Biomedical subjects

P Guitera-Rovel

Publications and source records attributed to P Guitera-Rovel.

3 recordsLinked to original sources

PubMed2001

Indium-111 octreotide scintigraphy of Merkel cell carcinomas and their metastases.

BACKGROUND: Somatostatin receptor scintigraphy (SRS) may be of interest for staging Merkel Cell Carcinoma (MCC). This study was undertaken to evaluate the sensitivity and specificity of SRS and to determine its role compared to conventional investigations. PATIENTS AND METHODS: From 1993 to December 2000, 20 patients (10 females and 10 males, aged from 38 to 88, mean 66 years) were included prospectively. At the time of SRS: 12 patients had been diagnosed as having stage I disease, 6 stage II and 4 stage III. Two patients had two SRS studies during the course of their disease. SRS was performed with Indium-111 pentetreotide (Octreoscan), a radiolabelled somatostatin analogue. Patients were treated according to the clinical stage. A regular follow-up was scheduled every three months. RESULTS: SRS depicted stage I and II MCC tumour sites with an overall sensitivity of 78% (95% confidence interval (CI): 40%-97%) and a specificity of 96% (81%-100%). The histopathological diagnosis was used as the gold standard. Sites visualised by SRS were compared to those detected with conventional modalities and to follow-up data for all stages: SRS visualised four out of five primary tumour sites, six out of eight lymph node sites, no skin metastases (14 sites in 2 patients), two out of three thoracic metastases and zero out of two hepatic metastases. SRS did not influence treatment decision-making in any of the cases. CONCLUSIONS: Although SRS seems highly specific in MCC and could be of help in difficult cases, it cannot be recommended for routine evaluation.

Adult↗

PubMedDate not supplied

[Painful bruising syndrome mimicking cellulitis of the leg].

BACKGROUND: Autoerythrocyte sensitization syndrome (painful bruising syndrome) is marked by spontaneous and painful ecchymotic bruising, without any biological abnormality, occurring in women with pathological mental profile. Sometimes, when the inflammation is severe, an infectious cellulitis or muscular compression may be suspected. CASE REPORT: A 21-year-old woman was referred for the rapid occurrence of a diffuse and painful inflammation of the right leg, with fever. The leg was red, warm, with diffuse bruising. The foot was fixed in varus equin. The biological parameters were normal. Magnetic resonance imaging showed normal muscles but modifications in the subcutaneous fat, similar to an acute cellulitis. A cutaneous biopsy showed a moderate oedema of the dermis and erythrocyte extravasation. Antibiotics were inefficient on the pain and the aspect of the lesions. Because of the efficacy of saline serum injections on the symptoms and a pathological psychological profile, an autoerythrocyte sensitization syndrome was suspected. The skin test was negative. Psychiatric evaluation revealed a severe personality disorder associated with depression. The ecchymotic lesions disappeared with adapted psychiatric treatment. DISCUSSION: Painful bruising syndrome occurs most often in young women with various psychiatric problems. The lesions are characterized by recurrent, painful, swollen and bleeding bruises in any part of the body. Fever, abdominal pain and external bleeding are possible. Haematological and immunological findings are usually normal. The histology of early lesions reveals oedema of the dermis and modest perivascular infiltrate, whereas extravasated erythrocytes appear later. The magnetic resonance imaging aspect of the lesions has never been described. Abnormalities of the subcutaneous fat are similar to those of acute cellulitis, expressing the inflammation process secondary to the ecchymoses. The syndrome results from complex somatic and psychological mechanisms. Many drugs were tried for the treatment of the disease, without any significant improvement.

Adult↗

PubMedDate not supplied

[Acquired circinated ichthyosis revealing a lymph node tuberculosis].

BACKGROUND: Acquired ichthyosis usually reveals or is associated with an internal disease. The classical clinical aspect is vulgaris ichthyosis. We report a case of acquired ichthyosis, presenting original clinical features, revealing a lymph node tuberculosis. CASE REPORT: A 63-year-old male patient without past history of skin disease consulted for a generalized eruption. The eruption was composed of multiple erythemato-squamous plaques. The edge of the plaque was raised and circinated. Histologic examination of the edge and the centre of the lesion supported the clinical diagnosis of ichthyosis. The diagnosis of lymph node tuberculosis based on large inguinal nodes was confirmed by the fast acid-bacilli found in the lymph node. Initiation of antituberculosis therapy was followed by the rapid and complete disappearance of the skin lesions. DISCUSSION: We report a case of acquired ichthyosis with original clinical features and we propose to coin the term "acquired circinated ichthyosis". This entity was clinically distinct from ichthyosis vulgaris or pityriasis rotunda. This dermatosis was concomitant to lymph node tuberculosis and healed under antituberculosis therapy.

Antibiotics, Antitubercular↗