Biomedical subjects
Publications and source records attributed to J Bazex.
Focal epithelial hyperplasia (FEH) of the oral mucosa occurring in a HIV-infected man is described. Molecular biology disclosed an HPV-32 type in oral lesions. The association of FEH and AIDS is uncommon although many HPV subtypes may manifest during HIV infection.
A 7-year-old Caucasian girl developed lipoatrophic areas on the abdomen and left thigh. Laboratory tests showed a partial IgA deficiency, circulating autoantibodies (ANAs, double- and single-stranded anti-DNAs, rheumatoid factor). The clinical aspect resembles lipodystrophia centrifugalis abdominalis infantilis, but autoimmune abnormalities suggest connective tissue panniculitis which underlines the overlap between the different forms of localized lipoatrophias.
INTRODUCTION: Transdermal administration of drugs to obtain a systemic effect may lead to allergic sensitization and compromise subsequent use via another administration route. OBSERVATION: A 52-year-old woman presented contact eczema with the transdermal therapeutic system Estraderm TTS50. Generalized eczema developed later after oral administration of an oestrogen derivative. Skin tests demonstrated allergic sensitization to 17 beta-oestradiol. DISCUSSION: Contact eczema due to transdermal therapeutic systems are usually caused by agents other than the active drug. Sensitization to the active drug raises the risk of generalized eczema and subsequent systemic complications. This risk must be taken into account when prescribing substitution hormone therapy for menopause.
INTRODUCTION: Skin reactions after vitamin K injections are uncommon and only seen with vitamin K1 (phytomenadione). Possible association with liver disease is debated. The pathophysiological mechanism would be related to hypersensitivity to phytomenadione. CASE REPORT: Two new cases of hypersensitivity reactions at the point of vitamin K1 injection are reported. Neither of the patients had liver disease. DISCUSSION: Injectable vitamin K1 can cause skin reactions whatever the dose and mode of injection. Two clinical presentations have been described: an acute eczematous aspect and a late onset sclerous and atrophic form. The first cases of hypersensitivity to vitamin K were reported in patients with liver disease. Several recent publications did not find such an association. Our two observations would confirm this hypothesis. The pathophysiological mechanism of the acute form would involve type IV allergy to phytomenadione as suggested by the delay between sensitization and reactivation, the histology, the patch tests which are positive with phytomenadione and negative with the carrier and the presence of reaction at rechallenge. However, the lack of the necessary sensitization phase and abnormally slow regression of eczematous lesions are unusual and might be explained by a particularly active antigenic effect of the phytomenadione molecule possibly related to the phytyl moiety.
INTRODUCTION: A 69-year-old man with an uneventful past history consulted for a proximal subungueal leukonychia and associated paronychia of the right greater toe. Macroscopic examination and culture lead to the diagnosis of Fusarium oxysporum. Local treatment with bifonazol and cyclopirox was effective. DISCUSSION: Fungal onychomycoses are uncommon and usually present as superficial leukonychia. The association of a proximal localization with paronychia would suggest possible Fusarium infection. Though no specific treatment protocol is well-established, this case emphasizes the importance of effective treatment since invasive fusariosis is described in immunosuppressed patients with ungueal localizations can be an important portal for infection.
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The number of skin cancers is doubled every ten years. The responsibility of excessive sun exposure is incontestable as much for what concerns spino and baso cellular epitheliomas as for malignant melanomas. Over-exposure to ultraviolet B rays was considered as the determining cause of skin cancer and the entire prevention campaign was limited to the safeguard from these rays only. In reality, ultraviolet B rays are not uniquely responsible. Recent studies show that ultraviolet A rays, previously considered innocuous, are on the contrary aggressive as well and in a very deceiving way: it appears that it is the exposure to these rays in weak but repeated doses which are the most dangerous. It appeared that the visually determined value of MED was unchanged but the minimal dose responsible for color changes detectable with chromameter was decreased in the presence of UV.A for 3 subjects out of 4. This decrease was about 50% of the value obtained with UV.B alone. The strategy of protection needs to be completely reconsidered, particularly because today's lifestyle favors the exposition to ultraviolet A rays. There is an increase in exposure to UV.A rays when protection is limited only against ultraviolet B rays, giving a false sense of security especially to those who frequent tanning salons. It is therefore necessary to limit exposure time, use sunscreens protecting against not only UV.B, but also UV.A rays, and prohibit tanning salons. Public educational measures are inexistant, but should be introduced hastily in all public services.
