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T Castel

Publications and source records attributed to T Castel.

At least 37 records · Page 2Linked to original sources

Adjuvant treatment in stage I and II malignant melanoma: a randomized trial between chemoimmunotherapy and immunotherapy.

A randomized trial comparing chemoimmunotherapy (bacillus Calmette-Guérin + chemotherapy) and immunotherapy (bacillus Calmette-Guérin alone) was carried out in high-risk stage I and II malignant melanoma patients. Eight-two evaluable patients were included. The follow-up median duration was 11 years. Recurrent melanoma developed in 28 patients (34%). The overall survival rate was 76% at 5 years and 65% at 10 years. There were no statistical differences in survival probability or disease-free survival (DFS) probability between the two treatment groups. Survival and DFS were also analyzed in relation to various prognostic factors. Statistically significant differences were only seen in a subset of 33 patients with lower limb malignant melanoma, the prognosis being better for the chemoimmunotherapy group in this location. Because of the small number of patients in each group, a week positive effect of either of these two treatments cannot be ruled out. Chemoimmunotherapy only seems to improve the prognosis of stage I or II malignant melanoma of the legs.

Adult↗

[Kaposi's sarcoma associated with the acquired immunodeficiency syndrome. An analysis of 67 cases with a study of the prognostic factors].

The features and prognostic factors of 67 cases of Kaposi's sarcoma (KS) associated to the acquired immunodeficiency syndrome (AIDS) diagnosed at the Hospital Clinic, Barcelona, are analyzed. All the patients were male; mean age was 39.7 years, ranging from 22 and 62 years. 64 were homosexuals (95.5%), two were homosexual-drug addicts (3%) and one was drug addict (1.5%). Prevalence of cytomegalovirus and herpes virus infections were 91.1% and 89.5% respectively. In 42 cases (62.7%) KS was the initial AIDS presentation. The most common localization was the skin (89.5%), followed by the digestive tract (52.2%) and the lymph nodes (22.4%). Staging distribution was: 20 patients (29.8%) were in stage I, 11 patients (16.4%) in stage II, 7 patients (10.4%) in stage III, and 29 patients (43.2%) in stage IV. Constitutional symptoms associated to KS were found in 37 patients (55%). Overall 39 patients have already died, and the actuarial survival possibility of these 67 cases was 55% after 12 months. Univariant statistical analysis showed the presence of six variables with prognostic significance (p less than 0.05): staging, symptomatology, total white blood count, total lymphocyte count, T helper lymphocyte count and hemoglobin. Multivariant statistical analysis only chose the staging and symptomatology variables as independent (p less than 0.01 and p less than 0.001, respectively).

Acquired Immunodeficiency Syndrome↗

[Primary malignant melanoma of the skin. Retrospective study of 375 cases. Clinical aspects and histology].

The clinical and histologic features of 375 cases of primary malignant melanomas of the skin diagnosed and/or treated in the Hospital Clinic i Provincial (Barcelona, Spain) over a seven years period (1981-1987) were evaluated. The analysis of data showed many differences between these cases and those previously reported by us or from other countries. Sex incidence showed an increased frequency in women (58%), and a high incidence on lower limb in female (26% of all cases). Superficially spreading melanoma was the most common type (58%), followed by nodular melanoma (27%), acral lentiginous melanoma (8%) and lentigo maligna melanoma (6%). 57% of cases were diagnosed when the tumor thickness indicated a moderate or high-risk.

Adolescent↗

[Toxic skin reaction caused by hydantoins in a patient with AIDS].

A case of clinically characteristic hypersensitivity reaction to phenytoin in a AIDS patient with cerebral toxoplasmosis is reported. There was response to therapy with systemic steroids. Laboratory data and histopathologic features of the skin are reported.

Acquired Immunodeficiency Syndrome↗

Immunoglobulin A in the skin of patients with ankylosing spondylitis.

