Josiane De Maubeuge

Thalidomide in Refractory Vulvar Ulcerations Associated with Crohn’s Disease

We report a case of recurrent vulvar ulcerations developed on vegetations associated with Crohn’s disease. Lesions responded to low-dose thalidomide treatment. A biopsy revealed a neutrophilic infiltrate with rare giant cells. Vulvar manifestations were consistent with metastatic Crohn’s disease or with a reactive neutrophilic dermatitis. Thalidomide reduces the activity of tumor necrosis factor (TNF) α by accelerating the degradation of its mRNA. Nowadays, it has become a promising drug in a broad variety of disorders in which TNF-α seems to play a pivotal role, including inflammatory bowel diseases. This is the first case report presenting the efficacy of thalidomide in the treatment of vulvar involvement in Crohn’s disease.

Clinically uninvolved skin in AIDS: evidence of atypical dermal vessels similar to early lesions observed in Kaposi's sarcoma: Ultrastructural study in four patients

The clinically uninvolved skin of 4 patients with well‐developed AIDS was investigated by electron microscopy. All biopsy specimens had vascular abnormalities: protruding endothelial cells, vascular channels reduced to slits, gaps within the vascular walls, and extravasated erythrocytes. These features are similar to those described in early lesions of Kaposis sarcoma. These findings suggest that blood vessels of the clinically uninvolved skin of AIDS patients are potential sites of Kaposis sarcoma lesions.

Cutaneous Mycobacterium chelonae infection extending distally in a hemodialysed patient.

We report a case of a cutaneous Mycobacterium chelonae infection on the dorsum of the forearm of a patient undergoing chronic hemodialysis. The infection showed a linear and distal extension. This unusual distal dissemination was apparently secondary to a venous reflux, a circulatory repercussion of the patient’s arteriovenous fistula.

Oral "hairy" leucoplakia in an African AIDS patient

A 34–year‐old African patient with AIDS developed a new form of oral leucoplakia closely resembling the “hairy” leucoplakia described by Greenspan in male homosexuals in the San Francisco area. A herpes‐like virus was seen on ultrastructural analysis with electron microscopy. This case supplies further evidence suggesting that the syndrome in patients originating in Central Africa is similar to the acquired immunodeficiency syndrome (AIDS) reported in American patients.