ABSTRACT
Linear IgA disease is an autoimmune subepidermal bullous disease in which linear IgA deposits are found at the basement membrane zone. It is classically idiopathic but a drug-induced variant seems to be individualized in which cutaneous lesions resolve spontaneously after cessation of responsible treatment. Among the commonly implicated drugs, vancomycin is the most frequently reported. One should not however ignore other precipitating events sometimes associated, particularly infectious diseases and non-lymphoid or lymphoproliferative malignancies. Authors present here clinical and histological features of this disease as well as drugs that have been implicated.
Subject(s)
Anti-Bacterial Agents/adverse effects , Drug Eruptions/etiology , Immunoglobulin A/immunology , Skin Diseases, Vesiculobullous/chemically induced , Vancomycin/adverse effects , HumansABSTRACT
Among gastro-intestinal complications reported in uremic or transplanted patients, colonic necrosis due to Kayexalate and sorbitol is not so unusual for english authors. This iatrogenic event is probably underestimated by physicians and pathologists. In France, neither literature nor pharmacovigilance refer this complication but Vidal dictionary advises against such association. We thought of interest to report 2 representative observations and, after reviewing literature, to discuss diagnostics circumstances and etiopathogenic hypothesis and then to give some advices.
Subject(s)
Cation Exchange Resins/adverse effects , Colon/pathology , Polystyrenes/adverse effects , Renal Dialysis/adverse effects , Colon/drug effects , Humans , Iatrogenic Disease , Necrosis , Renal Dialysis/methodsABSTRACT
BACKGROUND: Malignant blue nevus is a very rare tumor. Argyrophilic nucleolar organizer regions (AgNORs) have been reported to be both a diagnostic and prognostic clue in various tumors, especially if standardized using an image analysis systems. PATIENTS AND METHODS: Seven cases of malignant blue nevus were retrospectively recorded between 1974 and 1999, and their clinical and pathological features described. Using an image analysis system, AgNOR measurements were studied in all cases. These results were compared with those obtained in 10 cases of commun blue nevus, 10 cases of cellular blue nevus and 10 cases of malignant melanoma. RESULTS: The most frequent location of malignant blue nevus was the scalp. Clinically, the tumor generally consisted of a blue nodule, 2.5 cm in diameter. There was no single histopathological criterion for the diagnosis of malignant blue nevus. AgNOR measurement was significantly higher in malignant blue nevus in comparison with commun blue nevus (p<0.0004) or cellular blue nevus (p<0.012), whereas there was no difference between malignant blue naevus and malignant melanoma (p > 0.50). DISCUSSION: Our results confirm the severe prognosis of malignant blue nevus and highlight the necessity of removing all blue tumours located on the scalp. AgNOR measurement using an image analysis system appears to be a useful tool for the diagnosis of malignant blue nevus, but further studies remain necessary.
Subject(s)
Nevus, Blue/pathology , Nucleolus Organizer Region/pathology , Skin Neoplasms/pathology , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Nevus, Blue/diagnosis , Predictive Value of Tests , Prognosis , Retrospective Studies , Scalp/pathology , Skin Neoplasms/diagnosisABSTRACT
BACKGROUND: Renal sarcoidosis exceptionally presents as a unilateral pyelic pseudotumor as in this case where it was associated with granulomatous nephropathy. CASE REPORT: A 33-year-old man had a two-year history of systemic sarcoidosis with no renal involvement. He developed renal failure related to interstitial granulomatous nephropathy associated with a pyelic localization leading to unilateral hydronephrosis. Urine drainage associated with corticosteroid therapy provided a favorable course. DISCUSSION: Renal involvement in sarcoidosis is usually the consequence of hypercalcemia and hypercalciuria related to ectopic secretion of calcitriol by the sarcoidosic granulomas, with urinary lithiasis and nephrocalcinosis leading to renal failure and also granluomatous interstitial nephropathy. Glomerulopathy or obstructive nephropathy are rarely reported. Intraluminal localizations such as the pyelic lesion in our case are exceptional but must be detected early since they respond to corticosteroid therapy.
Subject(s)
Kidney Diseases/diagnosis , Kidney Pelvis/pathology , Renal Insufficiency/etiology , Sarcoidosis/complications , Adrenal Cortex Hormones/therapeutic use , Adult , Biopsy , Drainage , Humans , Hydronephrosis/etiology , Hydronephrosis/therapy , Kidney Diseases/etiology , Kidney Diseases/pathology , Kidney Diseases/therapy , Male , Renal Insufficiency/diagnosis , Renal Insufficiency/therapy , Sarcoidosis/pathology , Treatment OutcomeABSTRACT
INTRODUCTION: Congenital rubella, which should disappear with widespread vaccination and mandatory obstetrical care, can occur as a purpuric eruption in the newborn. We report a case of blueberry muffin baby. CASE REPORT: An infant delivered after an "uneventful" pregnancy presented a generalized "purpuric" eruption and had axial hypotonia. Histology of a biopsy showed evidence of cutaneous erythropoiesis. The complete workup led to the diagnosis of congenital rubella. DISCUSSION: Cutaneous erythropoiesis is a well defined clinical and histological entity. There are several causes including infection and hematology disorders. Metastasis of a neuroblastoma, which must be eliminated by early biopsy, is the main differential diagnosis. CONCLUSION: Blueberry muffin rash is never idiopathic. The prognosis depends on the cause. Physicians should remember that congenital rubella has not yet been completely eradicated in France.
Subject(s)
Hematopoiesis , Rubella Syndrome, Congenital/complications , Skin Diseases, Viral/etiology , Diagnosis, Differential , Humans , Infant, Newborn , Male , Skin Diseases, Viral/pathologyABSTRACT
A 13-year-old boy presented with a well limited, juxta-hilar intrarenal mass. Needle biopsy suggested a nephrogenic nephroma. The child underwent tumorectomy. The tumor was composed of uniform metanephric tubules with small calcospherites. This rare entity is known for benign course. Half of its cases have been described in children, the other half in adults, mainly women in their fifties.
Subject(s)
Biopsy, Needle/methods , Kidney Neoplasms/pathology , Wilms Tumor/pathology , Adolescent , Humans , Kidney Neoplasms/diagnostic imaging , Kidney Neoplasms/surgery , Male , Nephrectomy , Tomography, X-Ray Computed , Wilms Tumor/diagnostic imaging , Wilms Tumor/surgeryABSTRACT
A case of fatal cytomegalovirus pneumonia in a non-immunocompromised 65-year old man is reported. The patient presented with symptoms of a lower respiratory tract infection. The diagnosis of cytomegalovirus pneumonia was made after histopathological examination of the open lung biopsy. Confirmation of cytomegalovirus infection was made with in situ DNA Hybridization. The outcome was rapidly fatal. This case demonstrates the value of DNA probe analysis for diagnosis. This case is also unusual in that a non-immunocompromised adult had severe evolution of cytomegalovirus infection.
