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Y Scrivener

Publications and source records attributed to Y Scrivener.

17 recordsLinked to original sources
PubMed2002

Variations of basal cell carcinomas according to gender, age, location and histopathological subtype.

BACKGROUND: Most published series of basal cell carcinomas (BCCs) do not take into account the histopathological subtype. Recent studies suggest that the nodular and superficial types could be induced by different causal factors. OBJECTIVES: To analyse the three major subtypes of BCC with regard to sex, age and anatomical distribution. METHODS: We retrospectively included all cases of BCC diagnosed at a single centre of dermatopathology during 1967-96. The diagnosis and subtype (nodular, superficial, morphoeiform) were confirmed by two dermatopathologists. Gender, age at excision, number of tumours and location were recorded, and analysed by histopathological subtype. RESULTS: We recorded 13 457 cases in 10 245 patients (M/F ratio 0.92) of mean age 65 years. Of the BCCs, 78.7% were nodular, 15.1% superficial and 6.2% morphoeiform. Nodular tumours occurred at a mean age of 66.3 years, whereas superficial tumours were excised earlier (63.0 years) and more frequently in women (M/F ratio 0.96). Patients with morphoeiform BCC had a mean age of 65.8 years and were predominantly women (M/F ratio 0.73). Both nodular and morphoeiform types predominated on the head (89.6% and 94.8%), whereas the trunk was the most common location for the superficial type (45.9%). Superficial carcinomas were predominantly located on the head in women (44.8% vs. 34.7% in men), whereas they predominated on the trunk in men (49.9% vs. 42% in women). Tumours of the trunk were excised earlier than those of the face, whatever their histological subtype, in both men and women. CONCLUSIONS: This is the largest series of BCCs in the literature, and shows striking differences in anatomical distribution, sex and mean age according to histological type. The results suggest that the tumours of the trunk, and not only those of the superficial type, could represent a particular subtype of BCC. The analysis also suggests that the hypothesis of chronic vs. intermittent sun exposure cannot be simply extrapolated to BCC. Other causal factors, such as a genetic predisposition, could be involved in the development of carcinomas located on the trunk.

Adolescent↗
PubMed2002

[Erythroderma induced by hypercalcitoninemia: two cases].

INTRODUCTION: The most common cause of erythroderma is the extension of a previous cutaneous disease to the entire skin surface, as is the case in mycosis fungoides or drug reactions. Erythroderma related to endocrine disorders has only exceptionally been published. We report two cases of patients suffering from erythroderma probably induced by hypercalcitoninemia. OBSERVATIONS: Case 1. A 69 year-old man had a two year-history of fluctuating erythroderma, resistant to all topical or systemic therapy. After numerous unsuccessful investigations, a high serum calcitonin rate was detected. The pentagastrin test was highly positive, suggesting a medullar carcinoma of the thyroid. Thyroidectomy showed only hyperplasia of C cells. All skin signs disappeared within a few days after surgery. Two years later, there was no recurrence of the erythroderma and the serum calcitonin rate was normal. Case 2. A 58 year-old man suffered from congestive and pruriginous erythroderma for 2 1/2 months, which responded well to topical steroids. Biological investigations done for flushes, showed a raised calcitonin level and highly positive pentagastrin test. Thyroidectomy also revealed simple hyperplasia of the C cells. No recurrence of the erythroderma was noted during the 6 month follow-up. DISCUSSION: These are the first cases of erythroderma associated with hypercalcitoninemia. The causal role of calcitonin is probable in the first case, because of 1) long duration of skin signs before the hypercalcitoninemia; 2) quick post-operative recovery, in parallel with the decrease in calcitonin level; 3) absence of recurrence after thyroidectomy; 4) absence of other proven causes. Erythroderma may have resulted from dilation of the skin vessels, since calcitonin and calcitonin gene related peptide are powerful vasodilators.

Aged↗
PubMed2002

[Morphology of sweat glands].

There are two types of sweat glands: eccrine glands, which do not show cytological changes during secretion and apocrine glands, characterised by decapitation secretion, in which part of the cell is pinched off and released into the lumen. Eccrine glands play a major role in thermoregulation and electrolyte balance. They are present everywhere in the human skin and are composed of a secretory portion, an intradermal duct and an upper intraepidermal part, called acrosyringium. The acrosyringium has a unique symmetrical and helicoidal course, which length is correlated to the thickness of the epidermis. Apocrine glands are located only on genital, axillary and mammary areas, where they are always connected to a hair follicle. Their exact role in humans is unknown. A third type of intermediate sweat glands, the apoeccrine glands, was recently described in axillary areas. Sweat glands can be involved in various inflammatory processes and can lead to a large range of both benign and malignant tumors.

