[Keratoacanthomas on recent tattoos: Two cases]. / Kératoacanthomes sur tatouages récents : deux cas.

BACKGROUND: Increasing numbers of reports of rapidly arising, isolated or eruptive keratoacanthomas (KA) and squamous cell carcinomas (CSC) on the red part of tattoos tend to suggest a non-fortuitous link with the procedure. We report herein two different presentations of KAs on tattoos: one patient with multiple eruptive KAs on sun-exposed areas of a recent red tattoo and another with a solitary lesion on a recent tattoo. We discuss the issues related to the distinction between KAs and CSCs in this particular context. PATIENTS AND METHODS: Case No. 1: A 55-year-old heavily tattooed man presented multiple round keratotic verrucous-like lesions restricted to a red tattoo. The tattoo had been performed by a professional tattooist in summer 2016, a week before the onset of the symptoms. The patient did not protect a part of his tattoo from sun-exposure during the healing phase and lesions developed only on the sun-exposed tattooed parts. In January 2017, he consulted with about ten lesions. The histologic study by shaving of a lesion militated in favor of a CSC, KA type. The physical examination was unremarkable. He had no previous history of skin cancer. Two weeks later, most of the lesions regressed spontaneously. Based on the clinical history and progression of the lesions, a diagnosis was made of eruptive KA on a red tattoo. Residual lesions were treated by cryotherapy or excision. Case No. 2: A 72-year-old woman developed a 1-cm painful dome-shaped nodule with a central crust three weeks after tattooing. Full excision confirmed the diagnosis of KA. DISCUSSION: To date, we have found 31 case reports and series (17 men, median age: 50.5 years) of KA and CSC on tattoos. Lesions usually develop rapidly after completion of the tattoo, after between one week and several months. Exceptional cases have been described in old tattoos. Red tattoo ink is most commonly the culprit. The main difficulty lies in distinguishing between KA and CSC. Nowadays pathologists agree that a KA should be considered as a variant of CSC. Eruptive forms of KA present a peculiar situation. They may sometimes be inherited, and KA on recent traumatized areas or drug-induced have been described. Like other authors, we believe that cases of CSC on red tattoos belong rather to the KA type. The physiopathogenesis of tattoo-associated eruptive KA and CSC is not clearly understood, but could be multifactorial, involving: the trauma induced by tattooing, local inflammatory reaction, a component of the red ink, external factors such UV exposure, and a possible genetic predisposition. Rapidly arising KA and eruptive KA on top of recent (red) tattoos are not fortuitous. The lesions should be excised and the patient monitored. Additional studies on tumor specimens are warranted to identify the possible causative agents in tattoo ink that may be responsible for such reactions.

[The intestinal polyposes (author's transl)]. / Les polyposes recto-coliques.

In a general review of the different varieties of the intestinal polyposes, emphasis is laid upon the main three types of the so-called "genetic polyposes" (juvenile polyposis, Peutz-Jeghers syndrome, and adenomatous polyposis) because of their peculiar interest concerning the pathological diagnosis, prognosis and genetic background. A correct histological diagnosis is of the utmost importance before an appropriated treatment can be initiated.

An experimental study of survival after two hours of normothermic hepatic ischemia.

Total hepatic inflow occlusion is well tolerated in pigs with normothermia for as long as two hours, provided that splanchnic venous pooling is avoided by active pumping through a splenojugular bypass. Hepatic dysfunction after 60, 90 and, even, 120 minutes of hepatic ischemia is mild and transient. Complete return to normal liver function tests is rapid. Early microscopic alterations of the liver are moderate, and no late abnormalities, such as cirrhosis or vascular changes, were observed one to three months later. Conversely, interruption of hepatic blood flow for three hours is not compatible with life. In this study, a previously unsuspected resistance of the pig liver to warm ischemia is demonstrated. These findings corroborate and extend those of recent clinical studies in which a similar tolerance of the human liver to prolonged normotherthermic ischemia is reported, thus questioning the necessity for deliberate hypothermia in operations involving the liver.

Fetal membrane morphology and circulation of the liquor amnii.

Morphological study of the human fetal membranes (at the term of pregnancy) shows that under the amniochorion lies the chorionic cytophoblast, which completely surrounds the amniotic cavity. Chorionic cytotrophoblast as well as parietal decidua persist until full term and remain well-developed. Within trophoblastic cells there are numerous canalicular formations bordered by microvilli resembling those observed between amniotic cells. The authors therefore believe that the circulation of amniotic fluid, after traversing the amnion, will continue through the intercellular canaliculi of the chorionic cytotrophoblast to reach the decidua parietalis. All the components of this complex membrane must play a part in the amniotic fluid circulation.

[Experimental hepatic ischemia]. / Note sur l'ischémie hépatique expérimentale.

Total clamping of the hepatic pedicle was performed for a period of two hours in the normothermic pig. During this time an external pulsed spleno-jugular shunt ensured effective-portal decompression. Under such conditions, the biological and histological consequences of this ischaemia were minimal and perfectly compatible with survival. This would suggest that the clinical syndrome of "shock liver" above all reflects splanchnic impairment.