Asunto(s)
Personas con Mala Vivienda , Dolor/prevención & control , Pobreza/prevención & control , Condiciones Sociales , Servicio Social/organización & administración , Anciano , Femenino , Francia , Personas con Mala Vivienda/psicología , Humanos , Masculino , Evaluación de Necesidades , Dolor/psicología , Pobreza/psicología , Apoyo SocialRESUMEN
Frequent in France among domesticated sheep and goats, contagious pustular dermatitis of the sheep is called Orf when it occurs in man. The authors present a case of recontamination in a woman farmer of the Cher department (Central France), who had been bottle-feeding lambs affected with the zoonosis. This 71-year old woman developed papules, then papulopustules on the ulnar aspect of her hands and wrists (fig. 1). Within a few days, these lesions were 1.5 to 2 cm in diameter and surrounded with a severe inflammatory reaction. Two weeks later, the pustules became encrusted. Electron microscopy of a fragment of lesion demonstrated the virus. Cure was observed after 3 weeks. Eight months later, however, lesions identical with the previous ones appeared on the 4th finger and on the median aspect of the right wrist, corresponding to excoriations caused by nibbling from the lambs. The eruption was accompanied with fever which persisted for one month. In this patient's farm, the disease was present for the first time and affected only 2-month old lambs in the form of numerous papulo-pustules located on the lips and later covered by hard and thick scabs. These lesions were also found on the tongue and palate of some animals (fig. 5), preventing them from taking any food. Vaccination resulted in rapid and dramatic regression of the enzootie. From a more general point of view, the clinical features and epidemiology of the disease are described comparatively in animals and man. The differential diagnosis is dealt with at the end of the article. The literature on the subject is reviewed (151 references).
Asunto(s)
Enfermedades de los Trabajadores Agrícolas/transmisión , Ectima Contagioso/transmisión , Anciano , Animales , Ectima Contagioso/microbiología , Ectima Contagioso/patología , Femenino , Humanos , Virus del Orf/aislamiento & purificación , Recurrencia , Ovinos , Factores de TiempoRESUMEN
A patient with eosinophilic fasciitis and insulin-dependent diabete mellitus is recorded. Diabete and blood hypereosinophilia occurred four months before acute onset of severe proximal sclerodermic features. The deep seated level of fibrosis, mainly localized in subcutaneous fat and fascia was documented by histologic examination. Prednisone therapy (0,75 mg/kg/day) resulted in cutaneous improvement and disparition of eosinophilia. Survey of pertinent literature lead us to consider Shulman's syndrome as a distinct entity amid the broad scleroderma spectrum. Features of esosinophilic fasciitis are very close to, and sometimes undistinguable from generalized morphea. Simultaneous occurence of diabete mellitus in this case is not fortuitous. The same association has already been recoreded with various sclerodermic syndromes.