Animals↗
PubMed2002

[Hospitalization criteria for erysipelas: prospective study in 145 cases].

INTRODUCTION: Two recent studies conducted in France among general practitioners have shown that they only hospitalized between 20 to 50 percent of patients with erysipelas seen in private practice. We therefore conducted a hospital-based, prospective study designed to determine the hospitalization criteria for erysipelas, since a number of patients are also hospitalized directly through the emergency department. PATIENTS AND METHODS: This prospective, hospital-based study, included patients hospitalized for clinical diagnosis of erysipelas in 9 centres in north-eastern France. Clinical data were recorded using a standard questionnaire filled-in during the first 72 hours of hospitalization. They included: demographic (name and first name initials, age, sex) and clinical (location of erysipelas) characteristics, as well as the origin of the patient (home, emergency department, other department), the reasons for hospitalization (severity of local or systemic signs, suspicion of deep vein thrombosis, location on the face, age over 60 years, associated diseases, absence of improvement after ambulatory treatment, socioeconomic reasons or on principle hospitalization). Patients hospitalized by (or without) a general practitioner were compared using Chi-2 and Student t tests. RESULTS: One hundred forty-five adults (80 women and 65 men; mean age 61 +/- 20 years) were included in the study: 89 patients (61 p. 100) were hospitalized by a general practitioner whereas 56 (39 percent) went directly to the emergency department. In 128/145 cases (88 p. 100), erysipelas was localized on the lower limbs. The mean number of reasons for hospitalization per patient was of 2.2 +/- 1.2. The most frequent reason for hospitalization was an associated disease (diabetes, obesity, alcoholism, immunodeficiency), present in 77 cases (53 p. 100). Patients hospitalized through a general practitioner were older than those hospitalized directly through the emergency department (68 vs 51 years; p<0.001). Patients hospitalized by a general practitioner more frequently had an erysipelas located on the lower limbs (94 p. 100 vs 79 p. 100; p<0.001) and the mean number of reasons for hospitalization was greater (2.4 vs 1.7; p<0.001), especially suspicion of deep vein thrombosis and elevated mean age. The treatment started during hospitalization was intravenous penicillin G in 67 cases (46 p. 100), oral pristinamycin in 28 cases (19 p. 100) and intravenous or oral amoxicillin in 9 cases (6 p. 100). COMMENTS: This study demonstrates the existence of two distinct courses of hospitalization for erysipelas. Patients hospitalized by a general practitioner were older and their erysipelas more frequently located on the lower limbs and deep vein thrombosis was suspected. Our study also shows the emergence of a population of patients younger and without medical supervision, for whom the general practitioner is replaced by the emergency department of the local hospital. Nevertheless, the most frequent reason for hospitalization in both groups is the existence of an associated disease, possibly responsible for further complications.

Adult↗
PubMed2001

Molluscum contagiosum: histologic patterns and associated lesions. A study of 578 cases.

Molluscum contagiosum (MC) is rarely associated with other skin diseases, especially cutaneous neoplasms. Such associations are exceptional and of unknown frequency. The aim of this study was to record the histologic variants and frequency of associated lesions in a large series of consecutive MC cases. We reviewed 578 MC cases from the Laboratory of Dermatopathology of the University Hospitals of Strasbourg, France (1959-1999). The locations of MC were as follows: head and neck (34.7%), trunk (27.1%), lower limbs (20.7%), upper limbs (8.7%), and genitalia (3.8%). Molluscum contagiosum occurred more often in female patients (56.7%). The age range of patients included in this study was 0 to 19 years (34.9%), 20 to 39 years (31.1%), 40 to 59 years (22.8%), and over 60 years (6.5%). Histologic variants of MC were noted in 46 cases (31 pseudocystic, 8 giant, and 7 pedunculated). An underlying abscess was present in 65 cases. Of the 578 cases, 22 were associated with other lesions (3.8%). There were 9 cases of epidermal cysts, 4 of nevocellular nevi, 3 of metaplastic ossifications, 2 of true epidermal nevi, 2 of sebaceous hyperplasias, 2 of soft fibromas, and 1 of Kaposi sarcoma. Except in immunocompromised patients, such associations are likely to be coincidental. The clinical diagnosis was correct in 42.3% of the cases. Clinical accuracy varied according to the age, localization, and histologic pattern of MC. Pseudocystic MC, giant MC, and MC associated with other lesions were responsible for frequent clinical misdiagnosis.

