Lyme disease in Italy: first reported case.
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Biomedical subjects
Publications and source records attributed to F Crovato.
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Two middle-aged men with a cyclic eruption of transient urticarial papules of the face are described. Deposits of mucinous material were observed in cycstic spaces in their hair follicles. In direct immunofluorescence cells bearing IgE and C1q were found scattered in the dermis and were identified as mast-cells. Both patients experienced some relief of their disease in summer.
Skin biopsies from a subject affected by KS and AIDS were examined by means of EM. Samples were obtained both in correspondence of a typical nodule, and from an apparently normal area. The disease process had started at least 8 mo. before, and the patient showed a reduced number of OKT4 cells, with an inversion of the normal T4/T8 ratio. Besides that, high titre antibodies versus HTLV-III were present, whereas antibodies versus CMV and EBV were not demonstrable. Light and electron microscopy demonstrated the typical picture of KS, with marked proliferation of undifferentiated endothelial and spindle-like cells within a network of collagen fibers. Neoformed capillaries very rarely showed an organization comparable to small vessel of normal dermis. Retro-virus-like particles recalling the ones described in lymph-nodes of subjects affected by AIDS by Armstrong et al. (1984) were observed in the skin tissue obtained in correspondence of the Kaposi lesion; the same were either isolated or gathered in small groups within cytoplasmic vescicles. Similar particles were not evidenced in the tissue obtained from normal skin. The interpretation of morphological aspects requests of course a great caution. However the observation seems to be noteworthy, specially if one considers the demonstrated association between retro-virus of HTLV-III group and AIDS, and that its unusual frequency as well as the malignancy in an immunodepressed host are as yet poorly understood.
A patient with Richner-Hanhart syndrome had thigh skin grafted onto her heel in an attempt to improve her walking. The graft seemed to be spared by the hyperkeratosis that arrested at the periphery of the graft and formed a keratotic wall. A low-tyrosine, low-phenylalanine diet was effective in clearing hyperkeratosis.
The AA describe the first italian case of Lyme Disease in a middle aged woman: the patient developed after a tick bite the classical erythema chronicum migrans lesions and one month later an oligoarthritis. By indirect immunofluorescence assay it has been found a significant titre compatible with an infection by Borrelia burgdorferi, the causative agent of Lyme Disease.
A man displayed the acute inflammatory cutaneous manifestations and the late "incontinentia pigmenti-like" lesions of Conradi-Huenermann subgroup B of chondrodysplasia punctata. The case appears as unique in the literature in that, to our knowledge, both kinds of skin changes have been described only in newborns or early in infancy.
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A patient is described with the clinical and histopathological features of both Dowling-Degos disease and Kitamura's acropigmentatio reticularis. The possible identity of the two genodermatoses is discussed on the basis of the similarity of their clinical and histopathological features and of the presence of the two diseases in the family of the propositus.
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