[Remembering Mór Kaposi at Kaposvár].
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Austria↗
Biomedical subjects
J Maleville
Publications and source records attributed to J Maleville.
Asymmetric periflexural exanthem of childhood.
BACKGROUND: We report an expanded series of patients with a distinctive childhood exanthem. OBJECTIVE: Our goal was to describe a new clinical entity. METHODS: This is a clinical study. Twenty-one patients, mostly seen in the spring and late fall, are described. RESULTS: The mean age at onset was 21 months. The eruption began in the periflexural area (close to the axilla, in which an enlarged lymph node was noted in most cases) and spread in an asymmetric pattern, leading to a more generalized eruption in 11 patients. Complete resolution occurred in 3 to 6 weeks. CONCLUSION: An inoculation disease was first suspected, but a systemic viral exanthem seems more probable. We propose to name this eruption asymmetric periflexural exanthem of childhood.
Axilla↗
Repeated skin expansion for excision of congenital giant nevi in infancy and childhood.
Three children with giant pigmented nevi were treated by repeated tissue expansion. Five flaps were expanded twice, and one flap was expanded three times. The delay between expansions was 4 to 15 months (mean 9 months). With full inflation, vascularization of the flap remained good. However, every new expansion decreased flap length by 50 percent. Overall results with this technique, especially in two infants with giant pigmented nevi involving respectively 20 and 40 percent of the body surface, have been most impressive. Only one major complication has occurred: erosion of the skin caused by a fold of the expander envelope resulting in exposure of the expander. This technique improves the early surgical management of giant pigmented nevi and may provide better long-term functional and cosmetic results.
Abdominal Neoplasms↗
Acute febrile neutrophilic dermatosis in childhood (Sweet syndrome)
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Child↗
[Pediculosis capitis: a questionnaire survey in 4 schools of the Bordeaux Academy 1990-1991].
A questionnaire survey of head lice treatment was conducted in four schools--each including a nursery and an elementary school--in the Bordeaux area. Two schools were situated in the centre of the city, one in a suburban area and one in a rural area (50 km from the city). Four-page questionnaires were filled in anonymously by the parents in April 1991; 840 answers were obtained (80 p. 100 response rate). Between January 1990 and March 1991, 48.7 p. 100 of children had at least one episode of head lice infestation (infestation rates varied from 38.8 to 62.6 p. 100 depending on the schools); 30.5 p. 100 of children were contaminated for the first time during that period. Lice were detected by the parents in 95 p. 100 of the cases. The prevalence of lice was higher in females (60 p. 100) than in males (40 p. 100). The highest prevalence was noted in the suburban school where 17 p. 100 of the parents were unemployed at the time of the survey. The peak age for head lice was 7, but 19.4 p. 100 of nursery school children aged 2-4 years had been contaminated at least once. Impetigo was rare (1.2 p. 100), and pruritus was noted in only 14.2 p. 100 of the cases. Most children had been contaminated at school. Curative treatment was counselled by a chemist in 87 p. 100 of the cases. Pyrethrins were used in 81 p. 100, and the shampoo (Hegor) plus spray (Paraspecial Poux) association was the most frequent, totalling two-thirds of prescriptions.(ABSTRACT TRUNCATED AT 250 WORDS)
Child↗
[Treatment of psoriasis by oral calcitriol. A study of 5 cases and review of the literature].
Vitamin D topical analogues are now considered an excellent adjunct to the therapy of psoriasis. Systemic vitamin D3 treatment has been used occasionally, especially in case of associated hypocalcemia. We report five patients (aged 6, 16, 36, 58 and 79 years) successfully treated with vitamin D3 per os. Four had erythrodermic and/or pustulous psoriasis, and two of these had concomitant hypocalcemia. The fifth patient was a girl with pseudohypoparathyroidism and psoriasis vulgaris. The association of hypocalcemia and severe psoriasis is classical and was an incentive to try vitamin D treatment. A review of the literature showed that vitamin D can also be reported as a treatment of psoriasis vulgaris. Hypercalciuria and hypercalcemia are limiting risks. However calcium toxicity seems to be minor when vitamin D is given once a day at bedtime in doses lower than 2 micrograms/24 h. Double blind studies should be performed to determine the real efficacy of this treatment.
Administration, Oral↗
[Cutaneous manifestations of Kawasaki disease. Apropos of 30 cases].
