[Failure of thalidomide treatment in a case of leprous erythema multiforme].
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Biomedical subjects
Publications and source records attributed to A Puissant.
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Acute epidermal necrosis is an exceptionally serious condition whose onset, which is sometimes preceded by a few prodomes, is marked by an eruption mainly around the orifices and rapidly extending to the whole of the tegument. Epidermal necrosis results in extensive shedding of the skin and within the space of a few hours gives the patient the appearance of having been scalded. In adults, drugs and in particular certain combinations of drugs, are responsible; the drugs mainly involved are the sulfonamides, especially delayed action sulfonamides, derivatives of butazolidine, Barbiturates, Phenindione and Penicillin. In children, on the other hand, acute epidermal necrosis is usually secondary to infection by a phase 2 coagulase positive staphylococcus aureus, this staphylococcus secreting an exotoxin which appears to act by breaking up the desmosomes. Treatment mainly consists of emergency resuscitation.
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Fourty-two cases of Dühring-Brocq disease were analysed clinically, histologically and with direct and indirect immunofluorescence. One could only discriminate between bullous pemphigoid and dermatitis herpetiformis when all those criteriors were studied together. 17 cases were clinically composite ; histological and immunofluorescent analyses differentiated between 16 cases of bullous pemphigoid and 1 case of dermatitis herpetiformis.
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The authors successively study the oral, peri-oral, esophageal, intestinal and anal manifestations of systemic scleroderma. They point out that dental, salivary, and esophageal involvement is of great interest for diagnosis and prognosis. They particularly describe the malabsorption syndrome including anatomical and ultrastructural lesions of the smooth muscle fibers. They present an original study of arrector pili in clinically and histologically non-involved skin of patients undergoing scleroderma. Finally they state that any suspected or diagnosed scleroderma needs a digestive check-up as follows: radiologic examination of the teeth, biopsy of the minor salivary glands of the lower lip, radiologic study of esophageal motility and radioactive C 14 glycocholate test.
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