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Biomedical subjects

P D Ghislain

Publications and source records attributed to P D Ghislain.

17 recordsLinked to original sources
PubMed2002

[Acquired ichthyosis disclosing Hodgkin's disease. Simultaneous recurrence].

INTRODUCTION: Hodgkin's lymphoma is rarely evidenced by dermatological signs or symptoms. OBSERVATION: A 37 year-old man progressively developed widespread cutaneous roughness, with small parallel lines producing fish-like scales. A skin biopsy confirmed the diagnosis of acquired ichthyosis, as evidenced by the absence of the epidermal granular layer. The patient's condition was assessed to be satisfactory. However, two months later, his general condition had gradually deteriorated (night sweats, weight loss, axillary and scalp alopecia, and adenopathies). Hodgkin's lymphoma was diagnosed. After treatment with adriamycin, bleomycin, vincristine and dacarbazine, complete remission of the lymphoma was obtained, and concomitantly, the symptoms of acquired ichthyosis resolved; this was confirmed by serial skin biopsies that evidenced the progressive complete restoration of the granular layer. The level of plasmatic vitamin A and carotene, which had decreased before the treatment, returned to normal values. A subsequent relapse of Hodgkin's lymphoma was preceded by the recurrence of ichthyosis; this time vitamin A and carotene levels were not decreased. DISCUSSION: As a paraneoplastic syndrome, acquired ichthyosis as a first sign of Hodgkin's lymphoma is discussed. In the presence of acquired ichthyosis, repeated monitoring of the patient is required since clinical symptoms of Hodgkin lymphoma are often delayed. Acquired ichthyosis is also an early marker of lymphoma recurrence.

Adult↗
PubMed2002

[Ofuji's papuloerythroderma: two cases treated with azathioprine].

BACKGROUND: Ofuji's papuloerythroderma is a rare disorder, characterized by a generalized pruriginous eruption, sparing the folds. It predominates in the elderly. The pathology is still unknown but associations with lymphoma have been described. Various therapeutic approaches have been tried, most often including local and general corticosteroids and PUVA. OBSERVATION: Two patients aged 71 and 84 years presented red pruriginous macular rash sparing the abdominal folds. Eosinophilia and lymphopenia were observed. Cutaneous biopsies showed dermal lymphocytic and plasmocytic infiltrates with, in one case, eosinophil and neutrophil exocytosis. Clinical, biological and morphological investigations showed no association with other diseases such as cancer or lymphoma. Azathioprine permitted clinical and biological remission in both patients but had to be interrupted because of minor side effects (infection, gastroenterologic disorders) and corticosteroids were introduced in one case. DISCUSSION: We suggest that histological aspects, such as exocytosis, may represent a link between Ofuji's papuloerythroderma and lymphoma. Azathioprine led to clinical and biological improvement in our 2 patients. Because of its adverse effects, it could be proposed as second-line therapy in patients presenting resistance or intolerance to usual treatments.

Adrenal Cortex Hormones↗
PubMed2002

[Eccrine porocarcinoma with extensive cutaneous metastasis].

BACKGROUND: Porocarcinoma is a malignant tumour of the eccrine sweat duct, arising from acrosyringium. The tumoral lesions involve the deep dermal tissue. CASE REPORT: We report the case of an 84 year-old woman, suffering from a porocarcinoma, extensively involving the major part of the left lower limb. The first symptoms appeared two years ago. Hundreds of metastatic papules and small nodules were present, isolated or confluent into large plaques. The clinical picture was very close to lymphangioma. Diagnosis was confirmed by histopathologic examination. Radiotherapy was useful short-term, allowing partial flattening of the lesions and improving lymphatic drainage, thus providing comfort for the patient. It did not prevent a later progression of the tumoral process. DISCUSSION: Porocarcinoma is a rare tumour that usually appears as a single nodule or a plaque, arising from a preexistent eccrine poroma, or developing de novo. Two histopathological variants are described: trabecular or epidermotropic. This latter form, observed in the present case, is more aggressive, leading to frequent local recurrences and/or metastases. Our report is exceptional: the literature shows only one other case with such widespread cutaneous involvement. The clinical course of our case is discussed.

Acrospiroma↗
PubMed2001

Keratosis lichenoides chronica: report of a new case, with success of PUVA therapy.

Keratosis lichenoides chronica is a rare disorder. It consists of the progressive development of asymptomatic verrucosities on the limbs and the trunk, with a partially linear distribution. We report the case of a 78-year-old woman who presented with keratotic plaques and papules of the trunk and the limbs for several years. A diagnosis of keratosis lichenoides chronica was clinically and histologically evident. PUVA-therapy was started, with excellent results.

Aged↗
PubMed2001

[Orf in urban surroundings and religious practices: a study over a 3-year period].

