F. Cambazard

Skin graft secured by VAC (vacuum-assisted closure) therapy in chronic leg ulcers: A controlled randomized study

INTRODUCTION Leg ulcers are a common condition. There have been very few studies of combined therapy involving VAC (vacuum-assisted closure) and skin graft. METHODS We performed a randomized controlled trial of VAC therapy vs. hydrocolloid dressings over 5 days following autologous grafting on chronic leg ulcers. The primary objective was to assess the difference in success (defined as a reduction in wound area of at least 50% at 1 month) between the two dressing methods. Forty-six patients with ulcers present for over one month were included. Following a 7-day hospitalization period, follow-up was performed for 3 months on an outpatient basis. RESULTS Our study does not demonstrate a statistically significant difference, with a 45.8% success rate in the VAC group vs. 40.9% in the conventional dressing group (P=0.73). In the venous ulcer group, the success rate was 57.9% for VAC vs. 40% for conventional dressings (P=0.3). The difference in favor of VAC in this group was not statistically significant, most likely due to an insufficient number of patients studied. CONCLUSION Our study does not demonstrate superiority of VAC associated with skin graft over conventional dressings. We observed more complications with VAC (40%) than with conventional dressings (23%) (P=0.06).

Dermatophytose de la peau glabre diagnostiquée par microscopie confocale

n patient de 32 ans nous a été adressé pour une dermaose très prurigineuse, évoluant depuis environ un an. Le atient avait été traité sans bénéfice par acitrétine pour une ventuelle maladie de Darier suspectée en raison de lésions ératosiques sur le visage et le décolleté. À l’examen clinique, des macules érythématoquameuses aux bords bien limités, étendues étaient résentes sur le décolleté (Fig. 1), le cou, le visage, a zone pubienne, les fesses et la face antérieure des uisses (Fig. 2). Ces aspects étaient évocateurs d’une ermatophytose de la peau glabre.

The 'tissue press': a new device to flatten fresh tissue during ex vivo confocal microscopy examination.

The ‘tissue press’: a new device to flatten fresh tissue during ex vivo confocal microscopy examination E. Cinotti, D. Grivet, B. Labeille, M. Solazzi, A. Bernard, F. Forest, M. Espinasse, F. Cambazard, G. Thuret, P. Gain and J. L. Perrot Department of Dermatology, University Hospital of St-Etienne, Saint Etienne Cedex 2, France, Department of Ophthalmology, University Hospital of St-Etienne, Saint Etienne Cedex 2, France, Biology, Engineering and Imaging of Corneal Graft Laboratory, Institute of Research in Sciences and Health Engineering, EA2512, Jean Monnet University, Saint-Etienne, France, PERCRO Laboratory, Scuola Superiore Sant’Anna, Pisa, Italy, Department of Pathology, University Hospital of St-Etienne, Saint Etienne Cedex 2, France and Institut Universitaire de France, Paris, France

Apport de la dermoscopie et de la microscopie confocale par réflectance dans le diagnostic d’ochronose exogène

rance par Mavig, Munich) était réalisé pour orienter le iagnostic. Les structures bleu-gris vues en dermoscopie orrespondaient à la présence de nombreux macrophages yper-reflétants et de multiples zones hypo-reflétantes voïdes dans le derme papillaire (Fig. 3). L’examen histoloique trouvait de multiples corps ocres ovoïdes et en forme e banane dans le derme papillaire et moyen (Fig. 4), caracéristiques d’ochronose.

Imaging technique for the diagnosis of onychomatricoma

Onychomatricoma is a rare tumour that derives from the nail matrix and grows within the nail plate. The clinical presentation can mimic many other tumours and conditions, and surgical biopsy and histopathological examination are necessary to confirm the diagnosis. As nail surgery is a painful experience for the patient and sometimes can leave permanent onychodistrophy, more precise preoperative diagnosis is needed to distinguish onychomatricoma from other nail diseases more accurately and to limit surgical interventions. The objective of this study was to evaluate current literature on imaging techniques for the diagnosis of onychomatricoma in order to understand how this technology can help the presurgical diagnosis of this tumour. We searched in the Cochrane Skin Group Specialised library, Medline, Embase and LILACS databases all studies evaluating imaging technique for the diagnosis of onychomatricoma up to February 2018. We found that not only nail dermoscopy, but also reflectance confocal microscopy, optical coherence tomography, ultrasonography and magnetic resonance can be useful in this field.

Mucosal melanoma: clinical, histological and c-kit gene mutational profile of 86 French cases

Mucosal melanomas are rare and highly aggressive tumours. Few studies evaluated mucosal melanomas of locations other than the head and neck region, and other than those of the Asian population.

Fiche thématique / Microscopie confocale par réflectanceApport de la dermoscopie et de la microscopie confocale par réflectance dans le diagnostic d’ochronose exogèneRole of dermoscopy and reflectance confocal microscopy as an aid in the diagnosis of exogenous ochronosis

rance par Mavig, Munich) était réalisé pour orienter le iagnostic. Les structures bleu-gris vues en dermoscopie orrespondaient à la présence de nombreux macrophages yper-reflétants et de multiples zones hypo-reflétantes voïdes dans le derme papillaire (Fig. 3). L’examen histoloique trouvait de multiples corps ocres ovoïdes et en forme e banane dans le derme papillaire et moyen (Fig. 4), caracéristiques d’ochronose.

New findings in non-invasive imaging of cutaneous endometriosis: Dermoscopy, high-frequency ultrasound and reflectance confocal microscopy

Cutaneous endometriosis (CE) is rare and its dermoscopic features were reported only in 3 patients. The aim of this study was to examine a case of pigmented CE with multiple non‐invasive imaging techniques, to compare the obtained images with histopathology and to define their utility in an early diagnosis of the disease.

Reflectance confocal microscopy identification of subclinical basal cell carcinomas during and after vismodegib treatment

Recently, it has been shown that reflectance confocal microscopy (RCM) could identify subclinical basal cell carcinoma (BCC) during vismodegib treatment of locally advanced BCC.

In vivo reflectance confocal microscopy combined with the ‘spaghetti technique’ for the identification of surgical margins of lentigo maligna: experience in 70 patients

Lentigo maligna (LM) and lentigo maligna melanoma (LMM) account for 10% of all melanomas and are mainly located on head and neck areas.1-4 Complete surgical excision is the recommended treatment. However, this treatment is often challenging because of LM/LMM location in the face and the difficulty in the identification of its surgical margins1-5 . Local recurrence of LM/LMM still represents a major concern with recurrence rates after conventional surgical excision of 8 to 20% of cases, up to 47% in absence of Mohs micrographic surgery (MMS). This article is protected by copyright. All rights reserved.