Biomedical subjects
Publications and source records attributed to J C Moreno.
The only possible treatment of carcinoma of the vulva, the most frequent and malignant tumor of the external female genital area, is surgical excision. It is necessary to perform wide vulvectomy and bilateral node dissection which usually creates a problem in the reconstruction of the zone. Two local advancement flaps achieve excellent functional and aesthetic results.
The fortieth observation in the world literature and the four in Spain of Zinsser-Cole-Engman. Syndrome is presented, and for this reason we have reviewed the clinical, hematological, genetical and diagnostic features of this disease.
At present there are no reliable statistics on the relative prevalences of sexually transmitted diseases (STDs) in Spain. In a report of the first three years' experience in an STD diagnostic centre between 1977 and 1979 a total of 879 patients (534 men adn 345 women) were seen. They mainly consisted of university students and the mean age was 22 years in 1977 and 23 years in the following two years. All the patients were examined for syphilis and all women for gonorrhoea and trichomoniasis. Investigations for Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, Candida albicans, and Herpesvirus hominis infections were carried out according to the presenting symptoms. Non-specific genital infections occurred most commonly (25.7%); chlamydia were isolated from 30% of the patients with non-gonococcal urethritis (NGU). The second commonest infection was candidosis (13.5%). Gonorrhoea, which was found in 10.6% of the patients, was diagnosed more frequently in men (13.5%) than in women (6%). No strains of beta-lactamase-producing Neisseria gonorrhoeae were detected and all were sensitive to penicillin. Syphilis was diagnosed in 4.4% of patients (2% women and 5% men). Condylomata acuminata were diagnosed in 2.8% of patients and more frequently in men (4%). Herpes genitalis and venereophobia were uncommon (1.9% and 1.2% respectively) and were diagnosed only in men.
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We describe a child with an unusual presentation of perianal streptococcal dermatitis which included fever, acral scarletiniform desquamation, and extension of erythema to involve the genitalia and proximal thighs, as well as the commonly seen well-defined erythema of the perianal area. We suggest that isolated group A beta-hemolytic streptococci (GAS) in our patient produced a pyrogenic exotoxin similar to that which appears in scarlet fever.
A number of craniofacial malformation syndromes are characterized by prominent abnormalities of the skin, hair, nails, and mucous membranes. Crouzon disease has been reported in association with severe acanthosis nigricans in 12 patients. We report a new case of this association in a 16-year-old woman with multiple melanocytic nevi. Melanocytic nevi have been already reported in the medical literature in association with several congenital syndromes, although, to our knowledge, not with Crouzon disease.
Granulomatous slack skin is an uncommon cutaneous T-helper cell lymphoma closely related to mycosis fungoides. To the best of our knowledge this disease has not been previously described in children. We report on an 11-year-old boy who presented with painless slack skin masses in the neck, right axilla and arm, anterior wall of the abdomen, both inguinal regions, and the malleolar and dorsal aspects of the feet. The disease started 3 years earlier with erythematous lesions on the neck and wrists. Histologic examination of a specimen from the abdominal mass revealed an extensive lymphoid infiltrate with scattered multinucleated giant cells extending from the papillary dermis to the subcutis. The lymphoid cells showed the following immunophenotype: CD43+ (MT1), CD45+, CD45RO+, CD20-. The phenotype of the giant cells was lysozyme positive, CD68+ and Mac387-. The tumoral lymphoid cells had clonal rearrangement for the gene of the beta chain of the T-cell receptor (C beta TCR). The disease could be controlled with systemic glucocorticoids. Due to the presence of many histiocytes arranged in aggregates in the papillary and mid-dermis, this case was initially considered to be a cutaneous form of histiocytosis. We recommend deep and extensive biopsies in patients with slack skin disease.
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