[Lymphomatoid papulosis].
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Biomedical subjects
Publications and source records attributed to I Moulonguet-Michau.
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INTRODUCTION: Nail unit blue nevus is a rare and benign melanocyte proliferation of the nail unit matrix. OBSERVATIONS: We report two cases of nail matrix blue nevi with a blue-black spot of the lunular area associated in the first case with a longitudinal nail groove. COMMENTS: The analysis of our cases and of the previously reported cases give us the opportunity to describe different clinical and histological presentations.
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BACKGROUND AND DESIGN: We used the amplification of junctional V (variable)-J joining sequences of the rearranged T-cell receptor gamma (TCR gamma) genes by polymerase chain reaction for rapid and sensitive detection of a clonal T-cell population in a total of 51 skin specimens obtained from 45 patients with mycosis fungoides, five patients with Sézary syndrome, and 29 patients with chronic inflammatory dermatoses. RESULTS: A clonal TCR gamma gene rearrangement was present in all tumors (3/3, 100%) and in most infiltrated plaques (16/22, 73%) and erythrodermas (10/12, 83%). In the patch stage, a clonal subset was found in more than half of the cases (8/14, 57%), whereas no clonality was observed in the controls. We also amplified the V-J sequences of the Igh locus coding for the heavy chain of immunoglobulins, without evidence of clonal rearrangement. These data were compared with those from in situ immunophenotypic analysis. Moreover, by using the same assay with successive dilutions of standard clonal T-cell DNA, a semiquantitative study of the T-cell clone was carried out in some cases. The highest ratios of clonal DNA were observed in advanced stages. CONCLUSIONS: These data validate polymerase chain reaction V gamma-J gamma as a rapid, sensitive tool that can be used in the routine analysis of clonality in cutaneous lesions of mycosis fungoides and in the early diagnosis of mycosis fungoides and Sézary syndrome. Semiquantitative studies suggest that the malignant T-cell clone follows a selective process during the course of the progressive form of mycosis fungoides.
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We report three cases of epithelio-lympho-histiocytic tumour with very original histological features. The patients were young adults presenting with a nodular lesion on the face which had been present for several years. No recurrence was observed after surgical excision. Histologically, the dermal lesion consisted of epithelial pouches edged with a few layers of basal-like cells and filled with lymphocytes and large clear cells. Relations were found between these lobules and hair follicles, and rudiments of piliary differentiation were noted. The stroma was dense and infiltrated by small lymphocytes and large clear cells. An immunohistochemical study showed marking of the large clear cells by the S 100 protein, which suggested that they were Langerhans cells. The lymphocytes were recognized by the common panleucocyte antibody. The KL 1 antibody marked a few isolated cells within the lobules, but not the basal-like cells. These cases seemed to be similar to the 7 cases reported in the literature by Santa-Cruz and Barr who used the term lymphoepithelial tumour of the skin. We felt justified in putting the stress on the histiocytic component of this tumour and calling it epithelio-lympho-histiocytic tumour. We agree with these authors that this is a tumour of the appendages of the skin and in particular the hair.
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Acute disseminated multinodular non suppurative panniculitis in a 3 year-old boy is reported. The diagnosis was histologically confirmed. Detection of high levels of specific serum IgM favored a diagnosis of acute toxoplasmosis. The relationship between panniculitis and acute toxoplasmosis is discussed.