Kinetics of cell proliferation in benigh and premalignant tumors of the human epidermis.

A double labeling method with two levels of tritiated thymidine was used to study 6 patients with seborrheic keratosis, 1 with a fibroepithelial tumor of Pinkus, and 1 with basal cell nevus syndrome manifesting three pits on the palm of the hand. The two latter types of lesions, known to be able to evolve into basal cell carcinoma, had an increased S-phase duration (18 hr for the germ cells of the palmar pits) as compared with normal epidermis (10 hr). This situation was similar to that observed in basal cell carcinoma, However, the S phase was not lengthened in seborrheic keratosis (9.2 plus or minus 1.6), a benign tumor in which malignant transformation is extremely rare. S phase was also of normal duration in the benign eosinophilic septa of the tumor of Pinkus.

Graft versus host reaction. An ultrastructural study.

Graft versus host reaction (GvH) following leukocytic transfusions occurred in a 34-year-old man with a generalized lymphosarcoma. Histologic and ultrastructural studies were performed, with special reference to dyskeratotic cells scattered in the epidermis. These cells are usually considered to be a constant and important feature of GvH reaction. Dense aggregation of tonofilaments, including cytoplasmic organelles and loss of desmosomes, were seen in dyskeratotic cells. Several intracellular desmosomes with tonofilaments bound to their attachment plaque were observed. Some of these cells were able to reach the horny layer; some others were phagocytosed by neighboring keratinocytes. These cells could be the result of a toxic damage to the epidermis, provoked by the immunologic phenomenon implicated in GvH reaction. Later in the clinical course, bullae formations occurred, showing some features of toxic epidermal necrolysis (TEN), as well as features of GvH reaction.

Cutaneous malignant melanoma and exposure to sunlamps and sunbeds: a descriptive study in Belgium.

Two recently published case-control studies have highlighted the possibility of an association between the development of cutaneous malignant melanoma and exposure to sunlamps and sunbeds. Little is known about the behaviour patterns with regard to exposure to sunlamps and sunbeds in Western Europe. This descriptive study compares usage patterns of sunlamps and sunbeds of melanoma patients with the general population in Belgium. Evidence is given that melanoma patients are greater users of artificial ultraviolet sources than the general population, and that the incidence of melanoma in different geographical areas increases proportional to the percentage of people using tanning devices. Although this descriptive study may well be biased or refuted, it does advocate the need for further epidemiological research addressing specifically the issue of melanoma and exposure to artificial sources of ultraviolet radiation.

Nail changes in alopecia areata: light and electron microscopy.

Fragments of nail keratin removed with tweezers from patients suffering from alopecia areata were examined using light microscopy and electron microscopy. The results obtained from these two techniques show nail changes which are slits, cupuliform dips of the upper edge and parakeratosis, under light microscopy; vacuoles, depletion of keratin fibers, and electron-dense fibrillary deposits, under electron microscopy. These changes predominate in the nail plate with a maximum in the upper part while the subungual keratin is preserved. A serious disorder of the matrix keratinization is probably the source of this preferential localization. To determine whether it is a disorder of the keratin fibers themselves or rather of the interfilamentary matrix and especially of the filaggrin system will require further biochemical and immunological studies.

[Facial nerve palsy in syphilitic meningitis. Treatment of syphilitic meningitis (author's transl)]. / Paralysie faciale périphérique et syphilis secondaire. Problème du traitement des méningites syphilitiques.

The authors are presenting a case of meningitis with facial nerve palsy due to early syphilis. The frequency, symptomatology and treatment of this meningeal invasion during the septicaemic phase of secundary syphilis are discussed.

[Melanoma of the extremities a little known diagnosis and difficult treatment. Review of 20 cases]. / Le mélanome des extrémités: diagnostic méconnu et traitement délicat. Revue de 20 observations.

Twenty cases of melanomas of the extremities observed in Brussels, Belgium, between 1968 and 1981 were reviewed. The clinical and histological characteristics, the treatment and the evolution were analyzed and compared to the data of the literature. Diagnosis was often delayed, as it was rendered difficult by the misleading clinical symptoms. This delay explains the inadequacy of numerous treatments given prior to the definitive one as well as the high thickness of the melanomas at the time of diagnosis. The five year survival was only 50%. An early diagnosis made by excisional biopsy, if possible, and an adequate treatment given to start with, should improve the result.

