[A case for diagnosis: polyp of the omphalomesenteric canal].
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Biomedical subjects
Publications and source records attributed to A Dompmartin.
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Acral erythema (AE) is a painful, erythematous bullous eruption of the palms and soles which is chemotherapy-induced. To the numerous chemotherapies which induce AE we must add, perhaps, a new drug, Vépéside. AE is followed by graft-versus-host-disease in all patients receiving bone marrow transplantation. AE and early GVH disease being very similar, we discuss the differential diagnosis which can be very difficult.
Psoriatic-onycho-pachydermo-periostitis is a particular form of psoriatic arthropathy recently described, which combine psoriatic onychosis, thickening of the distal soft tissues and osteo-periostitis of the distal phalanx without lesion of the interphalangeal joint. Biological examinations are normal. Radiological lesions show a phalanx condensation which gives a spicule aspect. Two cases of onycho-pachydermo-periostitis are described. We report the first one with all the fingers and toes concerned.
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Idiopathic polymorphous light eruptions (PLE) are photodermatites due to an as yet unidentified photosensitizing agent. Benign estival PLE is the most frequent form: the face is spared, and as soon as the patient has acquired a slight tan the eruption will no longer occur. Juvenile spring eruption affects the free border of the helix and may be regarded as a localized and mild form of estival PLE. Polymorphous light eruptions appear as lesions of the face which may resemble lupus erythematosus; photobiological exploration reproduces the lesions experimentally in 70% of the cases; immunohistochemistry studies are in favour of an immunological mechanism. Solar urticaria is a rare physical urticaria started by UVA, UVB and/or visible light: tolerance to sunlight can be induced by repeated exposures, but it does not last. Hydroa vacciniform is a rare PLE in children with leaves smallpox-like scars; photobiological exploration reproduces the lesions with high doses of UVA applied for 3 consecutive days. The remanent photosensitivity syndrome is characterized by an extreme photosensitivity which may be very disabling, preventing the patient to go outdoors; photo-allergological exploration discloses numerous positive patch-tests or photopatch-tests to various allergens, but the role played by these allergens in the occurrence of photosensitivity remains unclear. The syndrome probably results from an exogenous photosensitivity accident that has not regressed after exclusion of the presumably responsible photoallergens. Many treatments tested for these PLE seem to be effective, but they have not yet been controlled by double-blind trials.
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A case of Sweet syndrome in a patient with an acute myelomonocytic leukemia is reported. It is an unusual case simulating a facial erysipela. This case illustrates the difficulty in differentiating infection from Sweet syndrome in an immunocompromised patient. The negative cultures, ineffective antibiotics, and histopathologic examination results allowed the onset of corticosteroid therapy. The phagocytic function of the neutrophils studied by chemoluminescence was normal in the patient. The physiopathology of Sweet syndrome is discussed, in particular the role of cytokines in the accumulation of granulocytes.
Cystic chondromalacia is a clinical and histopathological entity which can be clearly distinguish from all other cystic lesions of the auricle. We report a case which was clinically asymptomatic and involved the scaphoid fossa of the anterior surface of the pinna. The pathological process consisted of degenerative changes of the auricular cartilage which produced a cavity containing a serous fluid. No etiologic factor was found, in particular no trauma. The posterior wall of the cyst was excised under local anesthesia. This case allowed us to review the clinical, histopathological features and surgical difficulties of this rare lesion.
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After briefly summing up the nosology of rhinophyma, the authors report their experience with the surgical correction of this nasal disease, on the basis of eight cases. They explain their reasons for giving up dermasection and preferring dermabrasion.
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The results of a study on onychomycosis in AIDS related complex and AIDS patients presenting for dermatology consultation at an infectious diseases department are reported. The clinical results showed that most patients presented a proximal white superficial onychomycosis. The association with a clinical interdigital involvement was rare, but the association with a mycotic plantar keratoderma was more frequent. The laboratory results showed that dermatophytes were the most frequent etiologic agents, especially Trichophyton rubrum (58%). Although most of these patients presented an oral candidiasis, Candida albicans was isolated only in seven patients' nails. Surprisingly, Pityrosporum ovale was the only etiologic organism that was found in two patients. This result was confirmed with a histologic examination.
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The authors are concerned with 16 recently operated cases, and express their renewed interest in vermilionectomy in the management of precancerous states affecting the vermilion, immediately followed by reconstruction with a mucous advancement flap. After describing the method, the authors stress the benefits afforded by the method from both oncologic and prophylactic viewpoints. Functional and esthetic results are excellent.
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A little girl who was suffering from chronic mucocutaneous candidiasis also had a cellular immune deficiency and undetectable IgA levels. She was treated continuously for 6 years with ketoconazole at the same dosage of 200 mg/day. She was rapidly clear from infection and did not relapse although her immune abnormalities persisted. During this long-term therapy, voluminous fusiform intracranial aneurysm appeared, causing a paresis of the four limbs. Are they mycotic aneurysms?