ABSTRACT
Visceral malignancies often present as cutaneous lesion and are an important clue towards the diagnosis. Authors report a case of a 64 years old male, who presented to us with right hemiparesis and multiple purple-red skin lesions. Systematic evaluation, thorough history and histological examination of the skin lesion showing the characteristic lesion lead to a final diagnosis of Renal Cell Carcinoma. Although in the history and physical examination there was no sign of Renal Cell Carcinoma, but eventually the case turned out to be an extensively spread cancer. This kind of Cutaneous lesions in a case of RCC is a rare phenomenon and has not been frequently mentioned in the previous literature, thus this case reminds us about the importance of a detailed clinical look out in each and every patient and various clues to make a correct and timely diagnosis of systemic diseases. The list of visceral malignancies causing cutaneous metastasis is quite long and requires a battery of test to diagnose the same.
ABSTRACT
In the present study, allergenic significance of thirteen species of Aspergillus and their allergenic and antigenic relationship was studied. Of the 3025 ID tests performed with the 13 species of Aspergillus on 289 patients suffering with allergic respiratory diseases, 627 (20.7%) were positive (1+ to 4+), 386 (12.8%) being significantly positive (2+ to 4+) . Of the 64 patients eliciting a positive cutaneous response to at least one species, 42(65.6%) were positive to 5 or less number of species while others showed a broad spectrum of positive skin reactivity to different Aspergillus extracts. In RAST inhibition assays using pooled sera ofpatients sensitive to A. tamarii dose related inhibition was produced by homologous as well as 5 of the 12 heterologous species. Similarly, in A. terreus RAST inhibition was observed with homologous and A. tamarii extracts only. Our results suggested the presence of both species specific as well as shared allergenic components among different Aspergillus species. In TDIEP experiments using rabbit antisera to A. tamarii and A. terreus extracts multiple precipitin bands were observed with the homologous extracts. However, only 1-2 bands were produced by 6 heterologous Aspergillus species in each system. Collectively, these results gave evidence that there is heterogeneity of immune response in the patients with allergic respiratory diseases to different species of Aspergillus and also in rabbits immunized with Aspergillus extracts.