Biomedical subjects
Publications and source records attributed to J Abulafia.
The case of a patient with thoracic abdominal and left arm, migratory erythema-edematous plates over a space of three years is described. The histopathologic features reveal a eosinophilic panniculitis due to probable larva migrans (gnathostomiasis). This appears to be the first report on the subject because we have not found any reference to the subject in Argentina bibliographic search.
Male patient, aged twenty-six years. Having an eight-and-a-half-year- old dermatosis of localized evolution on scalp, under arms, thighs, pubis and legs, characterized by inflammatory papules and follicular and extra-adnexial pustules, tiny scars and lack of hair in the affected areas. The authors present a representative case of "depilating folliculitis" of (Arnozán and Dubreuilh) stressing the following: Uncommon frequency in our country but frequent in warmer climates where it is observed mainly among peasants and sugar-cane workers. Wide-depilated areas principally in folds. Seasonal outbreak. Good response to treatment. A revision of the theme is made emphasizing the histopathologic pathogenesis.
In a previous work, Segers and adl., the histological and histochemical study of the features of cellulitis is performed, expliciting the importance in this lipodystrophy of microangiopathy PAS positive. As a complement of that work, we study a group of 254 patients, all females, which came to us to be treated for their cellulitis, general clinical and local laser therapy. All of these patients presenting microangiopathy of their dermohipodermic capillary vessel confirmed by biopsy. These cases were divided in four groups according to the existence or not family antecedents of diabetes mellitus, and positivity or negativity to the test of glucose overcharge, sensibilized with corticoid (Fajans-Conn). The results are extensively described and discussed, and considerations are made referring to the aetiopathogenesis of both entities, diabetes and micro-pathological angiopathy, that could be generically and/or immunologically related.
In a group of 130 patients carriers of cellulite, that were subjected to a general clinic treatment and local treatment of laser-therapy, the authors, previous to the therapeutics, made an anatomopathologic study of the skin and the adipose tissue. The biopsies were done on patients of the feminine sex, confirming that all these cases presented the histopathologic and histochemical features of cellulite in their dermo-hypodermic tissue. A full study of intolerance to carbohydrates; lipidic, proteic and hormonal metabolism was also performed in all patients. Comparing the different parameters, the authors emphasize the multiple pathogenic varieties of the illness, and the possibility of future risk of macroangiopathy and coronariopathy.
An analysis of the bibliographical background is made. A study of 100 cases of cellulitis from the histopathologic and histochemical features is performed. The biopsies were done on patients of the feminine sex as a start of a whole treatment. It is inferred that in cellulitis pathologic, metabolic, hormonal and may be immunological factors, are linked to the malfunction of the vascular changes (micro-pathological angiopathy) in the form of thickening of the walls of capillaries and arterioles, that would generate a muco-edema in the dermo-hypodermic tissues. The cellulitis owing to its typical histological characteristics might be considered as a dystrophic capillary connective mucoidotic edema predominant in the skin of the root of the lower limbs.
Dystrophic epidermolysis bullosa has a rare recessive polydysplastic vegetant variant, which was described by Nicolas et al. Two siblings are reported. The male was affected by urethral lesions, an exceptional finding in this disease. Many members in family died of renal insufficiency . A variety of therapeutics was indicated along ten years. Only hydantoins caused a marked involution of the lesions. An interesting feature was that high drug levels in the blood produced not only common side effects, such as macrulia , but also exacerbation of the dermatosis and growth of new lesions, which took on a botriomicoid aspect.
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Sixty-six cases of P.F. of the mouth cavity have been studied. Osseous maxillary invasion (attack) has been detected (discovered) in five patients. It could be determined that in the first three patients the P.F. was originated in the maxillary sinus but in its development it destroyed bone walls and emerged in the mouth cavity. Moreover, in one of the patients it drilled the mucous of the surco naso-geniano outwards. In the other two cases left something attracted our attention the osseous destruction a invasive squamous x rayed was more important than the damage of the mucous membranes. In the last case a change of P.F. into a carcinoma epidermoide infiltrante was produced after cytostatic treatment; this was already published by us. The percentage of the bone invasion of the oral squamous all carcinoma is similar to the Papillomatosis Florida.
