Cutaneous metastases of hepatocellular carcinoma.

Cutaneous metastases are an unusual finding that may present as the first sign of an internal neoplasia. A case of cutaneous metastases of hepatocellular carcinoma, which may often involve other organs but very rarely metastases to the skin, is reported.

Interleukin-2 enhances the growth of human melanoma cells derived form primary but not from metastatic tumours.

Previously, we demonstrated that in vitro treatment of B16F10 murine melanoma cells with interleukin-2 (IL-2) enhances proliferation and metastasis. To further investigate the role played by IL-2 in human melanomas, we studied the expression of IL-2/IL-2 receptor and the effect of IL-2 on the proliferation of melanoma cell lines derived from primary (A375 and RMS cell lines) and metastatic (Hs294T cell line) tumours. We found a constitutive expression of cytoplasmic IL-2 and alpha, beta and gamma-subunits of the IL-2R on the surface of the three melanoma cell lines. The presence of IL-2 in the culture increased the proliferation rate in A375 and RMS cell lines, but no effect was observed in Hs294T metastatic cells. Biologically active IL-2 could be found in the supernatant of the three melanoma cell lines, particularly in A375 and RMS cells, in which an inhibition of the proliferation rate was observed when IL-2 was blocked. Moreover, the combination of anti-IL-2R beta and anti-IL-2R gamma blocking antibodies induced a significant down-regulation of cell proliferation in the three melanoma cell lines, and the combination of anti-IL-2R alpha, anti-IL-2R beta and anti-IL-2R gamma blocking antibodies inhibited IL-2-mediated growth stimulation in A375 and Hs294T cell lines. In RMS cells, a more significant effect was observed when only IL-2R gamma was blocked. Finally, exogenous IL-2 modulated the IL-2 endogenously produced by melanoma cells. These data show that IL-2 may modulate the growth of melanoma cells through autocrine or/and paracrine mechanisms.

Benign cephalic histiocytosis--study of a case.

Benign cephalic histiocytosis is a rare, benign, self-healing form of non-X histiocytosis. A case in a 3-month-old girl is reported. The papular eruption involved her face, neck, shoulders and upper trunk. Light and electron microscopic findings and clinical evolution confirmed the diagnosis. The differential diagnosis with the micronodular form of juvenile xanthogranuloma is discussed.

Focal dermal hypoplasia (Goltz syndrome): an adult case with multisystemic involvement.

Focal dermal hypoplasia (Goltz syndrome) is a rare congenital syndrome with suspected X-linked transmission that is characterized by a wide range of mesoectodermal defects. We describe a 39-year-old woman who had a peculiar phenotype and asymmetry of the body. Examination revealed atrophic erythematous and hyperpigmented linear streaks following Blaschko's lines, some of which were in a reticular or cribriform arrangement. Yellow, soft nodules caused by fat herniation were visible mainly in skin folds. The patient had multiple bone anomalies, including longitudinal striation of long bones (osteopathia striata). She had several ocular, dental, and kidney defects. Histopathologic examination showed a markedly thinned dermis that was replaced by adipose tissue.

Pseudocyst of the ear. Report of three cases.

Pseudocyst of the ear is a rare entity with controversial pathogenesis. Usually it is presented as a solitary, unilateral, fluctuant and non-inflammatory tumour of the ear with overlying normal skin. It occurs most often in young adult males. Incission reveals a serous liquid, with the consistency of olive oil, contained in the cyst-like lesion. Histopathology shows an intracartilaginous cavity with signs of degeneration and necrosis of the limiting cartilage. We present three new cases of this entity. Continuous minor trauma appears to be the causative factor in one of the patients, who also presented bilateral lesions.

Enoxacin-induced photosensitivity: study of two cases.

Enoxacin is a second-generation quinolone derivative recently introduced in Spain. Its activity comes through the inhibition of bacterial DNA-gyrase and it has a good antibacterial capacity against a broad spectrum of gram-positive and gram-negative bacteria. It is presumed to be less toxic than the rest of the quinolones and its use is increasing, specially to treat infections of the urogenital tract. Cases of photosensitivity to enoxacin have been very rarely reported. We describe 2 patients with photosensitivity reactions due to this drug.

