P199 Systemic amyloidosis. Report of four cases

S198

Posters

- Miscellaneous

Igs or C3) at the dermoepidermal junction located both in the roof and bottom of a blister provoked on perilesional skin by a solution of 1 M nace. The lesions of the skin responded to oral treatment with dapsone, but mucosal involvement required immunosupression with azathioprine. The clinical manifestations of this patient are indistinguishable from those of cicatricial pemphigoid. Only the immunofluorescence findings made possible the diagnosis of adult linear IgA disease. I P196 The acute effect of smoking on cutaneous

microcirculation blood flow in habitual smokers and non smokers

Cl. Monfrecola, G. Riccio, C. Savarese, G. Posteraro, E.M. Procaccini. Dept. of Dermatology, University “Federico II”,

Naples,

I PI 98 Subcutaneous

manifestation of metastatic thyroid carcinoma

Italy

Smoking is known to be a primary cause of chronic harmful effects on vascular system. It also induces some acute effects on the coronary circulation and on the ophthalmic artery. Our purpose was to assess the effect of a single cigarette smoking on cutaneous blood flow in habitual smoker as well as in non smoker subjects. A Laser Doppler flowmeter has been used to perform measurements of cutaneous microcirculation. Flowmetric data have been recorded (i) before smoking, (ii) inhaling an unlighted cigarette, (iii) during a cigarette smoking, (iiii) 2 and (iiiii) 5 minutes after smoking. Results show that the smoke of a single cigarette acts on cutaneous microcirculation reducing blood flow in both groups of patients (38.1% reduction in smoker subjects and 28.1% reduction in non smoker ones) (p < 0.01). Interestingly, the recovering phase is faster in non smoker subjects than in smoker ones; in fact, the recovering is complete 2 minutes and 5 minutes after a cigarette smoking in non smoker and in smoker subjects respectively. In conclusion the smoke of a single cigarette decreases the cutaneous blood flow in habitual smoker as well as in non smoker subjects. Moreover the slower recovering phase of smoker subjects suggest that their microcircle is become inured to smoke. 0PI 97 The prevalence of occupational dermatoses in the Cukurova region M.A. Acar, M. Karakag, V.L. Aksungur, Y.G. Denli, M. Baba, H. Kavukcu, H.R. Memigoglu. Cukurova University, Faculty of Medicine,

contact dermatitis 32 (5.94%), tinea infection 117 (21.74%) acne 82 (15.24%), pruritus 56 (10.40%), urticaria 28 (5.20%) pyodermia 20 (3.71%) psoriasis 21 (3.90%), scabies 28 (5.20), lichen planus 27 (5.01), keratoderma 13 (2.41%) and others 54 (10.03%). Skin tests have been planned for application to patients with allergic contact dermatitis, irritant contact dermatitis and urticaria since these may be associated with their occupation. It was observed that contact dermatitis occurred frequently in susceptible persons when protective gloves were not used. Tinea infections were the most common dermatological disease which are associated with the climate of the region rather than with their occupation. This study has been supported by the project No: TF.94.34 of Cukurova University Research Fond.

Department

of Dermatology,

Adana,

Turkey

The aim of this study was to determine the rate of occupational dermatoses in factories in the Cukurova region. After meeting with the managers of the industrial establishments in question, a dermatological examination was made of the workers. For 6 months, a dermatological examination was made of 2960 men and 1040 women (totaling 4000) in various branches of industry especially in the following 12 fields: Plastic, weaving, dye, thread, margarine, tobacco and textile dyeing: Skin diseases were found in 617 people (332 men and 285 women whose ages ranged between 18-54). Dermatological disease was observed as follows: Allergic contact dermatitis 81 (15.05%), irritant

L. Fabricio ‘3’ , M. D’Incan’, P. Souteyrand 2. ‘Department Curitiba, Brazil, 2Department Hotel-Dieu, Clermont-Ferrand,

H. Roger 2, S. Mansard2, of Dermatology, of Dermatology, France

FEMPAR, CRHU

An 89-year-old woman had a 4 month history of a progressively enlarging subcutaneous mass on the head. Examination revealed a firm, non-throbbing, subcutaneous mass 4 cm in diameter, localized in the right temporal region, with normal covering skin. A goitre and a homolateral exophtalmos were noted. She complained of intermittent headache. A computed tomographic scan of the head was performed before routine biopsy, fortunately, as it showed a large right temporal mass with osteolytic and cerebral invasion features. Metastatic thyroid carcinoma was diagnosed on the basis of histological specimens. During biopsy, performed by a neurosurgeon, the patient had a haemorrhage. She refused surgical treatment and thus radiation therapy was recommended. This report shows that care should be taken before performing biopsy in cases of subcutaneous cranial tumour to avoid potentially dangerous surgical complications. I PI 99 Systemic amyloidosis. Report of four cases: S. Cordoba, E. Vargas, J. Fraga’, E. Dauden, M. Aragties. Department Universitario

of Dermatology; de la Princesa,

‘Pathology, Hospital Madrid, Spain

Introduction: Immunoglobulin light chains related systemic amyloidoses, also called AL amyloidosis, are almost always associated with monoclonal gammopathy or myeloma. The occurrence of mucocutaneous lesions ranges from 29 to 40%. usually they become purpuric after minimal trauma, due to perivascular deposit of amyloid protein. Patients: We report four patients, two women and two men, aged ranged between 58 and 81, that assisted to our department reporting a 10 months-10 years history of white-yellowish plaques with purpuric zones. Two cases were associated with myeloma while the other two had monoclonal gammopathy. All the patients showed amyloid deposition throughout multiple organs as revealed by fine needle aspiration of subcutaneous fat and tongue, skin or bone marrow biopsies. Two cases presented diffuse plane normolipaemic xanthoma (DPNX) coexisting with amyloidosis in cutaneous lesions. One patient showed

