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G Perceau

Publications and source records attributed to G Perceau.

12 recordsLinked to original sources
PubMed2006

[Bullous amyloïdis revealing a light chains lambda myeloma].

INTRODUCTION: Although rare, skin lesions are regularly reported in patients with systemic amyloidosis. The existence of bullous skin lesions however is very rare; only thirty cases have been previously reported. We report a new case of bullous amyloidosis revealing a light chains lambda myeloma, and underline the usual characteristics of this type of systemic amyloidosis. EXEGESIS: An 85-year-old man was hospitalised for a bullous eruption associated with a general asthenia. Bullous amyloidosis revealing a light chains lambda myeloma was diagnosed and confirmed by histopathological examination of a skin biopsy specimen. The patient died of a severe congestive heart failure, 15 days later, due to cardiac involvement of the amyloidosis. CONCLUSION: Bullous amyloidosis lesions can be an early manifestation of occult dysglobulinemia. Early diagnosis would allow rapid treatment, before onset of systemic amyloidosis, which is often lethal.

Aged↗
PubMed2006

[Bilateral breast bacterial cellulite secondary to Streptococcus agalactiae septicemia].

BACKGROUND: We report a case of group B streptococcal septicemia of digestive origin with secondary bilateral breast dermal-hypodermal localization. CASE REPORT: A 71 year-old woman with a past history of bilateral breast cancer treated by conservation therapy was hospitalized because of the sudden occurrence of two clearly delimited, inflammatory, dermal-hypodermal cutaneous plaques located on each breast, associated with fever (39 degrees C), 4 days after a colonoscopy. Further investigations eliminated carcinomatous mastitis and blood cultures were positive for group B beta-hemolytic streptococcus (Streptococcus agalactiae). Histological examination of a sigmoid polyp revealed a tubular adenocarcinoma. DISCUSSION: We report the first documented case of secondary dermal-hypodermal bacterial skin infection (cellulitis) due to group B beta-hemolytic streptococcus. The occurrence after colonoscopy examination, chronology of clinical features, bilaterality and positive blood cultures are arguments in favor of the secondary nature of the skin infection process.

Adenocarcinoma↗
PubMed2006

Late lethal hepatitis B virus reactivation after rituximab treatment of low-grade cutaneous B-cell lymphoma.

The chimeric anti-CD20 monoclonal antibody, rituximab, is a promising treatment for cutaneous B-cell lymphomas. Classically used in combination with a multiagent-chemotherapy regimen, it can sometimes give excellent results alone. Because of its selective action on B lymphocytes, it is considered a moderate immunosuppressant in terms of infection. We describe a woman with relapsed cutaneous follicular centre B-cell lymphoma and secondary lymph-node involvement treated with rituximab alone, which induced a complete remission. One year later, she experienced a fatal hepatitis B virus (HBV) reactivation. Several such HBV reactivations were reported after combined rituximab and multiagent chemotherapy for B-cell lymphomas. This is the first case of HBV reactivation occurring during the year following rituximab monotherapy in the absence of any other immunosuppressive factor.

Aged↗
PubMed2005

Multiple spreading epidermolytic acanthomas of the genital and perigenital skin.

Epidermolytic acanthoma is an uncommon benign tumour mainly characterized histologically by a prominent epidermolytic degeneration of the keratinocytes of the upper layers of the stratum spinosum and of the stratum granulosum. The absence of desmosome involvement allows to differentiate this condition from others such as acantholytic acanthoma. We report the first case, to our knowledge, of a 54-year-old male patient exhibiting disseminated scrotal, gluteal, inguinal and perineal epidermolytic acanthomas.

Acanthoma↗
PubMed2004

[Frequency of associated malignancies in cutaneous lymphomas: a retrospective study of 86 cases].

INTRODUCTION: The initial staging and follow-up of cutaneous lymphomas is far from being standardized. In this retrospective study, we describe the results of systematic laboratory investigations dedicated to a better definition of the TNM stage for the detection of associated malignancies. PATIENTS AND METHODS: This was a retrospective, descriptive, single centre study, including all cases of cutaneous lymphomas seen in the department of dermatology, university hospital of Reims, between 1987 and 2001. Data systematically recorded for each patient included clinical, biological, histological and molecular (cutaneous or circulating T or B clone) findings, imaging (thoracic and abdominal computed tomography scan; or chest X-ray and abdominal ultrasound tomography) and bone marrow histology (for B-cell cutaneous lymphomas only). RESULTS: In cutaneous T-cell lymphomas (n=63 including 47 mycosis fongoides), imaging revealed deep lymph nodes in 4 cases, a carcinoma of the kidney in one case, and a benign tumour in 6 cases. A T-cell clone was detected in the skin in 19/33 cases and in peripheral blood in 17/31 cases. In cutaneous B-cell lymphomas (n=23), imaging showed splenomegaly in 2 cases, a B-cell clone was detected in 3/12 cases in the skin, and bone marrow histology was normal in 21/22 cases. Among patients with cutaneous T-cell lymphomas, 14/63 (22 p. 100) had an associated malignancy. In 8/14 cases, the diagnosis of the associated malignancy was made prior to that of the cutaneous T-cell lymphoma. In 4 cases, the interval between the previous malignancy and the diagnosis of lymphoma was <or=2 Years, and in 2 other cases the malignancy was discovered on the occasion of the staging of the T-cell cutaneous lymphoma. CONCLUSION: Laboratory investigations in cutaneous lymphomas are necessary to research deep lymph nodes, especially in case of high stage T-cell lymphomas. In exceptional cases they can reveal an associated malignancy, which is usually detected by clinical examination. In cutaneous B-cell lymphoma, bone marrow histology or cytology is generally normal hence may not be justified in low grade or localized cutaneous B-cell lymphomas.

