Absence of fodrin (spectrin-like protein) under the pseudopod membrane in stimulated thyroid cells.

A fodrin-like protein purified from porcine thyroid cells and characterized by its properties identical to those of pig brain spectrin (F. Regnouf et al., Eur. J. Biochem. 153, 313-319 (1985)) has been localized by immunofluorescence and electron immunocytochemistry in porcine and rat thyroid. Fodrin-like polypeptides were detected in subplasmalemmal meshworks of microfilaments attached to isolated or in situ plasma membranes. In resting cells, fodrin was found under apical and basolateral membrane domains, whereas it was always absent under the pseudopod membrane domain induced by acute TSH stimulation in vitro, using monolayers of porcine cultured cells attached to collagen permeable substrates, as well as in vivo, using rats intravenously treated with TSH. Thyroid fodrin could be involved in exocytosis and membrane stabilization which occurs during the formation of pseudopods induced by TSH stimulation.

Monoclonal anti-interleukin 2 (15-2) antibody binding to granular layer keratinocytes of human skin.

Among several monoclonal antibodies (moABs) directed against human interleukin 2 (IL-2), the 15-2 moAB raised in our laboratory against unglycosylated recombinant IL-2 (produced in Escherichia coli) cross-reacted with a human skin epitope. This moAB gave a strong staining on the cell-surface membranes of keratinocytes from the granular layer of the epidermis. In addition, the 15-2 moAB stained 15% of epidermal cell suspensions obtained from suction blisters and reacted with cells from the spinous layer in parakeratosis and psoriasis, as well as with spinous epithelioma cells. Preincubation of the 15-2 moAB with pure human recombinant IL-2 abrogated skin binding, whereas a polyclonal antikeratin antiserum did not block 15-2 skin binding. Two other anti-IL-2 moABs, one directed against unglycosylated recombinant IL-2 (17-2 moAB) and one against glycosylated natural IL-2 (9B11 IE5 moAB), were unreactive on skin. Taken together, the data suggest that the 15-2 moAB binds to an epitope cross-reacting with, but different from, IL-2 which is located in the cell-surface membranes of granular layer cells. This cross-reactive epitope may provide a useful probe for the study of human epidermal cell differentiation.

The benefit of chilling in argon-laser treatment of port-wine stains.

The authors compare results obtained in argon laser treatment of port-wine stains with and without preliminary chilling, noting that the success rate is considerably greater with the former procedure (68.6 percent) than with the latter (37.5 percent) (X2 = 4.37 p less than 0.05). The effect of chilling has been studied with special reference to the vitropressure test. Different hypotheses are presented to account for the difference and possible complications of the treatment are considered.

Thermography as a predictive tool for laser treatment of port-wine stains.

The argon laser, which has been proven both useful and safe for port-wine stain therapy, interacts with the hemoglobin of the vessels. In a percentage of cases, this treatment is still inefficient, and there is a lack of correlation between these bad results and clinical or histologic criteria. Thermography, which explores the vascularization of the port-wine stain, leads us to consider port-wine stains from a physical point of view. This very simple test shows no correlation with the clinical parameters of port-wine stain but is closely related to the results obtained with laser therapy. It seems to be a good criterion to estimate the argon laser treatment prognosis.

[Epidemiology of S. aureus cross-infections in dermatological wards]. / Epidémiologie des surinfections à Staphylococcus aureus dans un service de dermatologie

Over a three-year period, 196 of 3115 patients admitted in a dermatological department became infected with S. aureus (6,2 %). 205 strains of S. aureus were isolated. Serologic typing, phage-typing and antibiotic sensitivity tests revealed 3 epidemic and 2 endemic strains. The 3 epidemic strains infected 24 patients: 12 from july to november 1972 were infected with a serotype 66438 S. aureus resistant to fusidic acid. 6 patients (male) were infected with a serotype III in february and march 1972; 8 patients were contaminated with a serotype 18 S. aureus from december 1973 to february 1974, after staying in a surgical department. Of the 2 endemic strains 1, phage-pattern 53/79, is non-typable by serologic-typing; this strain has been observed only in the dermatological department and 20 patients were infected with, from january to october 1974. The second endemic strain, phage-pattern 81/+ serotype I, cross-infected 16 patients during this three-year survey; 12 of them were admitted repeatedly. During this three-year survey, it could be proved that, at least, 1 out of 3 patients is infected with an epidemic or an endemic strain. We can suggest that the factors enhancing cross-infection in dermatological department are: the sex of patients (80 % were male); presence of a tween splitting enzyme by S. aureus promotes growth of Staphylococci on the skin; patients transfered from a department to another or repeatedly admitted are more often infected. But, as they are source of some outbreaks, they need special measures (asepsis and hygiene); corticoïds or immunodepressors enhance cross-infection; antibiotics must not be only limited but varied too.

