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P308 Localized cutaneous infection due to mycobacterium kansasii in a patient with AIDS
Posters -
IP307
L. Chigorevska. Department Children
P309 El
Social syphilis in children hospital
of Medical
of Dermatovenerology Acsdemy of Latvia,
of the Riga, Latvia
Infection with syphilis may occur in various ways-by sexual activity, as a result of close contact in social life, indirectly, and through the placenta. While working in the dermatovenerology department experience in practical has shows that children my become infected from their parents who suffer from contagious forms of syphilis. A data analysis of syphilis morbidity during the past four years shows the following indices: 1993- 1 case, 1994- 4 cases, 1995- 5 cases, 1996- 6 cases. These children were aged from 11 months to 8 years. In 80% of cases parents were established to have L II relapse with such symptoms as syphilitic quinsy, stomatitis. 8 children were parents found to have latent syphilis (L latens) without manifest clinical signs, but all children had characteristic pallor of the skin, polyadenitis, increased erythrocyte sedimentation rate and conspicuously positive seroreactions. Six children were found to have recurring, one child-early (L II recens), and one child-primary (with chancre on oral mucou membrane) syphilis. Infection occurred because most of the children came from socially unfavourable families, when parents cultivated harmful habits, under poor hygienic conditions and where children were not cared for. Conclusion: All children who are in close contact with parents suffering from syphilis should be carefully examined in specialized departments clinically and serologically; measures of precaution should be indicated, especially in children up to 3 years of age. ElP308 Localized cutaneous infection due to
mycobacterium kansasii in a patient with AIDS
P. Herranz ’ , J. Gonzalez *, J. Garcia 3, T.E. Lgzaro ’ , F. Contreras 4, M. Casado ’ . ‘Departments of Dermatology; ‘Medicine; Hospital,
3Microbiology: Madrid, Spain
4Pathology;
La Paz Universitaty,
Introduction: We report an unusual case of isolated cutaneous affection due to m. kansasii in an AIDS patient. Case Report: A 38-year-old, HIV-positive male, who had been classified into group C3 (CDC) and diagnosed of chronic active hepatitis, consulted in September 95 because of an ulcerative, solitary inflammatory lesion over the right leg, that had started 1 month before. Histopathological studies and culture on Lowenstein-Jensen medium lead to diagnosis of m. kansasii infection, and absence of visceral dissemination was ruled out on complementary tests. Prolonged treatment with clarithromycin and ethambutol resulted in progressive clinical recovery, without significant adverse effects. Discussion: Most cases of cutaneous lesions due to m. kansasii in AIDS patients have been described in the setting of diseminated disease, and previous reports of isolated cutaneous affection are exceptional. In our patient, the efficacy of the association of clarithromycin and ethambutol, which allowed us to avoid the hepatotoxic effects of classic tuberculostatic schedules, is also remarkable.
s225
STD/HIV
Red fingers syndrome: An unusual feature in HIV-infection
L. Fabricio ‘.‘, M. D’Incan ‘, F. Gourdon3, J. Beytout 3, P. Souteyrand’. ‘Department of Dermatology, FEMPAR, Curitiba, infectious France
Brazil, 2Department Diseases, CRHU
of Dermatology; 3Department Hbtel-Dieu, Clermont-Ferrand,
of
Background: Red fingers syndrome is a rare cutaneous manifestation in HIV-infection not commonly related in reviews of AIDS. It has been reported mainly in association of HIV and hepatitis C virus infection. Case Report: A 30-year-old female AIDS patient developed erythema of the fingers, The erythema was restricted to the distal portion of the fingers with no other associated sign, such as Raynaud’s phenomenon. She was receiving zidovudine and lamivudine. Comment: There have been 18 published reports of red fingers syndrome in HIV-infected patients. Thirteen of the patients were coinfected with HCV, and in 4 cases cryoglobulinaemia was detected. Our patient had no anti-HCV antibodies nor cryoglobulinaemia. Red fingers syndrome is a rare cutaneous manifestation, which, because of differential diagnosis with drug-induced acral erythema or collagen disease, might be under reported. ElP310
Red fingers syndrome in HIV infected patients with chronic hepatopathy
P. Abajo, J.I. Porras Luque, G.F. Buezo, B. Bartolome, E. DaudCn. Department of Dermatology, Hospital Univ. de la Princesa,
Madrid,
Spain
Patients with HIV infection may develop a wide variety of vascular disorders. A periungual, pulpar and palmar erythema, called by some authors Red Fingers Syndrome, has also been described in these patients. Two HIV-positive patients, a 3 l-year-old woman (Case 1) and a 3 l-year-old man (Case 2), ex-intravenous drug users, assisted to our Department presenting striking, painless, well delimited periungual and pulpar erythema in fingers and hypotenar eminences. Case 1 had a chronic hepatitis C and Case 2 a chronic hepatitis B infection. Histologic studies revealed superficial dermal dilated vessels in the first case and a leukocytoclastic necrotizing vasculitis of small vessels in the second one. It has been speculated that vascular reactions leading to the red fingers might be due to the association of HIV infection with liver disease induced by hepatitis viruses (C and possibly B) with inmunological disturbances. It has also been described similar lesions, but no specific cause has been identified other than HIV infection. Only scarce histopathological studies have been performed revealing non specific findings. We would like to emphasize the association of cutaneous lesions with hepatitis C and hepatitis B virus infection in our patients and the previously non-described presence of leukocytoclastic vasculitis in the second one.
