S. Menni

Neurologic abnormalities in two patients with facial hemiatrophy and sclerosis coexisting with morphea

Abstract: Progressive facial hemiatrophy or Parry‐Romberg syndrome is a rare entity characterized by unilateral atrophy of the skin, subcutaneous tissue, and the underlying bony structures. This syndrome has many features of linear scleroderma en coup de sabre but is distinguished by more extensive involvement of the lower face and by only slight cutaneous sclerosis. We describe two unusual children with both atrophic and sclerotic changes of half of the face coexisting with multiple plaques of typical morphea. Both children developed neurologic disturbances with cranial magnetic resonance imaging (MRI) abnormalities 2 years and 15 years, respectively, after the onset of cutaneous lesions. Thus considering that it may not be possible to correlate impairment in neurologic function and cutaneous disease, as illustrated by our patients, we emphasize the importance of an accurate follow‐up.

Birthmarks and transient skin lesions in newborns and their relationship to maternal factors: A preliminary report from northern Italy

Background: A total of 620 healthy term neonates, randomly selected among babies born at the San Paolo Hospital in Milan (Italy), were examined to study the relationship between birthmarks and transient cutaneous lesions in newborns of different ethnic groups. Methods: Information on sociodemographic factors and on physiopathological variables of the pregnancy was collected. Multiple logistic analyses were performed to assess associations between diagnosed skin lesions and various factors. Odds ratios (OR) as a measure of association and the corresponding 95% confidence intervals were estimated. Results: A positive association was found between reduced hypoderm and pregnancy illness (OR = 2.78), hypertrophy genitalia and use of drugs (OR = 1.86) and illnesses in pregnancy (OR = 1.61). Hyperpigmentation in the genital area and Mongolian spot showed significant positive association with geographical area of origin, being systematically more frequent in non-European neonates, while for melanocytic congenital nevi a positive association was observed only for Asiatic newborns (OR = 4.67); salmon patch on the nape showed a significant OR of 1.81 among mothers aged ≧35. Conclusions: Significant associations between some sociodemographic factors and cutaneous lesions of the newborn and anamnestic data related to the pregnancy were found. Dermatologic conditions are common in the newborns and may justify dermatologic examination.

Overweight and childhood psoriasis

D. BE S S I S P . QU ITT ET* V. R IGAU B. GU I L LOT C . G IRARD Service de Dermatologie, Hôpital Saint-Eloi, CHU de Montpellier, 80 avenue Augustin Fliche, FR-34295 Montpellier cedex 5, France *Service d’Hématologie et d’Oncologie Médicale, Hôpital Lapeyronie, CHU de Montpellier, Montpellier, France Service d’Anatomie et Cytologie Pathologiques, Hôpital Gui-de-Chauliac, CHU de Montpellier, Montpellier, France Correspondence: Céline Girard. E-mail: celine-girard@chu-montpellier.fr

Anatomic location and histopathologic subtype of basal cell carcinomas in adults younger than 40 or 90 and older: any difference?

BACKGROUND Differences in age, site, and histopathologic subtype exist in basal cell carcinoma (BCC). OBJECTIVE To compare the distribution of BCCs in patients younger than 40 with that of those aged 90 and older according to sex, site, and subtype. METHODS & MATERIALS One hundred seventy‐five BCCs were examined. The site was classified as head and neck, trunk, or limbs and the subtype as nodular, superficial, or morpheic‐infiltrative. RESULTS Younger exhibited a lower prevalence of BCCs on the head and neck (36.0% vs 57.3%, p<.01) and a higher prevalence on the trunk (59.3% vs 31.5%, p<.01) and of superficial BCCs (43.0% vs 31.5%, p<.05) than older patients. Site was associated with subtype in younger (p<.001) and older (p=.004) patients. Superficial BCCs were mostly on the trunk (p<.001), with a higher prevalence in younger patients (86.5% vs 62.5%, p<.05). Morpheic BCCs were mostly on the head and neck (p<.001), and prevalence did not differ between age groups. Nodular BCCs were mostly on the head and neck in older patients (p=.011). Subtype was independently associated with site (p=.005) but not with age or sex. CONCLUSION A different distribution of site and subtype occurs in younger and older patients. Subtype is associated with site independent of age and sex. These findings suggest that, at least in some patients, the anatomic location of BCC may favor the development of a particular subtype. The authors have indicated no significant interest with commercial supporters.

Inflammatory linear verrucous epidermal nevus (ILVEN) and psoriasis in a child

A male infant, whose father was affected by psoriasis, was first seen in our department at 1 month of life for a “bipolar” seborrheic dermatitis, that resolved without treatment at 7 months of age.