[Prognosis of generalized scleroderma. A retrospective study of 78 cases]. / Pronostic de la sclérodermie généralisée. Etude rétrospective de 78 observations.

From 1960 to 1984, 78 new patients with progressive systemic sclerosis were followed up: 60 women and 18 men whose ages ranged from 20 to 83 years, with a mean age of 58 years. Twenty nine are known to be dead and 3 were lost of follow-up. Forty six have been followed up to the present time for a mean period of 5 years. The cumulative survival rates were 88 +/- 7 p. 100 at one year, 62,5 +/- 11,5 p. 100 at five years and 50,5 +/- 15 p. 100 at ten years. These figures are significantly different from those found in a matched group from the French general population. Nine features at the time of diagnosis which might influence prognosis were studied. Seven factors apparently have not affected prognosis: sex, age, time elapsed between initial symptom and definitive diagnosis, location of scleroderma, blood pressure, erythrocyte sedimentation rate and creatinine clearance. On the other hand, survival declined significantly faster in the 28 patients with anemia than in the 50 patients without anemia (P less than 0,001). Similarly, the 47 patients with radiological pulmonary involvement or pulmonary function abnormalities were at significantly higher risk for death than the 31 patients without interstitial pulmonary fibrosis. Anemia and pulmonary involvement are predictors of mortality and important prognostic tools in the management of the different drugs that have been recommended for the treatment of patients with systemic sclerosis.

[Alcoholic neuroacropathy. Recent diagnostic and pathogenic attainments]. / La neuroacropathie éthylique. Acquisitions diagnostiques et pathogéniques récentes.

The authors report the results of a prospective study of 28 patients with alcoholic neuroacropathy or the Bureau and Barrière syndrome. The investigations included biochemical analysis of the alcoholism, electrophysiological studies and, in 4 cases, electron microscopy of the musculocutaneous nerve biopsy. Bone scintigraphy with foot and hand scans was carried out in all cases for a more exact and above all, earlier diagnosis of the neurological osteoarthropathy. The clinical syndrome was attributed to a polyneuropathy with a large sensory component of the alcoholic "dying back" variety in all cases. High VGM levels associated with high serum IgA levels appears to be a biochemical diagnostic criteria of this condition. The latter parameter was not closely related to the hepatocytic status of the patient but suggests a direct or indirect effect of the neuropathy on humoral immunity. All cases had characteristic bone scans with high uptake at points of mechanical stress of the anterior part of the foot (first metatarsophalangeal joint). This finding, which is also observed in alcoholic sensory neuropathy without trophic disturbances prompts the authors to define a preacropathic state and an evolutive and pathogenic outline of the disease.

[Malignant atrophying papulosis (Degos' disease) (author's transl)]. / Papulose atrophiante maligne (maladie de Degos).

From 74 observations, 55 p. 100 of which caused death by intestinal lesions, the author searches, through the symptomatology of the disease, for possible factors of prognosis. No relation between the importance of cutaneous symptoms and the appearance of intestinal symptoms has been found. There is no constancy in the chronological evolution of the lesions. The interest of laparoscopy is emphasized. No biological constant seems specific of the disease. A few modest arguments are suggestive of an auto-immune disease. In spite of a varied range of therapeutic orientations, none of them could prove to be efficient, not even heparinotherapy.

[Study under scanning electron microscopy of scales of PUVA treated psoriasis (authors's transl)]. / Etude de l'évolution en microscopie électronique à balayage des squames de psoriasis au cours de la PUVA-thérapie.

