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Biomedical subjects

M Pisani

Publications and source records attributed to M Pisani.

At least 19 recordsLinked to original sources

[A case of idiopathic hypereosinophilic syndrome].

Idiopathic hypereosinophilic syndrome (IHS) is reported in a 59-year-old farmer. Skin manifestations were represented by pruritic erythemato-squamous and papulonodular lesions, the heart was affected by endomyocardic fibrosis, and periodic intestinal colics denoted a possible gut involvement. A mild and transient beneficial effect was achieved by treatment with antihistamines, sodium-chromoglycate, steroids. Recent studies indicate that IHS hypereosinophilia is caused by interleukins 3 and 5, cytokines able to activate circulating eosinophils and to enhance the survival of these cells.

Eosinophilia

[Mottled hyperpigmentation of the fundus oculi associated with angioid streaks in pseudoxanthoma elasticum].

The Authors report mottled fundus in association with pseudoxanthoma elasticum in 8 of 9 patients. The mottled hyperpigmentation is an early uncommonly described finding, consisting of a speckled, yellowish mottling of the posterior pole temporal to the macula at ophthalmoscopic examination; this appearance, called "peau d'orange", is believed to be caused by changes in the retinal pigmented epithelium overlying a calcified and degenerating Bruch's membrane. This finding is virtually pathognomonic of pseudoxanthoma elasticum and may be present even in the first decade of the disease, prior to the appearance of the angioid streaks. The Authors emphasize the significance of the retinal finding, that may represent an incomplete genetic expression of an autosomal recessive carrier state.

Adolescent

[Porokeratosis palmaris et plantaris disseminata with squamous cell carcinoma].

A 53-year-old man presented porokeratosis palmaris, plantaris et disseminata with some features (exacerbation of lesions, in the sun light, zosteriform fashion of them on the trunk and extremities) distinctive of other variants of porokeratosis. Lately, four squamous cell carcinomas had arisen on the areas involved by disease. Histologic study of porokeratosis lesions showed epidermal changes typical of the disease ("cornoid lamella"), but also a mild disorder of malpighian stratification. Neoplasms were removed surgically and the patient was given etretinate orally (75 mg/day for a week, 50 mg/day for a month, 25 mg/day for six months, i.e. up to now), which proved to be effective in improving porokeratosis lesions and preventing the occurrence of other squamous cell carcinomas.

Carcinoma, Squamous Cell

In vitro acantholysis by captopril and thiopronine.

The possible acantholytic property of captopril and thiopronine has been investigated using in vitro tissue cultures. Normal human breast skin explants have been cultured in Hanks' balanced salt solution containing 40% normal inactivated human serum with the addition of L-cysteine, or reduced glutathione (GSH), or captopril, or thiopronine, at four different concentrations (1, 5, 10, 15 mM). Patterns of diffuse, mainly suprabasal acantholysis, with formation of bullae, were observed in the skin explants cultured with captopril or thiopronine at a 15-mM concentration after 5 days of culture; intraepidermal splits were present also at a 10-mM concentration. Focal acantholysis was seen in specimens cultured with L-cysteine or GSH at a 15-mM concentration. No lesions occurred in the samples treated with lower concentrations of the above substances, nor in controls. The results show a biochemical acantholytic potential of both captopril and thiopronine, resembling that of penicillamine in similar experimental conditions, and consonant with clinical observations of pemphigus induced by drugs containing thiol groups in their molecule (SH drugs).

Acantholysis

[AIDS].

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Acquired Immunodeficiency Syndrome

An abortive form of pemphigus vulgaris probably induced by penicillin.

A case of an abortive form of pemphigus probably induced by protracted penicillin treatment is reported. Because of a positive patch test with penicillamine and the finding of such an amino acid in patient's plasma, the authors are induced to believe that the trigger factor could really have been penicillamine formed by the metabolic breakdown of the penicillin molecule.

Female

[Pulmonary aspergillosis. Presentation of an anatomo-clinical case of lobitis].

A case of pulmonary aspergillosis in an elderly, wasted patient is described from the clinical and anatomopathological points of view. The different ways in which pulmonary aspergillosis presents in humans are reviewed and the different factors favouring onset of the disease, which has become commoner in recent years, are considered. Finally, stress is laid on the anatomoclinical aspects of the case which, unlike those typical of aspergillosic pneumonia, also presented cavital zones.

Aged

Drug-induced pemphigus.

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Drug-Related Side Effects and Adverse Reactions

Kaposi's sarcoma as clinical manifestation of the acquired immunodeficiency syndrome in a hemophilic patient.

The authors report the natural history of HIV infection in a patient with severe hemophilia A who became HIV-seropositive in 1983 and, four years later, developed full-blown AIDS associated with a disseminated Kaposi's sarcoma. Neutralizing antibody titers against HIV were shown to be inversely disease-associated, while the progression of clinical symptoms was directly related to the decline of T4 cells and the increase of urinary neopterin levels. It is suggested that the presence of an HLA DR 5 phenotype and repeated CMV infection could have been crucial for the development of KS.

Acquired Immunodeficiency Syndrome

[Proteiform syndrome (Proteus syndrome). Skin manifestations in a recently observed case].

The case of a 4-year-old female affected by partial gigantism of the feet, syndactyly and polydactyly, partial right hemihypertrophy of buttock and lower limb, warty hyperpigmented nevus and vulvar lipoma is described. The Authors discuss about the Proteus syndrome, pointing out its rarity, the polymorphism and the problems of differential diagnosis with the Klippel-Trenaunay-Weber syndrome and with other congenital hamartomatous disorders.

Abnormalities, Multiple

Cytodiagnosis of oral pemphigus vulgaris.

A study was undertaken to verify the reliability of the Tzanck test, performed both by traditional cytomorphology and by a direct immunofluorescence technique, for the diagnosis of oral pemphigus vulgaris. Cytologic smears were obtained from oral erosions of 129 patients with various bullous diseases of the oral mucosa, clinically suspected of being oral pemphigus, as well as from 30 healthy subjects. The 40 cases with subsequent histologic proof of oral pemphigus were cytologically diagnosed as such, based on the significant cytomorphologic findings of acantholytic cells or on the pericellular deposition of IgG (which persisted after cytocentrifugation) in epithelial cells, as studied by direct immunofluorescence. Cytomorphology gave positive results in 37 patients with pemphigus and in one patient with a final diagnosis of herpetic stomatitis and gave negative results in all other cases. Immunocytology gave positive results in all patients with pemphigus and negative results in all other cases. The findings indicate that cytomorphologic studies may be useful in screening suspected cases of oral pemphigus vulgaris while the immunocytologic test may provide a reliable definitive diagnosis.

Diagnosis, Differential