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[What's new in internal medicine?]
No full textThis article focuses on current trends in various autoimmune diseases of interest for the dermatologist. In the antiphospholipid syndrome, many news: better characterization of the severe disease, involvement of the mTOR pathway in the vasculopathy-induced renal disease, and diversification of the therapeutic approaches: use of mTOR inhibitors and several biologics, new various antiplatelet and anticoagulants. In dermatomyositis, new autoantibodies are better characterized with a good correlation with clinical disease; the results of a large study on genetic predisposition to the disease are available. There are also some therapeutic innovations in systemic sclerosis: benefit of rituximab that seems well tolerated, the results of a large controlled European study about aggressive immunoablative chemotherapy followed by autologous stem cells have just been published, intralesional stem cells injections in the fingers of sclerodactylic patients. Finally, news in celiac disease that is constantly increasing and whose mild forms often have cutaneous manifestations, leading to diagnosis
TNF Inhibitors in Dermatology: From Thalidomide to Biologics
No full textInflammatory skin diseases represent an important part of dermatological pathology. Recent advances in the understanding of inflammatory processes have identified various cytokines, and in particular Tumor necrosis factor (TNF) as a potent and central proinflammatory cytokine involved in many conditions, including rheumatic, gastrointestinal tract, and skin diseases. Therefore, inhibition of TNF has become a major therapeutic target in the treatment of inflammatory disorders. Thalidomide is one of the first TNF inhibitors that have been used. It was initially prescribed by chance and pragmatically by dermatologists in inflammatory diseases such as erythema nodosum leprosum, lupus and severe aphtosis, but its identification as an inhibitor of TNF is more recent. The discovery of the major role of TNF alpha in the physiopathology of certain inflammatory diseases and notably in rheumatoid arthritis and Crohn's disease has led to the emergence of 3 new anti-TNF alpha drugs. These so-called biologics are two monoclonal antibodies (infliximab and adalimumab) and one fusion protein composed of a soluble TNF alpha receptor (etanercept) specifically directed against TNF. The first clinical data are very impressive, but new and unexpected side effects have progressively been described. These powerful drugs are increasingly prescribed, and the aim of this work is to summarize the recent knowledge on the old (thalidomide) and new (biologics) TNF inhibitors in dermatological diseases
Pityriasis rubra pilaire : une dermatose mal connue
No full textPityriasis rubra pilaris is a rare heterogeneous disorder characterized by follicular keratosis, perifollicular erythema and palmoplantar hyperkeratosis. The aetiology is still unknown. In the majority of cases some triggering factors are found such as trauma or bacterial infection, possibly on a predisposed condition. In other cases, some immunological disorders are associated, and in familial cases a genetic disorder of keratinization has been suggested. The evolution is variable according to the clinical type. The treatment is not well defined, and there is a lack of clinical trials. The best results however are obtained with oral retinoids, methotrexate or ciclosporine as alternative therapy. New TNF inhibitors and anti-IL-12/23 showed a good result and could be have interest in the future
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Dupilumab : au-delà de la dermatite atopique, les principales utilisations hors indication en dermatologie
No full textDupilumab is a humanized IgG4 monoclonal antibody that targets the IL-4 receptor inhibiting the signaling of interleukin-4 and interleukin-13, two major cytokines in type 2 inflammatory diseases such as atopic dermatitis, asthma and nasosinusal polyposis. Since its approval for atopic dermatitis in 2017, the molecule has occasionally been used off-label in several dermatological conditions where standard treatments are often disappointing.Furthermore, what emerges from the data currently in the literature is a favourable safety profile with few, reversible side effects.Le dupilumab est un anticorps monoclonal recombinant humain de type IgG4 qui inhibe la signalisation de l’interleukine-4 et l’interleukine-13, deux cytokines majeures impliquées dans les pathologies inflammatoires de type 2 telles que la dermatite atopique, l’asthme et la polypose naso-sinusienne. À côté d’une bonne efficacité dans ces pathologies, on retient un bon profil de sécurité avec peu d’effets secondaires, généralement assez bénins et réversibles. Depuis son approbation pour la dermatite atopique en 2017, cette molécule a été utilisée hors indication dans plusieurs pathologies dermatologiques où les traitements habituellement utilisés peuvent être insuffisants ou mal tolérés
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