[Tubercular fibrosing conjunctivitis associated with facial cutaneous tuberculosis]. / Conjonctivite fibrosante tuberculeuse au cours d'une tuberculose cutanée faciale.

BACKGROUND: Tuberculous conjunctivitis has been described only rarely during the course of lupus vulgaris. We report a case of hemifacial cutaneous tuberculosis, diagnosed as atypical lupus vulgaris, associated with homolateral fibrosing tuberculous conjunctivitis. PATIENTS AND METHODS: An 83-year-old woman presented inflammatory conjunctivitis without bullous involvement in the left eye leading to corneal neovascularisation, symblepharons and ptosis. Erythematous and atrophic papules were seen on the left side of the face. Biopsy of the skin and conjunctiva revealed a tuberculoid granulomatous infiltrate. Bacterial culture and PCR were both positive for Mycobacterium tuberculosis. DISCUSSION: This case illustrates the need to consider tuberculosis when faced with an atypical facial eruption and ocular involvement.

[Conjunctival melanoma at corneoscleral limbus on primary acquired melanosis. A case report]. / Mélanome conjonctival limbique développé sur mélanose acquise primitive.

A 51-year-old Caucasian man consulted for a visual loss in the left eye due to corneal extension of a conjunctival melanoma. This conjunctival melanoma arose from primary acquired melanosis with atypia at the temporal corneoscleral limbus. The patient was treated using a combination of surgical excision with physical treatment by ocular proton therapy. Progression remained under control 11 months after treatment: no local tumour recurrence or metastasis was observed. Primary acquired melanosis with atypia must be regarded as a premalignant melanocytic lesion. Based on this case report, the authors focus on primary acquired melanosis and its risk of transformation to a conjunctival malignant melanoma.

[Update on Kaposi's sarcoma]. / Actualités de la maladie de Kaposi.

Kaposi's sarcoma (KS) is a mesenchymal tumor involving blood and lymphatic vessels and induced by viral growth factors (HHV8-IL6). This article reviews the epidemiology, pathogenesis, clinical spectrum (classic KS, iatrogenic immunosuppressive KS, endemic African KS, and AIDS-KS), histological features, staging criteria and treatment of KS. Unlike industrialized countries that have benefited from widespread use of highly active antiretroviral therapy (HAART), developing countries continue to have a high incidence of AIDS-KS. Future therapeutic targets for KS are enhancement of immune function and treatment with angiogenesis inhibitors

[Primary gastric lymphoma complicating HIV infection]. / Lymphome gastrique primitif au cours d'une infection VIH.

This report describes a case of non-Hodgkin's lymphoma in a 31-year-old patient in whom HIV infection was subsequently diagnosed. The woman consulted for epigastralgia. Her medical history included gastritis caused by Helicobacter pylori that was given specific treatment. Clinical examination demonstrated type III splenomegaly and blood film examination demonstrated hypochromic microcytic anemia and neutropenia. Outcome was rapidly fatal and the patient died before start up of anti-retroviral therapy. This case suggests that a possible link between HIV and/or Helicobacter pylori and lymphomagenesis.

[Complete atrioventricular block of the young adult... do not forget sarcoidosis]. / Bloc auriculoventriculaire complet du sujet jeune... Penser à la sarcoïdose.

The authors report the case of a 27 years old athletic patient, without any antecedents, presenting with a recent complete atrioventricular (AV block, disclosed by an effort dyspnoea and syncope. The electrophysiological exploration showed a nodal AV block. The magnetic resonance imaging revealed the existence of a septal hypersignal in T1 mode enhanced after Gadolinium injection, and left ventricular function normality. It also revealed the existence of a pulmonary parenchyma infiltrate, confirmed by thoracic scanner. Pathological examination of transbronchial biopsies showed noncaseating granuloma, consistent with sarcoidosis. Programmed electrical stimulation induced no ventricular arrhythmia. A dual chamber pace-maker was implanted because of the AV block permanence and the poor clinical tolerance, associated with steroid therapy (prednisolone 1 mg/kg/j). After a 18 months follow-up, the patient remains asymptomatic, and the 12-lead ECG shows a normal AV conduction. The authors discuss the different aetiologies of AVB, and emphasize to realize an exhaustive assessment in young adults. The cardiac localization disclosing sarcoïdosis and the complete AV block disappearance under therapy make that observation original. The occurrence of a complete AV block complicating sarcoidosis poses a management and prognosis problem.

