[Confluent and reticulated papillomatosis of Gougerot and Carteaud associated with pityriasis versicolor].
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Biomedical subjects
Publications and source records attributed to M Weber.
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Hyperpigmentation of the lower limbs does not always reflect a phlebological abnormality. The authors briefly recall other pathological circumstances which result in cutaneous hyperpigmentation : cutaneous porphyria (hyperpigmentation of the exposed parts), malignant melanoma, Recklinghausen's neurofibromatosis (café-au-lait spots and naevo-cellular naevi), pigmented dermatoses (lichen planus), fixed pigmented toxidermias, drug induced hyperpigmentations (minocyne, synthetic anti-malarials which can provoke the development of large areas of greyish coloured s in), reticular "hot water bottle" dermatitis and malingering syndromes.
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The physiological colour of the skin is due, above all, to the presence of melanin in the dermis and the epidermis, but also to the presence of other pigments of endogenous or exogenous origin, such as iron and carotene. The authors present a study of melanogenesis. They review the structure of the eumelanins and the phaeomelanins and recall the steps in their biosynthesis. They examine the functioning of the epidermal unit of melanization, which is a functional unit consisting of a melanocyte, derived from the neural crest, and the keratinocytes which depend on it. The melanocyte synthetizes pigment granules, the melanosomes, which undergo maturation before being transferred and then broken down by the keratinocytes. Finally, the authors study the principal factors which influence the functioning of the epidermal unit of melanization : genetic control, ultra-violet radiation and endocrine factors.
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Enterobacteriaceae represent more than 11% of bacteria involved in osteoarticular infections in adult and, among them, Enterobacter cloacae is found in 12% of the cases. The increased evolution of the antibiotic resistance rate of this species is worrying. However, all isolates responsible for this type of infection at the University Hospital of Nancy from 1990 to 1994 (24 strains isolated from 22 patients presented an identical antibiotype with especially a natural resistance phenotype to beta-lactam antibiotics except one cephalosporinase-over-producing strain. The DNA of these strains was studied by pulse-field gel electrophoresis after digestion by the restriction enzyme XbuI. The great genomic diversity obtained showed that the stability of the antibiotic susceptibility during the period studied was not due to the existence of unique clone but to that of multiple clones. The analysis of the restriction profiles has permitted to achieve a better differenciation of the strains than biotyping and antibiotyping, which confirms the high discrimination power of this genotypic method.
Pemphigus is an autoimmune bullous skin disorder. Several cases have been reported to originate in traumatized areas or on a scar, suggesting Koebner's phenomenon. Pemphigus can either remain localized or subsequently extend. This paper reports on a 60-year-old man in whom pemphigus vulgaris began on a 40-year-old surgical scar. The pemphigus initially remained localized to the scar and subsequently extended after two months. The time to onset of this bullous disease on the scar was especially long, compared to that which has been previously reported in the literature. A few cases have been reported where pemphigus developed a few months to a few years after surgery. A time to onset exceeding 3 years is extremely rare.