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Biomedical subjects

H Bergoend

Publications and source records attributed to H Bergoend.

At least 55 records · Page 3Linked to original sources

[Psoriasis: development and fatal complications].

In a retrospective study we tried to evaluate the number of severe psoriasis with a lethal outcome observed in France in a 20-year period from 1965 to 1985. Among 992 psoriatic in-patients on care during this period in the Dermatology Clinic of Strasbourg, 7 died of different complications directly related to the skin disease or its therapy; 39 further cases could be gathered through different departments of dermatology of France. Patients who died had generalized psoriasis (13 cases), psoriatic erythroderma (15 cases) and generalized pustular psoriasis (18 cases); 18 (39 p. 100) also had psoriatic polyarthritis. Circumstances leading to death (table I) were metabolic disorders, related to erythroderma in most cases, non-specific complications (infections, amyloidosis) or complications of specific treatments (methotrexate, etretinate, corticosteroids, mechlorethamine). A comprehensive review of the literature over a century showed that only 72 lethal psoriasis cases have been reported: this rather low number may be due to the fact that some rare pathologies, such as visceral amyloidosis (12 cases) (table III) and fatal complications of methotrexate therapy (38 cases) (table V), paradoxically are more often published than non-specific complications occurring in severe psoriasis, such as cardiovascular failure or cachexy in erythrodermic patients. However, the review of the literature shows, as our own inquiry, the poor prognosis of generalized pustular forms and of psoriasis-associated polyarthropathies: among 42 lethal cases where enough data were available, 23 (55 p. 100) had psoriatic polyarthritis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Solid facial edema associated with acne. Therapeutic efficacy of isotretinoin].

Persistent solid facial edema is considered a complication of acne vulgaris and has never been reported in the French literature. The authors report the cases of 2 patients, a 15-year old girl and a 20-year old man, who suffered from the condition for 1 and 2 years respectively. Clinical features and course are described. Treatment with isotretinoin in doses of 1 mg/kg/day administered during 6 and 8 months resulted in an 80 p. 100 and 50 p. 100 reduction of the edema respectively.

Acne Vulgaris↗

Sweet's syndrome associated with Crohn's disease.

The first known case involving an association of Sweet's syndrome with Crohn's disease is described. A 36-year-old woman developed a diarrhea, fever, and infiltrated erythematous cutaneous plaques on neck and limbs, consistent with a presumptive diagnosis of Sweet's syndrome. This was confirmed by a skin biopsy showing a dense dermal infiltrate of polymorphonuclear leukocytes. Crohn's disease, extending from the anus to the terminal ileum, was diagnosed as well. Prednisolone treatment resulted in the improvement of both the bowel disease and skin lesions.

Adult↗

[Intravascular malignant lymphoma (malignant angioendotheliomatosis). Apropos of a case with histologic, immunohistochemical and ultrastructural studies].

We report a new case of intravascular malignant lymphoma that arose in an 81-year-old woman. The most prominent symptoms were impressive dermatologic anomalies including painful, diffuse edema over which arborescent telengiectasic lesions could be seen. This clinical picture was associated with the presence, in deep skin biopsy specimens, of mononucleate tumor cells located within the lumen of dermal vessels. Complementary immunohistochemical and ultrastructural studies confirmed that the intravascular tumor growth was lymphomatous in nature. Clinical manifestations of this disease are recalled, and histopathologic features as well as the characteristic location of this malignant lymphoma are analyzed and discussed. Thus, we agree with Félix [3] and Witschi [6] that the cords of cells that will give rise to the follicular cells surrounding the ovocytes originate only from the coelomic epithelium; the primary mesenchyma forms the cortical stroma, and this embryonic type tissue, characterized by enourmous physiologic plasticity, differentiates into endocrine tissue to form the inner theca. the mesonephros plays no part whatsoever in the formation of the ovary.

Aged↗

Roxithromycin in skin and soft tissue infections.

In a double blind randomised investigation in 76 patients, roxithromycin (150 mg bd) and doxycycline (200 mg once daily) were compared in two groups of patients who were well-matched for age, sex, body weight, diagnosis, duration and severity of disease and associated pathological conditions, with infected skin conditions. Clinical effectiveness was 92% for roxithromycin and 82% for doxycycline, and bacteriological effectiveness also 92% and 82% respectively, the differences not being statistically significant.

Aged↗

[Cutaneous manifestations of zinc deficiency in ethylic cirrhosis].