A series of 30 cases of Kawasaki disease has been studied retrospectively over a period of 11 years. The aim was to reassess the diagnostic value of the dermatological manifestations. A modification of the extremities was observed in 28 patients (23 had early inflammatory lesions, 25 had late desquamation). Exanthema was constant, polymorphous and most often urticaria-like. Vesicles, pustules or purpura were noted during the course of the eruption in 7 patients. A perineal eruption was observed in 17 cases and was found of good diagnostic value even though not pathognomonic. Cheilitis was the most frequent of buccopharyngeal modifications (93 p. 100). Conjunctival hyperemia was noted in 26 patients. Eight children had cardiovascular complications. Among these cases, the modification of the extremities seemed to be more pronounced and stomatitis and arthritis were apparently more frequent. Most of all, the inflammatory syndrome was significantly more severe as concerns CRP and polymorphonuclear leukocytes counts. Dermatological examination often rules out other diagnoses, such as measles, scarlet fever and staphylococcal toxic shock syndrome. However, a complete etiological workup remains mandatory.
Cheilitis↗
[Acute generalized exanthematous pustulosis in a child and epicutaneous tests with mercurials].
Diffuse exanthema with fever followed by superficial nonfollicular aseptic pustules was observed in an 11-year old boy after conducting a thiomersal epicutaneous test and manipulation of a broken medical thermometer. The patient healed within two days without any treatment. The initial responsibility of mercury and its derivatives, and the primary sensitization and relevance of the epicutaneous tests are discussed. Mercury and its derivatives should be limited as much as possible in medicine and cosmetology.
Child↗
[Epidemiology of urticaria in infants].
Epidemiology of childhood urticaria and especially that of infants is badly understood because of a lack of studies devoted to this age group. A retrospective study of 40 infants that were hospitalised for urticaria has been made to clarify the factors that produce urticaria at that age. Certain clinical signs seem to be more frequent at this age, such as the bruised appearance of the lesions. Acute urticaria is the most frequent form. An etiology has been confirmed or suspected in 2/3 cases: intolerance of cow milk proteins before 6 months, drug and infection causes after 6 months. Prospective studies of infantile urticaria are necessary.
Drug Eruptions↗
Aspirin-ticlopidin in Kasabach-Merritt syndrome.
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Aspirin↗
Eosinophilic pustulosis of the scalp in childhood.
BACKGROUND: Among sterile pustulosis in childhood, a pruritic relapsing eosinophilic variant beginning in infancy and located mostly in the scalp was first described as eosinophilic pustular folliculitis in infancy by Lucky and colleagues in 1984. OBJECTIVE: Our purpose is to describe such a condition in five boys and one girl and comment on differential diagnosis and relation with Ofuji's disease. METHOD: This is a clinicopathologic study. RESULTS: All patients had scalp pustules beginning in infancy or early childhood that were unresponsive to antibiotic therapy. Lesions also occurred on other areas but the scalp was the major site of involvement. Although secondary infection was demonstrated in one case, the lesions were primarily sterile. Smears of pustules showed a variable proportion of eosinophils. Histopathologic findings suggested a major role for eosinophils in this disorder because dermal eosinophilia was noted in all patients. The inflammatory pattern was not similar to Ofuji's disease. Transient blood eosinophilia was recorded in five patients. Topical steroids relieved inflammatory episodes. Dapsone was tried in one case with apparent benefit. CONCLUSION: Eosinophilic pustulosis of the scalp in childhood is a self-limited disease that can be relieved by topical steroids.
Child, Preschool↗
Perineal ecthyma gangrenosum in infancy and early childhood: septicemic and nonsepticemic forms.
BACKGROUND: Ecthyma gangrenosum is characterized by necrotic ulcerations surrounded by an erythematous halo. It is secondary to Pseudomonas aeruginosa infection. Most lesions are located in the anogenital and axillary areas, but the route of infection is generally difficult to establish. OBJECTIVE: We report six children with perineal ecthyma gangrenosum and discuss predisposing factors, origin, and route of infection. METHODS: This was a retrospective clinical study. RESULTS: Three children had blood cultures positive for P. aeruginosa, and one died. Predisposing factors were present in all cases; two had received chemotherapy (neuroblastoma, acute lymphoblastic leukemia), and two had idiopathic granulocytopenia. The last two patients previously had received treatment with systemic antibiotics and had abnormal granulocyte killing several months later. CONCLUSION: Septicemic ecthyma gangrenosum can be rapidly fatal in young children and requires aggressive antibiotic therapy. Benign ecthyma gangrenosum in healthy infants may result from a modification of bowel microflora after antibiotic therapy in conjunction with maceration in the diaper area. However, careful evaluation and long-term follow-up must be done to detect neutropenia, functional abnormalities of granulocytes, or a possible immune deficiency.
