Treatment of psoriasis by oral PUVA therapy combined with aromatic retinoid (Ro 10-9359; Tigason).

The authors discuss results observed in 126 patients affected with severe psoriasis covering more than 40% of the whole body area, some of them representing failures of oral photochemotherapy (PUVA). They were treated according to 5 different schedules, 3 of them combining aromatic retinoid Ro 10-9359 (AR) with PUVA therapy. The most effective results were obtained with a schedule entailing initial treatment for a 2-week period with AR only, followed on the 15th day by the adjunction of classic PUVA therapy with progressive daily decrease of AR dosage (schedule C). It was possible to reduce the frequency and duration of PUVA treatments and the amount of energy used although to a lesser degree than described by other authors. Even more important, far longer remissions were obtained than with PUVA therapy alone, even where the ratio of clearing was identical. This combination therapy made it possible to recover over 70% of the complete or relative failures of PUVA monotherapy. Thus the combination of AR + PUVA therapy (RE-PUVA) as in this schedule appears to be the most important improvement ot PUVA since its introduction as a therapy for psoriasis.

[Clinical, biological, histological, ultrastructural and therapeutic studies in one case (author's transl)]. / Une observation de glucagonome. 1--Etude clinique, biologique, histologique, ultrastructurale et thérapeutique.

The diagnosis of glucagonoma was made in a 51 year-old woman who suffered from a polymorphous dermatitis and an insulin-dependent diabetes mellitus. Denutrition was present and there was a previous history of thrombo-embolism. Immunoreactive plasma glucagon was constantly higher than 1 000 pg/ml (N less than 175). Plasma aminoacids were low. After angiographic confirmation, the tumour and part of its hepatic metastases were resected. The dermatitis disappeared soon after. Its recurrence required chemotherapy (successively mithramycin, streptozotocin, DTIC) and good clinical results were obtained. On histological examination, the cutaneous lesions consisted of an epidermal edema, and a bullous intra-epidermic detachment. The pancreatic tumour was of the trabecular type with a very important sclerosis. On electron microscopy, the tumoral cells, some with a syncitial aspect, contained granules of the D1 type. These granules are different from the typical glucagon granules. The clinical and biological features in this case are compared with those of the 41 cases of glucagonoma previously published.

[The association tretinoin-erythromycin base: a new topical treatment for acne. Results of a multicentric trial on 347 cases (authors transl)]. / L'association tretinoïne-erythromycine base: nouveau traitement local de l'acné. Etude multicentrique sur 347 cas.

A multicentric trial involving ten dermatological departments was conducted to evaluate the efficacy and tollerance of ANTIBIO-ABEREL (an association of Tretinoin and Erythromycin base) in 347 patients with persistant acne. Complete healing or considerable improvement was obtained in 85% of cases. This new treatment was active against both inflammatory lesions (papules and pustules) and retentional elements (microcysts and open comedones). It was also rapidly active, as very favorable results were obtained in ten weeks or less, in more than half of the cases. The tolerance was remarkable (less than 1% of cases had to interrupt treatment). This product represents an important progress as compared to Tretinoin alone. No other local or systemic therapy, especially long term antibiotherapy, is required.

[Skin lesions revealing a glucagonoma (author's transl)]. / Lésions cutanées révélatrices d'un glucagonome.

About a case of necrolytic migratory erythema erythema revealing a malignant pancreatic glucagonoma, the authors compare the results of their study with the 25 cases published in the world.

[Congenital or acquired unilateral nevoid stellar telangiectasias. About 5 cases (author's transl)]. / Télangiectasies stellaires naevoïdes unilatérales acquises ou congénitales. A propos de 5 cas.

Based on five personal cases (one neo-natal case, one in childhood, and three cases in pregnant women) and sixteen published cases, this study remind us of the essential caracteristics of unilateral nevoid telangiectasis. Prevalence in women is noticeable appearance during pregnancy, with complete regression during post-partum, is quasi constant. If their nosological place is not clear among the essential telangiectasias, they seem to be quite different from Hutchinson's serpiginious angioma (verrucous telangiectasis), from Osler-Rendu's disease, from Brocq's telangiectasias and from generalizated telangiectasias. The true signification of all these diseases is still completely unknown.

[Treatment of mycosis fungoides by PUVAtherapy. Report on 18 cases (author's transl)]. / Traitement du mycosis fongoïde par la puvathérapie. a propos de 18 cas.

A group of 18 patients with mycosis fungoides (M.F.) was treated by PUVAtherapy. According to VanScott classification, they have been set in:--5 parapsoriasis in large plaques = 5 stages I;--6 stages II;--3 stages III;--2 stages IV;--1Sézary syndrom.--1 erythrodermia. There was complete clearing of 12 patients (66 p. 100); 2 patients (11 p. 100) improved cutaneous lesions without a complete clearing, and there was no response to treatment for 3 patients (22 p. 100) (1 with erythrodermia, 1 with Sézary syndrom and 1 stage IV, and 1 forsaking). The method applied here was different in several points: orally administered methoxalen were given according to the body area (mg/m2) and some of the patients had twice a day puvatherapy. Puvatherapy seems to be the least dangerous and most effective treatment for the patients in the early stages of mycosis fongoides (I, II) and nitrogen mustard, electron therapy, corticoids and even mono- or polychimiotherapy could be associated to puvatherapy, if necessary, for the stages III and IV.

Eruptive nevocytic nevi after severe bullous disease.

In two patients, hundreds of nevocytic nevi (melanocytic nevi) appeared in sites of severe bullous dermatoses that were considered to be toxic epidermal necrolysis and erythema multiforme exudativum, respectively. This phenomenon may result from benign melanocytic hyperplasia accompanying keratinocytic hyperplasia during the healing process of some of the denuded areas of the skin.

Preferential replication of Sézary cells in the epidermis.

Skin biopsies from three patients with Sézary Syndrome have been labeled in vitro with H-3Thymidine. Labeled cells have been counted in semithin Epon embedded sections and characterized by electron microscopic autoradiography. The ratio of labeled Sézary cells to total lymphocytes was two to four times higher in the epidermis than in the dermis. It is concluded that Sézary cells replicate in the skin and that epidermal cells seem to possess new blastogenic properties in Sézary Syndrome.