Thirty-three patients with alcoholic cirrhosis (AC), selected on widely recognized criteria (16, 57), were investigated prospectively for cutaneous manifestations of zinc deficiency. The patients were divided into 3 groups: group A (n = 12): AC without skin lesions; group B (n = 12): AC with skin lesions responsive to a zinc-free topical treatment or resistant to enteral zinc sulfate intake; group C (n = 9): AC with skin lesions cured by oral zinc replacement therapy alone. The lesions observed in group C were studied microscopically. Data concerning zinc metabolism (Zn concentrations in plasma, red cells, urine and hair; alkaline phosphatase values), biochemical criteria of AC (plasma serum-albumin concentration, IgA/transferrin ratio) and a malabsorption test (xylosemia 120 min after oral absorption of D-xylose 25 g) were compared by the variance analysis method. A control group (D, n = 12) was used as reference. Few cases of cutaneous manifestations of zinc deficiency in AC patients have been published. In more than one half of the 15 or so we found in the literature, an aggravating factor (total parenteral nutrition, digestive tract surgery) had to be taken into account. In this prospective study 9 new cases in which AC was the only cause of zinc deficiency are reported. A clinical picture similar to acrodermatitis enteropathica with peribuccal bullous lesions was observed in only one patient. In all other cases the patients presented with a cracked and reticulated eczema on the extensor aspect of the limbs and (often erosive) in the perianal and genital regions. The eczema was associated with cheilitis, glossitis, stomatitis, alopecia and, seldom, ungual Beau's lines. Disorders of behaviour, diarrhoea and bouts of lever regressing under zinc replacement therapy were frequent. Histology was not very specific, except for the presence of necrotic areas in the stratum germinativum, sometimes associated with small subcorneal pustules containing altered polymorphonuclears. In every case, it was the rapid regression of symptoms under zinc sulfate treatment that confirmed the diagnosis. Plasma zinc concentrations were most significantly decreased in all AC groups as compared to controls (61.2 +/- 19.4 vs 97.8 +/- 10.4 micrograms/100 ml) and also in AC patients with skin manifestations of zinc deficiency as compared to the other AC patients (44.4 +/- 9.2 vs 66.5 +/- 18.8 micrograms/100 ml) table V). Changes in serum-albumin levels and in hepatocellular function were parallel to changes in plasma zinc concentrations.(ABSTRACT TRUNCATED AT 400 WORDS)

Acute Disease↗

[Lasers in dermatology].

Lasers are mainly used in therapeutics for their thermic effects. In dermatology, the most appropriate is the argon laser and its only uncontroverted indication is part-wine stain. The blue-green radiations of the argon laser are selectively absorbed by the haemoglobin pigment, so that coagulation necrosis is maximum in the dysplastic vessels. Since the non-pigmented surrounding tissues and, more precisely, skin appendages are relatively respected, healing is rapid and of good quality. Following the often protracted treatment, a satisfactory downgrading of colour is obtained, without scar in 60-80% of cases. The best results are observed in dark portwine stains located on the face or trunk in adults. All other indications are open to discussion since the superiority of laser over other treatments remains to be demonstrated or confirmed. Interesting indications are spider angioma and telangiectasis of the face (argon laser), extensive ano-genital verrucosis (CO2 laser or argon laser), mucosal leukoplasia and some cases of Bowen's disease affecting the genitalia.

Argon↗

[Dermatomyositis and colonic cancer. Review of the literature apropos of a case].

The authors report the case of a 56 year-old woman presenting with dermatomyositis revealing a cancer of the colon at the ganglial dissemination stage. Exeresis led to the regression of the dermatomyositis and allowed an attenuation of the steroid therapy. The muscular and cutaneous signs reappeared within six months, evidencing a metastatic hepatic dissemination. Death came within six months of the appearance of the dermatomyositis. The authors review the literature concerning dermatomyositis associated with cancers of the digestive tract in general, and of the colon in particular. This association is found in about 6 to 35% of cases of dermatomyositis, which is the most common paraneoplastic skin associated with cancers of the colon.

Colonic Neoplasms↗

Basal cell carcinoma overlying histiocytofibroma.

A case of basal cell epithelioma overlying a long-standing histiocytofibroma is presented. The association of these two tumors is a rare finding. The role of dermal factors in the pathogenesis of epidermal tumors is briefly discussed, just as the controversy about the reactive or neoplastic nature of the epidermal change.

Basal Cell Carcinoma↗

[Vesicles].

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Adolescent↗

[Laser in dermatology: biological effects; indications (author's transl)].

The various laser-systems can be classified according to: 1) the wavelength or range of wavelengths of the beam and 2) the method of delivery of the laser output: continuous or pulsed. -- Principal continuous-wave lasers are: -- the argon-ion laser, which produces multiple transitions ranging from 448 to 544 nm, -- the neodymium yttrium aluminium garnet (Y. A. G.) operating in the near infrared at a wavelength of 1,060 nm, -- and the carbon-dioxide laser with its output occurring in the far infrared, at 10,600 nm. Continuous-wave lasers induce essentially thermal effects which are used to coagulate or volatilize various superficial skin lesions. But when high power density is required, the relative benefit of lasers as compared with other conventional thermal devices (such as high-frequency electrocoagulator) is not obvious. On the other hand, the argon laser is capable of selectivity damaging pigmented cutaneous lesions with satisfactory healing of the laser wound and sparing of the overlying skin. This selective absorption is useful in the treatment of some vascular lesions such as port-wine stain or melanotic lesions or tattoos, and gives a good results. The specific color absorption is not so pronounced with the Nd-YAG laser and is absent with the carbon dioxide laser, chiefly used as an "optical scalpel". Photochemical effects produced by other continuous-wave lasers such as U.V. lasers, seem to be of interest in photobiology research and in destruction of tumors after the addition of a colorant. -- Pulsed laser systems produce not only thermal but also "non-linear" reactions, which are not well-known. The classical ruby laser is still appropriate in the treatment of some skin lesions.

Humans↗

Malignant melanoma and histiocytofibroma.

In patients with malignant melanoma, histiocytofibromas often appeared to be present. The frequency of this association has been determined in 60 female and 40 male patients, and compared with age- and sex-matched controls. Histiocytofibromas are significantly more common in females with malignant melanoma than in controls. This relationship is not found in males. Therefore, it would seem important to make a careful examination of nevocytic nevi in women having this benign tumour because of the high risk of developing a malignant melanoma.

Adolescent↗