Jorge Arrese Estrada

Cutaneous presentation of the cardio-facio-cutaneous syndrome

We present the clinical and histologic features of the cutaneous lesions in a girl with cardio-facio-cutaneous syndrome. Marked tortuosity with hyperkeratosis of the sweat ducts and dystrophy of the hair shafts appear to be the cutaneous hallmarks of this syndrome.

Comparative Study of the Activity and Lingering Effect of Topical Antifungals

We present a combined method of culturing pathogenic dermatophytes and yeasts on human stratum corneum. Topical marketed antifungals are applied in vivo, and the stratum corneum is removed by cyanoacrylate skin surface strippings. After inoculation of the test organism, the extent of fungal growth is measured, indicating by comparison with controls the level of inhibitory effect of the antifungal. Other samples of stratum corneum collected at different time intervals after the arrest of antimicrobial treatment are used to evaluate the lingering effect of the drug. The combination of the data gained by these approaches close to the in vivo situation is used to introduce a classification of antifungals.

Histogenesis of recurrent nevus.

We report an immunohistochemical study of eight cases of recurrent nevi. S-100 protein-positive and Factor XIIIa-negative fibroblast-like cells were found in and around the scar. Some cells were adjacent to vessels whereas others were dispersed in the fibrotic tissue. These cells probably represent entrapped or migrating nevus cells originating from the deep, unremoved portion of the nevus.

Immunohistochemical detection of incipient melanoma micrometastases. Relationship with sentinel lymph node involvement.

It is acknowledged that tumour thickness, ulceration and lymph node invasion are the most important prognostic factors for cutaneous melanomas. Other histopathological features may also be informative. The aim of this study was to ascertain whether immunohistochemical methods can improve the detection of satellite micrometastases in primary melanoma patients. In addition, the predictive value of cutaneous satellite micrometastases for sentinel lymph node involvement was evaluated. A total of 265 primary cutaneous melanomas and 68 of the respective sentinel nodes were studied using a panel of seven antibodies directed against melanocyte-related antigens. In 12.4% of the 265 cases, small satellite micrometastases were detected by immunohistochemistry. Sentinel lymph node metastases were found in 14% of the 68 cases. Invasion of the sentinel lymph node correlated with the presence of cutaneous satellite micrometastases. It is concluded that the presence of cutaneous satellite micrometastases may be an indication for the performance of sentinel lymph node biopsy, and this finding calls for a closer follow-up of these patients.

Cutaneous mixed infections in AIDS.

We report a new case of mixed infection occurring at the same site of the skin in a human immune deficiency virus-positive patient. Hyperkeratotic and crusted erosions contained fusospirochetal organisms, Cryptococcus neoformans, and another unidentified fungus.

Herpes Simplex Virus Type-I and Pyogenic Granuloma: A Vascular Endothelial Growth Factor-Mediated Association

Pyogenic granuloma (PG) is a vascular endothelial growth factor (VEGF)-related neoangiogenic process. Minor trauma, chronic irritation, certain drugs and pregnancy may favor PG. Viral triggers have not been reported up to date. A 52-year-old woman with hairy-cell leukemia presented because of a 3-month history of a giant pseudotumoral lesion on her left cheek. All prior antibacterial, antifungal and anti-inflammatory treatments had failed. Histology revealed PG with sparse and isolated epithelial cell aggregates. Immunohistochemistry (IHC) identified herpes simplex virus type-I (HSV-I) antigens in the nuclei and cytoplasm of normal-appearing as well as cytopathic epithelial cells, suggesting a chronic, low-productive HSV infection. No HSV-I signal was evidenced in the endothelial cells of the PG. Furthermore, IHC revealed VEGF in the HSV-I infected epithelial cells as well as within the PG endothelial cells. These results incited oral treatment with valaciclovir, and the PG promptly resolved after 2 weeks. These findings suggest that a chronic HSV-I infection might play an indirect, partial role in neoangiogenesis, presumably via HSV-I infection-related stimulation of keratinocytic VEGF production.

CUTANEOUS HAMARTOMA WITH PAGETOID CELLS

We report an unusual cutaneous hamartoma with pagetoid cells characterized by the presence of intraepidermal cells resembling Tokers cells of the nipple. These cells were EMA positive and could be related to the histogenesis of some Pagets disease.

Chronic Cutaneous Hyalohyphomycosis by Paecilomyces

Paecilomyces lilacinus is a ubiquitous saprophytic fungus that rarely causes infections in humans, frequently affecting the eyes and the skin. Cutaneous and subcutaneous infections mainly occur in immunocompromised hosts but have occasionally been reported in immunocompetent patients. The clinical spectrum is highly heterogeneous and diagnosis is often delayed. A 60-year-old woman with idiopathic chronic necrotizing vasculitis treated since 10 years with a series of immunosuppressive therapies presented since three years various clinical presentations of chronic hyalohyphomycosis caused by P. lilacinus. Diagnosis was only obtained three years after the first clinical signs, following the histologic analysis of the surgical excision of a cutaneous abscess. Treatment with oral voriconazole was successful. This case report illustrates the highly heterogeneous clinical aspects of hyalohyphomycosis by P. lilacinus leading to a delay in diagnosis and treatment, particularly in the immunosuppressed patient.

DNA fingerprinting using Diversilab system for genotyping characterization of Microsporum audouinii and Trichophyton violaceum

Poster sessions: All poster boards are situated on the exhibition floor of the congress centre. The poster exhibition is open to all participants during the entire congress. The numbers on the poster boards correspond with the abstract numbers in this abstract supplement. All authors of odd poster numbers must be present at their poster on Saturday 12 October, from 11:00 to 12:00 hours. All authors of even poster numbers must be present at their poster on Sunday 13 October, from 11:00 to 12:00 hours. All posters are indicated by the prefix: P.