IP307
L. Chigorevska. Department Children
P309 El
Social syphilis in children hospital
of Medical
of Dermatovenerology Acsdemy of Latvia,
of the Riga, Latvia
Infection with syphilis may occur in various ways-by sexual activity, as a result of close contact in social life, indirectly, and through the placenta. While working in the dermatovenerology department experience in practical has shows that children my become infected from their parents who suffer from contagious forms of syphilis. A data analysis of syphilis morbidity during the past four years shows the following indices: 1993- 1 case, 1994- 4 cases, 1995- 5 cases, 1996- 6 cases. These children were aged from 11 months to 8 years. In 80% of cases parents were established to have L II relapse with such symptoms as syphilitic quinsy, stomatitis. 8 children were parents found to have latent syphilis (L latens) without manifest clinical signs, but all children had characteristic pallor of the skin, polyadenitis, increased erythrocyte sedimentation rate and conspicuously positive seroreactions. Six children were found to have recurring, one child-early (L II recens), and one child-primary (with chancre on oral mucou membrane) syphilis. Infection occurred because most of the children came from socially unfavourable families, when parents cultivated harmful habits, under poor hygienic conditions and where children were not cared for. Conclusion: All children who are in close contact with parents suffering from syphilis should be carefully examined in specialized departments clinically and serologically; measures of precaution should be indicated, especially in children up to 3 years of age. ElP308 Localized cutaneous infection due to
mycobacterium kansasii in a patient with AIDS
P. Herranz ’ , J. Gonzalez *, J. Garcia 3, T.E. Lgzaro ’ , F. Contreras 4, M. Casado ’ . ‘Departments of Dermatology; ‘Medicine; Hospital,
3Microbiology: Madrid, Spain
4Pathology;
La Paz Universitaty,
Introduction: We report an unusual case of isolated cutaneous affection due to m. kansasii in an AIDS patient. Case Report: A 38-year-old, HIV-positive male, who had been classified into group C3 (CDC) and diagnosed of chronic active hepatitis, consulted in September 95 because of an ulcerative, solitary inflammatory lesion over the right leg, that had started 1 month before. Histopathological studies and culture on Lowenstein-Jensen medium lead to diagnosis of m. kansasii infection, and absence of visceral dissemination was ruled out on complementary tests. Prolonged treatment with clarithromycin and ethambutol resulted in progressive clinical recovery, without significant adverse effects. Discussion: Most cases of cutaneous lesions due to m. kansasii in AIDS patients have been described in the setting of diseminated disease, and previous reports of isolated cutaneous affection are exceptional. In our patient, the efficacy of the association of clarithromycin and ethambutol, which allowed us to avoid the hepatotoxic effects of classic tuberculostatic schedules, is also remarkable.
s225
STD/HIV
Red fingers syndrome: An unusual feature in HIV-infection
L. Fabricio ‘.‘, M. D’Incan ‘, F. Gourdon3, J. Beytout 3, P. Souteyrand’. ‘Department of Dermatology, FEMPAR, Curitiba, infectious France
Brazil, 2Department Diseases, CRHU
of Dermatology; 3Department Hbtel-Dieu, Clermont-Ferrand,
of
Background: Red fingers syndrome is a rare cutaneous manifestation in HIV-infection not commonly related in reviews of AIDS. It has been reported mainly in association of HIV and hepatitis C virus infection. Case Report: A 30-year-old female AIDS patient developed erythema of the fingers, The erythema was restricted to the distal portion of the fingers with no other associated sign, such as Raynaud’s phenomenon. She was receiving zidovudine and lamivudine. Comment: There have been 18 published reports of red fingers syndrome in HIV-infected patients. Thirteen of the patients were coinfected with HCV, and in 4 cases cryoglobulinaemia was detected. Our patient had no anti-HCV antibodies nor cryoglobulinaemia. Red fingers syndrome is a rare cutaneous manifestation, which, because of differential diagnosis with drug-induced acral erythema or collagen disease, might be under reported. ElP310
Red fingers syndrome in HIV infected patients with chronic hepatopathy
P. Abajo, J.I. Porras Luque, G.F. Buezo, B. Bartolome, E. DaudCn. Department of Dermatology, Hospital Univ. de la Princesa,
Madrid,
Spain
Patients with HIV infection may develop a wide variety of vascular disorders. A periungual, pulpar and palmar erythema, called by some authors Red Fingers Syndrome, has also been described in these patients. Two HIV-positive patients, a 3 l-year-old woman (Case 1) and a 3 l-year-old man (Case 2), ex-intravenous drug users, assisted to our Department presenting striking, painless, well delimited periungual and pulpar erythema in fingers and hypotenar eminences. Case 1 had a chronic hepatitis C and Case 2 a chronic hepatitis B infection. Histologic studies revealed superficial dermal dilated vessels in the first case and a leukocytoclastic necrotizing vasculitis of small vessels in the second one. It has been speculated that vascular reactions leading to the red fingers might be due to the association of HIV infection with liver disease induced by hepatitis viruses (C and possibly B) with inmunological disturbances. It has also been described similar lesions, but no specific cause has been identified other than HIV infection. Only scarce histopathological studies have been performed revealing non specific findings. We would like to emphasize the association of cutaneous lesions with hepatitis C and hepatitis B virus infection in our patients and the previously non-described presence of leukocytoclastic vasculitis in the second one.