Preliminary observations on the effect of recombinant leukocyte A interferon in homosexual men with Kaposi's sarcoma.
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Biomedical subjects
Publications and source records attributed to P L Myskowski.
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Disseminated mucormycosis, presenting with a cutaneous lesion, developed in a 20-year-old woman following bone marrow transplantation. The infecting organism was identified as Rhizopus rhizopodiformis. Despite early diagnosis and therapy with amphotericin B, the patient died.
Mycosis fungoides (MF) and Sézary syndrome (SS) are uncommon neoplasms of the lymphoreticular system with distinct clinical, histologic, and immunologic features. Based on the thymus-derived nature of the neoplastic cells, MF and SS are both classified as cutaneous T-cell lymphoma. While substantially greater understanding of MF and SS has been made possible, the exact mechanism for the initiation of either disease is still unknown. The possible involvement of environmental factors as well as viral etiology, i.e., retroviruses, has been suggested. In order to investigate the possible role of HLA-associated variations in genetic susceptibility, 74 patients with histologically documented MF were typed for HLA-A, -B, and -C antigens. Half of these patients were also typed for HLA-DR antigens. An increase in DR5 was the only statistically significant deviation in HLA antigen frequencies in these patients (53% in MF as compared with 20% in controls). An increased frequency of HLA-DR5 has also been associated with scleroderma and juvenile rheumatoid arthritis both of which have immunologic alterations. Also HLA-DR5 has been associated with renal cell carcinoma and Kaposi's sarcoma. The association of MF with DR5 suggests that some individuals with the DR5 antigen may be at higher risk for virally initiated and/or neoplastic diseases possibly through an HLA-linked defect in the immune system.
An outbreak of Kaposi's sarcoma in homosexual men has recently been observed in New York and California which differs from the "classic" North American disease with regard to younger age of onset and clinical prognosis. Although the exact mechanism for initiation of either disease is still unknown, a viral mechanism has been suggested in both cases. In order to investigate the possible role of HLA-associated variations in genetic susceptibility, 39 patients with histologically documented Kaposi's sarcoma were typed for HLA-A,B,C antigens. Most of these patients were also typed for HLA-DR antigens and for Gm allotypes. A significant increase in DR5 occurred in both groups. Decreases in B8 and DR3 and an increase in homozygosity for the Gm haplotype 3;5,13 were also noted. These results suggest that HLA and Gm linked immune response factors may play a role in the induction of both these forms of the disease.
An outbreak of KS has been observed in young homosexual men. These patients are different from those with classical KS for the following reasons: 1. geographic distribution (clustering in New York and California); 2. age (younger, mean--39 years); 3. higher incidence; 4. sexual preference (homosexual); 5. distribution of skin lesions (face, upper extremities, trunk); 6. lymph node involvement; 7. visceral lesions; 8. associated opportunistic infections (Pneumocystis carinii, toxoplasmosis); 9. history of sexually-transmitted diseases (hepatitis, syphilis, gonorrhea); and 10. aggressive course of the disease. Awareness of these features of the new KS will enable the practitioner to better recognize this important, emerging disease.
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Following Cobalt-60 irradiation for a left frontotemporal tumor, a 61-year-old woman developed comedones on the forehead. These changes responded to conventional acne therapy with retinoic acid. Multiple acneigenic factors were implicated in the pathogenesis of her lesions.
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