[Pediculosis capitis: a questionnaire survey in 4 schools of the Bordeaux Academy 1990-1991]. / La pédiculose du cuir chevelu: enquête par questionnaire dans quatre groupes scolaires de l'Académie de Bordeaux en 1990-1991.

A questionnaire survey of head lice treatment was conducted in four schools--each including a nursery and an elementary school--in the Bordeaux area. Two schools were situated in the centre of the city, one in a suburban area and one in a rural area (50 km from the city). Four-page questionnaires were filled in anonymously by the parents in April 1991; 840 answers were obtained (80 p. 100 response rate). Between January 1990 and March 1991, 48.7 p. 100 of children had at least one episode of head lice infestation (infestation rates varied from 38.8 to 62.6 p. 100 depending on the schools); 30.5 p. 100 of children were contaminated for the first time during that period. Lice were detected by the parents in 95 p. 100 of the cases. The prevalence of lice was higher in females (60 p. 100) than in males (40 p. 100). The highest prevalence was noted in the suburban school where 17 p. 100 of the parents were unemployed at the time of the survey. The peak age for head lice was 7, but 19.4 p. 100 of nursery school children aged 2-4 years had been contaminated at least once. Impetigo was rare (1.2 p. 100), and pruritus was noted in only 14.2 p. 100 of the cases. Most children had been contaminated at school. Curative treatment was counselled by a chemist in 87 p. 100 of the cases. Pyrethrins were used in 81 p. 100, and the shampoo (Hegor) plus spray (Paraspecial Poux) association was the most frequent, totalling two-thirds of prescriptions.(ABSTRACT TRUNCATED AT 250 WORDS)

A trial of labor after cesarean section in patients with or without a prior vaginal delivery.

OBJECTIVE: To determine the outcome of labor in women with a previous cesarean section, with or without prior vaginal delivery. METHOD: Records were reviewed for 1065 women with a previous cesarean section at 'Virgen Macarena' Hospital who were attended for a subsequent labor. RESULTS: Chi-squared tests demonstrated that women with previous vaginal delivery (n = 346) had a significantly higher rate of vaginal delivery after a trial of labor (95.24%) than those without previous vaginal delivery (n = 719) (82.95%). All the ruptures of uterine scar (n = 4) were found in women without previous vaginal delivery. CONCLUSION: It appears that a cesarean section in a multiparous woman is not a determinant fact in her reproductive history and the risk of rupture of uterine scar did not appear to be present.

[Periungual capillaroscopy patterns in normal children]. / Etude des aspects capillaroscopiques péri-unguéaux chez l'enfant normal.

In children as well as in adults, capillaroscopy is an unsophisticated and non invasive technique which allows to investigate vascular acrosyndromes and systemic diseases. We have studied nailfold capillaroscopy patterns in 80 children without over vascular or systemic disease: pericapillary halos and haemorrhages increased with age and capillaries matured towards the typical hair pin structure seen in adults. The number of minor dystrophies increased with age and the venous subpapillary plexuses became less easily visible.

[Linear porokeratosis of Mibelli in monozygotic twin girls]. / Porokératose de Mibelli linéaire chez des jumelles monozygotes.

Two monozygotic female twins with linear porokeratosis of Mibelli are described. One had only minimal lesions of the right elbow. The other had a linear lesion of the right arm following Blaschko's lines. Monozygotism was established using DNA fingerprinting. A single-gene defect of variable expressivity involving the clonal development of epidermal cutaneous cells according to the lines of cutaneous embryogenesis is suspected. Dithranol and carbon dioxide laser treatment are discussed.

["Saber-cut" scleroderma and Parry-Romberg facial hemiatrophy. Nosologic problems. Neurologic complications]. / Sclérodermie "en coup de sabre" et hémi-atrophie faciale de Parry-Romberg. Problème nosologique. Complication neurologique.

We report two cases of gradual facial hemiatrophy (Parry-Romberg syndrome). The first patient, an adolescent girl under treatment for hypothyroidism, presented with a very severe form combining advanced facial hemiatrophy, epilepsy with hemi-generalized seizures and hemiatrophy of the brain. The second patient was a girl who presented with localized scleroderma resembling a saber injury, homolateral cerebral atrophy and contralateral hemiparesis. Our two cases are evidence in support of a close relationship between saber injury-like scleroderma and the Parry-Romberg syndrome.

