Use of the intramuscular route to administer pentamidine isethionate in Leishmania guyanensis cutaneous leishmaniasis increases the risk of treatment failure.

Background: New world cutaneous leishmaniasis (NWCL) can be found in French Guiana as well as in several other parts of Central and South America. Leishmania guyanensis accounts for nearly 90% of cases in French Guiana and is treated with pentamidine isethionate, given by either intramuscular or intravenous injection. The military population is particularly exposed due to repeated missions in the rainforest.

[Sporotrichoid topographic distribution and Mycobacterium marinum grown on a subdermal contraceptive implant].

We report a 37-year-old woman who presented a cutaneous papulonodular skin eruption with sporotrichoid topographic distribution. The diagnosis of Mycobacterium marinum infection was obtained with the bacteriological examination of a cutaneous biopsy and related to cleaning her aquarium at home. Mycobacteriological grown on a subdermal contraceptive implant had not been published before.

[Tubercular fibrosing conjunctivitis associated with facial cutaneous tuberculosis].

Background: Tuberculous conjunctivitis has been described only rarely during the course of lupus vulgaris. We report a case of hemifacial cutaneous tuberculosis, diagnosed as atypical lupus vulgaris, associated with homolateral fibrosing tuberculous conjunctivitis.

Patients And Methods: An 83-year-old woman presented inflammatory conjunctivitis without bullous involvement in the left eye leading to corneal neovascularisation, symblepharons and ptosis.

[Complications of cosmetic skin bleaching in Africa].

Use of cosmetic products to bleach or lighten the skin is common among dark-skinned women in some sub-Saharan African countries. Long-term use of some pharmacologic compounds (e.g.

[Update on Kaposi's sarcoma].

Kaposi's sarcoma (KS) is a mesenchymal tumor involving blood and lymphatic vessels and induced by viral growth factors (HHV8-IL6). This article reviews the epidemiology, pathogenesis, clinical spectrum (classic KS, iatrogenic immunosuppressive KS, endemic African KS, and AIDS-KS), histological features, staging criteria and treatment of KS. Unlike industrialized countries that have benefited from widespread use of highly active antiretroviral therapy (HAART), developing countries continue to have a high incidence of AIDS-KS.

[Cutaneous tuberculosis overview].

Cutaneous tuberculosis is now uncommon in industrial countries despite the rising incidence of extrapulmonary tuberculosis in areas with high prevalence of HIV infection. Nevertheless it is still important to know the multiple clinical manifestations of cutaneous tuberculosis and to be aware of new laboratory diagnostic methods such as polymerization chain reaction gene amplification.

[Experience of a dermatologist on an overseas military mission: Operation Licorne in Cote d'Ivoire].

The authors report their experience as tropical physicians and as dermatologists within the Medico-surgical group during Operation Licorne an overseas mission with the French Army near Yamussoukro in Côte d'Ivoire. Most of the major endemic diseases were encountered. Only acute infections were treated.

[Characteristics of genetically pigmented skins].

The analysis shows that apart from the relative hyperpigmentation of the "black" skin (genetically determined and variable according to ethnic group, age, sex and solar exposure), which determines the secondary dyschromic reactions to the majority of the dermatosis, and, except the differences of frequency of diseases related especially to geographical or epidemiologic determinisms, there is no true specificity although some entities are little or not described on "white" skin (dermatosis papulosa nigra, acral punctuated hyperkeratosis, progressive macular hypomelanosis of the trunk, acne keloidalis, pseudofolliculitis barbae, aïnhum...

[Management of American cutaneous leishmaniasis. Outcome apropos of 326 cases treated with high-dose pentamidine isethionate].

The purpose of this retrospective analysis was to evaluate the outcome of pentamidine isethionate treatment (4 mg/kg of Pentamidine by the intramuscular route on Days 1 and 3) of cutaneous leishmaniasis in 326 cases that occurred during an outbreak among French military personnel in French Guyana from 1998 to 1999. A great difference was found between the 205 patients treated in French Guyana (series G) and 32 patients treated at the Laveran Military Hospital in Marseille, France (series L). Failure rate, i.

[Use of satellites for public health purposes in tropical areas].

The epidemiological hallmark of the new millennium has been the emergence or recrudescence of transmissible diseases with high epidemic potential. Disease tracking is becoming an increasingly global task requiring implementation of more and more sophisticated control strategies and facilities for sustainable development. A promising initiative involves the use of satellite technology to monitor and forecast the spread of disease.

[Clinical overview of New World tegumentary leishmaniasis].

This richly illustrated article (80 color photographs) based on the authors' experience in French Guyana documents the clinical diversity of American tegumentary leishmaniasis. Main highlights include the often outstanding aspect of lesions, the high frequency of forms not associated with ulceration or scab formation that must be recognized to achieve diagnosis in travellers returning from endemic zones, and the special prognosis of clinical forms associated with intradermic, lymphatic or hematogenous spread. The article also reviews an original diagnostic method based on culture of cutaneous biopsy specimens on specific nutrient mediums that provides isolates in a high percentage of cases (80%) and thus allows identification of offending parasite.

[Epidemiologic surveillance of cutaneous leishmaniasis in Guiana. Summary of military data collected over 10 years].

This report describes the results of epidemiological surveillance of cutaneous leishmaniasis in French military personnel in French Guiana. Data was collected regarding microscopic diagnosis, clinical manifestations, and lesion location as well as compliance with vector control measures. Year-to-year variations in the incidence in the general population have been attributed to changes in climatic conditions.

[Ainhum and pseudoainhum: clinical aspects and etiopathogenic hypotheses].

Pseudoainhum is a rare acquired or congenital disorder characterized by progressive development of a fibrotic band on a finger or toe until spontaneous autoamputation occurs. Ainhum is an idiopathic disease involving the fifth toes of black people mainly in tropical zones. Based on experience in five cases and a review of the literature, the authors describe clinical features of these diseases and analyze various etiological hypotheses including infectious (mycosis, mycobacteria), traumatic (plants), vascular (andysplasia), neurological (polyneuritis), and genetic (keratodermia) mechanisms.

[Atypical acral hyperkeratosis in a black woman].

This report describes the case of a 33-year-old black woman who presented atypical hyperkeratosis. Atypical features included location on the dorsum of the foot and presence of punctate pits. The lesion was classified as intermediate between keratosis punctata of the palmar creases and focal acral hyperkeratosis.

[Pemphigoid and acquired hemophilia].

Introduction: The association of bullous pemphigoid and acquired haemophilia is reported.

Case-report: A 74 year-old man developed a bullous pemphigoid after decreasing corticotherapy, ecchymosis and haematomas revealing a high level of acquired anti-VIII antibodies (110 Bethesda UB units; TCA 98 s). Immunosuppressive treatment (cyclosporine, prednisone, azathioprine and bolus of cyclophosphamide) did not stop the disease.

[Skin manifestations associated with myelodysplastic syndromes].

Purpose: Our purpose was to describe cutaneous manifestations associated with myelodysplastic syndromes.

Methods: Data from seven patients with cutaneous vasculitis (four cases), neutrophilic dermatosis (one case), relapsing polychondritis (one case), and possible erythema elevatum diutinum (one case) in association with myelodysplastic syndrome (refractory anaemia RA, RA with excess of blasts--RAEB-, RAEB in transformation RAEBt, chronic myelomonocytic leukaemia--CMML-), and analysis of the literature were reviewed.

Results: The cutaneous manifestations of myelodysplastic syndrome may or may not be specific, and may reveal hemopathy transformation.