The authors recall an particular aspect of microvilli at the surface of horney cells in psoriasic disease. These microvilli are rounded, irregular size and spaced. The photochemotherapy involves parallely the disappearance of these microvilli and the recovery of the cutaneous lesions. The authors describe a "crumpled" aspect of the microvilli, appearing during the evolution towards the recovery.

[Stefansky's serodiagnosis and ulcerative and mutilating acropathy (author's transl)]. / Séro-diagnostic de stefansky et acropathies ulcéro-mutilantes.

Systematic Stefansky's serodiagnostic test in the course of ulcero-mutilating acropathia reveals a frequent positivity (25/30 patients). Superinfection by atypical Mycobacterium of telluric extraction is considered. A delayed hypersensibility to several Mycobacterium antigens is proved to Mycobacterium kansasii, johnei, balnei. Perhaps, the same type of infection might exist in the course of chronic leg ulcers.

[Interest and justification of general corticosteroid therapy in suppurative tinea (kerion) (author's transl)]. / Intérêt et justification de la corticothérapie générale des trichophyties suppurées (kérions).

Persistency, especially in country people, of kerions (Trichophyton of animal origin with pus formation) led the authors to propound the use of general corticosteroid treatment as an original therapy. This concept is emphasized by many concordant features showing the importance of immune alterations in the pathogenesis of kerions. Six cases are reported according to this concept.

[Reflections on the treatment of acropathia ulcerans et mutilans; interest of a removable appliance (author's transl)]. / Réflexions sur le traitement des acropathies ulcéro-mutilantes. Intérêt d'un appareillage amovible.

The authors report their experience in the treatment of acquired ulcerating and mutilating trophic lesions of the lower limbs. Ligature of the dorsalis pedis artery and of its collaterals did not give good results, according to the pathogenic concept of the authors, in which lesions of the nervous system predominate over vascular alterations. More important lesions (such as osteo-arthritis of the first and fifth metatarsals) require immobilization of the axis of the wounded toe, control of any superinfection and use of a plastic removable limb appliance.

[Gold therapy in pemphigus]. / Chrysothérapie du pemphigus.

According to works of Penneys and Eaglstein on the management of pemphigus with gold compounds, the authors report one observation of chronic pemphigus, in which steroid therapy caused severe psychiatric disorders. The use of gold compounds permitted reduction of the dose of steroids and control of the pemphigus.

[Bureau-Barrière's acro-neuropathy. Complementary studies and definition of ante-acropathy status (author's transl)]. / Neuro-acropathie de Bureau-Barrière. études complémentaires et définition de l'état pré-acropathique.

Systematic study of 28 patients suffering of Bureau-Barrière's acro-neuropathy. This study emphasize several particular factors. Significant increase of IgA, with a slight extend of transferrin. The authors debate the straight correction between increase of IgA and nervous illness. Study of peripheral nerves exhibits, in optic and electronic microscopies, direct and indirect signs of wallerian degeneration and significant axonal lesional prevalence. The study of anatomical specimen (foot) corroborates this data. Bony scintigraphic show the constancy of fixation and his connection with bearing surface. Witness demonstrate the specific character of this data. This investigations prove that the Bureau-Barrière's diseases is an alcoholic neuro-acropathy and allow the definition of ante-acropathic status (axonal sensitive neuropathy-scintigraphic fixations, increase of IgA). Prophylaxis in emphasized.

[Household cleansers and nickel allergies]. / Allergie aux détergents et allergie au nickel.

Attention of authors has been drawn by the observation of patients presenting a nickel-dermatosis, instigating by the touch of jewelry (ear-rings, bracelets, necklaces...) and also a sensitization for housework cleansing agents. The chemical analysis of numerous housework cleansing agents exhibited the constant presence of nickel in these housework cleansings. These investigations enable the authors to affirm a close relationship between sensitization for nickel and sensitization for housework cleansings. Some patients present also sensitization for chromium or cobalt. The authors think this polysensitization is induced by metal's contamination.

