V. Pallure

Surgical treatment of Darier-Ferrand dermatofibrosarcoma: a systematic review.

BACKGROUND Wide‐excision surgery is required in Darier‐Ferrand dermatofibrosarcoma protuberans, but there is no consensus regarding the lateral margins. MATERIALS AND METHODS We performed a systematic review based on a MEDLINE search of articles, published from 1994 to 2009 to determine the optimal procedure to avoid recurrences and treatment morbidity. RESULTS The analyzed articles included five meta‐analyses of retrospective studies; three prospective, nonrandomized studies; and 35 retrospective studies. DISCUSSION Positive deep margins may lead to a recurrence independent of lateral margin status. Despite an absence of formal evidence, wide excision with 3‐cm margins appears to result in significantly less risk of a recurrence than surgery using <3‐cm margins. Negative histologic margins appear to be the best criterion to decrease recurrence. Despite a lack of strong data, there was a marked tendency of Mohs micrographic surgery (MMS) to produce better results than conventional surgery. If MMS is unavailable, surgery using 3‐cm lateral margins and a disease‐free anatomic zone deep into the lesion is proposed. Slow Mohs could be a safe alternative to MMS when the latter technique is not available. Patients should be followed for a minimum of 10 years and preferably indefinitely.

Sensitivity and specificity of BP180 NC16A enzyme-linked immunosorbent assay for the diagnosis of pemphigoid gestationis

REFERENCES 1. Liacouras CA, Furuta GT, Hirano I, et al. Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol. 2011;128(1):3-20.e26. 2. Chadha SN, Wang L, Correa H, Moulton D, Hummell DS. Pediatric eosinophilic esophagitis: the Vanderbilt experience. Ann Allergy Asthma Immunol. 2014;113(4):445-451. 3. Dellon ES, Jensen ET, Martin CF, Shaheen NJ, Kappelman MD. Prevalence of eosinophilic esophagitis in the United States. Clin Gastroenterol Hepatol. 2014;12(4):589-596.e581. 4. Maradey-Romero C, Prakash R, Lewis S, Perzynski A, Fass R. The 2011-2014 prevalence of eosinophilic esophagitis in the elderly amongst 10 million patients in the United States. Aliment Pharmacol Ther. 2015;41(10):1016-1022. 5. Asher MI, Montefort S, Bjorksten B, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC phases one and three repeat multicountry cross-sectional surveys. Lancet. 2006;368(9537):733-743.

Cutaneous indeterminate cell histiocytosis: two new observations including a case with paraneoplastic-like evolution.

We report two new cases of cutaneous indeterminate cell histiocytosis (ICH), clinically characterized by a profuse papular eruption, without systemic involment. The first patient, a 59-year-old man, was evaluated for a diffuse, mildly pruritic papular rash of 6 months duration, associated with an impaired general condition. His clinical history was remarkable for a hepatocellular carcinoma (HCC) on NASH treated by hepatic chemoembolization 4 months before the first consultation. No new drug had been [...]

Clostridium difficile infection may loom behind ipilimumab-induced auto-immune colitis

We report here the first case of a misleading association of Clostridium difficile infection (CDI) with ipilimumab-related immune diarrhea in a patient with unresectable stage III melanoma.After an unsuccessful first-line chemotherapy with dacarbazine (1000 mg/m2 every three weeks) for a subcutaneous and nodal relapse of a stage IIb melanoma of the right lower limb (Breslow index 3.75 mm, Clark level IV), treated by surgical excision 11 months previously and incomplete adjuvant treatment with alpha [...]

Dermatofibromes multiples « éruptifs » familiaux

BACKGROUND Multiple eruptive dermatofibromas (DF) are rare and frequently associated with immune and neoplastic diseases. There have also been reports of rare familial cases. Herein we report a new such case. PATIENTS AND METHODS A 79-year-old woman and her 37-year-old daughter were seen for disseminated DF over a period of several decades, from adolescence onwards. Neither had any history of diseases or treatments normally associated with multiple DF. History-taking revealed similar lesions in other family members. DISCUSSION DF are common benign cutaneous tumours, generally seen on the lower limbs of young or middle-aged women. These lesions occur either in isolation or are relatively few. Multiple or so-called eruptive DF, defined by the presence of more than 15 lesions in a single patient, is rare and is associated in 60% of cases with autoimmune diseases, HIV infection, neoplastic disease or immunosuppressant therapy. Familial forms such as those described herein are extremely rare.

Transient and relapsing reticulated erythema associated with probable focal infection on implantable catheter site: a toxin-induced reaction?

Editor A 51-year-old furrier man had a 3-month history of erythematous, desquamative, pruriginous lesions on cheeks, nasolabial folds, neck and eyelids. He received treatment with oral and topical corticosteroids with no improvement. His medical history was negative for atopic disease or seborrhaeic dermatitis. The skin lesions were worst at work. He worked cutting out dyed fur of animals for making fur coats, and he related the onset of symptoms with the use of a new dyed rabbit fur. The patient was patch tested with Spanish standard, textiles, cosmetics and fragrances series. Patch tests showed positive reactions to p-phenylenediamine (PPD) and p-aminoazobenzene. Neither the patient nor his wife has ever dyed their hair. We also performed patch tests with five different furs brought by the patient. Patch tests with dyed rabbit hair (a.i.) and dyed lamb hair (a.i.) were positive. Oxidative hair dyes based on PPD were used to dye the furs by the manufacturer. The patient was told to avoid the contact with dye furs, and the cutaneous reaction cleared. On the follow-up visit, he had changed work and was asymptomatic. PPD is know to be one of the most potent contact allergens. Contact allergy from PPD may occur in 0.1% to 2.3% of the general population but is higher in PPD-exposed workers. Occupational contact dermatitis from PPD is common in hairdressers, but other occupations with PPD exposure might theoretically develop occupational contact dermatitis. PPD-based oxidative hair dyes similar to those applied by hairdressers are used in dyed fur manufacture. Fur manufacturers and furriers are in risk for occupational allergy from PPD. Oxidative hair dyes formulations may also contain azo dyes which might cause contact allergy. Cross-reactivity in PPD-sensitized people has also been observed. Dyed hair is allergenic; skin reactions of PPD-sensitive individuals to hair recently dyed have been reported. Although patch testing to biological materials is not standardized, it has been tested in order to prove delayed contact dermatitis from dyed hair in this case.