[Cutaneous Kaposi disease disclosing acquired immunodeficiency syndrome in a child]. / Maladie de Kaposi cutanée révélatrice d'un syndrome d'immunodéficience acquise pédiatrique.

INTRODUCTION: Kaposi's sarcoma associated with acquired immunodeficiency syndrome is uncommon in children and cutaneous localizations are rare. We report a case of pediatric cutaneous Kaposi's sarcoma that revealed a human immunodeficiency virus infection. OBSERVATION: An 8-years-old girl native of the Ivory Coast, with normal statural and psychomotor development, presented cutaneous Kaposi's sarcoma after varicella. The serodiagnosis was positive for type 1 human immunodeficiency virus and CD4 lymphocytes count was 9/mm3. A tonsil localization of Kaposi's sarcoma occurred and bleomycin was a short time effective. A relapse of cutaneous Kaposi's sarcoma with digestive, pulmonary and neurological symptoms was transitorily controlled by the association prednisone-vinblastine-doxorubicin, but death occurred with recurrence of pharyngeal Kaposi's sarcoma. DISCUSSION: The review of literature shows that in pediatric acquired immunodeficiency syndrome, failure to thrive, encephalopathy and opportunistic infections are common. On the other hand, Kaposi's sarcoma is unusual and cutaneous localizations are especially observed when the contamination is postnatal and late. In our case the contamination is presumed perinatal and the human immunodeficiency virus infection was asymptomatic until 8 years old. Kaposi's sarcoma was the cause of the most presenting symptoms and of death, without demonstrated opportunistic infections.

[Homozygote erythropoietic protoporphyria associated with porokeratosis]. / Protoporphyrie érythropoïétique homozygote associée à une porokératose.

INTRODUCTION: Erythropoietic protoporphyria was generally assumed to be an autosomal dominant disease with variable penetrance. The determination of the ferrochelatase activity and the biological molecular studies have shown that both autosomal dominant and recessive patterns of inheritance are possible. CASE REPORT: Is reported the case of a 17 years-old male patient with erythropoietic protoporphyria and porokeratosis. There are some hepatic biochemical abnormalities without cholelithiasia and without pathological change of the liver biopsy. Leucocyte ferrochelatase activity is decreased to 5 p. 100 of the normal mean level. In both the parents, without photosensitivity, the enzyme activity is reduced to 40 p. 100 of the normal values. DISCUSSION: The patients with severe ferrochelatase defect have no more important clinical manifestations than in the usual form of erythropoietic protoporphyria. For clarify the exact mode of inheritance, the determination of the ferrochelatase activity and the identification of the mutations in the patient and his parents are necessary. In our patient the porokeratosis should be in relation with the protoporphyrin induced phototoxic reaction which facilitate the emergence of a mutant cellular clone of epithelial cells.

[Mycobacterium avium-intracellulare subcutaneous abscess after injections of interferon alpha in a patient treated for lymphoma]. / Abcès sous-cutané à Mycobacterium avium-intracellulare après injections d'interféron alpha chez une malade traitée pour lymphome.

INTRODUCTION: Cutaneous involvement with Mycobacterium avium-intracellulare is usually observed in disseminated disease but cutaneous infection alone without bacteraemia is uncommon. CASE REPORT: We report a case of Mycobacterium avium-intracellulare subcutaneous abscess of the thigh in a 32-year-old woman with lymphoma. The lesion was treated with drainage, excision and chemotherapeutic agents. Inoculation was probably secondary to alpha interferon injections performed during one year. DISCUSSION: The review of the literature shows that isolated Mycobacterium avium-intracellulare skin infections are rare, probably induced by traumatic percutaneous inoculation, frequently in immunocompromised patients. The pro-infectious effect of interferon alpha is considered. Treatment is unsatisfactory and surgical excision is often necessary.

[Cutaneous lupus erythematosus and buccal aphthosis after hepatitis B vaccination in a 6-year-old child]. / Lupus érythémateux cutané et aphtose buccale après vaccination contre l'hépatite B chez un enfant âgé de 6 ans.

INTRODUCTION: Although the hepatitis B vaccination tolerance is generally good, adverse effects, which are specially neurologic and cutaneous, have been observed and some cases of induced diseases with immunological disorders have been reported. CASE REPORT: A 6 year-old boy presented a cutaneous lupus erythematosus and a severe buccal aphthosis following hepatitis B vaccination. There was no clinical or biological symptom of systemic lupus erythematosus nor of Behçet's disease. Under chloroquine therapy, the cutaneous manifestations of lupus erythematosus disappeared quickly and those of buccal aphthosis improved. DISCUSSION: Hepatitis B vaccination side effects are probably in relation with a specific or non specific stimulation of the immune system. In our case, cellular immunity is perhaps involved through the HBs antigen. Considering the rarity of these side effects, an individual predisposition seems very likely.

[Basal uveo-retinitis (peripheral uveitis, chronic posterior cyclitis, pars planitis, vitritis, hyalo-retinitis). and other inflammations of the peripheral retina]. / Luvéo-rétinite basale (uvéite périphérique, cyclite postérieure chronique, pars planite, vitrite, hyalo-rétinite) et les autres inflammations de la périphérie rétinienne.

The study of the histological features of the peripheral retina and the observation of this periphery in 149 cases of uveitis of various types has led us to consider these peripheral retinal inflammations as presenting clinically either as a local reaction in this area during the course of anterior and posterior uveitis, manifested by a circular inflammatory condensation of the peripheral vitreous, or as a specific affection related to the periphery. These latter assume two forms: either that of a peripheral chorio-retinitis, or that of a basal uveo-retinitis, a term proposed in place of those considered inadequate--pars planitis, peripheral uveitis, chronic posterior cyclitis. In accordance with this conception four forms of uveitis can be distinguished: anterior uveitis, posterior uveitis, peripheral chorio-retinitis and basal uveoretinitis.