Revue Francaise d Allergologie最新文献

{"title":"Au service de la lutte contre l’ambroisie : la plateforme signalement ambroisie","authors":"S. Monnier","doi":"10.1016/j.reval.2025.104261","DOIUrl":"10.1016/j.reval.2025.104261","url":null,"abstract":"<div><h3>Prérequis/Contexte</h3><div>L’ambroisie à feuille d’armoise est une plante annuelle originaire d’Amérique du nord. Depuis son apparition en France, au milieu du XIX^e siècle, cette plante invasive s’est multipliée et colonise de nombreux territoires et plus particulièrement la région Auvergne-Rhône-Alpes. Le pollen de l’ambroisie est un des plus allergisants, il suffit de quelques grains de pollen pour que les symptômes apparaissent.</div></div><div><h3>Objectifs</h3><div>Face à un tel enjeu de santé publique, l’ARS Auvergne-Rhône-Alpes, la Région AURA et le RNSA ont lancé en 2014 une plateforme interactive « Signalement-Ambroisie » qui est devenue nationale en 2016 et permet d’impliquer chacun dans la lutte contre l’ambroisie.</div></div><div><h3>Méthodes</h3><div>Signalement-Ambroisie c’est une démarche simple en trois étapes qui permet à chacun d’être acteur de la lutte contre l’ambroisie. La plateforme interactive Signalement Ambroisie permet de réaliser des signalements par différents canaux : - site internet <span><span>www.signalement-ambroisie.fr</span><svg><path></path></svg></span>, - application mobile Signalement Ambroisie, - email [email protected] - téléphone 0 972 376 888. Les signalements effectués sont transmis « en direct » à la commune ou au référent ambroisie concerné qui coordonnera les actions de lutte nécessaires pour éliminer l’ambroisie.</div></div><div><h3>Résultats/Discussions</h3><div>Cette plateforme, permet chaque année le recensement et l’arrachage de plusieurs milliers de plants d’ambroisie. Le signalement est à la base du traitement, qui sera le gage de la destruction de la plante avant la grenaison. Seule une action de cette envergure, répétée année après année, permettra de limiter l’expansion de la plante et de voir la diminution de son aire d’implantation.</div></div><div><h3>Conclusion</h3><div>Signalement ambroisie est pour les acteurs de terrain un outil de gestion dynamique de la présence de l’ambroisie sur leur territoire (repérage, suivi…). Pour le grand public Signalement Ambroisie permet à chacun d’être acteur de la lutte et représente un support de communication positif. Enfin, pour les « superviseurs » de la lutte contre l’ambroisie, Signalement Ambroisie permet de collecter des données de présence d’ambroisie à grande échelle pour alimenter la cartographie de densité de la plante.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 ","pages":"Article 104261"},"PeriodicalIF":0.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chloroquine-induced erythema multiforme-like rash in a rheumatoid arthritis patient: A clinicalpresentation and management","authors":"A.N. Jha ,&nbsp;V.R. Gaikwad","doi":"10.1016/j.reval.2025.104257","DOIUrl":"10.1016/j.reval.2025.104257","url":null,"abstract":"<div><h3>Background</h3><div>Chloroquine (CQ), a synthetic 4-aminoquinoline, has been widely used since its introduction in 1947 for the prevention and treatment of <em>Plasmodium falciparum</em> malaria. Its mechanism of action involves disrupting the parasite's ability to detoxify heme. Beyond its antimalarial role, chloroquine is frequently prescribed for autoimmune disorders such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) due to its immunomodulatory effects. Despite its inclusion in the WHO's List of Essential Medicines for its affordability and efficacy, chloroquine is associated with adverse effects, including gastrointestinal disturbances, headaches, skin rashes, cardiotoxicity, retinal damage, and hepatotoxicity. Long-term use may also result in neuromuscular, neuropsychiatric, and renal complications, requiring careful monitoring, particularly in vulnerable populations.</div></div><div><h3>Case</h3><div>A 48-year-old male, diagnosed with rheumatoid arthritis based on clinical and laboratory findings, was started on chloroquine 250<!--> <!-->mg daily, folic acid 5<!--> <!-->mg weekly, and paracetamol for symptom relief. After 15 days of therapy, the patient developed a progressive erythematous rash with maculopapular and targetoid lesions primarily affecting the hands, forearms, and trunk. A skin biopsy revealed histopathological features indicative of a drug-induced hypersensitivity reaction, including spongiosis, epidermal necrosis, and perivascular lymphocytic infiltration with eosinophils. Following the confirmation of a chloroquine-induced hypersensitivity reaction, the drug was discontinued, and the patient was treated with prednisolone 20<!