe these patients.

Methods: We prospectively analysed standardized data for all patients referred to our departments between September 2014 and August 2016 for patch testing for suspected EACD as the main reason. All patients were patch tested with an eyelid series, the European baseline series (EBS), the French additional series, and their personal products. Patch testing with additional series and repeated open application tests (ROATs) or open tests were performed if necessary. A standardized assessment of the relevance was used, and the analysis of the results was focused on patients having positive test results with a current certain relevance.

Results: Two-hundred and sixty-four patients (238 women and 26 men) were included. Three-hundred and twenty-two tests gave positive results in 167 patients, 84 of whom had currently relevant reactions: 56 had currently relevant positive test reactions to the EBS, 16 had currently relevant positive test reactions to their personal products, 8 had currently relevant positive test reactions to the French additional series, and 4 had currently relevant positive test reactions to the eyelid series. Sixty-seven per cent of all relevant cases were related to cosmetic products. The most frequent allergens with current relevance were methylisothiazolinone (10.2%), fragrance mix I (3%), nickel (2.7%), hydroxyperoxides of linalool (2.7%) and limonene (2.3%), and Myroxylon pereirae (2.3%). Current atopic dermatitis was found in 9.5% of patients. The duration of dermatitis was shorter (23.2 vs 34.2 months; P = .035) in patients with currently relevant test reactions. The percentage of currently relevant tests remained the same when atopic patients or dermatitis localized only on the eyelids were taken into account.

Conclusion: In French patients, testing for EACD with the extended baseline series and personal products, also including ROATs and use tests, appears to be adequate, considering the currently relevant positive test reactions. The regular addition of an eyelid series does not seem to be necessary.
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http://dx.doi.org/10.1111/cod.13040DOI Listing
September 2018

Delayed hypersensitivity skin reaction to hydroxychloroquine: Successful short desensitization.

J Allergy Clin Immunol Pract 2019 Jan 22;7(1):307-308. Epub 2018 May 22.

Department of Dermatology and Pediatric Dermatology, CHU de Bordeaux, Bordeaux, France. Electronic address:

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http://dx.doi.org/10.1016/j.jaip.2018.04.041DOI Listing
January 2019

Positive patch test reaction to carbamazepine after a very long delay.

Contact Dermatitis 2018 Oct 24;79(4):240-241. Epub 2018 May 24.

Department of Dermatology, Hopital Saint-André, CHU de Bordeaux, Bordeaux, France.

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http://dx.doi.org/10.1111/cod.13031DOI Listing
October 2018

Atypical aluminium patch tests in children with persistent itching postvaccinal nodules.

Pediatr Dermatol 2018 Jul 15;35(4):531-532. Epub 2018 Apr 15.

Department of Dermatology, Saint André Hospital, Bordeaux University Hospital, Bordeaux, France.

Persistent itching nodules related to aluminium-adsorbed vaccines are well known in children with frequent positive patch tests to aluminium when tested. We report two cases of children with persistent postvaccination nodules who presented with atypical eruptions after aluminium patch tests.
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http://dx.doi.org/10.1111/pde.13481DOI Listing
July 2018

Inflammasome Activation Characterizes Lesional Skin of Folliculitis Decalvans.

Acta Derm Venereol 2018 Jun;98(6):570-575

Department of Dermatology and Pediatric Dermatology, National Centre for Rare Skin Disorders, Hôpital Saint-André, 1 rue Jean Burguet, FR-33075 Bordeaux Cedex, France.

Folliculitis decalvans (FD) is a chronic inflammatory disease leading to scarring alopecia with poorly defined pathogenesis. The aim of this study was to investigate the expression of markers associated with the activation of innate immune signals, such as inflammasome (NALP1 and NALP3), interleukin (IL)-1β and IL-8 and type I interferon (MxA). A retrospective monocentric study was conducted and included 17 patients with FD with available biopsies. Disease activity (stable vs. active) was defined clinically and histologically. Immunostaining was performed using antibodies directed against NALP1, NALP3, IL-1β, IL-8, and MxA on FD skin biopsies. Results were compared with normal controls and lichen planopilaris. Eleven patients had active disease and 6 had stable disease. NALP1, NALP3, and IL-1β expression were significantly increased in hair follicles in FD compared with controls and lichen planopilaris. This study highlights the predominant immune signal associated with inflammasome activation in FD, suggesting the use of IL-1β blockade in FD.
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http://dx.doi.org/10.2340/00015555-2924DOI Listing
June 2018

Photoaggravated allergic contact dermatitis and transient photosensitivity caused by methylisothiazolinone.

