Biomedical subjects
M Lessana-Leibowitch
Publications and source records attributed to M Lessana-Leibowitch.
An atypical case of penile carcinoma in situ associated with human papillomavirus DNA type 18.
We report an unusual case of penile carcinoma in situ in a heterosexual man. The histologic study showed a severe dysplasia, and the typing of human papillomavirus DNA, performed at the Pasteur Institute, disclosed a type 18, which is usually associated with penile and cervical carcinomas. The identification of an oncogenic human papillomavirus type in the penile lesions, such as type 18 found in this case, should lead to a search for cervical carcinoma in the sexual partner.
Successful treatment of the pruritus of human immunodeficiency virus infection and acquired immunodeficiency syndrome with psoralens plus ultraviolet A therapy.
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[A little known unilateral skin disease: linear basal cell nevus].
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Complete remission following recombinant interferon alpha-2a in a patient with diffuse large B cell cutaneous lymphoma.
Recombinant interferon alpha (r IFN alpha) has shown significant antitumor activity in patients with follicular small cleaved cell (low-grade non-Hodgkin's lymphomas) and cutaneous T-cell lymphomas. However, IFN alpha seems to be less effective in patients with intermediate or high-grade lymphomas. This case report describes a patient with an initial diagnosis of low grade B-cell lymphoma with histologic conversion to diffuse large B-cell (B1+, Kappa+) cutaneous lymphoma. This tumor proved refractory to chemotherapy but a complete and durable remission was induced with R IFN alpha 2a treatment.
[Scleromyxoedematous infiltrations disclosing a gastric adenocarcinoma].
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Dermatitis due to orthopaedic implants. A review of the literature and report of three cases.
The cases of three patients who had dermatosis that was caused by an orthopaedic implant are reported. The main clinical pattern was localized or generalized eczema or urticaria. The diagnostic criteria that have been proposed by various authors are reviewed. Removal of the implant did not always result in rapid disappearance of the dermatosis, presumably because a few particles of metal remained in the area of the implant.
[Cutaneous necrotizing angiitis].
The term necrotizing angiitis signifies a histological lesion combining an inflammatory infiltration rich in pycnotic polynuclear cells to fibrinoid deposits of the vessels wall and/or of the near by collagen. This type of lesions may affect vessels of small caliber or vessels with a muscular wall (arterioles). In the skin, with the term necrotizing angiitis, is implied a lesion affecting the small vessels of the dermis, capillaries and mostly post-capillary venules. The most frequent, by far, clinical manifestation is a palpable purpura; more seldom, it may be lesions of urticaria, livedo or necrotic lesions. these cutaneous necrotizing angiitis may represent alone the entire symptomatology; they may be associated with varied deep localizations of the same type and finally combine with or precede diseases perfectly defined in other respects, especially collagen diseases. Thus, the term necrotizing angiitis refer to a multitude of entities, syndromes which it is only possible to regroup with many clinical, immuno-pathological, etiological and biological data, each of these data alone being an insufficient reference to characterize them.
[Histopathology of cutaneous lesions].
Kaposi's sarcoma in AIDS syndrome differs in many ways from the typical nodular lesions observed in older patients. Clinical lesions are usually multiple with no predilection for the lower extremities; they usually present as small macules or patches with little or no infiltration, pink rather than deeply violaceous; indeed their clinical recognition may be difficult. Histological features of early patches of Kaposi are subtle: they are not as obvious as in well-developed nodular lesions: however certain precise clues exist which permit a correct diagnosis to be made.
[Vulvovaginogingival syndrome. New characteristic grouping of plurimucous erosive lichen planus].
The triple association of a chronic painful erosive vulvitis, an erosive or desquamative vaginitis and an erosive vestibular gingivitis constitutes a hitherto unreported syndrome. The first 19 cases of this affection seen in the Hôpital Tarnier over the last three years are presented and analyzed, the etiology of these erosive mucosal lesions, limited to three body regions, being lichen planus in each case. Detection of mucosal erosion at one of these three sites now requires clinical investigation of the other two, and biopsy of least one of them from the edge of an eroded zone, as well as search for other-possible mucocutaneous areas of lichen planus. Clinical onset is often asynchronous, one lesion appearing before the others, the simplest to recognize being gingival erosive lichen. In one case, however, peri-erosive lamellar detachments suggested chronic desquamative gingivitis of possible benign pemphigoid origin. Erosive lichen planus of vulva and vagina has not been reported previously. Knowledge of this syndrome allows correlation between lichen planus and certain cases of erosive gingivitis, erythroplastic vulvitis and desquamative vaginitis.
[Pick-Herxmeier disease: a new spirochetosis. Value of serodiagnosis of the spirochete of Ixodes ricinus (2 cases)].
