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Notes: Background Recent studies have shown that interleukin–2 (IL2) is less toxic when administered subcutaneously than intravenously. Moreover interferon α and Dacarbazine could increase the efficiency of IL2.Patients and methods Nineteen ambulatory patients with metastatic melanoma (1 stage 111 and 18 stage IV) were treated with an association of dacarbazine 400 mg/m2, interferon α2a (Roferon) 9 × l06 IU 3 times per week administered subcutaneously and recombinant interleukin-2 (IL–2) (Eurocetus) 3 × 106 IU five days per week for two weeks per month subcutaneously. The treatment consisted of 2 induction cures separated by a one-month interval followed by evaluation studies.Results At the end of the induction phase. 2 complete and 3 partial responses (response rate 26.2%) were observed. These responses were obtained in patients with sinus (1 case), skin (3 cases), lymph node (2 cases), bone (1 case) and liver (I case) targets. The mean response period was 10 months for the 2 complete responses. No patients had grade 4 toxicity, and treatment was stopped for only one patient. Painful subcutaneous nodules frequently (23%) formed at the injection site.Conclusion The association of subcutaneously administered dacarbazine, interferon α and IL2 would thus seem of interest for the treatment of metastatic melanoma. Moreover, toxicity is tolerable and compatible with ambulatory treatment ensuring the patient a decent quality of life.

Notes: Background Acne is usually perceived as a disease of teenagers, and most epidemiological studies have focused on adolescents.Objective The primary objective was to investigate the prevalence of acne in a representative sample of French females. Information about skin type, life-style factors influencing acne and quality of life were also recorded.Methods A self-administered questionnaire was sent to 4000 adult women aged 25–40 years, after a validation test by three dermatologists. A definition of acne severity, according to questionnaire answers, was established before the questionnaire was sent out.Results A total of 3394 women completed the questionnaire of which 3305 were useable. The data showed a prevalence of acne in 17% of the population, and physiological acne in 24%. Thus, the total acne prevalence was 41%. Forty-nine per cent of the acne patients had acne sequelae (scars and/or pigmented macules). Forty-one per cent of adult acne patients had not experienced acne during their adolescence. A premenstrual flare and stress was recorded as causing acne in 78% and 50%, respectively. Twenty-two per cent of acne subjects were currently receiving therapy. For most patients, acne did not severely impair their quality of life.Conclusion This study shows a prevalence of acne in 41% of women in the general population. A high proportion of these acne cases are late onset acne.

Notes: In two cases of Merkel cell tumor, the study of intermediate filaments, using monoclonal antibodies (vimentin, cytokeratin, neurofilaments), confirmed the double differentiation (neuroendocrine and epithelial) of this tumor as previously observed in histological, electron microscopical and histochemical analyses. Labelling of the tumor cells was positive with monoclonal antibodies against neurofilament proteins and cytokeratin.

Notes: Abstract: The migration of keratinocytes plays an important role in the re-epithelialization of cutaneous wounds. Zinc, copper and manganese are used in vivo for their healing properties and their mechanism of action is still only partially known. Thus, they have been shown both to promote keratinocyte proliferation and to modulate integrins expression. The aim of this study was to determine if trace elements induce an increase of the migration of keratinocytes and if this effect is related to the modulation of integrins. Two independent migration assays were used to study keratinocyte migration: the scratch assay using normal human keratinocytes and the modified Boyden chamber using HaCaT cells. Inhibition studies using function-blocking antibodies directed to α3, α6, αV and β1 subunits were performed to investigate the modulator effect of trace elements on integrin function. In this way, zinc and copper gluconates increased α3, αV and β1 function whereas manganese gluconate seems mainly able to modulate the function of α3 and β1. The stimulating effect of these trace elements on keratinocyte migration does not appear related to α6 subunit. Thus, zinc, copper and manganese enhanced keratinocyte migration and one of the mechanisms was going through a modulation of integrin functions.

Notes: Background Cytokines are of potential importance in the pathogenesis of cutaneous T-cell mediated disorders, including cutaneous T-cell lymphoma (CTCL). Objectives To compare interleukin (IL)-15 expression in certain inflammatory cutaneous diseases, with that in CTCL (mycosis fungoides and Sézary syndrome). Methods IL-15 mRNA and protein expression were examined by in situ hybridization and immunohistochemistry, respectively, on formalin-fixed, paraffin-embedded biopsies of normal human skin, atopic dermatitis, psoriasis, parapsoriasis and CTCL. Results Despite similar expression of IL-15 mRNA, we found differences in IL-15 protein expression between normal human skin, atopic dermatitis and psoriasis on the one hand, and parapsoriasis and CTCL on the other. IL-15 protein expression was not detected in normal human skin, atopic dermatitis or psoriasis, but was detected, mainly at low levels but in a few patients at higher levels, in epidermal keratinocytes in parapsoriasis, mycosis fungoides and Sézary syndrome. Conclusions Induction of keratinocyte IL-15 expression appears to be a feature of CTCL. The factors stimulating such an expression remain unknown.

