Acrokeratosis paraneoplastica (Bazex's syndrome): association with liposarcoma.

Acrokeratosis paraneoplastica (Bazex's syndrome) is a rare obligate paraneoplastic dermatosis characterized by erythematosquamous lesions localized symmetrically at the acral sites. The condition almost exclusively affects Caucasian men older than 40 years. It is usually associated with primary malignant neoplasms of the upper aerodigestive tract.

[Leucocytoclastic eosinophilic vasculitis with Löffler syndrome].

Histologically, leukocytoclastic vasculitis (LV) presents with neutrophilic granulocytes with leukocytoclasia and erythrocyte extravasation, associated with variable counts of lymphocytes, plasma cells and eosinophilic granulocytes. The association of a LV with eosinophilic granulocytes and eosinophilic pneumonia was first described by Chan et al. in 1982.

Prospective, randomized, multicenter, double-blind placebo-controlled trial comparing adjuvant interferon alfa and isotretinoin with interferon alfa alone in stage IIA and IIB melanoma: European Cooperative Adjuvant Melanoma Treatment Study Group.

Purpose: The combination of interferon alfa (IFNalpha) and isotretinoin has shown a direct antiproliferative effect on human melanoma cell lines, but it remained unclear whether this combination is more effective than IFNalpha alone in patients with metastatic melanoma. We evaluated safety and efficacy of IFNalpha and isotretinoin compared with IFNalpha alone as adjuvant treatment in patients with primary malignant melanoma stage IIA and IIB.

Patients And Methods: In a prospective, randomized, double-blind, placebo-controlled trial, 407 melanoma patients in stage IIA (301 patients) and IIB (106 patients) were randomly assigned to either IFNalpha and isotretinoin (isotretinoin group; 206 patients) or IFNalpha and placebo (placebo group; 201 patients) after excision of the primary tumor.

Papular xanthoma: a clinicopathological study of 10 cases.

Background: Papular xanthoma (PX) is one of several clinicopathologic variants of normolipemic cutaneous non-Langerhans cell histiocytoses (n-LCH). PX represents a monomorphous reaction pattern of n-LCH characterized by the presence of predominantly xanthomatized macrophages.

Objective: The purpose of this study was to identify the clinical, histological and immunohistochemical characteristics of PX.

Schönlein-Henoch purpura during pregnancy with successful outcome for mother and newborn.

Background: Schönlein-Henoch purpura is a systemic vasculitis that affects vessels of a small caliber and rarely reported in the literature.

Case Presentation: We report on a 35-year-old woman who developed palpable purpura with necrotizing cutaneous lesions on the lower limbs at 27 weeks of gestation. She also complained of epigastric pain and arthralgias.

[Lichen striatus or Blaschkitis in the adults. Variations of the same entity?].

A 64-year-old woman presented with extensive erythematous papulosquamous lesions along the lines of Blaschko on the right half of the trunk and the right leg. The clinical and histological features led to the diagnosis of lichen striatus, a dermatosis which usually appears during childhood. Treatment with acitretin led to marked improvement.

Primary mucinous carcinoma of the scalp.

Primary cutaneous mucinous carcinoma (MC) is a rare epithelial neoplasm derived from the sweat glands. Herein, we report a case of MC located on the head. A 66-year-old woman underwent excision of a nodular tumor with a reddish brown surface on the left parietal region.

Development of a disease activity index for the assessment of reactive arthritis (DAREA).

Objectives: The objectives of this study were to investigate and validate individual variables and to develop a composite score for disease activity measurement in patients with reactive arthritis (REA).

Methods: In the first cross-sectional part, the clinical and laboratory evaluation of 45 patients was used to elaborate the most important individual disease activity measures. In the second prospective part, these variables as well as a composite score for disease activity measurement of REA were prospectively validated in 23 patients at two points in time.

Primary invasive signet-ring cell melanoma.

The histopathological variants of malignant melanoma include the common type (lentigo maligna, superficial spreading melanoma, nodular melanoma, acrolentiginous melanoma), spindle cell, desmoplastic, balloon cell, pleomorphic (fibrohistiocytic), myxoid, small cell melanoma and malignant blue nevus. Recently, signet-ring cell melanoma was introduced as an additional cytologic variant. We describe a 72-year-old patient with a primary signet-ring cell melanoma of the skin located on the upper arm.

[Papular-purpuric gloves and socks syndrome].

In 1990, we first described the papular-purpuric "gloves and socks" syndrome (PPGSS). It is characterized by an itching erythema and edema of the hands and feet together with oral mucosal lesions and fever. The skin lesions subsequently become purpuric and resolve spontaneously after a few days.

Pseudoporphyria cutanea tarda induced by furosemide in a patient undergoing peritoneal dialysis.

We report on a 32-year-old female patient undergoing peritoneal dialysis for diabetic nephropathy who developed blisters and cutaneous fragility on the dorsa of the hands. Histopathology of an early lesion showed a subepidermal cleft under a regular epidermis with single necrotic keratinocytes and normal dermal structures. In an advanced lesion, a subepidermal bulla and caterpillar bodies were found in the epidermis.