Cutaneous immunofluorescence studies were carried out in 21 patients with ankylosing spondylitis (AS) and the results compared with those for 18 healthy subjects. The most prominent finding was the presence of IgA in dermal vessels of patients with AS (71% compared with 17% of the control group). IgG and IgM cutaneous deposits were also observed in patients with AS, but these results did not differ from those of the control group. A renal biopsy was performed in three of the patients presenting with unexplained microscopic haematuria. One of them had an IgA nephropathy, but no correlation was found between kidney and skin deposits of IgA. These findings suggest that IgA cutaneous deposits in AS are not a marker of IgA nephropathy but stress the role of immunoglobulin A in the pathogenesis of this disease.

Adult↗

Plasma cells within the infiltrate of primary cutaneous malignant melanoma of the skin. A confirmation of its histoprognostic value.

Plasma cells within the infiltrate of primary cutaneous malignant melanoma have been reported as a valuable criterion for the prediction of lymph node metastases. In order to evaluate plasma cells, their prognostic significance and their relationship with other clinical and histological parameters, 132 cases of malignant melanoma (29 plasma cell positive and 103 plasma cell negative) were studied. The Breslow thickness, location, and ulceration were the variables related to the presence of plasma cells. The most important variables in predicting survival were lymph node involvement, clinico-pathological type, age, plasma cells, and lymphatic emboli. The most important variables for disease-free interval were lymph node involvement, plasma cells, and age.

Adolescent↗

Why do melanomas ulcerate?

Ulceration is an indicator of unfavourable prognosis in malignant melanoma (MM). But why do melanomas ulcerate?. Possible causes of ulceration were investigated in a group of 69 ulcerated and 69 non-ulcerated malignant melanomas. A significant correlation (P less than 0.001) between ulceration and mitotic index was found. In a group of 69 ulcerated malignant melanomas, 49 had over 7, 15 had 4-6, and only 5 had 0-3 mitotic figures per 10 high-power fields. Among 69 non-ulcerated melanomas, 28 had more than 7, 24 had 4-6, and 17 had 0-3 mitotic figures per 10 high-power fields. This study supports the hypothesis that ulceration of melanomas is usually the result of the destruction of the epidermis by the proliferating neoplastic cells or modification of blood supply due to the expansile activity of the tumor. The relationship between ulceration and mitotic activity helps clarify the prognostic significance of ulceration.

Humans↗

[Immunoblastic sarcoma associated with dermatitis herpetiformis].

Association between dermatitis herpetiformis and gluten enteropathy is well established. An increased incidence of malignant disease has been reported in patients with coeliac disease and also in dermatitis herpetiformis. Linear IgA dermatitis herpetiformis has a much lower incidence of associated enteropathy compared with patients with papillary dermatitis herpetiformis, but the risk of malignancy could be the same. We report a case of linear IgA dermatitis herpetiformis in which immunoblastic sarcoma subsequently developed.

Celiac Disease↗

Specific cutaneous manifestations of Waldenström's macroglobulinaemia. A report of two cases.

Patients affected by Waldenström's macroglobulinaemia may rarely present specific cutaneous manifestations. The violaceous plaques or tumours infiltrated by lymphoplasmocytoid cells, and the pink, translucent, shiny papules composed of deposits of hyaline monoclonal IgM possess definite clinico-pathological characteristics that may permit the diagnosis before any other data were available. The immunopathological and ultrastructural features of these lesions are described.

Aged↗

[Lucio's leprosy].

A case of diffuse lepromatous leprosy with lepra reaction type II-Lucio's phenomenon-in a 24 years old male patient is reported. The histological examination of the necrotic lesions and of the apparently normal skin showed the presence of dense perivascular and perianexial lymphohystiocitic infiltrates with great quantities of bacilli. The first biopsy did not show a picture a leuccocytoclastic vasculitis but only areas of necrosis. The immunofluorescence studies revealed on direct examination complement deposits on vessel walls. The complement levels in blood were lowered and circulating inmunecomplexes were also detected. These data confirm the opinion that Lucio's phenomenon is caused by circulating inmunecomplexes fixed on dermal vessel walls causing skin necrotic lesions.

Adult↗