Notes: Background Propionibacterium acnes is the target of antimicrobial treatments for acne vulgaris. Acquired resistance to erythromycin, clindamycin and tetracyclines has been reported in strains from diverse geographical loci, but the molecular basis of resistance, via mutations in genes encoding 23S and 16S rRNA, respectively, has so far only been elucidated for isolates from the U.K. Objectives To determine whether similar or different resistance mechanisms occur in resistant P. acnes isolates from outside the U.K. Methods The phenotypes and genotypes of 73 antibiotic-resistant strains of P. acnes obtained from the skin of acne patients in the U.K., U.S.A., France, Germany, Australia and Japan were compared. Antibiotic susceptibilities were determined by minimum inhibitory concentration (MIC) measurements, and polymerase chain reaction and DNA sequencing were used to identify mutations in genes encoding rRNA. Results Most erythromycin-resistant isolates (MIC90≥ 512 μg mL−1) were cross-resistant to clindamycin but at a much lower level (MIC90≥ 64 μg mL−1). As in the U.K., resistance to erythromycin was associated with point mutations in 23S rRNA in 49 of 58 strains. An A→G transition at Escherichia coli equivalent base 2058 was present in 24 strains. This gave a unique cross-resistance phenotype against a panel of macrolide, lincosamide and type B streptogramin antibiotics. Two further point mutations (at E. coli equivalent bases 2057 and 2059) were identified (in three and 22 isolates, respectively) and these were also associated with specific cross-resistance patterns originally identified in isolates from the U.K. However, nine of 10 erythromycin resistant-strains from Germany did not exhibit any of the three base mutations identified and, in six cases, cross-resistance patterns were atypical. Consistent with previous U.K. data, 34 of 38 tetracycline-resistant strains carried a base mutation at E. coli 16S rRNA equivalent base 1058. Tetracycline-resistant isolates displayed varying degrees of cross-resistance to doxycycline and minocycline, but isolates from the U.S.A. had higher MICs for minocycline (4–16 μg mL−1) than isolates from other countries and, in particular, Australia. All the P. acnes isolates resistant to one or more of the commonly used antiacne antibiotics were sensitive to penicillin, fusidic acid, chloramphenicol and the fluoroquinolone, nadifloxacin. All but one isolate (from the U.K.) were sensitive to trimethoprim. Conclusions This study shows that 23S and 16S mutations identified in the U.K. conferring antibiotic resistance in P. acnes are distributed widely. However, resistant strains were isolated in which mutations could not be identified, suggesting that as yet uncharacterized resistance mechanisms have evolved. This is the first report of high-level resistance to minocycline and is of concern as these strains are predicted to be clinically resistant and are unlikely to remain confined to the U.S.A. Epidemiological studies are urgently required to monitor how resistant strains are selected, how they spread and to ascertain whether the prevalence of resistance correlates with antibiotic usage patterns in the different countries.

Notes: Epstein—Barr virus (EBV) is often associated with non–Hodgkin's T–cell lymphomas and has recently been found in the lesions of mycosis fungoides and Sézary syndrome. We sought to determine whether the anti–EBV antibody profile was disturbed in mycosis fungoides and Sézary syndrome and whether there are particular profiles characteristic of disease stage. Anti–EBV antibodies (anti–VCA,–EA and –EBNA) were studied in the sera of 64 patients. An immunoenzymatic technique was used, and the results were compared with the same number of age– and sex–matched healthy controls.Patients with mycosis fungoides and Sézary syndrome developed higher anti–VCA antibody titres (median 1200) than controls (median 320). Thirty–seven patients had anti–VCA ≥ 1200 vs. 19 controls (P〈0.01). These elevated anti–VCA antibody titres were associated with positive EA in 19 patients versus three controls. No differences were found between the illness stages. Anti–EBV antibodies were most often found in mycosis fungoides and Sézary syndrome when the serological profile was similar to that of cellular immune deficiencies and EBV–related non–Hodgkin's lymphoma. EBV could be involved, either directly on lymphocytes or, more likely, indirectly by chronic antigenic stimulation.