[Chemotherapy of malignant melanoma].
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Biomedical subjects
Publications and source records attributed to J Civatte.
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A 22 year old woman having disseminated discoid L.E. with alopecia, photosensitivity and normal renal function is presented. Speckled FANA type R.N.P. was found; L.E. cells and anti-DNA were not present. Direct IF of involved skin revealed deposits of IgG and C3 forming a band at the dermo-epidermal junction. In normal skin there was speckled epidermal nuclear staining with IgG. The study of the patient's complement revealed a selective defect of the C2 component (0 p.100) with a drop in total complement (6 p. 100). The father probably has a heterozygote deficit of C2 (55 p. 100); the mother, however, is within the normal range (119 p. 100). The HLA investigation of the patient and her immediate family did not demonstrate haplotype A10, B18, DW2 as is frequently seen in cases of L.E. associated with a C2 deficiency. The patient is A1, B18, DW--/A10 (W26), BW15, DW--.
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The term parapsoriasis was used by Brocq (1902) to group a number of conditions previously described under different names. This group has since then been modified, the same conditions being described under separate names and these have led to a great confusion especially between countries. In this study of 90 cases, three types of parapsoriasis en plaques are distinguished. The "parapsoriasis digitiforme" (40 cases) or benign type, or xanthoerythrodermia perstans, or chronic superficial dermatitis is characterized by small, oval or finger-like, yellow or pink patches. The histology is frequently not characteristic, but in a few cases, there is an exocytosis localized "en flammèches" in the epidermis. The condition is usually permanent but none of these cases has progressed to mycosis fongoides. The parapsoriasis "en grandes plaques simples" (25 cases) is characterized by few pink patches (3 to 5), larger than in benign type. In our cases the transformation to poikiloderma atrophicans vasculare is not observed. One of these cases progressed to mycosis fongoides. The "parapsoriasis en grandes plaques poïkilodermiques" (25 cas), or poikiloderma atrophicans vasculare, prereticulotic poikiloderma, atrophic parapsoriasis, parapsoriasis lichenoides, is characterized by large patches, in limited number, showing a reticulated pigmentation and slight atrophy with telangiectasia. Five cases changed into mycosis fongoides and 4 cases showed some symptoms of malignancy; The histologic features are the same in the two last types: sometimes they are non-specific, in numerous cases the picture is characteristic with micro-abscesses or "flammèches"; in some cases there is a dense infiltrate with a clearly defined lower limit: this histologic appearance can be seen in cases without transformation into mycosis fongoides.
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Referring to three comparable cases, a new form of lichen planus is described. This form is characterized by a prominent lesion, violaceus in color or pigmented, with white yellowish specks mimicking milia. The histologic picture of lichen follicularis, the presence of typical papules of lichen distant from the retro-auricular lesion make it possible to consider this clinical aspect as a variety of lichen planus.
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A research procedure used to study proximal rail folds in connective tissue diseases is described. The technique is simple and one that is suitable and agreeable to patients. It affords study of tissue from the proximal nail fold in three different ways, namely, light microscopy with histochemistry, electron microscopy, and direct immunofluorescence.
The authors report a new case of Churg and Strauss allergic angeitis, observed during the patients lifetime. Severe asthma preceded the cutaneous lesions by 16 months. There was an eosinophilia of 66 p. 100 of 21,000 white cells. The histological picture was characteristic. A general review of the literature is made in the light of this case.
The authors studied cutaneous biopsies of papulo-pustular lesions in Behçet's syndrome. In biopsies taken early, superficial oedema of the dermis appeared to be the first histological sign, subsequently resulting in a true sub-epidermal bulla, containing neutrophil polynuclear and eosinophil leucocytes. At this stage no major vascular involvement was seen. In later specimens, by contrast, marked vascular changes were seen with the appearances of allergic angiitis. At this stage, there is frank epidermal necrosis with resultant ulceration.