Tumorous variant of scleromyxedema. Successful therapy with intravenous immunoglobulins.

We present an unusual tumorous variety of scleromyxedema mimicking facies leonina in lymphoma. In spite of pronounced and widespread cutaneous changes, hypergammaglobulinaemia and paraproteinaemia, the general condition of the patient was satisfactory, there was no internal involvement and no symptoms of any malignancy. Initially, melphalan and corticosteroids were applied but were not effective. High-dose intravenous immunoglobulin (IVIG) therapy had dramatic effect, and after five 5-day monthly courses the tumours almost regressed and the skin became less hard. After a further five courses in the following year there was complete clearance, which was sustained without any therapy for 1 year (until now). IVIG appears to be the therapy of choice for scleromyxedema. We stress, however, that at the start of therapy, IVIG applications should be supplemented with small doses of melphalan and/or corticosteroids.

[Nervous system changes in patients treated with penicillin during the period of symptomatic and early asymptomatic syphilis]. / Zmiany w ukladzie nerwowym u chorych leczonych penicylina w okresie kily objawowej i bezobjawowej wczesnej

The results of cerebrospinal fluid examination of 451 patients treated for syphilis were analysed. In 34 patients abnormalities were found in the protein level, cell number and serological investigations. Thus, there is an absolute indication to cerebrospinal fluid examination in each case in which serological tests remain positive despite adequate specific therapy.