[Favus circinatus of so-called glabrous skin].
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Biomedical subjects
Publications and source records attributed to B Liautaud.
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A case of "verrucous dermatitis" caused by a dematiaceous fungus has been observed in an 30 y. o. Algerian patient. The lesion was localized on the face. The patient presented previously a chronic dermatophytic disease due to Trichophyton verrucosum. The dematiaceous hyphomycete has been isolated several time from superficial specimens and portions of biopsies. This fungus has been injected by intra-testicular route in guinea-pigs. The aspect of the fungus in its parasitical morphology has been described and compared with that seen in the testis: In the lesions, the vesiculous or short fungal elements are not pigmented; they are sometimes cross-walled. Successful treatment has been obtained with administration of intravenous amphotericin B. It seems that the patient is genetically predisposed and has a deficient cellular mediated immunity.
Histological study of cutaneous biopsies of an algerian girl with a "dermatophytic disease" (cf. supra Marill and al.). During the six first years of evolution diagnosis of mycosis had not been made for no specific fungus staining was done, but the fungus was present in the tissues. Vesicular forms and few filaments were seen in the first biopsies but polymorphism increased with the time and filaments became predominant and very abundant at the end of the disease.
The patient, the last of three children, died at 22 of a "dermatophytic disease" (Hadida et Schousboe) of probably trichophytic origin (T. schönleini) after eight years of evolution. Anterioraly her two brothers died respectively at II (six years) and 13 (seven years of evolution). Discussion of clinical, diagnosis and physio-pathologic features and of a familial immunological defect.
The immune response was studied in ten patients with benign dermatophytosis, and in five patients with a severe affection. At the humoral level no deficiencies were observed in both groups. However, all patients showed a marked and constant increase in IgE level. Skin test response in various concentrations of antigens as well as studies of activation of lymphocytes by specific and non-specific mitogens in vitro have demonstrated a depressed cell-mediated immunity. This anergy, however, is not an "all-or-none" phenomenon; it varies and there seems to be a direct relationship between the state of anergy and the severity of the cases. Furthermore, certain discrepancies were observed between the in vivo and in vitro responses suggesting that defective cellular immune reactions in dermatophytosis may be symptomatic of a lack of some humoral factor and do not necessarily reflect an intrinsic cellular defect. Finally, among these 15 patients, 7 were brothers and sisters from 3 separate and unrelated families, suggesting an autosomal hereditary influence.
Retroviruses (mainly H.I.V. 1 and H.I.V. 2) are now largely spread over in Central Africa and Caribbean Islands, particularly in large cities. Their transmission is essentially horizontal and mainly sexual. As a matter of fact, sexual transmission is responsible in about 80% of the cases, leaving only a small percentage to transmission by needle (or by any aggressive material), blood or blood by-products. As far as sexual transmission is concerned, it is essentially heterosexual, in spite of the primary epidemic outbreak in the occidental world that focused interest toward male homosexual group, the first exposed to A.I.D.S. Nowadays we know that heterosexual transmission is important and bi-directionnal, even if transmission female to male has seemed to be more difficult to enlight, as it is common in sexually transmitted diseases. Transmission risk to an heterosexual partner is between 20 and 70%. Virus is present in semen, and in cervico-vaginalis secretions during all menstruation cycle. Vertical transmission, mother to child, through placenta or during delivery is frequent, and is of about 50%. First data on heterosexual transmission have been found in Central Africa, indicating high rates for prostitutes, their "customers", unmarried women with numerous partners, women with an other S.T.D. A.I.D.S. in child has been first described in Haïti and in Zaïre. The very important role played by heterosexual transmission imposed sanitary education and usage of contraceptives which are efficient but difficult to firmly recommended for social and cultural considerations.
The immune response was studied in 10 patients with benign dermatophytosis and in 5 patients with a severe affection. At the humoral level no deficiencies were observed in both groups. However, all patients showed a marked and constant increase in IgE level. Skin test response in various concentrations of antigens as well as studies of activation of lymphocytes by specific and non-specific mitogens in vitro have demonstrated a depressed cell-mediated immunity. This anergy, however, is not an "all-or-one" phenomenon; it varies, and there seems to be a direct relationship between the state of anergy and the severity of the cases. Furthermore, certain discrepancies were observed between the in vivo and in vitro responses suggesting that defective cellular immune reactions in dermatophytosis may be symptomatic of a lack of some humoral factor and do not necessarily reflect an intrinsic cellular defect. Finally, among these 15 patients, 7 were brothers and sisters from 3 separate and unrelated families, suggesting an autosomal hereditary influence.