[Blaschkitis in adults].
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Biomedical subjects
Publications and source records attributed to A Rebora.
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BACKGROUND AND DESIGN: The nucleolar organizer regions (NORs) are chromosomal loops of DNA to which acidic proteins are associated that are seen by silver staining as black dots within the nucleoli (hereafter, these silver-staining NORs will be referred to as AgNORs). As their size and number reflect cell and nuclear activity, their counting in paraffin sections is regarded as a useful tool for diagnosing and prognosing malignant tumors. We counted AgNORs in 98 patients with stage I melanoma, followed up to an average of 73 months, to verify whether the number of AgNORs is of prognostic value. RESULTS: The number of AgNORs averaged 2.792 +/- 0.901 in the 64 patients without metastases and 4.889 +/- 1.403 in the 34 with metastases. In patients with counts higher than 3.62, there was an 82% probability of metastases developing. CONCLUSION: The technique is fast, simple, and reproducible with easily available reagents and standard light microscopy. In our population, AgNOR counts constituted a more accurate prognostic indicator than Clark's level and Breslow's thickness. Confirmation in a new population is needed.
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In the past years seven new cutaneous mucinoses have been described. These are briefly reviewed and included in a revised classification of cutaneous mucinoses.
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Acral erythema (AE) and eccrine squamous syringometaplasia (ESS) are distinctive clinico-pathological entities described in patients receiving chemotherapy for malignancies, mainly myelogenous leukemia. In no case of chemotherapy-induced AE have histopathologic changes of ESS been described. We report a patient with acute myelogenous leukemia who had typical AE due to cytarabine with histopathologic ESS. The latter findings in a case of AE may be a useful diagnostic clue for distinguishing chemotherapy-induced AE from palmo-plantar erythema of graft-vs-host reaction.
Ninety-one patients with progressive systemic sclerosis have been examined both clinically and serologically in order to have a better prognostic insight. Three main serological profiles have been isolated. The patients with anticentromere antibodies (ACA) represented one third of the cases, developed skin sclerosis rather later and rarely exhibited ankyloses and ulcerations. The esophagus was commonly involved while the lung, heart and kidneys were not. ACA-positive patients were not identified with the CREST syndrome, as the latter disclosed other profiles with the same frequency. Patients with anti-Scl-70 antibody represented one fourth of the cases and had the fastest progression, developing sclerosis in less than 5 years after the onset of Raynaud's phenomenon. Ankyloses and lung fibrosis, as well as joint, heart and kidney involvement, were found in most of them. Patients with anti-SSA/Ro antibodies were uncommon, but corresponded to a severe subset, having a fast progression and a constant involvement of the lung. Probably due to the rougher definition of their serology, patients with antinuclear, antispeckle-patterned and anti-Ku antibodies or without any detectable antibody could be defined less easily and corresponded to an intermediate position between ACA- and anti-Scl-70-positive patients. Though it is probably premature to trust it completely, a serological classification may provide the prognostic clues clinical classifications cannot.
A patient with an unusual form of follicular impetigo, who later developed classical systemic lupus erythematosus (SLE) is described. When she had pyoderma, direct immunofluorescence and serology already suggested a connective tissue disease. Pyoderma could have been the presenting manifestation of SLE.
Patients with mood depression have been found to have a higher prevalence of seborrheic dermatitis (SD), possibly related to their tendency to live indoors. The prevalence of outpatients with SD has now been found to be directly related to the number of gloomy days in the area. Since UV light might not be the only reason for the well-known improvement in SD in summer, an explanation possibly related to melatonin is envisaged.
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