Caroline Flagothier

New insights into the effect of amorolfine nail lacquer

Despite improvements in antifungal strategies, the outcome of treating onychomycoses often remains uncertain. Several factors account for treatment failure, of which the pharmacokinetics and pharmacodynamics of the antifungal are of importance. The taxonomic nature and ungual location of the fungus cannot be neglected, besides the type of nail and its growth rate. In addition, the biological cycle of the fungus and the metabolic activity of the pathogen likely play a marked influence in drug response. The presence of natural antimicrobial peptides in the nail is also probably a key feature controlling the cure rates. There are many outstanding publications that cover the full spectrum of the field. The purpose of this review is to put in perspective some facets of activity of the topical treatment using amorolfine nail laquer. The antifungal activity of the drug is likely less pronounced in onychomycosis than that expected from conventional in vitro studies. However, the nail laquer formulation should reduce the propensity to form antifungal‐resistant spores and limit the risk of reinfection.

Lipolyse électromagnétique et lipoatrophie semi-circulaire des cuisses

Resume Introduction La lipoatrophie semi-circulaire des cuisses est une affection dont l’incidence est restee rare pendant des annees. Ce n’est que tres recemment qu’une « epidemie » s’est manifestee chez des centaines de sujets qui avaient pour point commun un emploi administratif. Observation Les anciennes hypotheses etiopathogeniques font place a celles impliquant les champs electromagnetiques generes par des equipements informatiques et leurs cablages. Ce serait les modifications induites des proprietes bioelectriques intrinseques de la peau qui pourraient influencer la biologie de macrophages a activite lipophagique dans l’hypoderme. L’electroactivation de ces cellules serait suivie de la liberation de TNF-α. Discussion La lipoatrophie semi-circulaire des cuisses est un probleme qui peut toucher un employe sur deux. Plutot que d’esperer un traitement medicamenteux efficace, la prevention doit etre preconisee par l’adaptation des conditions de travail liees a l’emploi d’un equipement informatique.

Cutaneous myospherulosis and membranous lipodystrophy: extensive presentation in a patient with severe steroid-induced dermal atrophy.

Myospherulosis is a rare disorder that may develop in various organs including the skin. It is characterized by a typical histological presentation resulting from the interaction between erythrocytes and lipids. We present a case of cutaneous myospherulosis associated with membranous lipodystrophy. The lesions were supervening on severe steroid‐induced skin atrophy upon which ointments had been applied.

A four-generation Ehlers-Danlos syndrome with vascular dissections. Skin ultrastructure and biomechanical properties.

Ehlers-Danlos syndrome (EDS) is heterogenous with regard to genetic traits, clinical manifestation, the biomechanical and microscopic properties of connective tissues, and basic molecular defects. We report on nine relatives of four generations who suffered from large vessel dissections and cutaneous microscopic changes consistent with EDS. Measurements of the mechanical properties of skin were performed using a computerized suction device (Cutometer®). Morphological and biomechanical alterations suggestive of EDS were present in all examined subjects. A loose network of collagen bundles was admixed with clumsy elastic fibres. Factor XIIIa-positive dermal dendrocytes looked almost normal but were slim and rarefied in four subjects. The severity in ultrastructural alterations of the collagen network differed among the subjects. The group with the most prominent changes showed the most striking biomechanical alterations characterized by increased biologic elasticity without any excess in skin extensibility. A positive correlation was found between skin extensibility and elasticity. In conclusion, distinct alterations in the collagen scaffolding were found to be correlated to variable severity in biomechanical alterations of the skin. The predictive value of these changes for large vessel dissections in some families at risk remains to be settled.

Effect of a single overnight topical application of miconazole nitrate paste on acne papules.

Background  The classical management of acne calls for prolonged oral and/or topical treatments; however, some patients request a rapid effect to make the papules disappear within a few hours or days.

Granulomas por cuerpos extraños exógenos y endógenos

Un granuloma por cuerpo extrano es una lesion cronica constituida sobre todo por celulas de las lineas monocitica y macrofagica. La funcion de fagocitosis suele estar bien desarrollada. Esta reaccion puede estar inducida por diversas macroestructuras de naturaleza xenobiotica, por microparticulas exogenas cristalinas o amorfas, asi como por algunas estructuras de origen endogeno. En determinados contextos clinicos es dificil establecer una distincion clara entre una reaccion por cuerpo extrano pura y un granuloma con componente inmunogeno.