Y. Le Corre

Lichen sclereux acral

BACKGROUND Lichen sclerosus et atrophicus rarely affects the feet or hands and in this case, it is generally part of widespread cutaneous involvement. We report a case of lichen sclerosus et atrophicus involving only the extremities and the vulvar and perigenital area. PATIENTS AND METHODS A 56-year-old woman presented with lesions of the hands and feet, with ivory white papules on the dorsal aspect of the feet and the distal phalanx of the fingers, a few small keratotic papules with central depressions in the hollow of the palms, erythema on soles and thenar and hypothenar eminences. Further examination revealed lichen sclerosus et atrophicus of the vulva and genitocrural skinfolds. Histological study of these various cutaneous lesions yielded similar results and revealed the typical features of lichen sclerosus et atrophicus. DISCUSSION A few cases of lichen sclerosus et atrophicus confined to the hands and/or feet have been reported, involving the palms and soles or nail folds, but none has so far affected the genitalia. To our knowledge, no cases of lichen sclerosus et atrophicus involving both faces of the hands and feet and the genital region have ever been reported.

Granulome annulaire élastolytique à cellules géantes

BACKGROUND Annular elastolytic giant-cell granuloma (AEGCG) is a rare form of granulomatous dermatosis characterized by annular plaques with central atrophy and raised erythematous margins and is usually located on the facial and neck areas. It is characterized histologically by loss of elastic fibre and elastophagocytosis. We report a case of AEGCG. CASE REPORT A 72-year-old man consulted for annular plaques, some of which were atrophic, and papules that had been present for 2 years. The lesions involved sun-exposed and non-sun-exposed skin. The biopsies showed granulomatous infiltrates and discrete elastophagocytosis. After ruling out various differential clinical and histological diagnoses, the patient was diagnosed with AEGCG. DISCUSSION We report a case of AEGCG. Diagnosis was not easy. The differential diagnoses of this entity were discussed and we ruled out actinic granuloma, sarcoidosis, leprosy, and granuloma annulare. Our patient presented the classical annular variant combined with a papular variant. We report the first case involving response to isotretinoin.

Angiosarcome cutané de jambe sans lymphœdème associé

BACKGROUND Cutaneous angiosarcoma is a rare aggressive vascular neoplasm with a poor prognosis, seen chiefly in elderly subjects and usually on the scalp or face. The present case is original because of its localization on the leg without any chronic lymphoedema and because of the long survival period. The treatment modalities are discussed. CASE REPORT An 87-year-old woman presented with a rapidly growing large deep-purple ulcerated tumour on the anterior aspect of the leg. In addition, two nodules with a similar aspect appeared on the outer surface of the foot. Histological examination showed vascular channels lined with atypical cells consistent with a diagnosis of angiosarcoma. Computed tomography revealed no metastases. Amputation was performed at the thigh and there was no recurrence 30 months later. DISCUSSION The leg is a rare site of cutaneous angiosarcoma. Treatment usually consists of surgical excision with wide margins followed by radiotherapy, but in some cases amputation is unavoidable.

Phénomène de rappel après radiothérapie, induit par l’exemestane

classiques déclenchés, leur utilisation a également montré des résultats intéressants dans le traitement de lésions séquellaires d’hémosidérose dans le cadre d’une maladie de Kaposi. Le pic d’absorption du fer se situant entre 438 et 539 nm, il justifie l’utilisation préférentielle du laser déclenché Nd-YAG à 532 nm plutôt que l’Alexandrite à 755 nm ou le Nd-YAG à 1064 nm. Conclusion.— La description de notre cas soulève l’intérêt du laser Nd-YAG déclenché 532 nm dans le traitement des hyperpigmentations liées à des dépôts de fer. Déclaration d’intérêts.— Aucun. Iconographie disponible sur CD et Internet.