[Immunohistology of bullous autoimmune skin diseases]. / Immunohistologie des dermatoses bulleuses auto-immunes.

Autoimmune bullous dermatoses undertake frequently oropharyngeal mucous membranes and the skin surface, either in succession or simultaneously. Actual observation technics by photon and electron microscopy, by immunofluorescence and immunohistochemistry (with specific antibodies) have allowed to differentiate more particularly pemphigus, bullous pemphigoid, cicatricial pemphigoid, acquired bullous epidermolysis, all autoimmune bullous affections.

Cutaneous malignant melanoma and exposure to sunlamps and sunbeds: a descriptive study in Belgium.

Two recently published case-control studies have highlighted the possibility of an association between the development of cutaneous malignant melanoma and exposure to sunlamps and sunbeds. Little is known about the behaviour patterns with regard to exposure to sunlamps and sunbeds in Western Europe. This descriptive study compares usage patterns of sunlamps and sunbeds of melanoma patients with the general population in Belgium. Evidence is given that melanoma patients are greater users of artificial ultraviolet sources than the general population, and that the incidence of melanoma in different geographical areas increases proportional to the percentage of people using tanning devices. Although this descriptive study may well be biased or refuted, it does advocate the need for further epidemiological research addressing specifically the issue of melanoma and exposure to artificial sources of ultraviolet radiation.

Nails in light and electron microscopy.

The study and the diagnosis of nail disorders benefit from examination under light and electron microscopes. The alterations occurring in the matrix, bed, and hyponychium are comparable to those observed in the skin. Architectural and cellular alterations--loss of the cell's regular alignment, changes in stain affinity, parakeratosis, and changes in the intercellular spaces--are observed in the nail plate and subungual keratin. The intensity and singularities of these lesions are usually sufficient to orient the diagnosis from examination of the keratin alone. This microscopic examination is of particular interest in dealing with mycoses because it can specify the type of invasion of the keratin and avoid false-positive or false-negative results on culturing. Electron microscopy allows easy differentiation of melanin and ferric pigments.

Larva migrans of the oral mucosa.

A case of buccal larva migrans is presented. This rare peculiar localization is discussed. The different treatments are mentioned with special regard to the topical and systemic use of the thiabendazole.

Dominant dystrophic epidermolysis bullosa of Cockayne-Touraine in father and son: clinical and ultrastructural similarities.

Dominant dystrophic epidermolysis bullosa of Cockayne-Touraine occurred in a father and his son. Clinically, the child presented evident blistering, while the father, despite of his work, where minimal skin traumata frequently occur, was rarely affected. Absent or rudimentary anchoring fibrils were seen in the normal-appearing skin of the father; this suggests that other factors may play a role in the dermolytic separation.

Nail changes in alopecia areata: light and electron microscopy.

Fragments of nail keratin removed with tweezers from patients suffering from alopecia areata were examined using light microscopy and electron microscopy. The results obtained from these two techniques show nail changes which are slits, cupuliform dips of the upper edge and parakeratosis, under light microscopy; vacuoles, depletion of keratin fibers, and electron-dense fibrillary deposits, under electron microscopy. These changes predominate in the nail plate with a maximum in the upper part while the subungual keratin is preserved. A serious disorder of the matrix keratinization is probably the source of this preferential localization. To determine whether it is a disorder of the keratin fibers themselves or rather of the interfilamentary matrix and especially of the filaggrin system will require further biochemical and immunological studies.

Cosmetic intolerance.

A study of cosmetic intolerance has been undertaken in 5202 patients tested for possible contact dermatitis. Each patient has been evaluated by medical history and patch testing. Intolerance to cosmetics involved only 5.9% of the total population tested. If other possible sources of allergens (medication, occupation, hobbies etc) are associated, this figure rises to 11.7%. The origin of the cosmetic intolerance is more often an allergy than irritation. Soaps and shampoos are the most important types of cosmetics responsible for adverse reactions. The principal allergens are the fragrances, preservatives, hair dyes and the patients' own products. In this last category, the specific allergen has not always been detected.

[Atypical urticaria disclosing acute basophilic leukemia. Apropos of a case associated with hyperhistaminemia]. / Urticaire atypique révélatrice d'une leucémie aiguë à basophiles. A propos d'un cas associé à une hyperhistaminémie.

Acute basophilic leukaemia (ABL) is a rare disease characterized by high fever, anaemia and haemorrhagic diathesis. Its prognosis is somber and its response to therapy mediocre. Death is mainly due to cerebral or digestive hemorrhage and coronary disease. In a very small number of cases ABL, like all diseases accompanied by an increase in basophils, may be associated with hyperhistaminemia responsible for cutaneous and gastric symptoms.

[Melanoma of the extremities a little known diagnosis and difficult treatment. Review of 20 cases]. / Le mélanome des extrémités: diagnostic méconnu et traitement délicat. Revue de 20 observations.

Twenty cases of melanomas of the extremities observed in Brussels, Belgium, between 1968 and 1981 were reviewed. The clinical and histological characteristics, the treatment and the evolution were analyzed and compared to the data of the literature. Diagnosis was often delayed, as it was rendered difficult by the misleading clinical symptoms. This delay explains the inadequacy of numerous treatments given prior to the definitive one as well as the high thickness of the melanomas at the time of diagnosis. The five year survival was only 50%. An early diagnosis made by excisional biopsy, if possible, and an adequate treatment given to start with, should improve the result.

Clinical and immunologic response to Isoprinosine in alopecia areata and alopecia universalis: association with autoantibodies.

Twenty patients with alopecia universalis, alopecia semiuniversalis and alopecia areata were studied for their immune parameters. Fourteen of them received an oral treatment with Isoprinosine, a synthetic immunomodulator. Ten patients showed the presence of several autoantibodies. No significant abnormalities in various T cell rosette markers were found, but T4/T8 ratios tended to be elevated. Erythrocyte antibody complement (EAC) rosettes were usually decreased. Treatment with Isoprinosine produced a clinical response, as judged by total or partial hair growth, in nine of the fourteen patients treated. It was striking to observe that seven of the nine responders had autoantibodies prior to treatment. These autoantibodies disappeared or decreased with Isoprinosine therapy. In contrast, only one of five nonresponders had serum autoantibodies. After treatment, both groups showed an increase in blood-active T rosettes. These results suggest that alopecia is a heterogeneous disease subdivided by the presence or absence of autoantibodies since clinical response was mainly obtained in patients presenting autoantibodies.