Tumor regressions observed in patients with metastatic melanoma treated with an antigenic peptide encoded by gene MAGE-3 and presented by HLA-A1.

Thirty-nine tumor-bearing patients with metastatic melanoma were treated with 3 subcutaneous injections of the MAGE-3.A1 peptide at monthly intervals. No significant toxicity was observed. Of the 25 patients who received the complete treatment, 7 displayed significant tumor regressions. All but one of these regressions involved cutaneous metastases. Three regressions were complete and 2 of these led to a disease-free state, which persisted for more than 2 years after the beginning of treatment. No evidence for a cytolytic T lymphocyte (CTL) response was found in the blood of the 4 patients who were analyzed, including 2 who displayed complete tumor regression. Our results suggest that injection of the MAGE-3.A1 peptide induced tumor regression in a significant number of the patients, even though no massive CTL response was produced.

About two cases of Mycobacterium simiae infection in AIDS: review of the pathogenicity.

Mycobacterium simiae is an ubiquitous species rarely involved as a cause of human infection. Its pathogenicity remains therefore unclear and controversial. Disseminated infections with M. simiae occur rarely and only 7 cases have been reported in patients with acquired immunodeficiency syndrome (AIDS). At least, two were mixed infections caused by M. simiae and M. avium-intracellulare. We report the case of two AIDS patients presenting with pure M. simiae infections: one was a disseminated infection and the other a pulmonary infection. Epidemiology and pathogenicity of M. simiae in pulmonary, extra-pulmonary and disseminated infections are reviewed.

[Buschke-Loewenstein tumor. Apropos of 2 cases in Cotonou, Benin]. / Tumeur de Buschke-Loewenstein. A propos de deux cas vus à Cotonou, Bénin.

About two cases of Buschke-Loewenstein tumor--one of the penis in man infected with HIV and another of perianal area-, the authors insist on the relative frequency of Buschke-Loewenstein tumor in non-circumcised and homosexual groups. They emphasize the continuous precancerous spectrum of Buschke-Loewenstein tumor.

Mycobacterium simiae disseminated infection in a patient with acquired immunodeficiency syndrome.

Mycobacterium simiae is commonly found in nature and its role as a pathogen has been controversial. A case of disseminated M. simiae infection with blood, pulmonary and cutaneous localization is reported here. The pathogenic role of M. simiae was clearly demonstrated as it was the only organism isolated from sputum, broncho-alveolar lavage fluid, as well as blood and skin tissue. Identification of M. simiae by conventional testing may be difficult. Analysis of fatty and mycolic acid patterns, as performed in this case, is necessary to confirm its identification.

Expression of MAGE genes in primary and metastatic cutaneous melanoma.

Human genes MAGE-1 and MAGE-3 code for antigens that are recognized on melanoma cells by autologous cytolytic T lymphocytes. These antigens may constitute useful targets for specific anti-tumor immunization of cancer patients, since genes MAGE-1 and MAGE-3 are expressed in a number of tumors of different histological types, but are not expressed in normal adult tissues other than testis. This also applies to genes MAGE-2 and MAGE-4, which are closely related to MAGE-1 and MAGE-3. We have analyzed the expression of these 4 MAGE genes in cutaneous melanoma. Sixteen of 100 primary tumors vs. 69 (48%) of 145 metastases from individual patients expressed MAGE-1. Similar differences in the frequency of gene expression between primary and metastatic tumor samples were observed for MAGE-2, MAGE-3, and MAGE-4. MAGE expression in primary tumors was correlated with tumor thickness: there was a significantly increased frequency in the expression of MAGE-1, -2 and -3 in tumors of greater thickness. Benign and dysplastic nevi, as well as in situ melanomas, did not express any of the 4 MAGE genes.

Ki-1 anaplastic primary cutaneous large-cell lymphoma.

