A case of early congenital syphilis

A case of early congenital syphilis is reported in order to emphasize that syphilis is still present nowadays and that detection of syphilis in pregnant women is primordial for the prevention of this disease.

Tinea capitis in two black african adults with HIV infection

Tinea capitis is rare in adults, although a few cases have been described in HIV-infected patients. We present two cases in black African adults who were HIV positive. In one, the condition led to the diagnosis of HIV infection. It is possible that the rarity of tinea capitis in HIV-positive adults could be related to increased colonization of their scalp by Pityrosporum (Malassezia) spp. In patients well controlled with an antiviral therapy, the treatment of tinea capitis seems no more difficult than in non-immunosuppressed patients. There is possibly a relation between clinical presentation and degree of immunodeficiency.

Acyclovir vs isoprinosine (immunovir) for suppression of recurrent genital herpes simplex infection

OBJECTIVE

To compare the efficacy and safety of oral acyclovir (400 mg twice daily) with oral isoprinosine (500 mg twice daily) in the suppression of recurrent genital herpes.

DESIGN

Double-blind, double-dummy, randomised, controlled, parallel group trial.

SETTING

13 centres in UK, Belgium and Germany.

SUBJECTS

127 immunocompetent patients with frequently recurring genital herpes.

MAIN OUTCOME MEASURES

Proportions of patients reporting recurrences, recurrence frequency, and mean duration of lesions during breakthrough recurrences in each treatment group during a 6 month treatment period; time to first recurrence during treatment and follow-up after treatment cessation.

RESULTS

During treatment, acyclovir recipients showed significant differences (p < 0.05) when compared with isoprinosine recipients in terms of a lower proportion reporting recurrences (31% vs 96%), a reduced mean number of reported recurrences per patient (0.6 vs 3.6), a shorter mean duration of breakthrough lesions (6.4 days vs 8.2 days), and a longer mean time (standard error) to first recurrence (143.7 (9.1) days vs 40.5 (5.4) days. The mean time to first recurrence after treatment cessation did not differ between the two groups. As compared with placebo recipients, isoprinosine treated patients had an increased recurrence frequency (3.6 vs 2.5) during treatment, and a shorter time to first recurrence after treatment cessation. All treatments were well tolerated without serious adverse events or toxicity.

CONCLUSIONS

Acyclovir is very effective in suppressing recurrent genital herpes and is clearly superior to isoprinosine which is not clinically useful in the dosage studied.

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 Kaposi's sarcoma. These findings suggest that blood vessels of the clinically uninvolved skin of AIDS patients are potential sites of Kaposi's sarcoma lesions.

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.

[Giant condyloma of the anus: tumor of Buschke-Loewenstein (author's transl)]

The authors report a case of a Buschke-Loewenstein tumor located at the anus. Initial treatment with Bleomycin was remarkably effective. A recurrence 3 months later did not respond any more to Bleomycin. Multiple surgical resections were performed in association with this form of chemotherapy.

Contact sensitivity to rubber additives in Belgium

The frequency of positive patch tests to rubber additives in Belgium is recorded. Allergy due to rubber protective gloves represents 41% of the overall sensitivity to rubber.

IgE mediated hypersensitivity in ageing

The serum IgE concentration is significantly lower in aged as compared with young people. This is more pronounced in males than in females (P less than 0-05). In fifteen aged (greater than 70 years) compared with fifteen young subjects (less than 40) the specific IgE antibody response to an injection of diphtheria toxoid was significantly reduced (P less than 0-01). The minimum concentration of anti-IgE antibody able to induce a weal and flare reaction when injected intradermally, was comparable in the two age groups. However, the diameter of the weal reaction was significantly reduced in the aged. It is concluded that the reduced incidence of atopic symptoms in old people might be secondary to an anomaly of both the immune system and the mast cells.

Treatment of chronic urticaria with a beta2-adrenergic stimulant

Twenty-four patients with chronic utricaria resistant to conventional therapy were treated orally with terbutaline, a specific beta2 stimulant. This therapy was much more effective than antihistamines. At the dose of 1-25 mg three times a day, there were few side effects. The efficacy was independent of the IgE levels; it seemed greater in idiopathic cases than in cholinergic or pressure induced urticaria.