[Pseudo-Kaposi sarcoma]. / Pseudo-Kaposi-Sarkom.

Case report about a 45 year old man with hyperkeratotic papules and plaques on both lower legs now persisting for more than 20 years. After detection of arterio-venous shunts the initial clinical and histological diagnosis of Kaposi-sarcoma had to be replaced by the diagnosis of pseudo-Kaposi's sarcoma, a benign reactive process. In the pathogenesis of this disease arteriovenous shunts are of great importance.

Urticaria in association with etiocholanolone fever.

A 17-year-old girl is reported with a history of recurrent febrile episodes during her menstrual bleeding accompanied by a generalised exanthem. Increased plasma levels of unbound etiocholanolone were noticed during the febrile attacks. Both the fever and the skin eruption could be suppressed by oral contraceptives.

PIP: Etiocholanolone is a physiologically occurring metabolite of testosterone and androstenedione which are secreted by adrenals, testes, and ovaries. Free, unconjugated etiocholanolone is formed in the liver and is found in the blood in very low concentrations. Usually, cases of etiocholanolone fever can be associated with symptoms such as elevated ESR, leukocytosis, myalgia, arthralgia, abdominal pain, diarrhea, and vomiting. In the case discussed in this paper a 17 year old girl had been suffering from headaches, vomiting, and fever during the 1st days of menstrual bleeding for several years accompanied by a supervening generalized urticarial eruption lasting for 3-5 days. The patient's mother was found to have elevated levels of unconjugated etiocholanolone in her blood which raised the possibility of a genetically determined defect in the conjugation of this steroid in the liver. The parallel appearance of skin eruptions and the febrile attacks leads to the interpretation that both events are triggered by the increase of the unconjugated etiocholanolone before and during menstruation. With high-dose glucocortisteriod therapy (100 mg prednisolone daily) the fever and rash could be suppressed within several hours of administration. In addition, with the administration of oral contraceptives Ovoresta M and later Lyndiol only one relapse was noted during 18 months.

[Use of the ultrasonic Doppler stethoscope in the diagnosis of varicocele]. / Die Bedeutung der Ultraschall-Doppler-Sonde in der Varicocelen-Diagnostik.

In cases of varicocele the reverse venous blood flow can be detected by the use of the Doppler-stethoscope in a simple way. Applied to the basic examination of fertility patients this method has proved to be a valuable non-invasive screening in the evaluation of varicoceles including cases with minor clinical symptoms. According to our results, "subclinical varicocele" as a entity of venous diseases shows special clinical features. Varicocele-orchiopathy is caused by the reverse venous blood flow, when peritesticular venous anastomoses and crosses are less developed or insufficient in their compensatory function.