--> <!-->mg daily and omeprazole 20<!--> <!-->mg twice daily. The rash resolved within days of initiating treatment.</div></div><div><h3>Conclusion</h3><div>This case highlights a rare but significant dermatological adverse effect of chloroquine, manifesting as an erythema multiforme-like hypersensitivity reaction. Early recognition and prompt discontinuation of the offending agent, coupled with appropriate symptomatic management, are critical to patient recovery. Clinicians must remain vigilant for such adverse reactions, particularly in patients prescribed chloroquine for autoimmune conditions like RA.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 4","pages":"Article 104257"},"PeriodicalIF":0.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143679660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmaciens et auto-injecteurs d’adrénaline : évaluation et optimisation des pratiques","authors":"S. Jégu ,&nbsp;C. Rochefort-Morel ,&nbsp;B. Le Daré ,&nbsp;M. Mercerolle ,&nbsp;G. Pouessel ,&nbsp;E. Renard","doi":"10.1016/j.reval.2025.104540","DOIUrl":"10.1016/j.reval.2025.104540","url":null,"abstract":"<div><h3>Aim of the study</h3><div>Adrenaline auto-injectors (AAIs) are the first-line emergency treatment for anaphylactic reactions in community practice. Community pharmacists play a crucial role in ensuring the proper use of these treatments by patients. The aim of this study is to evaluate the information provided to patients during the dispensing of AAIs in pharmacies.</div></div><div><h3>Patients and methods</h3><div>An 18-item questionnaire created on Google Forms® was sent to 956 pharmacies in Brittany (France) electronically via the Regional Council of Pharmacists from 26/10/23 to 30/11/23, including a reminder.</div></div><div><h3>Results</h3><div>A total of 105 (11%) pharmacists responded to the questionnaire, and 33 (31.4%) reported knowing how to use all four AAIs available in France. Only 11 (10.5%) pharmacists mentioned all the symptoms that justify the administration of an AAI, and 27 (26%) reported systematically providing explanations when dispensing. When information is provided, 96 (91%) pharmacists specify that the injection should be administered in the anterolateral thigh, and 43 (41%) mention the recommended injection duration. Storage instructions at room temperature are explained to patients by 90 (86%) pharmacists. Finally, 66 (63%) pharmacists reported difficulties in obtaining AAI supplies.</div></div><div><h3>Conclusion</h3><div>The quality of information provided by community pharmacists during the dispensing of AAIs could be optimized. Hands-on device workshops and simulations are potential areas for improvement in pharmacists’ initial and/or continuing education.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 4","pages":"Article 104540"},"PeriodicalIF":0.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143679003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Allopurinol-induced Dress syndrome complicated with pancreatitis and ascites: Always look beyond the skin","authors":"M. Khallouki,&nbsp;L. Bendaoud,&nbsp;F. Zeroual,&nbsp;M. Aboudourib,&nbsp;O. Hocar,&nbsp;S. Amal","doi":"10.1016/j.reval.2025.104254","DOIUrl":"10.1016/j.reval.2025.104254","url":null,"abstract":"<div><div>A 54-year-old male patient with a history of hypertension for the past two years was admitted to the dermatology department with pruriginous maculopapular skin rash, facial edema, and fever after the initiation of allopurinol for hyperuricemia six weeks previously. Dermatological examination revealed generalized erythema with scales, facial edema, cheilitis, and lymphadenomegaly. Laboratory tests showed eosinophilia at 2850/mm³, increased liver enzymes (alanine aminotransferase at 821<!--> <!-->UI/L, aspartate aminotransferase at 258<!--> <!-->UI/L, alkaline phosphatase at 278<!--> <!-->UI/L), functional renal failure with creatinine at 74.59<!--> <!-->mg/dL, and increased pancreatic lipase enzyme at 508<!--> <!-->U/L. Abdominal sonography revealed normal renal size and a low-abundance ascites. The diagnosis of Dress syndrome was confirmed based on the diagnostic criteria of the RegiSCAR group. The incriminating drug was interrupted, and the patient received topical treatment, oral corticosteroids at a dose of 1<!--> <!-->mg/kg/day, and supportive care, including rehydration. Clinical and biological remission was achieved. DRESS syndrome is a serious adverse drug reaction. Hepatitis is one of the most frequent visceral manifestations, while pancreatitis occurs in<!