[Management of American cutaneous leishmaniasis. Outcome apropos of 326 cases treated with high-dose pentamidine isethionate]. / Thérapeutique des leishmanioses tégumentaires du Nouveau Monde. Expérience à propos de 326 cas traités par iséthionate de pentamidine à fortes doses.

The purpose of this retrospective analysis was to evaluate the outcome of pentamidine isethionate treatment (4 mg/kg of Pentamidine by the intramuscular route on Days 1 and 3) of cutaneous leishmaniasis in 326 cases that occurred during an outbreak among French military personnel in French Guyana from 1998 to 1999. A great difference was found between the 205 patients treated in French Guyana (series G) and 32 patients treated at the Laveran Military Hospital in Marseille, France (series L). Failure rate, i.e. 25% in series L versus 5% in series G, was significantly correlated with the delay to treatment which was much longer in series L. Extensive rhabdomyolysis was observed in all cases tested: this side-effect has not been reported. Based on these findings and a review of the literature on pentamidine isethionate, the authors recommend prompt treatment using lower doses. Other treatment alternatives for American cutaneous leishmaniasis are also presented including two of the latest developments in the field, i.e., oral treatment using miltefosine and topical treatment using agents such as paromomycine.

[Clinical overview of New World tegumentary leishmaniasis]. / Panorama clinique des leishmanioses tégumentaires du Nouveau Monde.

This richly illustrated article (80 color photographs) based on the authors' experience in French Guyana documents the clinical diversity of American tegumentary leishmaniasis. Main highlights include the often outstanding aspect of lesions, the high frequency of forms not associated with ulceration or scab formation that must be recognized to achieve diagnosis in travellers returning from endemic zones, and the special prognosis of clinical forms associated with intradermic, lymphatic or hematogenous spread. The article also reviews an original diagnostic method based on culture of cutaneous biopsy specimens on specific nutrient mediums that provides isolates in a high percentage of cases (80%) and thus allows identification of offending parasite.

[Malignant lymphoma of the mandible. A new case]. / Lymphome malin de la mandibule. A propos d'un nouveau cas.

Primary extranodal malignant lymphoma is relatively rare. Clinical and radiological features may lead to the misdiagnosis of chronic osteomyelitis. We report a case of primary non-Hodgkin's lymphoma that involved the mandibular region in a 53-year-old man. Differential diagnosis with other mandibular diseases is difficult because there is a non specific clinico-radiological features and the difficulty of histologic interpretation. This pathology is important to recognize because of specific treatment. Global prognosis is relatively favorable if the lesion is localized.

[Yellow nail syndrome associated with intestinal lymphangiectasia]. / Syndrome des ongles jaunes associé à des lymphangiectasies intestinales.

The yellow nail syndrome, a combination of yellow discoloured nails, lymphedema and pleural effusions, is a rare clinical condition. We report a case of the yellow nail syndrome associated with intestinal lymphangiectasia revealed by chylous ascites and protein-losing gastroenteropathy. This association reported in only three cases in the literature leads us to discuss the relations between yellow nail syndrome, primitive intestinal lymphangiectasia and primary lymphatic disorders.

[Non-Hodgkin lymphoma mimicking renal carcinoma: apropos of 1 case of follicular lymphoma]. / Lymphome non hodgkinien simulant un carcinome rénal. A propos d'un cas de lymphome folliculaire.

Primary renal non-Hodgkin's lymphoma (NHL) is unusual, in contrast to the frequent renal involvement in disseminated NHL. We report a case of follicular lymphoma presenting initially as a renal mass. In the literature, twenty-seven similar cases have been described since 1980. The median age at diagnosis is 64 years with a male predominance. Clinical and radiological findings generally evoke renal carcinoma. Histologically, tumors are usually large B-cell lymphomas. The existence of renal non-Hodgkin lymphoma mimicking renal carcinoma must be recognized. Such lymphomas can either be primitive or be nodal with a renal presentation. Nephrectomy followed by chemotherapy permits long disease free survival.