Nous rapportons un cas original de syndrome de Stevens-Johnson apparemment induit par l’ingestion de poudre à canon.Une étudiante de 22 ans était hospitalisée pour une éruption diffuse douloureuse évoluant depuis trois jours. Elle signalait dans ses antécédents une urticaire récidivante liée à la consommation d’ananas. Le dernier épisode d’urticaire était survenu six jours auparavant ; pour la soulager, sa mère lui avait alors fait ingérer de la poudre à canon achetée sur le marché et dissoute dans de l’eau, à l’exclusion de tout autre traitement. Au troisième jour de ce « traitement », des lésions maculopapuleuses puis érosives étaient apparues, dans un contexte fébrile. L’examen montrait une éruption polymorphe touchant l’ensemble du tégument sauf les paumes et les plantes, faite de maculopapules hyperpigmentées, de pseudo-cocardes, de bulles et d’érosions, sans signe de Nikolsky. L’atteinte des muqueuses conjonctivale, nasale, buccale, vulvo-vaginale et anale était sévère. Ce tableau évoquait un syndrome de Stevens-Johnson. La patiente avait arrêté d’elle-même l’ingestion de poudre à canon dès la survenue des premières lésions. Avec des soins locaux et une réhydratation, l’évolution se faisait vers une cicatrisation avec des séquelles à type de synéchies conjonctivales et vulvo-vaginales, et de dyschromie diffuse.Les caractères cliniques de l’éruption permettent de poser le diagnostic de syndrome de Stevens-Johnson chez cette patiente. En l’absence d’indice en faveur d’une autre cause, infectieuse ou médicamenteuse, la responsabilité de la poudre à canon dans sa survenue paraît vraisemblable, malgré un délai de survenue très court. À notre connaissance, c’est la première fois que la poudre à canon est décrite comme possiblement inductrice d’un syndrome de Stevens-Johnson.A cutaneous adverse drug reaction is a skin eruption secondary to the intake of a drug, be it prescribed by a medical practitioner or taken as auto-medication for a given ailment. In this document we present an original case of Stevens-Johnson's syndrome secondary to the ingestion of gunpowder.A 22-year-old female student was hospitalised for diffuse and painful skin eruptions for the previous three days. She had complained six days earlier of an allergic reaction to pineapples, an allergy she had presented for quite a long time. In an attempt to remedy the situation, her mother made her drink a solution made of gunpowder bought at a market mixed with some water. On the third day of this “treatment”, the patient noticed eruptions on her skin. These were initially maculopapular, later becoming erosive, and she had a mild fever. Later, a variety of eruptions appeared on the skin, from hyper-pigmented macular papules to blisters and erosive lesions with no Nicolsky sign. These lesions spared the palms of the hands and the soles of the feet. The mucosa of the conjunctivae, nose, buccal cavity, vulva, vagina and anus were severely affected. This clinical presentation was typical of Steven Johnson syndrome. The patient had stopped taking the “treatment” when she noticed the first lesions. On therapy, the outcome was favourable, except for severe complications such as synechiae with diffuse dyschromia.To the best of our knowledge this is the first time gunpowder has been incriminated in Stevens-Johnson's syndrome.

Background. - Hypocomplementemic urticarial vasculitis, described by MacDuffie in 1973, is rare. Some doubt surrounds its classification. We report a case of hypocomplementemic urticarial vasculitis (MacDuffie syndrome) treated with dapsone with a favorable outcome.Case report. - Over a number of years, a 43-year-old man presented urticarial vasculitis attacks with palpebral oedema and systemic symptoms such as fever and arthralgia. In 2006, MacDuffie syndrome was diagnosed on the grounds of positive anti-C1q antibodies. Treatment with dapsone was started and resulted in considerable improvement.Discussion. - Hypocomplementemic urticarial vasculitis is characterized by urticarial vasculitis lesions, leucocytoclastic vasculitis and systemic symptoms. The latter symptoms are similar to those of systemic lupus erythematosus (SLE), and some authors have suggested that MacDuffie syndrome may in fact belong to SLE. Diagnosis is based on clinical appearance, histology and the presence of anti-C1q antibodies. There is no specific treatment for hypocomplementemic urticarial vasculitis. Immunosuppressant therapy can be used for lesions refractory to systemic corticosteroids. (C) 2010 Elsevier Masson SAS. All rights reserved.