--> <!-->&lt;<!--> <!-->5% of cases. Allopurinol-induced DRESS syndrome is associated with significant mortality due to systemic manifestations. Judicious use of allopurinol for accepted indications is the only way to decrease the incidence and morbidity caused by allopurinol-induced Dress syndrome.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 4","pages":"Article 104254"},"PeriodicalIF":0.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143679659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug reaction with eosinophilia and systemic symptoms syndrome to non-steroidal anti-inflammatory drugs: A report of case series and literature review","authors":"M. Daldoul ,&nbsp;O. Charfi ,&nbsp;F. Zgolli ,&nbsp;K. Ferchichi ,&nbsp;G. Lakhoua ,&nbsp;S. Kastalli ,&nbsp;R. Daghfous ,&nbsp;A. Zaiem ,&nbsp;I. Aouinti ,&nbsp;S. El Aidli","doi":"10.1016/j.reval.2024.104221","DOIUrl":"10.1016/j.reval.2024.104221","url":null,"abstract":"<div><h3>Introduction</h3><div>DRESS syndrome is a rare, severe cutaneous adverse reaction that has been exceptionally described with NSAIDs. The objective of our study was to investigate the clinical, paraclinical, and epidemiological characteristics of DRESS syndrome associated with NSAIDs and to identify the implicated molecules.</div></div><div><h3>Patients and methods</h3><div>A retrospective descriptive study that included all cases of DRESS syndrome occurring with NSAIDs and reported over a 10-year period. Records were analyzed according to the RegiSCAR criteria for the diagnosis of DRESS and the French imputability method.</div></div><div><h3>Results</h3><div>We included 7 cases, with a female-to-male ratio of 1.33. The age of patients ranged from 18 to 75 years, with a mean of 55 years. The time to onset varied from 4 to 30 days, with a mean of 12 days. A fever equal to or greater than 38.5<!--> <!-->°C was observed in 5 patients. All patients had skin involvement, mainly in the form of a maculopapular rash in 6 cases and erythroderma with glossitis in one case. Hypereosinophilia was found in 4 out of 7 patients. Hepatic involvement was observed in 4 patients, associated with renal involvement in 2 cases. One patient had isolated renal involvement. The NSAIDs implicated in DRESS syndrome in our patients were diclofenac, piroxicam, ketoprofen, and celecoxib.</div></div><div><h3>Conclusion</h3><div>Our study highlights the rarity and potential severity of DRESS syndrome associated with NSAIDs, due to systemic involvement. Clinicians should be vigilant about the possibility of DRESS syndrome with NSAID use, in order to promptly discontinue the implicated drug and ensure rapid management.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 4","pages":"Article 104221"},"PeriodicalIF":0.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143679657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prise en charge des allergies professionnelles dans les services de prévention en santé au travail dans le département des Bouches-du-Rhône : enquête de satisfaction auprès des médecins du travail et proposition d’un projet innovant","authors":"M. MENDIL","doi":"10.1016/j.reval.2025.104539","DOIUrl":"10.1016/j.reval.2025.104539","url":null,"abstract":"<div><h3>Aim of the study</h3><div>To study the preventive management of employees exposed to the risk of occupational allergy and occupational physicians’ satisfaction in the Bouches-du-Rhône department. The secondary objective was to study occupational physicians’ interest in an innovative project to set up an occupational allergy unit within the occupational health prevention department.</div></div><div><h3>Patients and methods</h3><div>Descriptive, cross-sectional epidemiological study including occupational physicians working in an occupational health prevention service in the Bouches-du-Rhône who responded to the questionnaire.</div></div><div><h3>Results</h3><div>According to the 50 occupational physicians who took part in the study, the preventive management of occupational allergies in their department was judged to be in need of improvement (88%, i.e. 44 of occupational physicians). Primary prevention (<em>n</em> <!-->=<!--> <!-->37 or 74%) is most concerned along with secondary prevention (<em>n</em> <!-->=<!--> <!-->33 or 66%). Tertiary prevention was considered to be improvable to a lesser extent (<em>n</em> <!-->=<!--> <!-->24 or 48%). The majority of occupational physicians (<em>n</em> <!-->=<!--> <!-->32 or 64%) believe that the presence of this unit would be beneficial in improving the management of occupational allergies within their occupational health department.