[Treatment of Kaposi's sarcoma with dapsone].
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Biomedical subjects
Publications and source records attributed to B Christol.
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We have recently evaluated eight patients with an unusual genetic dermatosis that was characterized by the development of painful callosities at pressure points of soles, with tender yellowish-brown hyperkeratosis. These lesions are very painful: walking produced pain that was severe. The patients performing manual labor, in addition, had multiple callosities on the palms. Hyperhidrosis of the soles and palms was frequently present. Skin lesions were first noted in adolescence. There was no similar family history. There was no personal nor family history of hair, nail or dental disease. A biopsy was performed in one case and showed a simple hyperkeratosis similar to these observed in callosities. Classification of our cases is difficult. They are not similar to the entity named "hereditary painful callosities" by Roth et al. Review of the literature did not show similar cases. The patients received Etretinate (1 mg/day/kg). In all 8 cases, a dramatic improvement was obtained within seven days; the pain disappeared entirely and the patients were able to walk again without any pain. Then, the per-day dose was diminished without reappearance of the pain.
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Subjects afflicted with atopic dermatitis are particularly predisposed to such viral superinfections as verruca, herpes (eczema herpeticum) and vaccinia (eczema vaccinatum). Knowledge of superinfection by the molluscum contagiosum virus is more recent and the authors describe one case. The orf virus (responsible for ovine ecthyma contagiosum), however, has never been described as responsible for the profuse superinfection of an atopic eczema. The authors observed one case of this in a child, atypical as result of his age (16 months), the cervical localization and the aspect, which was a telangiectasic granuloma type of the initial element, and finally of the satellization observed one week later. This child suffered from a generalized atopic eczema. Propagation of the orf lesions could have been favored by scratching, local corticoid treatment and by the deficit in cellular immunity observed in patient with atopic dermatitis. Indeed, viral superinfections, which are unusual by their profusion or their chronic nature, are often observed in immunodepressed subjects.
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The authors present three familial cases of Schonfeld's type I pachyonychia. This syndrome represents the association of pachyonychia with palmoplantar keratodermia, frictionnal keratosis and bullae, hyperidrosis, oral leucokeratosis. This genotype is present in the remaining family. Traumatisms produce or increase several symptoms as: a) palmoplantar keratodermia: voluminous callus confined to site of pressure; b) hyperkeratosis of the nails, with hyperplasia and papillomatosis of the nail bed and the hyponychium due to the frequents microtraumatisms of the finger-pulps; c) oral leucokeratosis. The authors describe the painful character of the palmoplantar lesions: walking and working with the hands are very difficult. They assert the outstanding action of aromatic retinoid (RO 10.9359) which entertains a dramatic improvement of the palmoplantar and pachyonychia lesions, the decrease of the pain. Now, the patient life is normal. In these three cases, an hyperuricemia is associated: this feature is probably a fortuitous association. One of these patients has a Lesch-Nyhan's syndrome.
It appears justified to isolate under the term syndrome of Nicolau and Balus', a group of deformities that include eruptive syringomas of the disseminated micropapular type, milium cysts and atrophoderma vermiculata. We present here a highly typical observation of an 11-year-old child whose mother also presented with eruptive syringomas. This syndrome accentuates the semiological value of disseminated syringomas and atrophoderma vermiculata, which often occur in the context of a complex syndrome. In addition, an associated elastopathy was discovered by light- and electron-microscopic observations.
We describe two cases of acquired hyperpigmented macular eruption following pityriasis rosea. This condition is characterized by an eruption of discrete grayish macules on the trunk. On the back, the lesion are oval and their long axis follows the cutaneous liners. Similar features have been described by Runtova. The clinical type of this pigmented eruption is quite comparable to the cases recently described by Degos, Civatte and Belaïch under the title of "idiopathic eruptive macular pigmentation". Sometimes the "idiopathic" character of this pigmented eruption may be lacking, when a retrospective diagnosis of lichen planus or pityriasis rosea can be made. We think that the pigmentogenes pityriasis rosea should be included in the group of atypical pityriasis rosea. A survey of the literature allows to recognize some identical cases formerly reported under various titles. All these cases should be grouped together under the title of pigmentogenes pityriasis rosea.
A type of acne induced by vitamin B-12 deserves a special place among acneiform eruptions. The eruption is monomorphic and of a particular type. It consists of voluminous folliculitis lesions which develop acutely after the first injections of vitamin B-12 and disappear rapidly when treatment is discontinued. The etiologic and pathogenic mechanisms of the disease are not know.
Pseudoxanthoma elasticum can induce acne-like eruption. The lesions are located on the latero-cervical parts and consist of comedones, cysts and inflammatory nodules. Histologically, there are no transepithelial eliminations or follicultitis, but a very important granulomatosus tissue with epithelioid cells and a giganto-cellular reaction with elastotic fibres phagocytosis. These findings are different from the cases with association of P.X.E. and elastosis perforans, but they are closely related to it. We think that these features are of a very great interest for the dermatological practice.
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We report a very curious case of a condition which has never been described before. Its features are comparable but not quite identical with those of Christensen's saltpetre-induced PXE which the author considers to be an exogenous variety of pseudoxanthoma elasticum. Since our case appeared spontaneously without any accidental episode we prefer to designate it under the name 'localized PXE'. The chequered appearance of the lesions seems to be the characteristic feature of the disease.
The authors report 2 cases of atypical vitiligo in which they observed 1) "cockade-like" lesions resembling those of "trichrome" vitiligo (from the centre to the periphery, achromic area, hypochromic ring, normal or hyperchromic border), 2) numerous linear achromic lesions corresponding to former excoriations (Koebner's phenomenon, isomorphic phenomenon). Related affections are discussed with reference to these cases; the trichrome vitiligo described by Lerner and Fitzpatrick, and the primary leukomelanodermas described in black patients by Basset and by Sarrat and Nouhouayi.
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