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[Virological and anatomo-clinical findings in 20 cases of Bowen's disease of the vulva].
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[Kala-azar in immunosuppressed patients. Apropos of a case disclosed by skin lesions].
Kala-azar was revealed by skin lesions in a patient treated for recurrent Hodgkin's disease. These lesions, extremely discreet, consisted of papules on the forehead and in the peribuccal area. Histological examinations initially showed nodular infiltration of the dermis with very few Leishman-Donovan bodies; subsequently, foamy, Virchow-type histiocytes appeared, and Leishman-Donovan bodies became numerous. This clinical and histological similarity with leprosy has already been noted for post-kala-azar dermal leishmaniasis which is frequent in India and in Ethiopia. Skin lesions in kala-azar appear to be exceptional since they were not observed in the 7 cases of kala-azar in immunodepressed patients previously published. The fact that they are discreet may account for their apparent rareness. Easily accessible, they make it possible to diagnose visceral leishmaniasis--an often difficult diagnosis in these patients owing to the underlying disease. Immunodepression has little influence on the clinical and biological manifestations of kala-azar, but reserves must be made concerning the usual criteria for cure.
The diagnosis of cutaneous T-cell lymphoma by morphometric evaluation of the cellular infiltrate, using semithin sections.
In order to improve the cytological criteria for the diagnosis of cutaneous T-cell lymphomas (CTCL), a number of morphometric assessments in semithin sections have been performed on the dermal infiltrates of twenty-one cases of overt CTCL (group I) and twenty-two cases of well-defined benign dermatoses (group II). In each biopsy, an average of 250 cells were measured for perimeter (P), surface area (S), 'nuclear shape index' (NSI), mean surface and mean NSI. We also determined the percentage of typical 'highly cerebriform lymphocytes' (HCL). Cells of group I patients were found to have mean S and mean NSI that differed significantly from those of group II. HCL were found to have a mean NSI value of less than 0.40. The diagnostic value of these measurements was confirmed in the group I patients. Nineteen of them had a mean NSI value of less than 0.61, together with a mean S greater than 14 sq. micron. None of the twenty-two patients of group II had such values. The discriminating power of these criteria was then tested retrospectively on another group of initially controversial patients who presented with suspected CTCL (group III patients). Nine have since evolved into overt CTCL (group III M) while the other ten have remained benign (group III B). All group III B patients and five patients of group III M were correctly assigned using the above morphometric criteria. This method could improve the diagnosis of the early stage of cutaneous T-cell lymphoma.
[Pediatric vulvar lichen sclerosus (22 cases)].
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[Skin manifestations of sarcoidosis. Review of the literature and 53 personal cases].
The authors review the literature and 53 personal cases, and describe the very variable appearances of the skin lesions in sarcoidosis: these may be divided into two main groups: non-specific "vasculitis" mainly represented by acute lesions of the erythema nodosum type, and specific polymorphic lesions often difficult to diagnose clinically and requiring skin biopsy. As in previous reports, the personal cases bring out a number of special features: silicotic granulomatous sarcoid like lesions may be observed in authentic cases of sarcoidosis; lesions identical to those described in systemic sarcoidosis may appear in isolation without other localisations. Is this cutaneous sarcoid? or sarcoid-like granulomata of unknown origin? The treatment of sarcoid skin lesions is described briefly.
[Male genital dyskeratotic tumor. 2 case reports].
Two cases of genital vegetant tumors are described associated with lichen sclerous in male patients. Clinically they were very close to giant condyloma acuminatum. This diagnosis was rejected after histological examination of the tumors. The pathological changes consisted of epithelial hyperplasia, dyskeratosis, epidermal dysplasia and presence of some vacuolated keratinocytes. After surgical excision, the relapses are frequent. Etr etinate or local 5-fluorouracil seemed to prevent these relapses.
[Diffuse normolipemic xanthomatosis and IgG monoclonal dysglobulinemia].
A 56-year-old man with diffuse cutaneous xanthomatosis had neither mucosal lesions nor diabetes insipidus. Cutaneous lesions were characterised by dermal histiocytic infiltration, without X bodies, associated with Touton's cells and abundant iron deposits. Plasma lipid levels were normal. A lambda G monoclonal dysglobulinemia was present without Bence-Jones proteinuria or myeloma, except for a moderate increase in medullary plasmocytic cell elements. The diagnosis of disseminated xanthomatosis was established, the differential diagnosis from other histiocytic proliferations, particularly diffuse plane xanthoma, being sometimes difficult. The relation between normolipaemic xanthomatosis and dysglobulinemia certainly exists, but no satisfactory pathogenic explanation was possible in this case, in the absence of cryoglobulin, paraprotein antilipoprotein activity, and cutaneous deposits of lipoprotein-paraprotein complexes.