[Recurring pyoderma gangrenosum in pregnancy]. / Pyoderma gangrenosum récidivant lors des grossesses.

BACKGROUND: We report the case of a 25-year-old patient developing pyoderma gangrenosum (PG) during the third trimester of her first and second pregnancies. CASE REPORT: A 25-year-old woman developed PG on her left calf during week 32 of her second pregnancy; previously, during week 36 of her first pregnancy, the patient had presented abdominal pain with inflammatory syndrome. She underwent caesarean delivery at week 37 of pregnancy. Surgery was complicated by aseptic abdominal and parietal abscesses as well as aseptic endometritis with neutrophil infiltrate. She underwent two further surgical interventions that were followed by skin manifestations typical of PG. The two newborns were otherwise healthy. After five years of follow-up, we found no disorders usually associated with neutrophilic dermatosis. DISCUSSION: Pyoderma gangrenosum is extremely rare in pregnancy, with only 16 cases being reported in the international literature: nine during pregnancy and seven post-partum. The question is thus raised of a possible relationship between this neutrophilic dermatosis and pregnancy. The association could be due to the pathergy phenomenon or to the increase in G-CSF levels occurring in pregnant women.

[Does the direct immunofluorescence examination of superficial temporal artery biopsies have any value? Results of the study of 101 biopsies]. / L'examen en immunofluorescence directe des biopsies d'artères temporales superficielles présente-t-il un intérêt? Résultats de l'étude de 101 biopsies.

The lesions in temporal arteritis (TA) are known to be often segmental and the pathologic study of involved temporal arteries may be falsely negative. Several reports suggest that direct immunofluorescence (IF) may be of value in the diagnosis of the disease. We have studied by IF 101 consecutive biopsies from 100 patients investigated during the last two years. Adjacent segments were processed for light and immunofluorescent microscopy. For the latter, tissues were immediately frozen in liquid nitrogen and stored at -- 70 degrees C. Cryostat sections were stained with anti-gamma, alpha, mu, C3, fibrinogen and albumin conjugates. A sister section was also stained with HE for light microscopy. Deposits of Ig and/or C were either granular (intra- or extra-cellular) or linear closely applied to internal elastic lamina. The 100 patients fall into 4 groups: Group I, (19 patients) with diagnosis ascertained upon typical clinical record and clear cut anatomic lesions by light microscopy; Group II (10 patients) with the clinical features of TA and a negative biopsy by light microscopy; Group III (29 patients) in whom the diagnostic criteria of polymyalgia rheumatica were fulfilled according to Forestier and Certonciny; Group IV (42 patients) affected with various diseases unrelated to T.A. (1 with polyarteritis nodosa, 5 with rheumatoid arthritis...). The following results were obtained by IF: in group I, deposits were found in 63% of the patients studied (linear in 11 and granular in 4 cases). They included Ig usually with C3 and fibrinogen. In group II, we observed linear deposits of IgG in one patient and granular C3 deposits in another case.(ABSTRACT TRUNCATED AT 250 WORDS)

Femoral neuropathy secondary to ossification of the ligamentum flavum.

Radiculopathy resulting from ossification of the ligamentum flavum (OLF) is extremely rare and concerns only intercostal neuralgias. We describe a 37-year-old Caucasian woman with a lumbar radiculopathy revealing an OLF. Her symptoms were completely and definitively relieved by surgery.