Biomedical subjects
Publications and source records attributed to G Achten.
The authors report a new case of induced pemphigus: a 64-year-old man has had rheumatoid arthritis for 10 years. When he developed his pemphigus, he had been taking D-penicillamine and piroxicam for about 8 months. He needed high doses of prednisolone associated with azathioprine to clear his eruption. The case had a fatal outcome.
The authors show the noteworthy efficacy of the aromatic retinoid Ro 10-9359 in the treatment of ichthyosis linearis circumflexa. The initial dose was 1 mg/kg daily; later on, the maintenance dose was 0.3 mg/kg daily. Ultrastructurally, transitional cells were observed between the granular and the horny layer. After treatment, large perinuclear pseudovacuoles appeared, as well as numerous microvilli.
2 cases of cutaneous vasculitis associated with chronic hepatitis and mixed cryoglobulinaemia are reported. Further studies revealed in the first case hypocomplementaemia and glomerulonephritis. The cutaneous lesions of this patient responded dramatically to plasma exchange whereas prednisolone 20 mg/day and azathioprine 50 mg/day for 10 months showed no effect. The second case (chronic active hepatitis with acute colitis) responded well to prednisolone and azathioprine. The cutaneous lesions (vascularitis) may be the only clinical symptom of a chronic hepatitis and the study of those cases sometimes allows an early diagnosis of renal failure to be made.
Seborrhoeic dermatitis, psoriasis and atopic dermatitis in infants were studied morphologically and autoradiographically on skin biopsies. A similar picture with an increased germinative cell population and accelerated cell turnover has been found in psoriasis and seborrhoeic dermatitis. These features may suggest a relationship between both diseases.
The authors describe a new case of multiple cutaneous leiomyomata: a female patient aged 33 presents lesions in hundreds causing severe pain. The subjective symptoms are highly improved by the calcium antagonist nifedipine.
We have treated 48 cases of onychomycosis (of which 37 were caused by dermatophytes, 10 by yeasts and one by Scopulariopsis brevicaulis) with 200 mg ketoconazole daily. We obtained recovery in 65 p. 100 of the cases of onyxis caused by dermatophytes and in 80 p. 100 of the cases of onychomycosis due to Candida. The one patient presenting an infection with Scopulariopsis brevicaulis recovered in 13 months. The average duration necessary to obtain complete recovery was 6 1/2 months for onychomycosis of the hands due to dermatophytes and 12 1/2 months for those of the feet. Perionyxis due to Candida needed 2 months of treatment with this drug, however 6 months of treatment were necessary to obtain recovery for onycholysis due to Candida. Biological tests remained normal and the side-effects were minimal and essentially gastrointestinal in our study. Ketoconazole is an effective treatment for onychomycosis: it is active against the different mycotic agents infecting nails and well tolerated by the patient. Several minor effects such as itching, nausea, headache and more serious reactions such as erythrodermia and hepatitis have been reported. Regular control and biological tests are therefore necessary. Patients with other diseases should avoid the use of ketoconazole for treatment of onychomycosis.
Monoclonal antibodies were used to determine the level of circulating helper and suppressor T cells in 34 infants and adults with severe atopic dermatitis and in normal controls. The percentage of OKT3 (total T lymphocytes) was reduced significantly in all the atopic infants. The percentage of OKT8 (suppressor-cytotoxic T lymphocytes) was reduced significantly in all patients with active lesions. The percentage of T gamma lymphocytes was reduced in all the atopic patients with or without active lesions.
The authors present 2 cases of AIDS revealed by severe recurrent genital herpes simplex. The patients are 2 young, previously healthy, African women without histories of homosexuality or drug abuse. The first patient died after 5 months of follow-up (post mortem findings: viral bronchopneumonia with positive cultures for herpes and cytomegalovirus (CMV), viral colitis due to CMV). The second patient survived. She has been treated, during the last 11 months, for filariasis, buccal and vaginal candidiasis and cerebral toxoplasmosis.
A 14-month-old boy with neurofibromatosis and skin xanthomas associated with normal lipemia is described. Acute lymphocytic leukemia complication and its connection with the cutaneous disease are discussed.
The associations between skin conditions and malignant tumours are reviewed and classified in two groups: indirect associations (predisposing genetic factor or carcinogenic agent), and direct associations with parallel evolutions corresponding to the true paraneoplastic syndromes. Occasional associations are also mentioned. The cutaneous paraneoplastic syndromes can be classified according to their pathogenic mechanisms, although these are mostly hypothetical, allowing those of secretory, immunological, deficient and neurovascular origins to be distinguished.
A case of cat-scratch syndrome is described. The dermatological features and skin reactions reported in this illness (erythema nodosum, erythema multiforma) as well as the diagnostical criteria are reviewed. The hypothetical nature of the etiologic agent of this syndrome is discussed.
The atopic chronic dermatophytosis syndrome is uncommon in children. Clinical and immunological characteristics are reviewed. The infecting fungus is Trichophyton rubrum, occasionally Trichophyton interdigitale.
The authors propose a new case of Buschke- Ollendorff syndrome: a female patient aged 54 years presents 17 tumoral lesions out of which some are dermatofibromas and other elastomas . Deafness appeared 5 years after the cutaneous lesions and seems to be the result of a pathological condensation of petrous bones.
Explore the source record for details and available documents.
Aspergillus, which has a saprophytic life, is an opportunistic fungus and manifests his pathogenicity when a weakened state of the host facilitates its development. The conditions are particularly favorable in severely burned patients like the 54-year-old woman presented here. The criteria of pathogenicity of this opportunistic fungus, the incidence of epidemiology and prognosis of this type of infection and the clinical signs that allow an early diagnosis are discussed here.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.