Background. - BCG therapy is an effective adjuvant treatment for superficial bladder tumors. Therapy involves intravesical instillation of live attenuated Calmette-Guerin bacilli. BCG infection of the glans is a rare Local complication associated with this treatment, two cases of which are reported below.Patients and methods. - Case 1: A 77-year-old man presented relapsing urothelial bladder carcinoma treated by endoscopic resection and BCG therapy. One week after the seventh instillation, severe balanitis developed. Three months Later, examination revealed massive painful perimeatal ulceration with yellowish papules in the peripheral regions. Histology revealed epithelioid giant-cell granulomas. Ziehl-Neelsen staining was positive. Slow cure of the lesions was achieved within 12 months using double antitubercular antibiotic therapy. Case 2: In a 61-year-old man receiving BCG therapy for relapsing bladder carcinoma in situ, the sixth instillation was considered traumatic since it was highly painful. One week later, papular nodules appeared on the glans with a sclerosing lesion of the batanopreputial sac, dark purple perimeatal papules and a mass beneath the mucosa of the glans. Antibiotic treatment comprising ofloxacin followed by rifampicin for two months proved ineffective. Histology revealed granu-tomatous dermal lesions with eosinophilic necrosis. Triple antitubercular antibiotic therapy was initiated.Discussion. - The first reported case of BCG infection of the glans in patients undergoing intravesical BCG therapy was published in 1992. Since then, there have been nine other reports. There is no stereotypical clinical presentation. In most cases, an infiltrated erythematosus plaque is seen together with yellowish papules in certain patients. Diagnosis is based upon history and histological examination. (C) 2008 Elsevier Masson SAS. Taus droits reserves.

The meeting was called to order on 28 July 2002 at 1:00 P.M. by President P. Barrows. Council members present included L. Creekmore, M. Drew, J. Fischer, S. Gibbs, E. Greiner, T. Jones, T. Kreeger, T. Kuiken, J. Mazet, T. Mörner, C. Quist, T. Rocke, L. Uhazy, and E. Williams. P. Barrows asked that the report on the Carlton Herman Founder’s Fund be given first. T. Yuill provided the report. The Carlton Herman Fund investment is currently parked in the American Funds Group and the balance is about $23,500. When he set up this fund, Carlton Herman originally selected the American Funds Group as the place to invest the money and the money has continued to be invested in this particular group with good results. T. Yuill asked Council how much latitude the trustees should be given to more actively manage the funds within the family of American Funds or to invest in other types of funds to maximize return on this investment. As the chair of this committee, he has felt constrained in managing the funds in the absence of guidance from Council. He also pointed out that there is no direction in the constitution or charter regarding management of the fund. T. Yuill requested some guidance from Council regarding actions the trustees might take, perhaps some ideas on checks and balances. Also, T. Yuill is planning to retire in mid-January and suggested that it would be appropriate to begin the process of selecting a new trustee, as well as selecting a new chairperson. Other trustees on the committee are D. Forrester and A. Fairbrother. C. Quist suggested that the President and Treasurer be allowed to review decisions by the trustees to serve as an additional check or oversight. T. Yuill agreed that this would be acceptable. T. Rocke suggested that the Charter for the Carlton Herman Fund should be on file. T. Yuill will send the Charter to the secretary. A motion was made by C. Quist (second by L. Uhazy) that Carlton Herman Fund trustees be allowed the latitude to make adjustments in the funds as needed with secondary approval by the current President and Treasurer. In the discussion, I. Barker asked if there would be any advantage to having the fund managed professionally to allow for more rapid response and flexibility with regard to market changes versus the delay that would be inherent in relying on a decision involving five persons. T. Yuill replied that the fund is probably too small to interest professional managers; however we could possibly see if Buttonwood Partners would manage it as a separate subcomponent of our Buttonwood accounts that they already manage. C. Quist suggested that this is something that the trustees could evaluate and return with a recommendation to Council. T. Yuill will make the inquiry to Buttonwood. The motion passed. With regard to T. Yuill’s retirement and the selection of a new trustee, P. Barrows suggested checking with the other committee members for their input. P. Barrows will discuss with T. Yuill and the other committee members. Officers and Council approved the minutes from the previous Council meeting via teleconference. P. Barrows asked if there were any further comments. There were none and the previous minutes will stand as written.

The systemic complications of therapy with lithium are well known, but toxidermia has only been recognised since 1968. The carbonate (Teralithe) is the lithium salt which is mainly responsible, leading to minor dermatoses: oedema, pruritus, alopecia, urticaria, purpura, allergic vasculitis, pretibial ulceration. Some more specific conditions have been individualised by their severity and rarity: acne form eruptions, seborrheic dermatitis, follicular keratoses and psoriasis-like dermatosis as well as true psoriasis induced or aggravated by lithium. The authors review the literature and discuss the pathogenesis of these toxidermias. The cause of some dermatoses can be explained, especially the allergic vasculitis and psoriasis lesions. The underlying mechanism of most of these conditions remains unknown, but excessive tissue concentrations of the drug probably play an important role in inducing these complications.

The authors report a new case of the association Hodgkin's disease and Kaposi's sarcoma. A woman of North African origin and suffering from mediastinal Hodgkin's disease developed, after the commencement of polychemotherapy with radiotherapy, Kaposi's cutaneous sarcoma, typical, clinically, histologically and by electron microscopy. In the light of this new case, the authors review 41 cases of the Hodgkin-Kaposi association found in the literature and discuss the inter-relations between Kaposi's sarcoma and diseases of the haemoreticular system, in particular carcinomas, immuno-depressive states (notably in association with renal transplants) and virus disorders (essentially herpes). It might be possible to incriminate in the aetiology of Kaposi's disease a carcinogenetic process of viral origin during a state of immuno-depression.