Bernard Guillot

Prevalence of Chlamydia trachomatis , Neisseria gonorrhoeae and Mycoplasma genitalium in asymptomatic patients under 30 years of age screened in a French sexually transmitted infections clinic

BackgroundAn increasing prevalence of sexually transmitted infections (STI) has been noted in France over the past decade. Asymptomatic carriage may be high in patients infected with Chlamydia trachomatis attending free and anonymous screening centres (CDAG) and information, diagnosis and screening centres for STI (CIDDIST). In these centres, systematic C. trachomatis detection is recommended in women ≤25 years and in men ≤30 years.ObjectivesThis study aimed at estimating the prevalence of C. trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium in asymptomatic patients younger than 30 years attending a CDAG-CIDDIST.Material and MethodsA free systematic screening for C. trachomatis, N. gonorrhoeae and M. genitalium was offered to asymptomatic subjects under 30 years attending the Montpellier CDAG-CIDDIST from April to August 2009. Pathogens were identified by PCR in first void urine samples.ResultsOf the 1381 subjects included (53.8% women and 46.2% men), 105 (42.9% men and 57.1% women) tested positive for C. trachomatis (7.6%, 95% CI [6.3;9.13]); eight (seven men and onewoman) tested positive for M. genitalium (0.58% [0.2;1]) of whom two were infected with C. trachomatis; five (two men and three women) tested positive for N. gonorrhoeae (0.36% [0.1;0.8]) of whom three were infected with C. trachomatis.ConclusionThis study confirmed the need for C. trachomatis screening in all patients under 30 years. Our results did not support a systematic screening for N. gonorrhoeae and M. genitalium in urine samples in this kind of facility.

Merkel cell polyomavirus: Its putative involvement in a particular subset of cutaneous lymphoma with possibly unfavorable outcome

BACKGROUNDnA major etiologic hypothesis in primary cutaneous T-cell lymphomas is a defective lymphocyte apoptosis after antigenic activation, which could be induced by various infectious agents.nnnOBJECTIVEnTo investigate the presence of the possibly lymphotropic and folliculotropic Merkel cell polyomavirus (MCPyV) DNA and proteins in folliculotropic mycosis fungoides (fMF).nnnSTUDY DESIGNnFresh-frozen and fixed skin biopsies were collected in lesional and non-lesional skin from 24 fMF patients, in lesional skin from 22 patients with various T-cell mediated skin benign infiltrates (TSBI) and in normal-appearing skin from 22 healthy individuals (HI). Detection and quantification of MCPyV DNA were carried out using real-time PCR; MCPyV genome integration status was presumed through a previously described differential real-time PCR (MCPyV ΔC-TAg) targeting a constantly conserved sequence versus an integration-induced deleted sequence. The MCPyV proteins expression was assessed by immunohistochemistry using antibodies targeting a tumoral antigen or a capsid protein.nnnRESULTSnAlthough MCPyV DNA was similarly detected in lesional versus non-lesional fMF samples (50% each), in 36.4% HI and 40.9% TSBI; viral load was significantly higher in fMF lesional samples versus HI and TSBI. The integration of the viral genome appeared unlikely. The MCPyV proteins expression was exclusively observed inside skin appendages in 18.2% of the fMF lesional skin samples.nnnCONCLUSIONnMCPyV genome detection rate was similar in all skin samples, but MCPyV viral load was significantly higher in fMF lesions versus TSBI and HI, although the viral genome was probably not integrated. Episomal MCPyV DNA may be expressed in skin appendages in fMF.

Manifestations dermatologiques des maladies du système hématopoiétique et oncologie dermatologique, vol. 3

Manifestations dermatologiques des maladies du systeme hematopoietique et oncologie dermatologique, vol. 3 - Libros de Medicina - Dermatologia Oncologica - 76,54

Effets cutanéo-muqueux indésirables des cytokines et des nouvelles molécules anticancéreuses

Les interferons (IFN) sont des glycoproteines appartenant au groupe des cytokines et dotes de proprietes antivirales, antitumorales et immunomodulatrices. Leur production par genie genetique, sous la forme d’interferons recombinants, hautement purifies, a permis leur utilisation therapeutique au cours de diverses pathologies tumorales, infectieuses et dysimmunitaires. Ils se divisent en trois classes alpha, beta et gamma. L’interferon alpha (IFN-α) est commercialise sous la forme α-2a et α-2b et les principales indications therapeutiques sont les hepatites virales B ou C chroniques actives, la leucemie atricholeucocytes, la leucemie myeloide chronique, le lymphome cutane T, le lymphome folliculaire non hodgkinien, la maladie de Kaposi au cours du SIDA, le cancer du rein et le melanome de stade II. Une formulation pegylee par combinaison d’IFN-α-2b et de polyethylene-glycol est disponible pour le traitement de l’hepatite virale chronique C (HCV), classiquement en association avec la ribavirine. Les avantages majeurs de cette derniere formulation sont un allongement de la demi-vie d’elimination permettant une seule injection par semaine et l’obtention de taux plasmatiques eleves et stables de la molecule. L’interferon beta (IFN-s) est utilise sous la forme s-1a au cours du traitement de la sclerose en plaques. L’interferon gamma (IFN-γ) est utilise sous la forme γ-1b dans le traitement de la granulomatose septique familiale et de l’osteopetrose maligne.

Effets cutanéo-muqueux indésirables des chimiothérapies antitumorales

Alopecie Elle est le plus frequent des effets secondaires cutaneo-muqueux des traitements cytotoxiques. Il s’agit le plus souvent d’un mecanisme de type effluvium anagene avec interruption brutale de la phase de croissance du cheveu et production d’une tige pilaire amincie et fragile qui peut se casser pour des traumatismes minimes. Cet effluvium anagene est une consequence directe et non specifique de l’action cytotoxique des produits utilises en chimiotherapie et est donc difficile aprevenir. L’effluvium anagene apparait typiquement dans les deux semaines qui suivent l’introduction du traitement cytotoxique et aboutit aune alopecie diffuse dans les deux mois. Elle concerne le cuir chevelu, mais egalement d’autres regions pileuses, tels les sourcils, les cils, la barbe, la pilosite corporelle, notamment axillaire et pubienne, en fonction du nombre de follicules en phase anagene lors du traitement. Toutefois, ces autres zones corporelles sont en general moins sensibles que le cuir chevelu, probablement parce que le pourcentage de