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Allaoui M.,Francois Baclesse Cancer Center | Hubert E.,Louis Pasteur Hospital | Michels J.-J.,Francois Baclesse Cancer Center
Turk Patoloji Dergisi/Turkish Journal of Pathology | Year: 2014

Malignant pilomatricoma or pilomatrical carcinoma is a rare malignant hair follicle neoplasm. This tumor is locally aggressive with increased tendency to recur, but a low metastatic potential. Its histopathological diagnosis is difficult and based on a detailed evaluation of the infiltrative nature, the importance of the mummified and necrotic cell component, atypical mitoses, and perineural or vascular invasion. Surgical wide resection is the recommended treatment. It reduces the risk of focal recurrence by 50%. Here we report two new cases including one that occurred on a lesion initially diagnosed as benign pilomatricoma.

Sathekge M.,University of Pretoria | Maes A.,AZ Groeninge | Maes A.,University Hospital Leuven | Kgomo M.,Louis Pasteur Hospital | And 3 more authors.
Nuclear Medicine Communications | Year: 2010

Objective: To evaluate differences in glucose uptake by skeletal muscle tissue and subcutaneous fat in HIV patients on highly active antiretroviral therapy (HAART) presenting with and without lipodystrophy as well as in drug-naive HIV patients using 18F-fluorodeoxyglucose (FDG) positron emission tomography. Patients and methods: Thirty-nine consecutive patients suffering from HIV: seven drug-naive patients, 21 nonlipodystrophic patients on HAART and 11 patients on HAART, respectively, suffering from lipodystrophy were prospectively included. All patients underwent a whole-body FDG positron emission tomography examination. Standardized uptake values (SUV values) of muscle and subcutaneous fat were compared and related to demographic and biochemical variables. Results: SUV mean values of subcutaneous fat were significantly higher in patients under HAART presenting with lipodystrophy when compared with untreated and treated, nonlipodystrophic patients (P=0.000). SUV mean values of subcutaneous fat significantly correlated with treatment duration (r =0.56, P=0.000) and CD4 count (r=0.51, P= 0.001) and inversely correlated with viral load (r = -0.61, P=0.000). Finally, SUV mean values of thigh muscles were not significantly different between the three different patient groups under study. Conclusion: Quantitative FDG uptake by subcutaneous fat proved significantly higher in HIV patients under HAART presenting with lipodystrophy. HAART did not influence FDG uptake by human skeletal muscle tissue under basal conditions. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Bastuji-Garin S.,University Paris Est Creteil | Bastuji-Garin S.,Henri Mondor University Hospital | Joly P.,University of Rouen | Lemordant P.,Aix - Marseille University | And 12 more authors.
Journal of Investigative Dermatology | Year: 2011

A rise in the incidence of bullous pemphigoid (BP) was documented recently in Europe, and the main risk factors for BP remain unknown. We conducted a multicenter case-control study to evaluate risk factors for BP. We identified 201 incident BP cases and 345 controls individually matched for age, gender, center, and place of residence (home, nursing home, or extended-care facility). We used univariate and multivariate logistic regression analyses to compare drugs used for over 3 months, comorbidities, and physical and cognitive impairments between cases and controls. Mean age of BP patients was 84.2 (8.7) years. Factors independently associated with BP by multivariate analysis were major cognitive impairment (odds ratio (OR), 2.19; 95% confidence interval (95% CI), 1.24-3.87), bedridden condition (OR, 2.19; 95% CI, 1.23-3.89), Parkinson's disease (OR, 2.16; 95% CI, 1.09-4.27), unipolar or bipolar disorder (OR, 5.25; 95% CI, 1.21-22.86), and chronic use of spironolactone (OR, 2.30; 95% CI, 1.20-4.46) or phenothiazines with aliphatic side chains (OR, 3.70; 95% CI, 1.21-11.34). Chronic analgesic use was associated with a lower risk of BP (OR, 0.49; 95% CI, 0.30-0.81). Thus, risk factors for BP include neurological disorders, particularly dementia and Parkinson's disease, psychiatric disorders (unipolar and bipolar disorders), bedridden condition, and chronic use of several drugs. © 2011 The Society for Investigative Dermatology.

Zaanan A.,University Paris - Sud | Costes L.,University Paris - Sud | Gauthier M.,Biostatistics and Epidemiological Unit | Malka D.,University Paris - Sud | And 11 more authors.
Annals of Oncology | Year: 2010

Background: Small-bowel adenocarcinoma (SBA) is a rare tumor of poor prognosis. Data on the efficacy of chemotherapy for advanced SBA are scarce. Patients and methods: All patients with advanced SBA who received frontline chemotherapy from 1996 to 2008 were eligible for this retrospective multicenter study. Results: Ninety-three consecutive patients were included. In the entire population, the median progression-free survival (PFS) and overall survival (OS) times were 6.6 and 15.1 months, respectively. Median PFS times among patients treated with LV5FU2 (n = 10), FOLFOX (n = 48), FOLFIRI (n = 19) and LV5FU2-cisplatin (n = 16) were 7.7, 6.9, 6.0 and 4.8 months, respectively, while median OS times were 13.5, 17.8, 10.6 and 9.3 months, respectively. In multivariate analysis, World Health Organization performance status (PS) (P < 0.0001) and elevated serum levels of carcinoembryonic antigen (CEA) (P = 0.02) and carbohydrate antigen 19-9 (CA 19-9) (P = 0.03) were the only variables significantly associated with poor OS. In the subgroup of patients treated with platinum-based chemotherapy, multivariate analysis showed that LV5FU2-cisplatin was associated with poorer PFS (P < 0.0001) and OS (P = 0.02) compared with FOLFOX. Conclusions: This is the largest study of chemotherapy in advanced SBA. Baseline PS and CEA and CA 19-9 levels were the main prognostic factors. FOLFOX seems to be the most effective platinum-based chemotherapy regimen. © The Author 2010. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.

Sathekge M.,University of Pretoria | Maes A.,AZ Groeninge | Maes A.,University Hospital Leuven | Kgomo M.,Louis Pasteur Hospital | Wiele C.V.D.,Ghent University
Nuclear Medicine Communications | Year: 2010

Objective: To assess prospectively the relationship between fluorodeoxyglucose uptake by lymph nodes, the number of sites of lymph node involvement and cluster of differentiation 4 (CD4) cell count. An inverse relationship, if existing, between these variables would provide indirect support for the concept of homing induced apoptosis. Methods: We evaluated the intensity and extent of fluorodeoxyglucose uptake in lymph nodes of HIV patients under antiviral treatment by means of PET imaging. Quantitative results obtained were related to CD4 cell count and viral loads. Correlation analysis was performed using a nonparametric test and correction for multiple comparisons. Results: Predominant sites of lymph node involvement were the cervical and axillary regions, followed by the inguinal region. CD4 cell count was inversely correlated to the average of the averaged standardized uptake values (SUV) of involved lymph nodes and to the number of sites of lymph node involvement. Viral load was positively correlated to the average of the averaged SUV-mean values of involved lymph nodes and also to the number of sites of lymph nodes involved. An inverse correlation between CD4 cell count and viral load was identified. Conclusion: The inverse relationship between CD4 cell count and the average of the averaged SUV-mean values of involved lymph nodes and between CD4 cell count and the number of sites of lymph node involvement observed, indirectly supports the theory of CD4 cell depletion through forced lymph node homing. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.

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