[Cell cycle time of normal epidermis, psoriasis and some epidermal tumors (author's transl)]. / Cycle cellulaire de l'épiderme normal, du psoriasis et de quelques tumeurs cutanées.

Cell kinetic of human epidermis has been studied with different techniques of labeling by 3H-thymidine. A review of the literature for human epidermis, psoriasis and some epidermal tumors has been performed and discussed in the light of our own studies. If the cell cycle time seems to be slightly shorter in epidermal tumors in comparison to normal epidermis, this doesn't constitute the fundamental characteristic of the neoplastic lesions. Indeed the most specific alteration in the cell cycle parameters for precancerous and cancerous tissue is a lengthening of the S phase duration. This modification of the DNA synthesis time is perhaps of reflection of the depressed state of the chromatin of neoplastic tissues.

[Ketoconazole and onychomycosis]. / Kétoconazole et onychomycoses.

We have treated 48 cases of onychomycosis (of which 37 were caused by dermatophytes, 10 by yeasts and one by Scopulariopsis brevicaulis) with 200 mg ketoconazole daily. We obtained recovery in 65 p. 100 of the cases of onyxis caused by dermatophytes and in 80 p. 100 of the cases of onychomycosis due to Candida. The one patient presenting an infection with Scopulariopsis brevicaulis recovered in 13 months. The average duration necessary to obtain complete recovery was 6 1/2 months for onychomycosis of the hands due to dermatophytes and 12 1/2 months for those of the feet. Perionyxis due to Candida needed 2 months of treatment with this drug, however 6 months of treatment were necessary to obtain recovery for onycholysis due to Candida. Biological tests remained normal and the side-effects were minimal and essentially gastrointestinal in our study. Ketoconazole is an effective treatment for onychomycosis: it is active against the different mycotic agents infecting nails and well tolerated by the patient. Several minor effects such as itching, nausea, headache and more serious reactions such as erythrodermia and hepatitis have been reported. Regular control and biological tests are therefore necessary. Patients with other diseases should avoid the use of ketoconazole for treatment of onychomycosis.

[Oral treatment of great ichthyotic disorders by ethylester retinoid (author's transl)]. / Traitement oral de grands états ichtyosiformes par le rétinoïde éthylester.

Observations of 3 different great ichthyotic disorders, no longer responding to local keratolytics and to oral vitamin A are reported: a case of erythrokeratoderma variabilis, one of ichthyosiform erythroderma, and one of bullous ichthyosiform hyperkeratosis. After a week of oral treatment by the ethylester retinoid (Ro 10-9359), the hyperkeratotic component of each disease already improved dramatically. A maintenance treatment had to be continued. With equal or superior keratolytic effects, the retinoid has lower toxicity and less important side-effects than retinoic acid itself. The ethylester retinoid is nowadays the choice oral treatment in these great hyperkeratotic disorders.

[Idiopathic liquefying panniculitis with fatal outcome]. / Panniculite liquéfiante idiopathique a évolution fatale.

A 34 year's old female patient died of nodular liquefying panniculitis after a six months evolution. The only systemic lesions found at post mortem histological examination were an involvement of both pleural cavities with an oily fluid. This seemed to have been the cause of death. This symptomatology was not observed in any of the 26 fatal cases of Weber-Christian disease published in the literature among which 11 cases with no other lesions than adipous tissue lesions, 6 cases where death was related to secondary effects of panniculitis and 9 cases where death was related in intercurrent diseases.

[Atypical urticaria disclosing acute basophilic leukemia. Apropos of a case associated with hyperhistaminemia]. / Urticaire atypique révélatrice d'une leucémie aiguë à basophiles. A propos d'un cas associé à une hyperhistaminémie.

Acute basophilic leukaemia (ABL) is a rare disease characterized by high fever, anaemia and haemorrhagic diathesis. Its prognosis is somber and its response to therapy mediocre. Death is mainly due to cerebral or digestive hemorrhage and coronary disease. In a very small number of cases ABL, like all diseases accompanied by an increase in basophils, may be associated with hyperhistaminemia responsible for cutaneous and gastric symptoms.