[The ABCD rule in dermatoscopy: analysis of 500 melanocytic lesions].

500 melanocytic lesions were examined by dermatoscopy using the ABCD rule prior to excision and histologic diagnosis. Regular nevi (n = 272) exhibited a score of 3.55 +/- 0.

Necrotizing cutaneous lesions caused by interferon beta injections in a patient with multiple sclerosis.

We report a patient with multiple sclerosis who was receiving subcutaneous injections of recombinant interferon beta. During the third month of treatment, painful necrotizing cutaneous lesions appeared at the injection sites. The possible pathogenesis of interferon-induced skin necrosis is discussed.

Cutaneous malakoplakia on the forehead.

A case of cutaneous malakoplakia in an 81-year-old woman in reported. A reddish slowly growing plaque had appeared on her forehead 13 years previously. Histopathology revealed a dense dermal granulomatous infiltrate consisting of lymphocytes and numerous histiocytes containing Michaelis-Gutmann bodies.

Relapsing linear acantholytic dermatosis.

The case of an 81-year-old man with relapsing linear acantholytic dermatosis is described. This is the second description of this disease entity, which is characterized by the histopathologic and ultrastructural features of Hailey-Hailey disease. Clinically, it is characterized by skin lesions that wax and wane in a systematic pattern following the lines of Blaschko.

[Specific IgM tests in syphilis diagnosis].

A total of 359 sera of untreated patients with syphilis were examined by three methods for the detection of Treponema pallidum specific IgM antibodies, the 19S-IgM-FTA-ABS test, the IgM solid phase haemadsorption assay (IgM-SPHA), and the IgM Captia assay. The results were compared and evaluated. In primary syphilis, the 19S-IgM-FTA-ABS and IgM-captia yielded reactive results in all patients, whereas only 40% were positive in the IgM-SPHA; the corresponding values for early latent syphilis wee 96.

[Dyshidrosiform bullous pemphigoid].

Dyshydrosiform bullous pemphigoid is a clinical variant of bullous pemphigoid in which the lesions appear primarily on palms and soles. Knowledge of this unusual manifestation of bullous pemphigoid may be of practical relevance, since it has to be included in the differential diagnosis of blistering palmoplantar dermatoses. The correct diagnosis is confirmed by histological examination and immunofluorescence, which reveal all the characteristic hallmarks of bullous pemphigoid.

[Recurrent venous thromboses in hypoplasia of the vena cava inferior and factor XII deficiency].

The cause of recurrent pelvic and leg venous thromboses in a 24-year-old man was found to be a combination of two rare anomalies, hypoplasia of the hepatic, prerenal segment of the inferior vena cava and factor XII deficiency (factor XII activity 38%, its antigen 39% of normal), the latter considered a risk factor for thromboembolism. Subsequent fibrinolysis was not successful. No thromboembolic phenomena occurred during the following 16 months of oral anticoagulation with phenprocoumon.

Ischemic venous thrombosis caused by a distinct disturbance of the extrinsic clotting system.

Ischemic venous thrombosis that led to necrosis of four toes developed in an 81-year-old man. Despite the extensive thrombosis, results of blood clotting tests showed an extremely low prothrombin time (20%). Plasma mixing studies demonstrated an inhibitor that may have features in common with the lupus anticoagulant.

[Detection of causal agents of AIDS using polymerase chain reaction and chemiluminescence measurement].

The polymerase chain reaction (PCR) allows the detection of minimal amounts of DNA segments, and thus is used for the laboratory diagnosis of HIV (human immunodeficiency virus). In the present study a solution hybridization assay using acridinium ester-labelled probes was applied for detection of amplified HIV-1 DNA segments. Amplification was achieved by 30 cycles of the polymerase chain reaction using SK38/SK39 primers specific for a constant region of the HIV-1 gag region.

[Successful use of isotretinoin in type Zumbusch generalized pustular psoriasis following recovered etretinate-induced hepatitis].

Administration of etretinate in a 29-year-old female patient suffering from severe pustular psoriasis caused a dramatic increase in liver enzymes. Liver biopsy revealed changes characteristic for drug-induced hepatitis. After normalization of liver parameters following withdrawal of etretinate, isotretinoin was administered during a severe pustular relapse.

[A simple test for the monitoring of plasma anti-XA activity of patients following subcutaneous administration of enoxaparin].

Since low molecular weight heparin is used for the prevention of thromboembolism, the coagulation laboratories are in need of a simple, reliable and practicable test for factor Xa inhibition in order to monitor the effect of low molecular heparin in plasma. Effects of subcutaneous administration of 20 mg or 40 mg enoxaparin were studied in blood samples drawn from 20 patients before and 1, 2, 3, 4, 6, 12 and 24 hours after injection. Thrombin time, aPTT, Heptest and the anti-Xa activity (amidolytic assay) were measured.