</div></div><div><h3>Conclusion</h3><div>A majority of occupational physicians consider that practice can be improved, mainly in terms of primary and secondary prevention. The high level of support for the innovative project among occupational health physicians justifies its creation within the occupational health prevention department. In the future, the project will be evaluated to prove its usefulness and relevance.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 3","pages":"Article 104539"},"PeriodicalIF":0.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of biological agent use on symptoms in patients diagnosed with NSAID-Exacerbated Respiratory Disease (NERD)","authors":"H. Çelik Tuğlu,&nbsp;K. Aksu,&nbsp;O. Telli,&nbsp;F. Dindar Çelik,&nbsp;M. Yağdıran,&nbsp;Ö. Akkale,&nbsp;G. Köycü Buhari,&nbsp;S.N. Bahçecioğlu,&nbsp;G.T. Vural Solak","doi":"10.1016/j.reval.2024.104219","DOIUrl":"10.1016/j.reval.2024.104219","url":null,"abstract":"<div><h3>Introduction</h3><div>In recent years, biological approaches targeting Type 2 cytokines have emerged as potential treatment options in NSAID-Exacerbated Respiratory Disease (NERD) patients. In this study, we aimed to evaluate the clinical efficacy of omalizumab and mepolizumab in NERD patients with severe asthma via nasal and respiratory symptoms, pulmonary functions and exacerbation status.</div></div><div><h3>Methods</h3><div>The study was conducted retrospectively in adults with NERD who were initiated on omalizumab and mepolizumab and had been treated with a biologic agent for at least 1 year. Data on lung function test results, eosinophil counts, asthma exacerbation rates, asthma control levels, and Sino-Nasal Outcome Test-22 scores before starting the biological agent were compared with data obtained 1 year after starting the biological treatment.</div></div><div><h3>Results</h3><div>The study included data from 18 NERD patients, 10 of whom received omalizumab and 8 of whom received mepolizumab. In the NERD group receiving omalizumab, statistically significant changes were observed in terms of clinical improvement in FEV1 values, mean eosinophil counts, annual exacerbation rates, asthma control and SNOT-22 scores after biologic treatment. In patients receiving mepolizumab, significant decreases were found in mean eosinophil counts, annual exacerbation rates and SNOT-22 scores after biologic treatment compared to pre-treatment. Daily oral corticosteroid requirements were significantly reduced in patients receiving both omalizumab and mepolizumab.</div></div><div><h3>Conclusion</h3><div>In conclusion, the present study results reveal that both omalizumab and mepolizumab treatments are effective in controlling nasal symptoms, reducing the number of asthma exacerbations, and reducing the need for low-dose maintenance steroids in severe asthmatics with NERD.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 4","pages":"Article 104219"},"PeriodicalIF":0.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143679656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Yellow mealworm (Tenebrio molitor): A rare cause of chronic urticaria","authors":"D. Tekcan,&nbsp;I. Kulhas Celik,&nbsp;H. Artac","doi":"10.1016/j.reval.2025.104255","DOIUrl":"10.1016/j.reval.2025.104255","url":null,"abstract":"<div><div>This report presents a unique case of chronic urticaria (CU) caused by a food allergy to mealworm. A 10-year-old boy experienced daily itchy urticarial rashes for three months, accompanied by swelling, especially in the morning. Despite high-dose second-generation antihistamines, montelukast, a hypoallergenic diet, and intermittent steroids, symptoms persisted. Routine investigations, including hemogram, thyroid function tests, and autoantibodies, were normal. Total IgE level was elevated (715<!--> <!-->kU/L), but skin prick tests showed no sensitivities. Component-resolved diagnosis revealed a reaction to yellow mealworm (<em>Tenebrio molitor</em>, 0.53<!--> <!-->kUA/L). Investigation uncovered daily bread consumption prepared from flour stored in non-heat-resistant sacks, where mealworms proliferated. Symptom resolution followed dietary elimination of contaminated flour, enabling treatment tapering. <em>Tenebrio molitor</em> thrives in high-temperature storage and is increasingly used as a protein source. Cross-reactivity with shrimp allergens is documented. This case highlights the role of environmental factors in CU and the utility of component-resolved diagnostics. Identifying yellow mealworm as a rare CU cause emphasizes the importance of comprehensive evaluation in persistent cases.