The Experts below are selected from a list of 3663 Experts worldwide ranked by ideXlab platform

Michael Scharl - One of the best experts on this subject based on the ideXlab platform.

Kiarash Khosrotehrani - One of the best experts on this subject based on the ideXlab platform.

  • significance of Erythema Nodosum and pyoderma gangrenosum in inflammatory bowel diseases a cohort study of 2402 patients
    2008
    Co-Authors: David Farhi, Nada Zizi, Philippe Seksik, Selim Aractingi, Laurent Beaugerie, Jacques Cosnes, Olivier Chosidow, Kiarash Khosrotehrani
    Abstract:

    : Erythema Nodosum and pyoderma gangrenosum are the most common cutaneous manifestations in inflammatory bowel diseases (IBD). We conducted the current study to assess the cumulative prevalence of Erythema Nodosum and pyoderma gangrenosum in patients with IBD and to appraise their association with demographic, clinical, and prognostic factors related to IBD. Between 2000 and 2005, data for all patients with IBD at our gastroenterology department were prospectively and systematically collected using a standardized protocol. Among 2402 patients (1521 diagnosed with Crohn disease [63.3%] and 744 with ulcerative colitis [31.0%]), 140 (5.8%) had at least 1 skin manifestation. The most frequent dermatologic symptoms were Erythema Nodosum (4.0%) and pyoderma gangrenosum (0.75%). In multivariate analyses, Erythema Nodosum was significantly and independently associated with a diagnosis of Crohn disease (p < 0.001), female sex (p < 0.001), eye and joint involvement (p < 0.001), and pyoderma gangrenosum (p < 0.0001). Among patients with Crohn disease, Erythema Nodosum was associated with isolated colonic involvement (p = 0.0001). Pyoderma gangrenosum was significantly and independently associated with black African origin (p = 0.003), familial history of ulcerative colitis (p = 0.0005), uninterrupted pancolitis as the initial location of IBD (p = 0.03), permanent stoma (p = 0.002), eye involvement (p = 0.001), and Erythema Nodosum (p < 0.0001). It is noteworthy that the association between pyoderma gangrenosum and permanent stoma persisted after exclusion of patients with peristomal pyoderma gangrenosum (p = 0.07). In conclusion, neither Erythema Nodosum nor pyoderma gangrenosum was significantly associated with the severity criteria in IBD; however, their occurrence may reflect a peculiar phenotype among affected patients.

  • Erythema Nodosum-like eruption as a manifestation of azathioprine hypersensitivity in patients with inflammatory bowel disease.
    2007
    Co-Authors: Anne-laure De Fonclare, Selim Aractingi, Kiarash Khosrotehrani, Jacques Cosnes, Paul Duriez, Laurent Beaugerie
    Abstract:

    BACKGROUND: Clinical manifestations of hypersensitivity to azathioprine may mimic symptoms of the initial disease. We report 5 cases of peculiar skin hypersensitivity reactions to azathioprine in patients with inflammatory bowel disease. OBSERVATIONS: In 5 patients with a recent azathioprine regimen, manifestations appeared between 8 and 18 days after drug introduction. All patients had a high fever. Three patients initially had Erythema Nodosum; 2 patients had sterile pustules. All had elevated neutrophil counts and serum C-reactive protein levels, whereas eosinophil counts were normal, ruling out drug-induced rash with eosinophilia and systemic symptoms. In 3 patients who were rechallenged with azathioprine or with 6-mercaptopurine, dermatological lesions recurred within hours. CONCLUSIONS: Erythema Nodosum and pustules are rarely reported manifestations of azathioprine hypersensitivity. Both skin lesions may be related to the clinical activity of inflammatory bowel disease. Relapse of such lesions shortly after thiopurine rechallenge should raise the hypothesis of hypersensitivity rather than pharmacological manifestations.

Jay S Keystone - One of the best experts on this subject based on the ideXlab platform.