[Teutschlaender lipo-calcino-granulomatosis or tumoral calcinosis of Inclan (author's transl)]. / Lip-calcino-granulomatose de Teutschlaender ou calcinose tumorale de Inclan

The present report describes a typical case of tumoral calcinosis. Differential diagnosis was initially directed towards sarcoma suggested by fibrous connective tissue surrounding cystlike cavities. The course of this disease led to chronic multiple fistulae with secondary infection in spite of two attempts of surgical excision. This case adds further support to the results of earlier reports showing no specific biological abnormalities. The present sutyd indicates otherwise that tumoral calcinosis and lipo-calcino-granulomatosis of Teutschlaender are the same condition. The pathogenesis of this affection remains enigmatic; there is no evidence that the lipidic excess should be the beginning of the process, but this disease must be considered as a distinctive form of calcinosis. The surgical exeresis is the only possible treatment, even if it doesn't prevent recurrence.

[Scleroderma: peripheral vascular exploration by Doppler ultrasound (author's transl)]. / Sclérodermie: exploration vasculaire périphérique par effet Doppler.

In this preliminary study the authors consider the data that a Doppler investigation may provide for scleroderma. These data are on three levels. 1) At the diagnostic stage: in case of Raynaud phenomenon the Doppler investigation might allow to establish a diagnosis at an early stage in one of two directions:--whether a Raynaud disease, in case of a normal Doppler without taking into account its long-term future;--whether a Raynaud syndrome, in case of abnormal Doppler (thrombosis of the cubital artery or digital collaterals. Because of a recurring fact we must consider scleroderma first; 2) At the therapeutic stage, the Doppler investigation will perhaps allow to select at an early stage the patients who are able to respond to a cervical sympathectomy in a favorable way. 3) At the pathogenic stage, the Doppler investigation should allow a better selection of patients who are suspicious of being affected with a macroangiopathy has to be accurately diagnosed.

[Shulman's syndrome. A variant of scleroderma? Two cases (author's transl)]. / Syndrome de Shulman: une forme clinique des sclérodermie? A propos de deux cas.

Observations of two patients illustrating the problem of Shulman syndroma. The first had presented an oedema of the four limbs, without injury of the trunk, but with myalgias, histological fasciitis, eosinophilia and hypergammaglobulinemia. In spite of corticotherapy, evolution toward a generalized morphea. The second has presented the same oedema of the four limbs, with myalgias, but also Raynaud syndroma, histological fasciitis and eosinophilia. Evolution toward acrosclerosis in spite of corticotherapy. For the authors, Shulman's syndroma is apprehended as a particular clinical form of scleroderma.

[Pyoderma gangrenosum and haemopathy. Report of three cases (author's transl)]. / Pyoderma gangrenosum et hémopathie. A propos de 3 observations.

The authors report three personal cases of phagedenic pyoderma associated with hemopathy. Studying twenty-five other cases, described in the reviews, the question can be debated on three levels: 1) The clinical characteristics of hemopathic pyoderma remain non-specific. However blisters, pustules, and even vegetating lesions occur very often; 2) the etiology of hemopathy is subject to change; acute leukaemia or myeloproliferation syndrome. During the polyglobulars associated with pyoderma, anemia and myelofibrosis appear quite constantly; 3) finally on the pathogenic level, the recent works tend towards the hypothesis of a damage in the functioning of the polymorphonuclears hence displaying the increase in the inflammation during phagedenic pyoderma.

[Cutaneous achromia and malignant melanoma]. / Achromies cutanées et mélanome malin.

A cutaneous depigmentation occurring either far, or the primary tumour, or about the excision scar, or appearing in different other conditions was noted 29 times among 500 cases of malignant melanoma. Before excision, a vitiliginous depigmentation was present only in two patients. Nevertheless 9 patients observed a vitiligo after surgical excision of the tumour (2.5 years after, as an average) this proportion must conjecturally increase thereafter and so represent a minimal score. Twice, an achromic halo was obvious around the primary melanoma. In seven patients there was evidence of secondary depigmentation around the excision. Seven times a localized achromia was observed on the site of BCG-application or DNCB-test. Two patients had a halo-naevus (Sutton naevus). These varying achromias accompanying malignant melanoma were largely studied in animal pathology (horse and chimpanzee). They are usually in animals a factor of good prognosis. This good prognosis was likewise related in human malignant melanoma, but our series is against the assertion of any prognosis significance.