Adolescent↗
PubMed2000

Tumors arising in nevus sebaceus: A study of 596 cases.

BACKGROUND: Prophylactic surgical excision of nevus sebaceus (NS) during childhood is often recommended because various neoplasms can occur on NS. The proportion of malignant tumors occurring on NS is highly variable among the published series, and there are controversies on the nature of these neoplasms because many of the previously described basal cell carcinomas could actually be trichoblastomas, which are benign follicular tumors. OBJECTIVE: We retrospectively analyzed all cases of NS of our collection, excised during the period from 1932 through 1998, and recorded all associated epithelial and nonepithelial changes. We especially differentiated basal cell carcinomas from trichoblastomas by silhouette analysis and examination of the stroma. These findings were analyzed according to gender, age, and localization. METHODS: Microscopic analysis of NS by two examiners was performed independently of clinical data. RESULTS: A total of 596 cases were included from 290 females and 306 males, mean age 25.4 years (range, 1 month to 87 years); 232 were excised in children younger than 16 years. NSs were located on the scalp in 49.8% of cases. Basal cell carcinomas were found in 5 cases (0.8%, mean age 39.3 years) and benign tumors in 81 cases (13.6%, mean age 46.3 years). Syringocystadenoma papilliferum (n = 30, 15 males, 15 females) and trichoblastoma (n = 28, 7 males, 21 females) were the most frequent benign tumors. NS with associated tumors were located on the scalp in 79% of cases. Only 4 benign tumors (1.7%) and 2 warts were observed in patients younger than 16 years. Various types of epithelial hyperplasia were noted that could not be considered neoplasms, as well as epidermal and apocrine cysts. CONCLUSION: The rate of malignant tumors arising on NS was very low and we did not observe such cases in children, who had associated benign tumors in only 1.7% of cases. Benign neoplasms were common and most of them occurred on the scalp; this was not a bias resulting from a longer duration before surgery. Trichoblastoma and not basal cell carcinoma was the most frequent follicular tumor associated with NS and showed a striking female predominance. Most trichoblastomas had previously been misdiagnosed but could actually be easily recognized by typical histologic features. Because most tumors occurred in adults older than 40 years, our study suggests that prophylactic surgery in young children is of uncertain benefit. Clinical follow-up is probably sufficient, and even those cases with clinical changes often proved to be benign tumors or warts.

Adolescent↗
PubMed1998

[Erythroderma with immunoglobulin deposits along the basal membrane. Pemphigoid erythroderma?].

INTRODUCTION: There are many clinical forms of bullous pemphigoid. Nodular, localised, vegetating, vesicular and dysidrosiform variants have been described. The appartenance to the spectrum of pemphigoid was confirmed by the demonstration of antibodies directed against the 230 and 180 kDa BP antigens. Three cases of erythrodermic pemphigoid were recently described. OBSERVATIONS: We describe two cases of patients suffering from erythroderma for several months associated with a linear deposit of immunoglobulins and complement along the basement membrane. In the first observation, the patient suffered from bullae of the legs before developing erythroderma. The positive direct immunofluorescence of the skin was associated with circulating anti basement membrane antibodies, making therefore the diagnosis of erythrodermic pemphigoid possible. In the second case, the patient never developed blisters. We also found a linear deposit along the basement membrane, localized on the dermic side of a skin treated by molar NaCl. No circulating antibodies were found by indirect immunofluorescence or by immunoblott. Direct immuno electron microscopy showed a deposit of immunoglobulins into the deep layers of the lamina lucida and into a part of the lamina densa. CONCLUSION: These two cases suggest that there are true erythrodermic pemphigoid without blisters. The value of the systematic direct immunofluorescence examination of the skin of erythroderma should be evaluated.

Aged↗
PubMed1998

[Orbital edema induced by psychotropic drugs?].

