Lymphomatoid papulosis type A: clinical, morphologic, and immunophenotypic study.

BACKGROUND: Lymphomatoid papulosis (LyP) is a cutaneous clonal or polyclonal Ki-1 + T-cell lymphoproliferative disorder, morphologically resembling Ki-1 + anaplastic large cell lymphomas (Ki-1 + ALCL) or Hodgkin's disease (HD). Lymphomatoid papulosis usually has a characteristic benign clinical course with remissions and relapses of the cutaneous eruptions. METHODS: The authors studied three patients with LyP. In each case the diagnosis was established based on the typical clinical history and presentation of the cutaneous lesions as well as the morphologic and immunophenotypic findings. RESULTS: In all three cases the skin biopsies showed a polymorphic, nonepidermotropic, dermal lymphocytic infiltrate, composed of small lymphocytes and fewer large, atypical cells. The large cells were positive for the activation markers CD30 (Ki-1) and CD45R (leukocyte common antigen), and were negative for the HD marker CD15 (Leu MI). CONCLUSIONS: In most cases, LyP can be distinguished from Ki-1 + ALCL and HD on the basis of clinical, morphologic, and/or immunophenotypic findings. We emphasize the importance of the recognition of LyP as a clinicopathologic entity and the awareness of dermatologists, oncologists, and surgical pathologists in differentiating LyP from other primary cutaneous Ki-1 + lymphoproliferative disorders (Ki-1 + ALCL and HD). The prognosis of cutaneous Ki-1 + ALCL and HD is usually different from LyP and requires a different therapeutic approach.

Hydrofluoric acid burns.

We observed seven patients who presented consecutively with hydrofluoric acid hand burns. The clinical characteristics of these patients and the course of their disease and treatment are reviewed. Dermatologists should be aware that a hydrofluoric acid burn constitutes a dermatologic emergency. Specialized treatment is required to prevent topical, system, and even lethal toxic effects.

Sweat gland carcinoma in a patient with sarcoidosis and primary biliary cirrhosis.

Primary biliary cirrhosis (PBC) and sarcoidosis are both granulomatous disorders of unknown etiology. Although they are distinct clinical entities, a small number of patients presenting with manifestations of both has been reported. We describe a female patient with PBC and sarcoidosis who developed a malignant cutaneous tumor with histologic and immunohistochemical characteristics of a sweat gland carcinoma (SGC). An SGC, developing in a patient with concurrent PBC and sarcoidosis has not been reported previously.

[Retroauricular dermatitis of the "milia en plaque" type]. / Dermatoses rétro-auriculaires à type de grains de milium en plaque.

We report 3 cases of very rare dermatoses with retroauricular location, having lesions of "milia en plaque" type. These dermatoses are the retroauricular follicular lichen planus tumidus, the retroauricular "milia en plaque" and an exceptional case of sebocystomatosis (steatocystoma multiplex) with exclusively retroauricular location, which is unique in the literature. In this group of retroauricular dermatoses can also be included the small retention cysts and comedones of the retroauricular area, attributed to paraffin products in shaving soap inadequately rinsed from this region. On the occasion of these cases we make a review of the literature and a detailed study of the retroauricular follicular lichen planus tumidus and retroauricular milia en plaque and we discuss the differential diagnosis emphasizing the clinical and histologic features, which permit to make the accurate diagnosis.

Oriental sore: a case report.

We report a typical case of an oriental sore (cutaneous leishmaniasis) in a 28-year-old patient. The lesion was located on the upper lip, causing macrocheilia and an esthetic problem to the patient, who required urgent treatment. N-Methylglucamine antimonate proved to be an effective, well-tolerated drug.

[Multiple condylomata of the urethra and bladder disclosing HIV infection]. / Condylomes multiples de l'urèthre et de la vessie révélant une infection par HIV.

The authors report the case of a 26 year old man, in whom recurrent hematuria revealed the diagnosis of urethral condylomata with bladder extension, and HIV serology positive. This case reminds us that it is essential to search for immunodeficiency in every case of extensive or recurrent condylomata. The analysis of such cases in the literature allows discussion of the various clinical courses according to the Human Papilloma Virus types found in condylomatous tissues.

[Oral isolation of Neisseria gonorrhoeae in the presence of gonococcal urethritis]. / Isolement buccal de Neisseria gonorrhoeae en présence d'une urétrite gonococcique.

The Neisseria Gonorrhoeae, the etiologic agent of the gonococcic urethritis, can produce other clinical manifestations, such as stomatitis, TMJ arthritis and sialadenitis. The investigation of this germ in the oral cavity of 50 patients with gonorrhea, was positive in only one case, which did not present any buccal symptom. It was concluded from this study that an oral gonococcic infection is extremely rare, and that the transmissibility of this germ orally is not frequent eventhough possible in theory. However the infection can spread through the blood stream and can induce other pathology.