[Immunologic changes in linear scleroderma in children. Apropos of 11 cases]. / Les perturbations immunologiques dans la sclérodermie en bande de l'enfant. A propos de 11 cas.

Immunologic data collected in 11 children (6 girls and 3 boys under fourteen) presenting with linear scleroderma were analysed in a retrospective study: 2 children presented with superficial linear scleroderma, 6 with monomelic scleroderma, 1 with dimelic scleroderma, 1 with the "en coup de sabre" variety associated with dimelic homolateral involvement, and another with "en coup de sabre" scleroderma combined with facial hemiatrophy: Antinuclear antibodies (ANA) were demonstrated in 9/11 cases (i. e. 81 p. 100). The immunofluorescence staining pattern was homogeneous in all nine with a low titer (less than 250 in 5 of them). ANA to single stranded DNA was present in 1/3. The demonstration of ANA in these 9 children was correlated with deep or extensive sclerosis with muscular involvement in 7. But neither the presence nor the titer of ANA were correlated with the subsequent development of osteoarticular sequelae. The level of total complement appeared to be lowered in 3/8 cases. No renal involvement was demonstrated. Blood tests for circulating immune complexes were positive in 4/8 patients. Skin biopsy for direct immunofluorescence was performed in 6 children and demonstrated immunoglobulin deposits in 4: three had IgM fixation on the dermo-epidermal junction, and one had speckled fixation of IgG on epidermal nuclei (this has not previously been reported in localized scleroderma). There data highlight: a--the high frequency of ANA in linear scleroderma.(ABSTRACT TRUNCATED AT 250 WORDS)

[3 cases of neonatal cyto-steatonecrosis. Physiopathological discussion]. / Trois cas de cytostéatonécrose néo-natale. Discussion physiopathologique.

Three cases of subcutaneous fat necrosis of the newborn (SFNN) are presented. They occurred after a therapeutic coma induced by intravenous barbiturates to control convulsions unresponsive to conventional treatment. Two patients had widespread lesions. Histopathology showed prominent vascular involvement. Since 1970, 26 cases of SFNN have been published. Among the aetiological factors already described, hypothermia and ischaemia play a major role. It is suggested that brown adipose tissue might be of importance in the pathophysiology of subdural fat necrosis of the newborn.

[Congenital cutaneous candidiasis: a case with review of the literature]. / Candidose cutanée congénitale: une observation avec revue de la littérature.

The clinical features of CCC are stereotyped. Twenty-two cases have been found in the literature. Skin lesions are present at birth (12/22) or within the first twelve hours of life (7/22) and sometimes later, up to the sixth day of life. Maculopapular lesions are the first to appear, followed by the more typical vesiculopustular rash and secondary desquamation. Involvement of the upper half of the body is frequent. Interestingly, palm and sole pustules are almost constant. Oral, periungueal and conjunctival lesions are rare. In most cases, healing occurs within ten days of topical treatment using either nystatin or imidazole derivatives. Rarely (2/22), systemic candidiasis may be associated and may progress to death because of lung or meningeal involvement. Differential diagnosis includes post-natal acquired candidiasis, infectious pustulosis-impetigo, herpes, varicella-, and syphilis. In the authors' experience, pustular erythema toxicum is the most difficult diagnosis to rule out and the value of the direct smear must be emphasized. The clinical picture of CCC correspond to intrauterine infection due to a specific chorioamnionitis, for the following reasons: the rash may occur at birth; experimental cutaneous candidiasis required from 2 to 7 days of incubation; C. albicans has already been demonstrated in the adnexae, even in cases with late onset; culture of C. albicans in multiple sites favours intrauterine infection. Ascending infection of the fetal skin by C. albicans via the birth canal occurs probably through intact membranes, but fissures or late amniocentesis may create a portal of entry. CCC is rare as compared with the frequent maternal carriage of C. albicans.(ABSTRACT TRUNCATED AT 250 WORDS)

[Course of the dermatophytic spectrum in tinea capitis. Apropos of 124 cases seen in Bordeaux]. / Evolution du spectre dermatophytique des teignes du cuir chevelu. A propos de 124 cas observés à Bordeaux.