INTRODUCTION: Drugs known to be responsible for orbital edema are calcium channel blockers, rifampicin, atracurarium, methylprednisolone and mannitol. We describe three patients with orbital edema induced by psychotropic drugs administrated for a long period of time. OBSERVATIONS: These patients were aged 51 to 73 years, and had orbital edema predominant in the morning, but persisting during the day. All the other causes of orbital edema--including steatoblepharon--were ruled out by medical history and investigations. In one case the edema decreased after the interruption of nearly all psychotropic drugs. DISCUSSION: The exclusive orbital localization of the edema suggests a local or regional mechanism that could be an exacerbation of the physiological morning orbital edema induced by decreased lymphatic flow. This flow is usually enhanced by gravity and automatic palpebral blinking.

Aged↗
PubMed1998

[Contact sensitization in leg ulcers].

BACKGROUND: The leading complication of leg ulcers is the development of peri-lesional eczema. The etiological diagnosis is often difficult due to the large number of topical agents used. PATIENTS AND METHODS: Fifty patients, 35 women and 15 men, mean age 67.8 years, range 37-91 years, with leg ulcers of variable duration (15 days to 32 years, median 2 years) underwent explorations using the standard EECDRG battery in search of contact allergies. Eighteen potential allergens and the topical agents employed were tested. Readings were made at 48, 72, 96 or 120 hours. RESULTS: Sensitization rate was 76 p. 100 (90 p. 100 of the patients with a history of contact dermatitis and 50 p. 100 in those without such history). The respective percentages of positive tests were: balm of Peru 40 p. 100, fragrance-mix 28 p. 100, Amerchol L101 18 p. 100, lanoline alcohols 14 p. 100, colophane 12 p. 100, glycol propylene and parabens-mix 8 p. 100, stearylic alcohol, thiomersal, clioquinol and sorbic acid 6 p. 100, cetyl-stearylic alcohol, cetylic alcohol, eosin, cetrimide, chlorocresol, budesonide, tixocortol pivalate, bufexamac, formaldehyde, nickel, thiuram-mix and P.P.D. 4 p. 100, hexamidine, chlorhexidine, neomycin, benzocaine, potassium bichromate and cobalt 2 p. 100, triethanolamine, ethanol and other allergens in the EECDRG battery 0 p. 100. Tests were positive in 29 cases with commercial formulations, Biafine (8 cases), Parfenac (7 cases), and Rifocine ampoules (3 cases). Among 13 of the 29 cases, tests were positive with one or more allergens common to the product and the complementary battery. DISCUSSION: Contact sensitization rate is high in leg ulcer patients. Most of the tests had a relationship with leg ulcers. The number one causal agent is balm of Peru. Thirty percent of all the patients are sensitized to at least one excipient, generally lanoline. Allergy tests are positive in 22 p. 100 for one or more antiseptics and in 18 p. 100 for preservatives. Allergy to latex and neomycin is unusual, but sensitization to steroid anti-inflammatory agents was not tested. The main active ingredient in a topical agent is not always the allergen and a detailed test must be performed, generally with a complementary battery adapted to common prescriptions for leg ulcers.

Adult↗
PubMed1997

[Spironolactone-induced pemphigoid].

BACKGROUND: Sporadic observations would suggest that certain drugs play a role in the development of pemphigoid. A recent case-control study on long-term drug use associated with pemphigoid was unable to confirm the suspected role of these drugs, but did demonstrate a significant association between the development of pemphigoid and use of spironolactone. CASE REPORT: An 82-year-old patient had bullous erythematous lesions on the left thigh suggestive of pemphigoid. Histology and direct cutaneous immunofluorescence confirmed the diagnosis. The patient had been taking alimemazine, adrafinil, flunarizine, spironolactone and furosemide as long-term treatment. Spironolactone alone was withdrawn. The cutaneous lesions regressed and have not recurred during the 18-month follow-up. DISCUSSION: The causal effect of spironolactone in this case of pemphigoid is quite plausible. This hypothesis is favored by the agreement with epidemiological data. Other observations are however required before the causal role of spironolactone in development of pemphigoid can be confirmed.

Aged↗
PubMedDate not supplied

Perianal striated muscle hamartoma associated with hemangioma.

Striated muscle hamartoma is a rare entity which was described only recently. It is a congenital malformation characterized by the presence of striated, mature muscle fibers in the reticular dermis and hypodermis. We describe a striated muscle hamartoma of the perianal region in a female infant associated with an hemangioma in the same area that regressed completely. Including the present patient, only 14 cases of striated muscle hamartomas have been reported, but this association with an hemangioma is unique. The lesion was polypoid and histopathologic examination showed numerous striated muscle fibers located within the dermis.

Anal Canal↗