A 63-year-old woman presented with a large, subumbilical ulcerated nodule that was a Ki-1+ anaplastic large-cell lymphoma with exclusively cutaneous localization. This high-grade lymphoma, in this case, has a less severe prognosis. Surgical resection or local radiotherapy seems sufficient for the localized cutaneous forms.

Retrolumbar subcutaneous ependymoma and giant bathing-trunk nevocellular nevus.

BACKGROUND: Subcutaneous ependymomas have been reported rarely in dermatologic reviews and, apparently, were never associated with other cutaneous malformations. METHODS: A 60-year-old woman with a retrolumbar subcutaneous ependymoma and a giant bathing-trunk nevocellular nevus submitted to thorough dermatologic and neurologic investigation. The surgical material was extensively analyzed with light and electron microscope. The literature was reviewed. RESULTS: The tumor fits exactly the classical prerequisites of the clinical and pathologic diagnosis. In contrast with the literature, it developed at 53 years, apparently after a trauma, within a congenital giant nevocellular nevus, at the retrolumbar level; it proved unrelated to any spinal cord alteration and so far appeared quite benign. CONCLUSIONS: The observation of a retrolumbar subcutaneous ependymoma is reported with detail; this tumor exceptionally recognized by dermatologists must be included in the differential diagnosis of lumps arising in the retrolumbar-retrosacral area. The most peculiar feature was its development within a giant bathing-trunk nevocellular nevus; such a fascinating association of two neurectodermal defects, as far as known, is presented for the first time.

[Longitudinal melanonychia and hydroxyurea]. / Mélanonyche en bandes longitudinales et hydroxyurée.

A patient with chronic myeloid leukaemia was treated with hydroxyurea and developed longitudinal melanonychia on 10 of 20 nails. Such intense lesions are extremely rare.

Pseudoxanthoma-elasticum-like papillary dermal elastolysis: a new case.

We report the clinicopathological features of an old woman with a recent and progressive development of soft white-yellow papules of the neck and supraclavicular areas reminding of pseudoxanthoma elasticum without systemic involvement. The similarity of this entity with fibroelastopathic papular dermatoses of the neck is briefly discussed.

Pigmented epidermotropic metastasis of a breast carcinoma.

Mammary and extramammary Paget's disease is believed to remain non-pigmented, in contrast to superficial pagetoid melanoma; the same holds true for epidermotropic metastases of breast carcinoma. We recently had the opportunity to observe intensively pigmented epidermotropic metastasis of breast carcinoma, with dispersion of melanocytes in the dermal infiltrate. Similar observations, although exceedingly rare, have been reported: melanocytes 'may' pullulate within the dermo-epidermal foci of malignant epithelial cells. The final diagnosis relies on very careful analysis and, as far as possible, on immunohistological techniques.

[Cutaneous-pulmonary sarcoidosis. Diagnostic difficulties in the Black African milieu]. / Sarcoïdose cutanéo-pulmonaire. Difficultés diagnostiques en milieu Noir Africain.

About a case of pulmonary and dermatologic manifestations of sarcoidosis, in a Black African patient, the authors emphasize the clinical polymorphism of sarcoidosis. They insist on the diagnostic criteria of sarcoidosis which are not at all specific of the disease but necessitate a compatible interpretation; particularly in Black Africa where leprosy, tuberculosis and many others granulomatous diseases are endemic.

Histopathological aspects of myiasis.

Myiasis, a rare infestation caused by mainly tropical fly larvae, is now more often encountered in Europe, because of the increasing intercontinental trips. A recent case allowed us to study some anatomopathological and entomological aspects of the African fly maggot.

Dermatofibrosarcoma protuberans: ultrastructural investigation.

The ultrastructural aspects of nucleus and cytoplasm of tumor cells and the interstitial material of dermatofibrosarcoma protuberans are described in detail, especially the very peculiar labyrinthic nucleus. Opinions about its development are reviewed; some, such as melanocytic, neural, histiocytic and smooth muscle proliferation, might be discarded. The myofibroblast appears as the most probable stem cell.