Fibromatosis plantar / Plantar fibromatosis

La fibromatosis plantar es una enfermedad fibrosa benigna que afecta la aponeurosis plantar. Presentamos el caso (..) (AU)

Plantar fibromatosis is a benign fibrous disease involving plantar aponeurosis. A 27 year old male (..) (AU)

[Lichen planus with esophageal involvement]. / Liquen plano con afectación esofágica.

Lichen planus is an inflammatory disease of unknown etiology which may affect the esophagus. Patients with esophageal lichen planus are usually elderly women. The most frequent symptoms are dysphagia and odynophagia. There is usually concomitant oral involvement in cases of esophageal lichen planus. Endoscopic findings include erosions, exudates and stenosis. Systemic steroids are the most effective therapy for these patients. We report a 68-year-old woman with oral, genital and submammary lesions of lichen planus of nine months duration, that referred dysphagia and odynophagia. The endoscopic study revealed white plaques and areas of friable mucosa without stenosis. Histological findings were not conclusive but excluded changes due to fungal or reflux esophagitis. Biopsy of oral and cutaneous lesions showed typical features of lichen planus. Treatment with systemic steroids significantly improved the symptoms.

Liquen plano con afectación esofágica / Lichen planus with esophageal involvement

El liquen plano es una enfermedad inflamatoria de etiología desconocida que puede afectar al esófago. Los pacientes con liquen plano esofágico suelen ser mujeres de mediana o avanzada edad. Los síntomas más frecuentes son la disfagia y la odinofagia. Suele haber afectación oral concomitante en los casos de liquen plano esofágico. Los hallazgos endoscópicos incluyen la presencia de erosiones, exudados y estenosis. Los corticoides sistémicos son el tratamiento más efectivo en estos pacientes. Presentamos el caso de una mujer de 68 años de edad con lesiones orales, genitales y submamarias de liquen plano de nueve meses de evolución y que aquejaba disfagia y odinofagia. El estudio endoscópico reveló la presencia de placas blanquecinas y zonas de mucosa friable. No había datos de estenosis. Los hallazgos histológicos no fueron concluyentes, pero excluyeron los cambios debidos a esofagitis fúngica o por reflujo. La biopsia de las lesiones orales y cutáneas demostró datos típicos de liquen plano. El tratamiento con corticoides sistémicos produjo una considerable mejoría de los síntomas

Lichen planus is an inflammatory disease of unknown etiology which may affect the esophagus. Patients with esophageal lichen planus are usually elderly women. The most frequent symptoms are dysphagia and odynophagia. There is usually concomitant oral involvement in cases of esophageal lichen planus. Endoscopic findings include erosions, exudates and stenosis. Systemic steroids are the most effective therapy for these patients. We report a 68-year-old woman with oral, genital and submammary lesions of lichen planus of nine months duration, that referred dysphagia and odynophagia. The endoscopic study revealed white plaques and areas of friable mucosa without stenosis. Histological findings were not conclusive but excluded changes due to fungal or reflux esophagitis. Biopsy of oral and cutaneous lesions showed typical features of lichen planus. Treatment with systemic steroids significantly improved the symptoms

Prolonged survival after liver transplantation for Hodgkin's disease-induced fulminant liver failure.

A 30-year-old male with a past history of nodular lymphocyte predominance Hodgkin's disease in apparent complete remission for two years received a liver transplantation because of fulminant liver failure. Histopathological examination of the explanted liver showed massive infiltration by Hodgkin's disease. In spite of a nodal recurrence of Hodgkin's disease, the patient is alive and in excellent general condition six years after liver transplantation.

Fatal Kikuchi-Fujimoto disease: the lupus connection.

Kikuchi-Fujimoto disease (KFD) is a histiocytic necrotizing lymphadenitis found mainly in young women. Patients typically present with cervical lymphadenopathy and fever and follow almost always a benign course with excellent outcomes. The etiology of KFD remains unknown and controversial although several viruses have been associated with this disease. One theory proposes that KFD may be a self-limiting form of systemic lupus erythematosus (SLE). This theory is strongly supported by the fact that microscopic features of KFD can be very similar to those found in lupus lymphadenitis. Despite its usually benign course, several cases with fatal outcomes have been reported. We report here a case of clinically aggressive KFD, which featured several autoimmune-related events and resulted in a fatal outcome. Autopsy studies showed characteristic findings of SLE, which suggests a remarkable link between SLE and KFD. Early and intensive immunosuppressive treatment may be the only option for patients who develop very aggressive forms of KFD in order to avoid a fatal outcome.

Increased serum tissue polypeptide specific antigen (TPS) in alcoholics: a possible marker of alcoholic hepatitis.

BACKGROUND: Serum tissue polypeptide specific antigen (TPS) is widely used as a tumor proliferation marker. There is some evidence of an increase in serum TPS in benign liver diseases. The aim of the study was to evaluate serum TPS levels in alcoholics. METHODS: Seventy-seven alcoholics (64 men and 13 women) admitted to the hospital with ethanol withdrawal syndrome entered the study. Twenty-three patients were biopsied (12 of them had alcoholic hepatitis and 11 steatosis or fibrosteatosis). Serum TPS was determined by enzyme immunoassay in all cases. Results were compared with those of 24 healthy controls. RESULTS: Serum TPS levels were significantly increased in alcoholic patients compared with controls (median 365 units/liter and range 41-6400 units/liter versus median 79 units/liter and range 19-235 units/ liter, respectively, p < 0.0001). Seventeen alcoholics (22%) had a TPS value 10 times higher than the upper normal threshold level (> or = 1000 units/liter). Among alcoholics, serum TPS levels were higher in patients with alcoholic hepatitis than in those with steatosis or fibrosteatosis (median 1486 units/liter and range 176-5023 units/liter versus median 106 units/liter and range 41-221 units/liter, respectively, p = 0.0001), offering a better discriminant value for the diagnosis of alcoholic hepatitis than usual liver function parameters. Serum TPS values showed significant correlation with liver cell necrosis and Mallory's hyaline degeneration. TPS values decreased after alcohol abstinence during hospital admission. CONCLUSIONS: Serum TPS is frequently increased in alcoholics and may be a marker of alcoholic hepatitis. Specificity of this molecule as a tumor marker is limited in alcoholics.

A sensitive spectrophotometric method for the determination of superoxide dismutase activity in tissue extracts.

Superoxide dismutase (EC 1.15.1.1) has been assayed by a spectrophotometric method based on the inhibition of a superoxide-driven NADH oxidation. The assay consists of a purely chemical reaction sequence which involves EDTA, Mn(II), mercaptoethanol, and molecular oxygen, requiring neither auxiliary enzymes nor sophisticated equipment. The method is very flexible and rapid and is applicable with high sensitivity to the determination of both pure and crude superoxide dismutase preparations. The decrease of the rate of NADH oxidation is a function of enzyme concentration, and saturation levels are attainable. Fifty percent inhibition, corresponding to one unit of the enzyme, is produced by approximately 15 ng of pure superoxide dismutase. Experiments on rat liver cytosol have shown the specificity of the method for superoxide dismutase. Moreover, common cellular components do not interfere with the measurement, except for hemoglobin when present at relatively high concentrations. The assay is performed at physiological pH and is unaffected by catalase.