Contact Dermatitis 2018 Apr 12;78(4):241-245. Epub 2017 Dec 12.

Service Dermatologie, Hôpital St André, CHU Bordeaux, 33000 Bordeaux, France.

Background: Photoaggravated allergic contact dermatitis caused by methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI) and MI has been reported.

Objectives: To describe the clinical characteristics and results of (photo)patch tests and photo-tests of 10 patients in Belgium and France suffering from photoaggravated contact dermatitis caused by MI.

Patients And Methods: Five men and five women, with a median age of 49.5 years, were investigated between January 2012 and February 2017 because of suspected photoaggravated contact dermatitis. Patch tests, photopatch tests and/or photo-tests were performed.

Results: Seven patients had positive patch test reactions to both MCI/MI and MI, whereas 3 patients had positive patch test reactions only to MI. In most cases, MI was the (strong) primary sensitizer. Photopatch tests with MCI/MI and/or MI gave stronger reactions than patch tests with these derivatives, indicating photoaggravation. Sensitization probably took place from cosmetics and work-related biocides, whereas elicitation of dermatitis was remarkably often related to airborne exposure to MI present in paints or industrial biocides. Four patients suffered from transient photosensitivity.

Conclusion: Photoaggravated allergic contact dermatitis and transient photosensitivity caused by MI is a peculiar clinical presentation of allergic contact dermatitis caused by this preservative, and should be considered in daily clinical practice.
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http://dx.doi.org/10.1111/cod.12926DOI Listing
April 2018

A first case of erythema multiforme-like contact dermatitis caused by propolis.

Contact Dermatitis 2017 Oct;77(4):263-264

Dermatology Department, Saint André Hospital, 33075 Bordeaux, France.

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http://dx.doi.org/10.1111/cod.12814DOI Listing
October 2017

A case of lichenoid and pigmented drug eruption to acetazolamide confirmed by a lichenoid patch test.

J Allergy Clin Immunol Pract 2018 Jan - Feb;6(1):283-285. Epub 2017 Aug 26.

Department of Adult and Pediatric Dermatology, Bordeaux University Hospitals, Bordeaux, France.

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http://dx.doi.org/10.1016/j.jaip.2017.07.005DOI Listing
October 2019

Cryotherapy to treat anogenital warts in nonimmunocompromised adults: Systematic review and meta-analysis.

J Am Acad Dermatol 2017 Sep 23;77(3):518-526. Epub 2017 Jun 23.

Antilles-Guyane University, Fort-de-France, Martinique; Délégation à la Recherche Clinique et à l'Innovation, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique; Department of Dermatology, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique.

Background: Cryotherapy is one of the most commonly used therapeutic modalities to treat anogenital warts (AGWs), but this treatment was not clearly established in the recent international recommendations.

Objective: To compare the efficacy and safety of cryotherapy versus other AGW treatments.

Methods: Through a systematic search of 12 electronic databases, we identified 11 randomized controlled trials, screened from database inception through October 2016, that met the inclusion criteria (including immunocompetent adults with AGWs receiving cryotherapy in 1 of the comparison groups). Primary endpoint was complete clearance of AGW. Risk-for-bias assessment was based on Cochrane Handbook recommendations. Meta-analyses used Review Manager v5.3 software.

Results: Cryotherapy efficacy did not appear to differ from that of trichloroacetic acid, podophyllin, or imiquimod. Electrosurgery was weakly associated with better AGW clearance than cryotherapy (risk ratio [RR] 0.80, 95% confidence interval [CI] 0.65-0.99). Cryotherapy was associated with more immediate low-level adverse events (erythema, stinging, or irritation; RR 3.02, 95% CI 1.38-6.61) and immediate pain requiring oral analgesics (RR 2.11, 95% CI 1.07-4.17) but fewer erosions (RR 0.57, 95% CI 0.36-0.90).

Limitations: All but 1 randomized-controlled trial had a high risk for bias.

Conclusion: With low-level quality of the evidence, cryotherapy is an acceptable first-line therapy to treat AGWs.
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http://dx.doi.org/10.1016/j.jaad.2017.04.012DOI Listing
September 2017

Cutaneous larva migrans: a case in Bordeaux, France and a systematic review of locally acquired cases in Europe.

Eur J Dermatol 2017 08;27(4):426-429

Department of Dermatology, Hôpital Saint-André, 1 Rue Jean Burguet, 33 000 Bordeaux, France.

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http://dx.doi.org/10.1684/ejd.2017.3043DOI Listing
August 2017
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