Posters - Miscellaneoits
Coexistence of confluent and reticulated papillomatosis with acanthosis nigricans
S. Lewis-Jones’, H.S. Inalijz’, G. PateI*. ‘Maelor Hospital, Wrexham; ‘Univ of Wales College of Medicine, Cardi& UK Confluent and reticulated papillomatosis of Gougerot and Carteaud (CRP) is a rate dermatosis with distinctive clinical features. It was first described by Gougerot and Carteaud as papillomatoses papuleuse confluente et r&iculte in 1929. It is the least common occurring of the papillomatoses and the pathophysiology of CRP is still unknown. Clinically, it is characterised by greyish-brown, persistent verrucous papules mostly distributed on the trunk and neck which are confluent in the centre and reticulated at the periphery. Acanthosis nigricans may present a problem in clinical as well as histological differential diagnosis. The clinical presentation of CRP is strikingly different and reticulated pattern is an almost unique feature for CRP Overall, CRP and Acanthosis nigricans are classified separately due to their distinctive clinical features. The coexistence of CRP on two different patients with Acanthosis nigricans is described. To date, three concurrent cases of CRP and Acanthosis nigricans have been reported.
Porokeratosis in immunosuppressed patients
Y. Higaki, E. Teraki, N. Kanda, M. Kawashima. Tokyo Women’s Medical College, Tokyo, Japan We described 6 cases of porokeratosis developed in immunosuppressed Japanese patients and analyzed Langerhans-cell density in porokeratotic lesions. Five patients were kidney transplant recipients receiving methylprednisolone and ciclosporin or azathioprine. One patient had Beh9et disease treated with prednisolone. Porokeratotic lesions developed 6 months to 11 years after the commencement of immunosuppressive treatment. One patient showed disseminated superficial porokeratosis. Five patients developed plaque type porokeratosis; 4 of the 5 patients had a single or a few lesion(s) while the fifth had multiple lesions. Histopathologically, the changes typical for porokeratosis were seen in the epidermis with a mild to moderate, mononuclear-cell infiltrate in the dermis. Immunohistochemical study using monoclonal antibodies, CDl, CD4, CD8, HLA-DR, revealed the reduction of CDl+ and HLA-DR+ dendritic ceils in the lesional epidermis. The derrnal infiltrates were revealed to be CD4+ and CD8+ with a predominance of CD4+ cells. We speculated that the modifications of the keratinocyte cell membrane, occurred under immunosuppressive treatment contribute to develop porokeratotic clone and to decrease Langerhans cells. The reduced immunosurveillance might permit porokeratotic clone to survive.
Sweet’s syndrome: A clinlcopathologic study of 11 cases
E. Kurishima, Y. Higaki, M. Kawashima. Tokyo Women’s Medical College, Tokyo, Japan We have experienced 11 cases of Sweet’s syndrome during 1980 to 1997 and studied their clinical manifestations and histopathologic findings of the skin. The mean age of the onset was 44.2
years, with a male:female ratio of 7:4. All patients showed skin lesions characterized by tender erythematous plaques sometimes with vesicles and/or pustules on the trunk and extremities, which were the same as the original report. Other signs and symptoms were fever (IO/l l), general fatigue (S/l I), regional lymphnodes swelling (7/l 1) and arthralgia (4/l 1). Laboratory examination revealed neutrophilic leukocytosis (S/l 1) and elevated erythrocyte segimentation ratio (5/l 1). Histopathologic findings of the skin biopsy showed a neutrophilic dermal infiltrate (7/l 1). None of our patients had malignancy. Six patients were treated with prednisolone, 3 patients with nonsteroidal anti-inflammatory drugs and 1 patient with topical steroid. In 8 cases, skin lesions and other symptoms disappeared within 2 weeks to 2 months and no relapse was observed during the follow-up period. Two patients relapsed once or several times. In conclusion, our patients showed typical skin lesions. Fever and neutrophilic dermal infiltrate were usually observed. However, neutrophilic leukocytosis was not frequent. The response to the treatments was rather good and systemic steroid therapy was not always required. I P276 Cutaneous pathology in soldiers N. Doss, M.R. Dhaoui, N. Ben Tekaya, K. Jaber, M. Touati. Dermatology Clinic, Military H spital of Tunis, Tunisia Objective: Study of the profile of the dermatoses observed in Soldiers. Materiel and Methodes: a retrospective study on two years where have noted: motives of consultation in dermatology, bestowed cares and followed it by these pathologies. Results will be compared to data of the civilian hospitals. Results: the infectious dermatoses are by far the most frequent followed by the allergic dermatoses and “occupational” derlatoses. Psoriasis is equally very frequent in soldiers. Conclusion: hypotheses will be advanced to explain the profile of the cutaneous pathology in soldiers as well as of the recimmendations will be proposed to reduce by the frequency of these dermatoses. I P277 Linear lichen planus with mucous
membrane involvement: Case report of a rare linear eruption
C. Hartl’, K. Steen’, H. Wegner’, H. Seifert2, T. Bieber’. ‘Dept. of Dermatology, Clniv. of Bonn; ‘Dermatolgy Practice, Bonn, Germany Linear lichen planus is a rare variant of lichen planus (LP) characterized by a pruritic eruption of lichenoid violaceous papules in a linear distribution. We describe a 33-year old women who presented with a 4 month-history of slightly pruritic linear papular lesions on the left side of her neck, that where clinically and histologically consistent with linear LP Nail changes and mucous membrane eruptions were absent. She was on no oral medication and her past medical history was unremarkable. A routine laboratory panel showed normal values except for a moderate iron deficiency anemia. Serologic tests for hepatitis A-, B- and C-virus infection were negative. The patient was treated with topical class I corticosteroids twice daily with good effect. Two month after the onset of her skin disease she