Posters

condyloma-like lesions in perianal area. Two cases died from congestive cardiopathy, one is alive under dialysis treatment for his renal failure while the fourth shows no evidence of any other disease. Conclusions: The appearance of cutaneous lesions within systemic amyloidosis strongly suggests AL amyloidosis, as they are very unusual in AA amyloidosis. Although there is a great variability in the clinical picture, we would like to emphasize the presence of condyloma-like lesion and the coexistence of DPNX in our patients. I P200 Carcinoid syndrome with prevalent

cutaneous expressiveness

E. Pezzarossa, F. Cirillo ‘, G.B. Lazzari. Dept. ‘Dept.

of Surgery,

Cremona

Hospital,

of Dermatology;

Italy

A forty-one old male was seen for Rosacea and intense episodes of flushing. Carcinoid tumor was diagnosed on the basis of raised level of 5-hydroxyindoleacetic acid. Echography and Octreo-scan demonstrated multiple liver metastasis. A laparotomy identified carcinoid tumor in the ileum. Treatment combined surgical excision, chemo = embolization of hepatic artery with doxorubicin and a long term treatment with a somata = statin analogue (octreotide). The following normalization of 5-hydroxyndol = acetic acid provoked the flushing remission and improvement of rosaceiform aspect of the face. I P201 Surface evaluation of living skin - SELS H. Tronnier ’ , M. Wiebusch ’ , U. Heinrich ’ , R. Stute ‘. ’ Institut fir experimentelle Witten/Herdecke, Ireland, und MeJtechnik, Dortmund

Dermatologie, 21ngenieurbiiro

s199

- Miscellaneous

Universitiit fiir Automatisierung

Question: An evaluation of the surface structure of the skin is an important factor in diagnosing dermatoses and a differentiated quantitative analysis of the factors determining it is an essential aid for the assessment of therapeutic and cosmetic measures, as well as for the evaluation of side-effects (e.g. corticoid atrophy). Until now, different profilometric methods and photoanalytical evaluations of replicas, the drawing-up of which already leads to changes of the skin’s surface structure, were used. Methods: With a measuring head containing a CCD-camera and two UV-metal-halogen lamps, positioned contrarotatingly, the skin is lit and the picture of the skin taken which is then analysed with a special software as to luminosity and distribution of the pixels according to the following parameters: (1) SE, = scaling (2) SE, = roughness (3) SE, = wrinkling (4) SE,, = smoothing Covering the picture with false colours allows a topographical classification ot the measuring parameters. Results: With examination examples of local influence on the skin surface the given assignment of the measuring parameters to skin-physiological changes and processes is demonstrated

and it is shown how they are influenced by therapeutical and care measures. Conclusion: The new SELS-method allows fast, simple and reproducible recording of the surface structure of living skin in several, skin-physiologically relevant parameters and quantification of their values. I P202 Vaginal melanoma in pregnancy M. Alcalde, F. Simon, F. Alonso, J.F. Moriana, L. Canosa, J. Roig. Torreca’rdenas Hospital, Almeria, Spain Primary malignant melanoma of vagina is a rare entity. There are, in our knowledge, less than 100 cases, and none in a pregnant woman. Case Report: A 36 years old, pregnant at 27 weeks woman was admitted because of metrorrhagia. It was caused by a sessile, 5 cm. tumor, in upper half of the antero-lateral vaginal wall. Total cutaneomucosal and ocular examination were normal. Biopsy from vaginal mass revealed an indifferentiated carcinoma. Cesarean section was practiced at 30 weeks. The newborn and placenta were normal. The vaginal tumor, that didn’t infiltrate adjacent structures, and two hepatic nodules were extirpated. Abdominopelvical CT and MRl show multiple hepatic metastasis; but they didn’t find lymphadenopathy. All biopsies showed a proliferation of atypical, intermediate size cells and numerous mitosis. Immmunohistochemical and Masson-Fontana stainings revealed nodular melanoma. Patient was treated with DTIC, tamoxifen and interferon. At the time of writing this abstract, 9 months after diagnosis, the patient has survived and presents normal vaginal examinations but multiple hepatic metastasis as in initial explorations. ElP203 Cutaneous necrotizing vasculitis: A non innocent entity with frequent renal

involvement D. Ioannidou ’ , K. Perakis 2, E. Dafnis 2, M. Stefanidou ’ , University J. Katsantonis ’ , A. D. Toska ’ . ‘Dept. Dermatology, Hospital Hospital

of Heraklion of Heraklion

Crete; Crete,

2Dept. Greece

Nephrology,

University

Forty nine patients with clinical and histologically confirmed cutaneous necrotizing vasculitis (CNV) have been put on a standard protocol in order to correlate clinical and laboratory parameters. Special interest was paid in the frequency of the renal involvement. In different series, systemic involvement has been recorded with a range from 40-90%. In our report, systemic disease was recognized in 32/49 (65%) patients. Abnormalities in the laboratory findings were also noted. In 8/49 patients abnormal urinary findings were found and in another 1 l/49 an active urinary sediment was documented. Six out of nineteen patients with renal dysfunction were submitted to renal biopsy which confirmed, vasculitic glumerulonephritis with specific findings. A correlation of the characteristic skin lesions and the anatomical sites with the renal findings was attempted. A reevaluation of the spectrum of the clinical and the laboratory exams necessary to be carried out in every patient with primary or relapsing vasculitis will be discussed.