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INTRODUCTION: We report a new case of eccrine carcinoma with mucinous stroma characterized by its voluminous exophytic growth. CASE REPORT: An 80-year-old patient was hospitalized for a voluminous vegetating tumor localized over the left temporal region and which had developed over the 10 preceding years. Wide exeresis was performed and histology confirmed the diagnosis of eccrine carcinoma. No locoregional recurrence was noted 18 months later. DISCUSSION: Eccrine carcinoma with mucinous stroma, also termed eccrine mucinous adenocarcinoma, is a rare adnexal skin carcinoma usually localized on the face or scalp. Abundant zones of mucine are characteristic dissociating a dermal cell proliferation with ruban architecture. The volume of the tumor in our case was particularly remarkable although outcome was favorable after surgical treatment.
OBJECTIVE: Provocative phototests are used regularly to explore photobiology in patients with photodermatoses. Our objective was to determine the reliability of the phototest in the diagnosis of idiopathic and exogenous light eruption in order to identify the ideal date for the histological examination by correlation between the histological aspects of light- triggered and spontaneous lesions. PATIENTS AND METHODS: Among 66 patients, there were 48 with polymorphous light eruptions, 13 with exogenous eruptions and 5 with chronic actinodermatitis. The histological findings of the provocative phototests were correlated with the clinical aspect, the date of biopsy and the histological aspect of the spontaneous lesions. RESULTS: In polymorphous light eruptions (48 cases) this test triggered a photoallergic reaction in 48% of the patients. There was a good correlation between the histological findings and clinical features in 96% of the cases. The histological image of the light-triggered lesion on day 6 was the closest to that of the spontaneous lesion. In exogenous eruptions and chronic actinodermatitis (18 cases), only 33% of the clinically positive phototests were also positive at histological examination. The histological image was the same for the provocative tests whether they were clinically positive or negative, with signs of epidermal phototoxicity, regeneration acanthosis and moderate perivascular lymphocyte infiltration of the superficial dermal layer. CONCLUSIONS: Our findings confirmed that the phototest provides a good correlation between histological findings and clinical presentation in idiopathic polymorphous light eruptions, justifying simple clinical interpretation, but did not demonstrate a rate of positive results as high as reported in the literature. Day 6 is the ideal date for a phototest biopsy. In exogenous light eruptions, the phototest is less reliable since the correlation between histology and clinical presentation is weaker. It is difficult to reproduce spontaneous lesions with the phototest, but if used, the phototest biopsy should be done on day 18.
UNLABELLED: INTRODUCTION This case report of benign summer light eruption emphasizes the importance of phototests in the diagnosis of photosensitive dermatoses. CASE REPORT: A 25-year-old man, phototype II, had experienced a pruriginous papulovesicular erythematous eruption of the axillary and inguinal regions each summer for 12 years. A high-dose UV phototest (40 J/cm2 x 3 days) directed on the right posterior axillary area and a whole body exposure test (4 J/cm2 UVA, 20 mJ/cm2 UVB x 3 days) were positive both clinically and histologically on day 4. DEM B was normal at 26 mJ/cm2. Iterative polychromatic phototest (DEM x 3 days) in the area usually involved (left posterior axillary region) was negative. The simple UVA (13 J/cm2) and iterative phototests performed on the back were negative. The results of the phototests led to the diagnosis of benign light eruption despite the unusual localization. DISCUSSION: The diagnosis of benign light eruption is generally clinical. Phototests are unnecessary in most cases. Benign light eruption can be triggered by high-dose iterative UVA exposure of the susceptible area or whole body phototests (UVA-UVB). These specific phototests are indicated in atypical forms or localizations in order to determine the course of benign light eruption and to uncover simulations.
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Localized elastolysis refers to a group of heterogeneous conditions which includes cutis laxa. We report a form of localized and non-inflammatory elastolysis evocative of cutis laxa, localized to the anteromedial aspect of the left thigh and knee, acquired at the age of 8 years and associated with unilateral adjacent venous dilatations appearing at the age of 39 years. Our case is clinically and ultrastructurally compatible with cutis laxa. Localized forms of cutis laxa not preceded by inflammation are exceptional; localization on the leg has never been described. This clinical form of elastolysis calls into question the classification of acquired elastolysis. The adjacent varicose veins also raise the question of the risk of subcutaneous damage in this condition.
BACKGROUND: Generalized verrucous epidermal nevus is a disorder characterized by papulokeratotic and verrucous plaques involving a large area of the skin. This disease has been associated with a number of malformations including osseous, neurological, and ophthalmologic anomalies. OBJECTIVE: To report clinical and histologic features of verrucous epidermal nevus that developed in association with osseous anomalies, and the surgical technique employed. METHODS: Treatment consisted of razor blade shaving using a dermatome, followed by phenol peeling on the pigmented areas of the face. RESULTS: The described procedure resulted in a cure of the verrucous epidermal nevus with good cosmetic outcome. CONCLUSION: Generalized verrucous epidermal nevus can be successfully managed by surgical excision using a razor blade mounted on a dermatome.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.