Erythema multiforme associated with autoreactivity to 17 alpha-hydroxyprogesterone.

We report a case of a 23-year-old woman who was afflicted with disseminated skin erythema multiforme-like eruptions that started at the menarche, relapsed at the premenstrual periods, dramatically spread during two pregnancies and cleared after abortion; the skin lesions responded dramatically to thalidomide treatment. A high-affinity binding factor to 17 alpha-hydroxyprogesterone (17-OHP) was found in the serum of this patient. Her lymphocytes did not proliferate in vitro after exposure to exogenous 17-OHP but showed significant chromatin activation. There was a decreased expression of HLA antigens at the surface of the patient's blood lymphocytes. This is a unique well-documented case of erythema multiforme most possibly due to autoreactivity to 17-OHP; the precise mechanism(s) of this autoreactivity has not been established.

Primary invasive carcinoma of the vagina.

A retrospective study of 29 patients with invasive carcinoma of the vagina was completed at The Milton S. Hershey Medical Center, Pennsylvania State University, for a ten-year period from 1976-1986. The overall incidence was 1.3% of all gynecologic malignancies. Twenty-four patients (83%) had squamous cell carcinoma and five (17%) had adenocarcinoma. Squamous cell carcinoma was most commonly located in the upper anterior and lateral vaginal vaults, whereas adenocarcinoma was found more often in the lower anterior and lateral vaginal vaults. The majority of the patients (96%) were managed by a combination of whole-pelvis irradiation and brachytherapy. Twenty-four percent of the patients had a recurrence in the vagina only, indicating the need for better local control. The overall survival rate was 48%. Patients with previous hysterectomy were more likely to develop serious treatment-related complications.

[Behçet's syndrome. Treatment by plasmapheresis]. / Sindroma de Behçet. Tratamiento por plasmafereses.

Two females patients suffering from Behçet syndrome were treated by manual plasmapheresis. A total of eight (8) sessions were performed in both patients. In each session, about 800 cm.3 of blood were depurated , without plasmatic replacement. In no case other therapeutic methods were used neither during nor after plasmapheresis. There was a rapid improvement of all clinical manifestations, which became particularly evident after the 3.rd session. Lesions were completely healed in both patients by the end of treatment. Laboratory data became normal or nearly normal, namely: fibrinogen, syderemia and plasma fibrinolytic activity. In the two years follow-up, patients have been well and free of symptoms with the exception of some episodic crisis of little oral aphtae of short duration.

Carcinogen-induced cutaneous neoplasms in nonhuman primates.

Dimethylbenzanthracene (DMBA) combined with UV light, dodecylbenzene (DDB), or both was oncogenic when applied to the skin of nonhuman primates. Ten years after the cutaneous application of DMBA and a cocarcinogen, 2 groups of rhesus monkeys (Macaca mulatta) displayed dermal melanosis, papillomas, basal cell tumors, and mesodermal sarcomas (accompanied in one case by hepatic metastasis). One group had been painted for 15 months; the other, for 6 1/2 years. Eight years after the initiation of a 4-year regimen of biweekly applications of DMBA plus a cocarcinogen, papillomas, basal cell tumors, and basosquamous cell epidermal tumors with satellite lipomas were observed in galagos (Galago crossicaudatus). The same carcinogen applied to the skin of pottos (Perodicticus potto) caused death in 6 of the 7 animals within 9 weeks. Neoplasms occurred in 17 of the 19 primates that lived longer than 9 weeks after the cutaneous application of DMBA combined with either UV light or DDB.