[Arsenic poisoning].
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Arsenic Poisoning↗
Biomedical subjects
T Jouary
Publications and source records attributed to T Jouary.
A case of primary cutaneous nasal type NK/T-cell lymphoma and review of the literature.
INTRODUCTION: Cutaneous T-cell lymphoma subtypes are now better identified thanks to progress in immunohistochemistry. This article describes a new case of primary cutaneous natural killer/T-cell lymphoma of nasal type (NKTL-NT) and reviews 18 other cases of this rare neoplasm. CASE REPORT: A 79-year-old man presented with a 3-cm nodular tumor of the left leg occurring on a primary chronic lymphedema of the legs. The lesion was CD56+, CD3 intracytoplasmic+, CD45+ and Epstein-Barr virus+. A comprehensive workup including CT scan and bone marrow biopsy was negative and a diagnosis of NKTL-NT with a primary cutaneous involvement was made. The patient was free of disease under multi-agent chemotherapy after 24 months of follow-up. DISCUSSION: After reviewing 18 other cases of primary cutaneous NKTL-NT, we conclude that the prognosis of these lymphomas is usually poor. However, limited cutaneous forms have a longer median survival than extracutaneous variants.
Aged↗
[Microvenular hemangioma].
INTRODUCTION: Microvenular hemangioma belongs to the group of acquired vascular tumors. It is important to differentiate such lesions because of their prognostic and nosologic consequences. We report a case of microvenular hemangioma. CASE REPORT: A 31 year-old man presented with a 3 cm erythematous and asymptomatic nodule of the abdomen, which had grown for 2 months. Histopathology showed the irregular dermal proliferation of small vessels, composed of capillaries and venules, without atypia. No relapse was noted 6 months after complete exeresis. DISCUSSION: Microvenular hemangioma is a recently described vascular tumor. The first three cases were reported in 1989, with the denomination of "microcapillar hemangioma". Twenty-one further cases have been reported since 1991. We discuss the typical clinical and histological characteristics of this lesion and present criteria permitting the differential diagnosis with other vascular neoplasms. Dermatologists should be aware of this lesion, notably for the differential diagnosis with early onset Kaposi's disease.
Abdomen↗
[Cocaine-related localized necrotic livedo].
INTRODUCTION: The cutaneous signs of toxicomania are better known since the last two decades. We describe an original case of segmental necrotic and chronic livedo of the right arm associated with cocaine use. OBSERVATION: A 31 year-old intravenous cocaine user presented a necrotic and painful livedo of the right arm. Two years before referral, localized recurrent edema was noted without general involvement. No local (infectious, vascular) or general (dysimmunity, coagulation abnormalities) aetiologies could be found. An amorphic substance composed of mineral bodies was found in the dermis, without damage to the vessels. Dramatic improvement was obtained with simple supportive care, while intravenous injections were stopped. DISCUSSION: The vasoconstrictive properties of cocaine have been demonstrated in Raynaud's phenomenon, ischemia, focal necrosis of the extremities, and also in liver and kidney disorders. This drug has pharmacological effects on endothelial cells and coagulation, explaining the arterial and venous thrombosis reported. The foreign bodies found in our patient probably came from an intraarterial injection. The progressive and chronic evolution, without any evidence of thrombosis at the time of examination, are suggestive of the vasoconstrictive action of chronic dermal deposits.
Adult↗
[Effectiveness of 20% salicylated vaseline in the treatment of profuse tungiasis. Report of 8 cases in French Guiana].
The treatment of tungiasis involves the mechanic extraction of the gravid females of Tunga penetrans. We have observed on 8 patients profuse tungiasis diagnosed in the centre hospitalier de Cayenne. We have carried out different types of treatment, including the occlusive application of 20% of salicylated vaseline during 12 or 24 hours. This procedure causes the death of the parasites and facilitates their extraction.
Adult↗
Mycosis fungoides mimicking granuloma annulare.
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Aged↗
[Reflex sympathetic dystrophy of childhood: one case].
INTRODUCTION: Reflex sympathetic dystrophy (Complex Regional Pain Syndrome type 1) is little known by dermatologists. We report a pediatric case of reflex sympathetic dystrophy with predominant cutaneous involvement. CASE REPORT: A 10 year-old girl presented a warm, painful and relapsing right hand edema for seven months (three outbreaks). The hand was cyanotic, pigmented and painful. Routine blood tests were normal. Radiography and radionuclide bone scan were consistent with stage 1 reflex sympathetic dystrophy. Physiotherapy led to dramatic improvement. DISCUSSION: Reflex sympathetic dystrophy is known since the XVIIIth century. In the last decade, progress in radiology and bone scan have provided elements for understanding the physiopathology of the disease. Microvascular abnormalities under the control of sympathetic nervous system are characteristic of different stages of reflex sympathetic dystrophy. Recently, neurovascular system experiments showed that sympathetic reflex tonus changes may be controlled by the central nervous system. Dermatologic changes of reflex sympathetic dystrophy are well known: edema and erythema in first stage, cyanosis in second stage, sclerosis and atrophia in third stage, but pediatric cases are rarely reported. CONCLUSION: Reflex sympathetic dystrophy is a complex disease, however its physiopathology is now understood. The clinical presentation can be atypical and the dermatologist may be the first to be consulted.
Child↗
[Arrhythmogenic right ventricular cardiomyopathy. A pathologic diagnosis to invoke in the sudden death of a young subject].
We report a case of arrhythmogenic right ventricular cardiomyopathy revealed by sudden death during exercise in a 13-year-old patient. Postmortem diagnosis was made on multiple tissue samples taken from right ventricular free wall, showing light adipous infiltration of the myocardium at gross examination. Arrhythmogenic right ventricular cardiomyopathy is histologically characterized by fibro-fatty replacement of right ventricular myocardium. Left ventricular involvement may be observed. Diagnosis at an early stage is often difficult. Etiology remains unknown. Since familial occurrence has been documented, postmortem identification is useful for the other members of the family.
Adolescent↗