Child, Preschool↗
Production of epidermal sheets in a serum free culture system: a further appraisal of the role of extracellular calcium.
Rhenwald and Green's technique is currently the standard method for growing stratifying epidermal cell cultures. The serum free system developed in Ham's laboratory (MCDB 153) was designed to grow keratinocyte monolayers in clonogenic conditions. Our aim was to optimize conditions in serum-free MCDB 153 for culturing epidermal sheets from adult normal skin, and to assess the effect of extracellular calcium and temperature on proliferation and differentiation of cultured keratinocytes. Sixteen strains derived from plastic surgery specimens (mean age of donors 37 years; range 5-89) were used. Primary cultures were seeded at an optimal density of 8 x 10(4) cells/cm2 in primary cultures and 10(4) cells/cm2 in secondary cultures in complete medium including EGF, insulin, hydrocortisone and bovine pituitary extract, supplemented with isoleucine, tyrosine, methionine, phenylalanine, tryptophane and histidine. Amino acid (AA) supplementation allows a 5.8-fold increase in cell counts at confluency and monolayers with densely packed cells are obtained. In AA supplemented cultures, confluency is obtained in 16 +/- 3 days in primary cultures and in 13 +/- 0.5 days at first passages. Switches to 1.1 mM calcium at first or second passages resulted in a significant increase in cell counts (P less than 0.001), when compared with AA supplemented low calcium cultures. Low temperature/low calcium cultures resulted in a 50% decrease in cell counts. Low temperature/high calcium cultures gave similar cell counts as the 37 degrees C controls. AA and calcium supplemented cultures were evaluated for differentiation markers: involucrin expression was increased, keratins 5, 6, 14, 17 were expressed, and the sheets were 6-10 layers thick by electron microscopy, with keratohyalin granules and cornified envelopes appearing at layers 3-6 (from basal layer). Dispase treatment allowed an easy detachment of these sheets. These results show that the culture medium MCDB 153 can be adapted without serum supplementation to batch culture of human adult keratinocytes to produce epidermal sheets suitable for grafting. They also indicate that extracellular calcium in physiological range of concentration is not a sufficient signal for growth arrest when other growth conditions are optimized.
Adolescent↗
Treatment of leg ulcers with allogeneic cultured keratinocyte-collagen dressings.
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Biocompatible Materials↗
Shwachman syndrome: a case report.
Cutaneous involvement is frequent in Shwachman syndrome, and includes various degrees of dry skin, and eczematous and ichthyosiform lesions. A 12-year-old boy with Shwachman syndrome had cutaneous involvement characterized by dry skin, perioral dermatitis, and follicular keratosis. Polymorphonuclear motility was decreased. A nutrition work-up showed a decrease in liposoluble vitamins, and suggested a causative link with the skin lesions.
Bone Marrow Diseases↗
Inflammatory familial palmoplantar keratoderma: Greither's disease?
A case of a familial palmoplantar inflammatory keratoderma with autosomal dominant inheritance is reported. Associated clinical features included vasomotor troubles and hyperhidrosis consistent with a diagnosis of Greither's disease. Light microscopy was nonspecific. Electron microscopy showed aggregated tonofilaments around the nucleus, without true clumps. Desmosomes were numerous and cell-cell junctions showed an imbricated pattern, well demonstrated in the stratum corneum. The diagnosis of Greither's keratoderma is discussed.
Adult↗
[Cutaneous tumors and nodules in the neonatal period].
A review of neonatal cutaneous tumors and nodules is presented, based on a 10-year experience. Pitfalls in diagnosis are especially emphasized. A biopsy should be performed in most instances when there is a clinical doubt.
Dermoid Cyst↗
[Gangrenous ecthyma of the diaper area in infants].
Ecthyma gangrenosum due to Pseudomonas aeruginosa is a skin infection in which necrotic ulcerations surrounded by a red areola develop. The diaper area is the region most often involved in infants. Typically, ecthyma gangrenosum occurs in patients with septicemia and risk factors (chemotherapy, neutropenia). However, transient bacteremia or an infection confined to the skin may be the cause in some patients, with maceration in the diaper area and previous antibiotic therapy as risk factors.
Diagnosis, Differential↗