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FC087 Endoscopic dorsal sympathectomy the treatment for hyperhidrosis
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sis. In order to evaluate urokinase (U.) fibrinolytic activity, a loco-regional infusion of U. was performed in 6 patients with large venous leg ulcers. Method: A loco-regional infusion was performed: 100,000 units of urokinase dissolved in 100 ml of saline solution were infused in a foot vein (minimum time 15 minutes) once a day for 4 days (complete occlusion of circulation below the knee). A 6 mm punch biopsy was taken before the first day of treatment and the last day, twenty minutes after U. administration, on the edge of the ulcer. Thin sections (6 nm) were obtained to evaluate the cutaneous fibrinolytic activity (CFA). Direct immunofluorescence (DI) was performed using fluoresceinate antifibrinogen antiserum. Specificity of antibody includes native fibrinogen as well as D, E, X, Y fibrinogen-fragments. Results: CEA resulted in an increase after U. administration. A similar specific filamentous fluorescent activity (DI) was observed before and after the U. administration. Discussion: The impossible dissolution of the fibrin cuffs notwithstanding loco-regional fibrinolytic treatment indicates that these so called fibrin cuffs may be principally composed of fibrinogen or fibrin fragments.
FC084 1 Armauer Hansen (1941-1912): The life of the discoverer of the aetiology of leprosy A. Nyfors. Haukeland
Sykehus,
N-502I
Bergen,
Norway
Gerhard Armauer Henrik Hansen was born in Bergen July 29, 1841. He was the eight in a family of 15 children. In 1859 he moved to Christiania (Oslo) to study medicine. He was a diligent student who developed a special interest in pathological anatomy. In the autumn of 1866 he passed his medical examinations with honours. In 1867 he served as a registrar in the northern part of Norway in a fishing community. In the spring of 1868 Armauer Hansen (AH) returned to Bergen to work under the world-known leprologist dr. Danielssen at Pleiestiftelsen no. I (leprosarium no. I) as a clinician and researcher. AH studied sections from lymph nodes and organs from lepers in his microscope. On a rainy evening the 28. of February 1873 he noticed some small rods moving in the field he studied. Later he was able to stain such rods (mycobacterium leprae). AH’s life will be reviewed with photos from Pleiestiftelsen no. I as well as from the Lepramuseum in Bergen.
FCO85 Subcorneal pustular dermatosis H.E. Gore ’ , R.J. Black ‘, D.J. Eedy ’ , G. McCusker ‘. ‘Dept of Dermatology; Group Trust,
2Dept of Pathology, Craigavon Co Armagh, NI, USA
Area
Hospital
A 29 year old lady presented with arcuate/serpiginous rashes over trunk. Diagnosis of tinea incognito was considered. The rash then became pustular and spread to involve face and limbs. There was no history of psoriasis. Past Medical History: Congenital cyanotic heart disease. Investigations: Histopathology: Pustules in subcomeal layer. Eosinophils were not a feature. No psoriasiform changes at dermal/epidermal junction. Immunofluorescence: Negative. Plasma protein electrophoresis essentially normal.
- Miscellaneous
s135
‘beatment: Systemic steroids initially, then dapsone introduced with caution due to cyanosis. Condition stabilized and controlled. Comment: Our patient is relatively young. We note the absence of any gammopathy. Facial involvement, a feature in our case, is rare. Management was complicated by several factors, namely congenital heart disease, the patient’s plans for pregnancy and the frequency of movement of the patient.
FC086 Lichenoid tattoo reaction H.E. Gore ’ , D.J. Eedy ’ , J. Somerville2. Dermatology; Group Trust,
2Dept of Pathology, Northern Ireland
’ Dept of Craigavon Area
Hospital
A 35 year old man presented with elevated itchy areas in tattoos on both forearms, involving all the areas of red pigment only. He had tattoos on both forearms for 16 years, and had recently had an extension to the one on the left forearm. The changes occurred in the red areas of both the new and pre-existing tattoos. No past medical history of note. No other rashes. No reaction in scars on wrists. No respiratory symptoms. Investigations: Histopathology: red pigment granules within macrophages, consistent with tattoo pigment. Inflammatory cell infiltrate, lichenoid in character. No granulomata. Patch testing: No sensitivity to mercury compounds. Diagnosis: Lichenoid tattoo hypersensitivity. Treatment: Intralesional steroid injection, proving successful. Comment: Lichenoid reaction to red pigment in tattoos has been described rarely. Mercuric sulphide (cinnabar) in red pigment has been replaced nowadays by organic dyes. The exact nature of the agent producing this hypersensitivity is unclear.
FC087 Endoscopic dorsal sympathectomy treatment for hyperhidrosis
the
P. Rat, A. Bernard, S. Dalac, J.P. Favre, D. Lambert. Department Dermatology
of Digestive and Thoracic Surgery, Department Che Le Bocage 21034 Dijon, France
of
Sixty endoscopic dorsal sympathectomy (EDS) were performed between january 1993 and 1997 on 30 patients with severe palma and/or axillary hyperhidrosis. The first 5 patients were operated twice under 2 anesthetics, the remaining 25 were operated bilaterally during one single operation. No major complications were observed. The average hospitalisation time was only two days. 7 patients (23%) suffered back pains for about two weeks, all pains disappeared spontaneously. 5 patients (17%) developed temporary compensatory hyperhydrosis, and one (3%) gustatory sweating. This treatment was 100% successful. The success of this single operation leads us to propose this treatment in cases of severe hyperhidrosis.