Adolescent↗
PubMed2003

Lichen sclerosus is frequently present in penile squamous cell carcinomas but is not always associated with oncogenic human papillomavirus.

BACKGROUND: Penile squamous cell carcinoma (SCC) may occur on pre-existing lesions of lichen sclerosus (LS). However, the prevalence of histological changes of LS in penile SCC is not well established. Moreover, mucosal oncogenic human papillomaviruses (HPVs) are sometimes detected in penile SCC, but have not been systematically sought in LS-associated penile SCC. OBJECTIVES: To establish the prevalence of LS histological changes and of mucosal oncogenic HPV in a series of patients with penile SCC. METHODS: Consecutive cases of histologically proven penile SCC from a single university hospital over a 14-year period were retrospectively selected and reviewed. Histological signs of LS were systematically sought. HPV was detected by polymerase chain reaction (PCR) amplification of DNA from paraffin-embedded skin samples using general primers GP5+/GP6+ (allowing detection of mucosal HPV) and oncogenic type 16-, 18-, 31- and 33-specific primers. RESULTS: Eighteen cases of penile SCC were found. The mean +/- SD age of patients at diagnosis was 67.3 (14.5 years). In eight of 18 (44%) cases, SCC was associated with histological features of LS. Seventeen skin biopsy specimens of SCC (nine without and eight with LS histology) were subjected to PCR amplification for HPV. Mucosal HPV was detected in six of them (35%). Five of nine SCCs without histological features of LS were positive for mucosal HPV: three with HPV type 16 and two with only general primers. In contrast, all eight SCCs associated with LS were negative for oncogenic HPV types, although one was positive with general primers. CONCLUSIONS: Penile SCC seems to be frequently associated with LS histological changes. As with vulval SCC, we found that non-LS-associated penile SCC tended to be frequently associated with oncogenic HPV infection, whereas LS-associated penile SCC was not. Larger series are needed to confirm this association.

Adult↗
PubMed2003

[Haemorrhagic cellulitis: three cases].

BACKGROUND: Haemorrhagic erysipelas (cellulitis) is a recently described clinical condition. We report 3 new cases of this rare bacterial dermatosis requiring both antibiotics and systemic corticosteroids for complete resolution. CASE REPORTS: Case 1 was a 75 year-old male patient, with a past history of hypertension and diabetes mellitus. Case 2 was a 69 year-old female patient with a past history of hepatic cirrhosis. Case 3 was a 56 year-old female patient without medical past history, except for obesity. All patients presented with a haemorrhagic and bullous erysipelas of the leg without clinical improvement under parenteral antibiotics. In all cases, adjuvant systemic corticosteroids (prednisone: 0.5 mg/kg/d) for 5-8 days in addition to antibiotics provided dramatic and complete resolution of skin lesions and disappearance of pain and fever. DISCUSSION: Haemorrhagic cellulitis may be misdiagnosed as necrotizing fasciitis because of ecchymotic areas with frequent bullae resulting in haemorrhagic crusts and partial inefficacy of antibiotics given alone. Adjuvant anticoagulant therapy or coagulation abnormalities may have facilitated the clinical condition in 2 of our 3 cases. The efficacy of adjuvant systemic corticosteroids during 5-8 days, in addition to antibiotics is the hallmark of this syndrome.

Aged↗
PubMed2000

[Acute generalized exanthematous pustulosis in hypercalcemia].

BACKGROUND: We report a case of typical exanthematous pustulosis rash that was particularly severe both clinically and biologically. Laboratory tests led to the diagnosis of acute parvovirus B19 infection. CASE REPORT: A 23-year-old man with no past medical history developed fever with an erythematous pustulosis rash predominantly involving the folds. Blood cell count revealed hyperleukocytosis. There was no previous drug intake. This skin reaction was associated with severe systemic manifestations including hypovolemic shock, and hematologic and metabolic disturbances. Virology tests revealed acute parvovirus B19 infection. The hospital physician caring for this patient also presented evidence of acute parvovirus B19 infection. DISCUSSION: The clinical features and the course of this skin eruption were typical of generalized exanthematous pustulosis. We discuss the rare viral causes of acute generalized exanthematous pustulosis and compare our case with a previously reported case of acute generalized exanthematous pustulosis with mononucleosic syndrome in a patient with no prior drug intake. The clinical and biological manifestations of this case were similar to drug hypersensitivity syndrome.

Acute Disease↗
PubMedDate not supplied

[Skin location of multiple myeloma mimicking a vascular tumor].

INTRODUCTION: Cutaneous location of multiple myeloma is rare, and generally develops as a consequence of direct spread from an underlying bony focus of the disease. Metastatic skin lesions without adjacent bone involvement are uncommon. The prognosis is very poor. CASE REPORT: A 74-year-old man consulted for a hemorrhagic cutaneous nodule localized on the left inguinal area. This patient had been treated for five months for a stage I IgG lambda multiple myeloma. The histopathologic examination of the lesion showed a predominantly nodular configuration made up of masses of atypical cells with numerous hemorrhagic areas. The diagnosis of cutaneous metastasis of multiple myeloma was confirmed by the positivity of the cells for anti-IgG lambda antibodies. DISCUSSION: Cutaneous involvement in multiple myeloma without extension from underlying bony focus is exceptional. The lesions generally consist of firm, erythematous nodules involving the neck and lower extremities. To our knowledge, we present here the first case mimicking clinically and histologically a malignant vascular proliferation.

Aged↗