ABSTRACT
Gestationis pemphigoid is an autoimmune subepidermal blistering dermatosis occurring predominantly in pregnancy, more seldom in early puerperium, and exceptionally in post-abortion. The association of gestationis pemphigoid with choriocarcinoma is extremely rare. We report this association in a patient of 35 years in which the diagnosis of gestationis pemphigoid was made on clinical, histological and immunological criteria, and the one of choriocarcinoma was made on clinical, biological radiological and histological criteria. Through this article, we put the item on this association reported for the first time in post-abortion.
Subject(s)
Choriocarcinoma/complications , Pemphigoid Gestationis/pathology , Uterine Neoplasms/complications , Abortion, Induced , Adult , Choriocarcinoma/pathology , Female , Humans , Pemphigoid Gestationis/drug therapy , Pemphigoid Gestationis/immunology , Pregnancy , Uterine Neoplasms/pathologyABSTRACT
BACKGROUND: Tripe palms is a rare cutaneous paraneoplastic syndrome, primarily evocative of lung and gastric neoplasia. Association of many paraneoplastic diseases has also been reported. PATIENTS AND METHODS: A 49-year-old man with a history of alcoholism and smoking addiction reported haemoptysis and thoracic pains present for one year. The physical examination showed left lung condensation. The skin examination revealed a thickened yellowish keratoderma with exaggerated skin ridges and digital clubbing. A diagnosis of paraneoplastic tripe palms was made, prompting repetition of the biopsy which ultimately revealed a neuroendocrine carcinoma. Skeletal scintigraphy showed periosteal proliferation with hypertrophic osteoarthropathy. COMMENTS: "Tripe palms" or "osteoarthritic acanthosis" is a paraneoplastic syndrome. It involves an acquired keratoderma taking on a yellow velvety appearance with accentuation of dermatoglyphic lines. Malignancy is discovered in over 90% of individuals with tripe palms. If malignancy is isolated, it mostly involves the lung (53%). Gastric cancer is associated in 77% of cases if the condition is associated with acanthosis nigricans. In approximately one third of cases, the keratoderma may resolve, generally after treatment of the tumour. The association of many paraneoplastic syndromes has also been reported, in particular digital clubbing and hypertrophic osteoarthropathy. At least 90% of cases of hypertrophic osteoarthropathy in adults occur in patients who have or will eventually develop a malignancy. It is characterized by periostosis of long bones, joint pain, and clubbing, and it is often seen on bone scintigraphy during staging of lung carcinoma.
Subject(s)
Carcinoma, Large Cell/diagnosis , Carcinoma, Neuroendocrine/diagnosis , Keratosis/etiology , Lung Neoplasms/diagnosis , Osteoarthropathy, Secondary Hypertrophic/etiology , Paraneoplastic Syndromes/etiology , Biomarkers, Tumor/analysis , Carcinoma, Large Cell/complications , Carcinoma, Neuroendocrine/complications , Chromogranin A/analysis , Dermatoglyphics , Humans , Keratosis/pathology , Lung Neoplasms/complications , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/metabolism , Lymphatic Metastasis , Male , Marijuana Smoking/adverse effects , Middle Aged , Neoplasm Proteins/analysis , Neoplasm Proteins/metabolism , Palliative Care , Paraneoplastic Syndromes/pathology , Radionuclide Imaging , Smoking/adverse effects , Synaptophysin , Tibia/diagnostic imaging , Tomography, X-Ray Computed , Vesicular Transport Proteins/analysisABSTRACT
Tuberculosis is still endemic in Morocco. Cutaneous tuberculosis is the fifth most common form after pleuropulmonary, glandular, digestive and urogenital tract tuberculosis. The purpose of this single-center prospective study is to describe all cases of cutaneous tuberculosis treated between May 2006 and June 2009. Diagnosis was suspected based on clinical, immunological and histological features. The main clinical presentations, i.e., scrofuloderma and gumma, were consistent with endemicity of tuberculosis in Morocco. Since definitive diagnosis by detection of the tubercle bacillus was rarely possible, therapy was usually undertaken presumptively based on clinical and laboratory findings and therapeutic response.