sis. In order to evaluate urokinase (U.) fibrinolytic activity, a loco-regional infusion of U. was performed in 6 patients with large venous leg ulcers. Method: A loco-regional infusion was performed: 100,000 units of urokinase dissolved in 100 ml of saline solution were infused in a foot vein (minimum time 15 minutes) once a day for 4 days (complete occlusion of circulation below the knee). A 6 mm punch biopsy was taken before the first day of treatment and the last day, twenty minutes after U. administration, on the edge of the ulcer. Thin sections (6 nm) were obtained to evaluate the cutaneous fibrinolytic activity (CFA). Direct immunofluorescence (DI) was performed using fluoresceinate antifibrinogen antiserum. Specificity of antibody includes native fibrinogen as well as D, E, X, Y fibrinogen-fragments. Results: CEA resulted in an increase after U. administration. A similar specific filamentous fluorescent activity (DI) was observed before and after the U. administration. Discussion: The impossible dissolution of the fibrin cuffs notwithstanding loco-regional fibrinolytic treatment indicates that these so called fibrin cuffs may be principally composed of fibrinogen or fibrin fragments.
FC084 1 Armauer Hansen (1941-1912): The life of the discoverer of the aetiology of leprosy A. Nyfors. Haukeland
Sykehus,
N-502I
Bergen,
Norway
Gerhard Armauer Henrik Hansen was born in Bergen July 29, 1841. He was the eight in a family of 15 children. In 1859 he moved to Christiania (Oslo) to study medicine. He was a diligent student who developed a special interest in pathological anatomy. In the autumn of 1866 he passed his medical examinations with honours. In 1867 he served as a registrar in the northern part of Norway in a fishing community. In the spring of 1868 Armauer Hansen (AH) returned to Bergen to work under the world-known leprologist dr. Danielssen at Pleiestiftelsen no. I (leprosarium no. I) as a clinician and researcher. AH studied sections from lymph nodes and organs from lepers in his microscope. On a rainy evening the 28. of February 1873 he noticed some small rods moving in the field he studied. Later he was able to stain such rods (mycobacterium leprae). AH’s life will be reviewed with photos from Pleiestiftelsen no. I as well as from the Lepramuseum in Bergen.
FCO85 Subcorneal pustular dermatosis H.E. Gore ’ , R.J. Black ‘, D.J. Eedy ’ , G. McCusker ‘. ‘Dept of Dermatology; Group Trust,
2Dept of Pathology, Craigavon Co Armagh, NI, USA
Area
Hospital
A 29 year old lady presented with arcuate/serpiginous rashes over trunk. Diagnosis of tinea incognito was considered. The rash then became pustular and spread to involve face and limbs. There was no history of psoriasis. Past Medical History: Congenital cyanotic heart disease. Investigations: Histopathology: Pustules in subcomeal layer. Eosinophils were not a feature. No psoriasiform changes at dermal/epidermal junction. Immunofluorescence: Negative. Plasma protein electrophoresis essentially normal.
- Miscellaneous
s135
‘beatment: Systemic steroids initially, then dapsone introduced with caution due to cyanosis. Condition stabilized and controlled. Comment: Our patient is relatively young. We note the absence of any gammopathy. Facial involvement, a feature in our case, is rare. Management was complicated by several factors, namely congenital heart disease, the patient’s plans for pregnancy and the frequency of movement of the patient.
FC086 Lichenoid tattoo reaction H.E. Gore ’ , D.J. Eedy ’ , J. Somerville2. Dermatology; Group Trust,
2Dept of Pathology, Northern Ireland
’ Dept of Craigavon Area
Hospital
A 35 year old man presented with elevated itchy areas in tattoos on both forearms, involving all the areas of red pigment only. He had tattoos on both forearms for 16 years, and had recently had an extension to the one on the left forearm. The changes occurred in the red areas of both the new and pre-existing tattoos. No past medical history of note. No other rashes. No reaction in scars on wrists. No respiratory symptoms. Investigations: Histopathology: red pigment granules within macrophages, consistent with tattoo pigment. Inflammatory cell infiltrate, lichenoid in character. No granulomata. Patch testing: No sensitivity to mercury compounds. Diagnosis: Lichenoid tattoo hypersensitivity. Treatment: Intralesional steroid injection, proving successful. Comment: Lichenoid reaction to red pigment in tattoos has been described rarely. Mercuric sulphide (cinnabar) in red pigment has been replaced nowadays by organic dyes. The exact nature of the agent producing this hypersensitivity is unclear.
FC087 Endoscopic dorsal sympathectomy treatment for hyperhidrosis
the
P. Rat, A. Bernard, S. Dalac, J.P. Favre, D. Lambert. Department Dermatology
of Digestive and Thoracic Surgery, Department Che Le Bocage 21034 Dijon, France
of
Sixty endoscopic dorsal sympathectomy (EDS) were performed between january 1993 and 1997 on 30 patients with severe palma and/or axillary hyperhidrosis. The first 5 patients were operated twice under 2 anesthetics, the remaining 25 were operated bilaterally during one single operation. No major complications were observed. The average hospitalisation time was only two days. 7 patients (23%) suffered back pains for about two weeks, all pains disappeared spontaneously. 5 patients (17%) developed temporary compensatory hyperhydrosis, and one (3%) gustatory sweating. This treatment was 100% successful. The success of this single operation leads us to propose this treatment in cases of severe hyperhidrosis.