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A 15 year old boy with congenital angiomatosis showing associated features of Sturge-Weber-Dimitri and Klippel-Trenaunay syndromes is presented by the authors. Some peculiar characteristics are commented in the article.
1. Florid Papillomatosis (FP) seems to be another form of verrucous carcinoma. 2. Besides the mouth, FP can be found in the larynx, nose, genitalia, skin, etc. 3. FP would appear to be a carcinoma with a low degree of malignancy, and is locally aggressive. They do not cause generalized metastases and rarely metastasize locally. 4. In the mouth, the lesions, either single or multiple, usually occur in adult men. The most frequent sites are the buccal mucosa and the alveolar-gingival area. They develop on a healthy mucosa, or on preexisting lesions, namely, leukoplakia, atypical lichen, abrasive cheilitis and traumatic ulcers. FP may cause fistulas and jaw destruction. 5. Histologically, three stages can be recognized: type I, with acanthosis and papillomatosis, etc., type II, with the aspect of an in situ carcinoma, and type III, carcinoma-like in aspect but with some characteristics of FP. 6. Ten percent of the cases may develop an anaplastic carcinoma or may become associated with other types of carcinomas in other organs and near the area where the FP appeared. 7. Predisposing factors are the same as those for classical carcinomas (especially smoking and chewing tobacco or betel). FP may develop on preexisting lesions similar to those described for regular carcinomas. No virus has been isolated. Some authors believe FP is a precancerous condition; we think it is a cancer with a low degree of malignancy. 8. Treatment should be initiated with cytostatic drugs, especially methotrexate, followed by electrocoagulation, radium implantation and surgery. If the lesions are small in size, methotrexate is not required. If the lesions are large or there is bone destruction, surgery is the treatment of choice after methotrexate and sometimes high-voltage therapy with 60Co. 9. A cure rate of 75% can be obtained in properly treated cases.
A case is presented of squamous cell carcinoma developed from carcinoma in situ of the nail bed of the first finger in a 79-year-old patient. Stress is laid upon the importance of the differential diagnosis. Surgery is considered the treatment of choice for this uncommon condition.
A case of a picture described by Huriez et al. under the title of scleatrophying and keratodermic genodermatosis of the limbs usually degenerative is presented. In the genealogic study it was observed that seven out of the sixteen members that belonged to this primary family group were affected or probably affected and it is stressed that one of them died from metastasis of spinocellular epithelioma.
Two cases of a condition including palms and soles keratoderma, ectodermal dysplasias and basal cell epitheliomas are reported by the authors, with clinical, genetical and pathological data. The condition is called Keratodermal Genodermatose with hydrocystomas, milium cysts, xanthelasma, dental and nail dysplasias and basal cell epitheliomata (Borda's syndrome).
Three cases of Erythema Elevatum Diutinum are reported and a revision of the literature about this subject is made. The authors described extensively the general and cutaneous clinical picture. They precise the histological characteristics and mention other dermatological proceses from which this entity must be differentiated. Finally the ethiology and treatment of this clinical picture are discussed.
The case is report of a boy aged 6 months whose dermatosis had set in suddenly 15 days before in the form of large round circinate patches on the face, thorax, abdomen, dorsum and extremities. These patches were limited by a slightly elevated erythematous border, the inside of which was constituted by collarette-like epidermal desquamations with central parakerotosis. The patches impairment was observed in the child's general condition. A histopathological study was carried out.
The Woringer-Kolopp's disease must be considered a clinical-pathologic variant of mycosis fungoides. It is characterized by heterogenous clinical features and a peculiar histological aspect given by the cellular infiltration of the epidermis. The orgin of the reticular elements is discussed. Though some investigators think they originate in the dermis, others consider their origin to be "in situ". The evolution and prognosis are not well defined, as is the case with the hyperplastic, heteromorphic and polymorphic reticuloses. The case presented has had Hodgkin's disease and then developed a picture of pagetoid reticulosis.