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PubMed1977

[The difference forms of "parapsoriasis en plaques". A report of 90 cases (author's transl)].

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.

Adult↗
PubMed1981

Topical chemotherapy of pigment abnormalities in surgical patients.

Disorders of epidermal pigmentation not amenable to surgical intervention were treated with topical agents in 15 patients. In cases of hypopigmentation, methoxsalen 1% solution was applied prior to photosensitizing ultraviolet light exposures on alternate days for 2 to 6 months. In cases of hyperpigmentation, hydroquinone 4%, retinoic acid 0.05%, and triamcinolone acetonide 0.25% were applied twice daily for 6 weeks. Of three patients with surgically induced depigmentation, all had moderate repigmentation. Of 12 patients with hyperpigmentation, 4 had significant resolution, 5 had partial resolution, and 3 failed to complete the study. Overall, 6 of the 15 patients reported marked satisfaction with their therapy. Mild localized phototoxicity or irritant reactions were the only complications. Topical chemotherapy produced subjective and objective improvement in all patients who completed a therapeutic trial for either hyperpigmentation or hypopigmentation, and in several patients the results were excellent. The safety of these medications and the lack of acceptable alternatives justify their further use in appropriate clinical settings.

Administration, Topical↗
PubMed1986

Investigation and prognosis in the retinal pigment epitheliopathies.

Eighty-three patients with retinal pigment epitheliopathy have been identified from the photographic and fluorescein records of the Tennent Institute of Ophthalmology in Glasgow. Many have been brought back for follow-up assessment. Twenty-seven patients had placoid lesions, 22 geographic lesions and 15 a condition which we propose to rename the 'not ocular histoplasmosis' (NOH) syndrome. Patients with placoid lesions could be divided into typical acute multifocal placoid pigment epitheliopathy (AMPPE), where the long-term visual prognosis was poor because of recurrent disease leading to extensive areas of atrophy, and acute diffuse placoid pigment epitheliopathy which seemed to be self-limiting. No consistent evidence of viral or immunological abnormality was found in either group of patients. Geographic lesions appeared to result either from a coalescence of focal lesions or from a slow (serpiginous) spread from a single focus. Four patients with helicoid atrophy lost central vision from disciform lesions. Seven patients had pigment epithelial disorder associated with sarcoidosis. The pigment epithelial disease was unresponsive to systemic corticosteroid therapy and tended to be complicated by disciform lesions. Disciform lesions may occur in any type of pigment epitheliopathy, as may serous retinal detachment or pigment epithelial detachment. A technique for the biopsy of choroid and retinal pigment epithelium is described. This may lead to a better understanding of these disorders.

Eye Diseases↗