Bazex's syndrome (acrokeratosis paraneoplastica)--first case report of association with a bladder carcinoma.

Bazex's acrokeratosis paraneoplastica is a clinically well-defined entity consisting of a distal erythemato-squamous eruption and nail dystrophy. It is always associated with neoplasia, mainly squamous carcinomas of the upper digestive and respiratory tracts; therefore, Bazek's acrokeratosis is considered to be a specific marker of internal malignancy. Two new cases of this syndrome are reported. The first was in a 41-year-old man with a squamous cell carcinoma of the oesophagus, the second in a 73-year-old man who presented with a transitional cell bladder carcinoma, an association not previously reported.

Successful treatment of musk ketone-induced chronic actinic dermatitis with cyclosporine and PUVA.

We describe a patient with chronic actinic dermatitis whose photopatch tests revealed reactions to musk ketone and musk ambrette, both of which were found in his aftershave lotion. Minimal erythema doses of UVA and UVB were decreased. After initial unsuccessful treatment with PUVA therapy the patient was successfully treated with a combination of cyclosporine and PUVA.

Disseminated bacillus Calmette-Guerin infection in an HIV-infected child: a case with cutaneous lesions.

A boy born to a mother with unknown HIV infection was immunized with BCG in his first month of life. Seven months later axillary adenopathy developed. At the age of 10 months, 2 months after HIV infection had been diagnosed, papular skin lesions appeared all over his body. Mycobacterium bovis, BCG strain, was cultured from a lymph node and blood. Ziehl-Neelsen stain of a skin biopsy specimen showed histiocytes loaded with numerous acid-fast bacilli. The patient died 10 days later, before the infection was confirmed. This is the first reported case of disseminated BCG infection in an HIV-infected child presenting with cutaneous lesions.

Soluble interleukin-2 receptor, intercellular adhesion molecule-1 and interleukin-10 serum levels in patients with melanoma.

Serum soluble interleukin-2 receptor (sIL-2R), intercellular adhesion molecule-1 (sICAM-1) and interleukin-10 (IL-10) have each been reported as useful markers for melanoma progression. To evaluate the clinical relevance of these three markers, we simultaneously analysed their serum levels in patients with melanoma. A longitudinal study with a 3-year follow-up was performed and different stages of the disease were considered. Mean values of sIL-2R were significantly higher than in normal controls in all stages and correlated with the disease progression. The prognosis of patients with levels > 529 U/ml of sIL-2R was significantly poorer than in patients with sIL-2R levels < 529 U/ml. Levels of sICAM-1 were also elevated in melanoma patients, specially at the time of the metastatic disease. Serum IL-10 levels were more frequently detectable in the patients that developed metastasis during follow-up, and the prognosis of patients with detectable IL-10 levels was significantly poorer than in those patients with IL-10 undetected levels. Statistical analysis based on Logistic and Cox regression models showed that only sex, stage and sIL-2R value are factors significantly associated with metastatic progression. Moreover, high levels of sIL-2R could be a risk factor for malignant progression in melanoma.

Serum-soluble IL-2 receptor and IL-6 levels in patients with melanoma.

Elevated soluble IL-2 receptor (sIL-2R) and IL-6 serum concentrations have been reported as adverse prognostic factors in several types of cancer. In order to determine whether these factors are predictive of metastatic progression in melanoma, sIL-2R and IL-6 levels were measured in sera from 172 patients with melanoma and 60 in healthy controls. Mean sIL-2R values were significantly higher in the patients than in normal controls and the highest values were observed in those that developed metastasis during follow-up. However, no correlation was found with the stage of the disease. Serum IL-6 levels were found to be correlated with age and sex, but not correlated with sIL-2R levels. Statistical analysis was based on logistic and Cox regression models. The factors considered were age, sex, stage, disease-free interval and serum sIL-2R and IL-6 levels. The analysis showed that only the sIL-2R value is significantly linked to metastatic progression. This finding suggests that high serum levels of sIL-2R could be a predictive factor of metastatic progression in malignant melanoma.