Comma Hairs in Tinea Capitis: A Useful Dermatoscopic Sign for Diagnosis of Tinea Capitis

Abstract:  Diagnosis of tinea capitis (TC) can be challenging for dermatologists, especially in noninflammatory TC caused by anthropophilic dermatophytes and in black patients, in whom erythema of the scalp is difficult to appreciate. The finding of a typical TC dermoscopic pattern may lead more quickly to a correct diagnosis.

Basosquamous cell carcinoma: a survey of 76 patients and a comparative analysis of basal cell carcinomas and squamous cell carcinomas

BACKGROUND Basosquamous carcinoma (BSC) is a rare epithelial tumor with a still confusing terminology. Since 2005 a more comprehensive and broader classification has existed. AIM To retrospectively review our cases of BSC according to the new WHO definition and to re-evaluate their clinical and demographic characteristics and the margin involvement after traditional surgical excision. The data were compared with the same results obtained by basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs). PATIENTS AND METHODS Histologically confirmed carcinomas observed in our Department during a sixteen-year period (1994-2011) were studied. Surgical excision was evaluated following the international guidelines. Histopathologic subtypes of BSC were classified in accordance with accepted criteria. RESULTS Seventy-six patients had a BSC, 305 a SCC, 3,643 a BCC. There were significant differences among the median age of BSCs, the total BCCs and Non-Aggressive BCCs (74.7, 68.8 and 68.3 years respectively; p<0.05). BSC was more significantly located on head-neck region than Non-Aggressive BCC (p<0.04), and less on trunk than Mixed Histology BCC (p<0.01) and Non-Aggressive BCC (p<0.005). BSC has higher prevalence of positive margins after excision than total (p<0.03) and Non-Aggressive BCC (p<0.001). CONCLUSION Basosquamous carcinoma fits to a tumor type with a different behavior pattern from non-aggressive basal cell carcinoma and more similar to squamous cell carcinoma or aggressive variants of basal cell carcinoma. Its infiltrative growth and the stromal reaction patterns give enough evidence to support the notion of considering basosquamous carcinoma as a relatively aggressive tumor.

Demodectic infestation of the pilosebaceous follicle.

Scanning electron microscopy revealed Demodex folliculorum on the face surface of twenty healthy subjects. The ultrastruclural morphology of Demodex and the follicle parasitization process are briefly illustrated.

Anatomic Location of Basal Cell Carcinomas May Favor Certain Histologic Subtypes

Background: Differences in age, site, and subtype exist in basal cell carcinoma (BCC). Objective: To evaluate whether an independent association exists between the anatomic location and the histologic subtype of BCC. Materials and Methods: A series of 3,254 BCCs was examined. The location was the head/neck (n = 1,766), limbs (n = 362), trunk (n = 1,113), or genitals (n = 13). Subtype was classified as superficial, nodular, micronodular, morpheic-infiltrative, or fibroepithelial. Results: Prevalence of BCCs on the head/neck or chest/abdomen increased with age (p < .001). The prevalence of superficial subtype decreased with age (p < .0001), whereas the prevalence on nodular subtype increased (p < .0001). Subtype was associated with location (p < .0001). The prevalence of superficial subtype was lower among BCCs on the head/neck than other locations (24.9% vs 64.4%, OR 0.18, 95% CI 0.16–0.21). The prevalence of nodular or morpheic/infiltrative subtype was higher among BCCs on the head/neck than other locations, that is, 57.1% versus 29.2%, OR 3.23, 95% CI 2.79 to 3.74 (nodular) and 16.1% versus 4.0%, OR 4.56, 95% CI 3.42 to 6.08 (morpheic/infiltrative). Conclusion: Anatomic location and subtype of BCC were associated with age, but the anatomic location was the only independent predictor of histologic subtype. Although a bias by referral patterns may not be excluded, the results suggest that the anatomic location may favor the development of particular BCC subtypes.

Tinea Capitis in the Paediatric Population in Milan, Italy: The Emergence of Trichophyton violaceum

Tinea capitis (TC) is the most common type of dermatophytosis in children. The epidemiology of TC depends on the geographical areas, and it changes over time. The aim of the study is to determine the incidence of TC and to identify the causative species in children observed at Dermatology Outpatient Department of the University of Milan, Italy, between January 2004 and December 2011. Four hundred and eighty-six children with suspected dermatomycosis were observed; TC was the most prevalent dermatomycoses with 86 cases. The most common isolated dermatophyte in scalp lesions was Trichophyton violaceum with 33 cases. The most recent epidemiological Italian studies still show zoophilic fungi as primary cause of TC. We are the first medical team in Italy to demonstrate a dominance of anthropophilic fungi, in particular T. violaceum.