BACKGROUND: Orf is a sheep disease, due to a parapox virus. Men in close contact with these animals may be contaminated. This generally occurs during professional activities. In our clinic, located in the heart of Brussels, we were surprised by the number of orf cases encountered each year, grouped during a short three-week period. PATIENTS AND METHODS: We decided to set up a prospective study of three years. Forty-four cases (14 to 64 years of age) were observed: 14 in 1998, 18 in 1999 and 12 in 2000. There were 29 men and 15 women. RESULTS: Only one patient had professional contact with sheep; 42 were muslims. Forty-two lesions out of 44 developed in the same time span, 10 days earlier each year. Complications observed were: erythema multiforme (7 cases), lymphangitis (3 cases), axillary adenitis (3 cases), eyelid edema (2 cases), generalized maculopapular eruption (2 cases) and contact dermatitis to the cream applied (1 case). DISCUSSION: This peculiar epidemiology can easily be explained: patients are contaminated during a religious feast, Aid el Kebir (the Feast of Sacrifice). On this occasion, they slaughter sheep, which they manipulate with bare hands. Small trauma often occur at that time. We conclude that orf is not only a professional disease but particuliar habits may cause epidemic-type contamination.

Adolescent↗
PubMed2000

[Aspirin-induced angioedema of the nape of the neck with naproxen cross-reaction: a case report].

We report a case of angioedema limited to the nape of the neck. The symptoms occurred every morning for fifteen days, two or three hours after taking aspirin. The patient took salicylic acid, 100mg per day, orally for two years. The angioedema occurred alone, without urticaria. When aspirin was stopped, the symptoms disappeared. A few weeks later, the patient took napoxen, with occurrence of more pronounced symptoms. The causality score was I3 for both drugs. The most common side-effects of aspirin intake are asthma and urticaria/angioedema. The mechanism of this hypersensitivity is unknown. There are numerous cross-reactions between aspirin and other NSAIDs. This case points out the importance of accurate history taking concerning self-medication for the diagnosis of angioedema.

Angioedema↗
PubMed1999

[Toxic dermatitis caused by tramadol].

BACKGROUND: Tramadol chlorhydrate (Topalgic) is a powerful analgesic recently introduced in France where its use has spread rapidly. We report a case where this drug induced a maculopapulous toxic skin reaction with secondary erythrodermia. CASE REPORT: A 47-year-old man was treated for lower back pain with tramadol chlorhydrate (50 mg b.i.d.). Otherwise, he was in good general health and was taking no other medications. Shortly after beginning the treatment, he developed a highly pruriginous maculopapulous eruption involving the entire skin surface, hyperthermia and general degradation. There was no skin exfoliation, mucosal involvement nor nodal enlargement. Tramadol was withdrawn and the patient was given corticosteroid therapy. Secondary erythrodermia developed after termination of the corticosteroids. The lesions regressed after tramadol withdrawal. DISCUSSION: Tramadol-induced skin reactions are uncommon and usually benign. In our case, the delay from onset of tramadol and the development of the maculopapulous eruption was very short (four days). The patient was taking no other medication. We hypothesize that the patient had been sensitized by cross-reaction with another compound and recall the fundamental aspects of tramadol and opiate drugs.

Analgesics, Opioid↗
PubMed1999

[Symmetrical benign lipomatosis of the tongue and Launois-Bensaude lipomatosis].

BACKGROUND: There are many causes of macroglossia, including fatty infiltration. Unlike unique or multiple lipomas of the tongue, non-encapsulated adipocyte masses develop in the tongue in symmetrical benign lipomatosis. Only six cases have been reported in the literature. CASE REPORT: A 69-year-old man with a history of chronic alcoholism developed a soft tumefied formation on the lateral margins of the tongue. A yellow-colored content was perceived through the thin mucosa. The formation was bilateral and had developed for more than 10 years. The patient also presented Launois-Bensaude lipomatosis localized on the neck, the nuchal region and the shoulders. DISCUSSION: This is, to our knowledge, the first reported case of symmetrical benign lipomatosis associated with Launois-Bensaude lipomatosis. An analogy between these two conditions has been suggested, but the six earlier cases of lipomatosis of the tongue reported in the literature developed in patients without cutaneous lipomatosis.

Aged↗
PubMedDate not supplied

[An unusual complication of bronchitis: Sweet's syndrome].

Sweet's syndrome (acute febrile neutophilic deromatosis) is a rare but not exceptional disease. Its first description was done in 1964, and its diagnosis is now well defined. A few days after a common upper respiratory infection, out patient presented erythematous plaques on the head, neck and forearms, with fever and general malaise. A skin biopsy showed a neutrophilic infiltrate. Oral steroids were prescribed, and healing occured within 48 hours. Respiratory and gastointestinal infections are frequently associated with Sweet's syndrom. Other associations have been described: neoplasias (mainly hemoproliferative diseases), inflammatory diseases, pregnancy, drugs. Cases classified as 'idiopathic' need a close follow-up: Sweet's syndrome may announce a malignant disease. There are also intermediate forms with other neutrophilic dermatoses, e.g. pyoderma gangrenosum.

Anti-Inflammatory Agents↗