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 3","pages":"Article 104255"},"PeriodicalIF":0.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food allergy in adults. Is there a difference between HIV and non-HIV patients?","authors":"R. Cohen ,&nbsp;S. Nemet ,&nbsp;K. Mahlab-Guri ,&nbsp;L. Kadar ,&nbsp;I. Asher ,&nbsp;S. Rosenberg-Bezalel ,&nbsp;D. Elbirt","doi":"10.1016/j.reval.2025.104252","DOIUrl":"10.1016/j.reval.2025.104252","url":null,"abstract":"<div><h3>Background</h3><div>Human Immunodeficiency Virus infection is known to cause significant immunological changes, including a shift towards a Th2-dominant immune response, which is typically associated with allergic conditions. However, the relationship between HIV infection and the incidence of food allergies remains unclear.</div></div><div><h3>Objective</h3><div>This study aims to investigate the incidence of food allergies in HIV-infected patients compared to a non-HIV population.</div></div><div><h3>Methods</h3><div>This retrospective cohort study utilized observational data including individuals diagnosed with HIV between 2004 and 2023. A control group matched for age and sex (1:60) was created from non-HIV individuals. Data on allergic conditions were extracted using ICD9 codes, and statistical analyses were conducted using Cox proportional hazards models to assess the effect of HIV on food allergy incidence over a 10-year follow-up period.</div></div><div><h3>Results</h3><div>The study included 1616 HIV-positive patients and 95,773 controls. While higher rates of asthma and atopic dermatitis were observed in the HIV group, no cases of food allergy were detected among HIV patients, compared to 185 cases in the non-HIV cohort. The adjusted hazard ratios indicated that factors such as asthma, atopic dermatitis, vitamin D insufficiency, and kidney transplantation were associated with increased food allergy risk in the non-HIV population.</div></div><div><h3>Conclusion</h3><div>Despite the Th2-dominant immune environment associated with HIV infection, no increased risk of food allergy was observed in HIV-positive individuals over a 10-year period. This suggests that the immunological alterations caused by HIV may not predispose patients to food allergies as they do to other allergic conditions.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 3","pages":"Article 104252"},"PeriodicalIF":0.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Évolution fatale liée à l’abus de dermocorticoïdes chez un adulte","authors":"S. Ait Oussous ,&nbsp;I. Lakhal ,&nbsp;M. Hamaichat ,&nbsp;I. Damoune ,&nbsp;F. Ajdi ,&nbsp;R. Chakiri","doi":"10.1016/j.reval.2024.104220","DOIUrl":"10.1016/j.reval.2024.104220","url":null,"abstract":"<div><h3>Introduction</h3><div>Topical corticosteroids are widely used in the management of chronic inflammatory dermatoses with impaired skin barrier, such as atopic dermatitis and psoriasis. However, their long-term use can lead to systemic effects due to percutaneous absorption. We report a case illustrating the severity of complications associated with excessive use of these medications.</div></div><div><h3>Observation</h3><div>A 32-year-old woman had been under follow-up for a dermatologic condition with a relapsing-remitting course, evolving since the age of 3. She was initially treated with a high-potency topical corticosteroid, which led to good improvement. However, she continued self-administering topical corticosteroids for 22<!--> <!-->years. She presented with erythroderma characterized by desquamation, edema, and erosions in some areas. The clinical presentation, along with excessive use of betamethasone, suggested iatrogenic Cushing's syndrome. Laboratory tests revealed corticotropic adrenal insufficiency. A skin biopsy confirmed the diagnosis of atopic dermatitis. Management included treatment of fungal, infectious, and metabolic complications. Hydrocortisone was initiated, and after education, topical corticosteroids were replaced with topical tacrolimus. The patient was lost to follow-up and succumbed to adrenal insufficiency one month later.</div></div><div><h3>Conclusion</h3><div>This case highlights the severity of iatrogenic complications secondary to misuse of topical corticosteroids and underscores the need for proper therapeutic education and adequate follow-up.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 4","pages":"Article 104220"},"PeriodicalIF":0.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143679658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}