  • severe refractory Erythema Nodosum leprosum successfully treated with the tumor necrosis factor inhibitor etanercept
    2011
    Co-Authors: Michele L Ramien, Alexander Wong, Jay S Keystone
    Abstract:

    Erythema Nodosum leprosum (ENL), or type II reaction, is a common complication of lepromatous leprosy that can cause significant patient debility. First-line therapy includes prednisone and thalidomide, with clofazimine reserved for patients who do not respond to first-line treatment. We present the case of a 33-year-old woman with ENL that failed to respond adequately to conventional therapy over a 6-year period. Because of the severe nature of her disease and the adverse effects of therapy that she experienced, a trial of etanercept was undertaken, which led to full resolution of her ENL. The rationale behind our choice of therapy and its future implications are discussed.

Laurent Beaugerie - One of the best experts on this subject based on the ideXlab platform.

  • significance of Erythema Nodosum and pyoderma gangrenosum in inflammatory bowel diseases a cohort study of 2402 patients
    2008
    Co-Authors: David Farhi, Nada Zizi, Philippe Seksik, Selim Aractingi, Laurent Beaugerie, Jacques Cosnes, Olivier Chosidow, Kiarash Khosrotehrani
    Abstract:

    : Erythema Nodosum and pyoderma gangrenosum are the most common cutaneous manifestations in inflammatory bowel diseases (IBD). We conducted the current study to assess the cumulative prevalence of Erythema Nodosum and pyoderma gangrenosum in patients with IBD and to appraise their association with demographic, clinical, and prognostic factors related to IBD. Between 2000 and 2005, data for all patients with IBD at our gastroenterology department were prospectively and systematically collected using a standardized protocol. Among 2402 patients (1521 diagnosed with Crohn disease [63.3%] and 744 with ulcerative colitis [31.0%]), 140 (5.8%) had at least 1 skin manifestation. The most frequent dermatologic symptoms were Erythema Nodosum (4.0%) and pyoderma gangrenosum (0.75%). In multivariate analyses, Erythema Nodosum was significantly and independently associated with a diagnosis of Crohn disease (p < 0.001), female sex (p < 0.001), eye and joint involvement (p < 0.001), and pyoderma gangrenosum (p < 0.0001). Among patients with Crohn disease, Erythema Nodosum was associated with isolated colonic involvement (p = 0.0001). Pyoderma gangrenosum was significantly and independently associated with black African origin (p = 0.003), familial history of ulcerative colitis (p = 0.0005), uninterrupted pancolitis as the initial location of IBD (p = 0.03), permanent stoma (p = 0.002), eye involvement (p = 0.001), and Erythema Nodosum (p < 0.0001). It is noteworthy that the association between pyoderma gangrenosum and permanent stoma persisted after exclusion of patients with peristomal pyoderma gangrenosum (p = 0.07). In conclusion, neither Erythema Nodosum nor pyoderma gangrenosum was significantly associated with the severity criteria in IBD; however, their occurrence may reflect a peculiar phenotype among affected patients.

  • Erythema Nodosum-like eruption as a manifestation of azathioprine hypersensitivity in patients with inflammatory bowel disease.
    2007
    Co-Authors: Anne-laure De Fonclare, Selim Aractingi, Kiarash Khosrotehrani, Jacques Cosnes, Paul Duriez, Laurent Beaugerie
    Abstract:

    BACKGROUND: Clinical manifestations of hypersensitivity to azathioprine may mimic symptoms of the initial disease. We report 5 cases of peculiar skin hypersensitivity reactions to azathioprine in patients with inflammatory bowel disease. OBSERVATIONS: In 5 patients with a recent azathioprine regimen, manifestations appeared between 8 and 18 days after drug introduction. All patients had a high fever. Three patients initially had Erythema Nodosum; 2 patients had sterile pustules. All had elevated neutrophil counts and serum C-reactive protein levels, whereas eosinophil counts were normal, ruling out drug-induced rash with eosinophilia and systemic symptoms. In 3 patients who were rechallenged with azathioprine or with 6-mercaptopurine, dermatological lesions recurred within hours. CONCLUSIONS: Erythema Nodosum and pustules are rarely reported manifestations of azathioprine hypersensitivity. Both skin lesions may be related to the clinical activity of inflammatory bowel disease. Relapse of such lesions shortly after thiopurine rechallenge should raise the hypothesis of hypersensitivity rather than pharmacological manifestations.

Nina Roth - One of the best experts on this subject based on the ideXlab platform.