ABSTRACT
INTRODUCTION: Two cases of perianal basal cell carcinoma were reported. Less than 100 cases have been so far described. OBSERVATIONS: The first case was a pigmented tumour, in the second an erosive erythematous plaque somewhat similar to Paget's disease. COMMENTS: Basal cell carcinoma of the anal margin is about 15-fold less common than squamous cell carcinoma. The tumour is often ulcerated, sometimes infiltrative but metastasis never occurs. Histopathological findings are often close to what is observed in cloacogenic carcinoma. Surgical resection of the lesion is the best treatment but electrontherapy permitted lesion healing in one of our cases.
Subject(s)
Anus Neoplasms/pathology , Carcinoma, Basal Cell/pathology , Skin Neoplasms/pathology , Aged , Aged, 80 and over , Anus Neoplasms/radiotherapy , Anus Neoplasms/surgery , Carcinoma, Basal Cell/radiotherapy , Carcinoma, Basal Cell/surgery , Diagnosis, Differential , Female , Humans , Radiotherapy Dosage , Skin Neoplasms/radiotherapy , Skin Neoplasms/surgerySubject(s)
Lichen Planus/diagnosis , Pemphigoid, Bullous/pathology , Adult , Blotting, Western , Diagnosis, Differential , Epidermis/pathology , Fluorescent Antibody Technique , Humans , Lichen Planus/pathology , Male , PUVA Therapy/adverse effects , Pemphigoid, Bullous/etiology , Sunlight/adverse effectsABSTRACT
This report concerns two siblings we observed, one male the other female, who presented with primary disseminated amyloidosis. Repeated blood and urine examinations failed to demonstrate dysglobulinaemia. The brother developed, at the age of 51, extensive cutaneous amyloidosis with xanthochromia of the entire upper part of his body. His dermis contained a potassium permanganate-resistant amyloid substance. One year later, he presented with amyloid cardiomyopathy confirmed by biopsy. Owing to the intractable cardiac failure, heart transplantation was performed, but the patient died post-operatively. At autopsy, amyloid deposits were found to be present in the heart, liver, spleen and adrenal glands. His sister developed, at the age of 40, cutaneous amyloidosis in the form of yellowish and purpuric papules and plaques disseminated over the upper part of her body. Histological examination and electron microscopy of the skin showed large potassium permanganate-resistant amyloid deposits. In addition, endoscopy and histology demonstrated the presence of amyloid substance deposits in her larynx, oesophagus and rectum. Echocardiography revealed amyloid cardiomyopathy. She now has moderate cardiac failure, and heart transplantation is being contemplated. Like her brother, she has no renal of neurological amyloid lesions. There is no abnormality of serum or urinary globulins, and her SAA protein is present in normal concentrations. These cases do not fit in with the known nosological framework of amyloidosis. Clinically, both patients had disseminated amyloidosis of the AL type, and their disease clearly differed from familial systemic amyloidosis with neuropathy or nephropathy. To our knowledge, no case of familial primary amyloidosis of the AL type without dysglobulinaemia has yet been reported.
Subject(s)
Amyloidosis/genetics , Cardiomyopathies/genetics , Amyloidosis/classification , Amyloidosis/pathology , Cardiomyopathies/pathology , Female , Humans , Male , Middle Aged , Myocardium/pathology , Skin/pathology , Ultrasonography , Viscera/pathologyABSTRACT
The authors have analyzed the results of cultures in Sabouraud's agar performed over a 20-year period in 6,000 patients with lesions of the skin, skin appendages and mucosae of suspected fungal origin. Throughout this period all patients, almost exclusively urban or suburban, were seen at the Dermatology out-patient consultation of a central city hospital. The 6,000 specimens were analyzed globally, with special attention to time-related changes in the 10 groups of 6,000 specimens each whenever a significant modification was observed. The analysis was divided into two parts: a review of the fungi isolated, of the manifestations they produced and of the time-related changes in their respective prevalence; a study of the fungi responsible for the main dermatological syndromes. Out of 6,000 cultures, 2,502 strains of pathogenic fungi were isolated, representing a growth rate coefficient of 41.66 p. 100. There were 1,237 dermatophytes and 1,265 yeasts of the Candida group. However, this overall impression of two equal groups gives a wrong idea of the changes that occurred during this long period. Figure 1 clearly shows that in 20 years the number of dermatophytes increased whereas the number of Candida decreased. Figures 2 and 3 demonstrate that the rise in dermatophytes was almost exclusively due to an increase in T. rubrum and the fall in yeasts, to a decrease in Candida albicans.(ABSTRACT TRUNCATED AT 250 WORDS)