The purpose of this study was to evaluate the epidemiology of tinea capitis in the Bordeaux area (Dermatology Unit of the Hôpital des Enfants, Bordeaux) during a 6-year period (January, 1979 to December, 1984). Dermatophytic infection of the hair was proven by culture in 124 patients, 21 of whom had a negative potassium hydroxide direct examination. Age and sex distribution are shown in figure 1. One case was observed in a 15 days old infant, and 4 cases in adult females (3 young black mothers of affected children, 1 elderly white woman). Table I indicates the geographical origin of the patients and the isolates identified. The incidence of anthropophilic dermatophytes has increased from 13 p. 100 to 50 p. 100 since our previous survey (1975-1978). M. langeronii (29 cases), T. soudanense (19 cases) and T. violaceum (10 cases) were isolated mostly among African immigrants from Western tropical Africa and the Maghreb. However, 4 children of French origin without any history of previous sojourn in endemic areas developed tinea capitis due to M. langeronii; the source of contamination could not be determined. Zoophilic dermatophyte infection was mainly caused by M. canis (50 cases), with cats being the most frequent source of contamination. Family cases were frequent: 64 corresponding to 28 families. This may be due to either interhuman contamination or the presence of a contact pet animal in the family. The discussion is focused on: the shift in dermatophytic isolates from tinea capitis toward anthropophilic species, notably M. langeronii, mainly caused by an increased immigration from West Africa; the relevant clinical and mycological correlations.(ABSTRACT TRUNCATED AT 250 WORDS)

[Immature cutaneous hemangiomas. Epidemiologic study of 351 cases]. / Hémangiomes cutanés immatures. Etude épidémiologique de 351 cas.

The purpose of this study was to determine the course of cutaneous immature angiomas in a population of 362 children examined in a pediatric dermatology unit from 1975 to 1982. 461 angiomas were observed in these patients: 110 were of the naevus flammaeus type (port wine stain) including 23 forehead salmon patches. 351 were immature angiomas (IA)--strawberry angiomas. 3.5 p. 100 of children were afflicted of two types of hemangiomas. Results concerning the 282 patients with 351 IA are detailed as followed: average follow-up: 2 years; sex-ratio M/S 1.9, most of them Caucasians. Prematurity (data obtained prospectively during 1982): 19 p. 100; clinical features: dermal: 253, subcutaneous: 35, mixed pattern 63; 2 IA or more were detected in 12 p. 100 of the patients; site: head and neck; 49 p. 100, trunk: 21 p. 100, upper limbs: 14.5 lower limbs: 12 p. 100, genitals 3.5 p. 100; maximal size during follow-up: less than 1 cm: 36 p. 100, between 1 and 3 cm: 43 p. 100, more than 3 cm; 21 p. 100; time of onset: 51 p. 100 were noted at birth, 35 p. 100 during the first month, 13 p. 100 after the first month. Course of untreated IA is shown in figure 1. At the end of follow-up, spontaneous evolution in 52 patients was judged; very good in 44 p. 100, good in 41 p. 100, poor or bad in 15 p. 100. Minor complications (ulceration, infection, bleeding) were observed in 12.8 p. 100. Functional impairment requiring therapy was present in 2/4 plantar IA, 3/30 eyelid IA, 3/3 IA with laryngeal involvement.(ABSTRACT TRUNCATED AT 250 WORDS)

[Pediatric papular acrodermatitis and double primary infection by the hepatitis B virus and the Epstein-Barr virus]. / Acrodermatite papuleuse infantile et primo-infection double par le virus de l'hépatite B et le virus d'Epstein-Barr.

A case of papular infantile acrodermatitis was evaluated in a twenty-two month-old child. Laboratory data showed the presence of a cytolytic hepatitis associated to an increase in circulating monocytes (1.500/mm3) with hyperbasophilic cells. Hepatitis B surface (HBs) antigen was detected in the serum, associated to anti-HBc antibodies of the IgM class, without detectable anti-HBs antibodies. Simultaneously, EBV serologic profiles were consistent with a primary infection. The authors review the clinical presentation of previously described cases according to their suspected cause, and discuss the etiologic role of both EBV and HBV in the hereby reported case.