[Transitory apocrine hidrocystomatosis of the scrotum]. / Hidrocystomatose apocrine transitoire du scrotum.

BACKGROUND: Apocrine hidrocystomas are benign cystic tumors that develop from apocrine gland proliferation. In most cases, they are translucent solitary lesions of the face, generally found in the periorbital region, on the scalp or on the neck. More rarely, apocrine hidrocystomas may be multiple and appear on the ears, trunk, shoulders and genital area. They generally appear in adulthood, with only a few pediatric cases being reported, of which three in the genital area, with a solitary case of multiple hidrocystomas of the scrotum, although no cases of spontaneous involution of hidrocystomas have previously been reported. PATIENTS AND METHODS: Two boys aged 4 and 6 months were seen in consultation for small sub-millimeter size, subcutaneous, black lesions on the scrotum that appeared in the weeks following birth. Histological examination of these lesions resulted in a diagnosis of apocrine hidrocystoma. The children were seen again a few weeks later and the skin lesions had totally disappeared. We report two cases of multiple apocrine hidrocystomas on the scrotum with spontaneous involution diagnosed in a 4- and a 6-month-old boy. DISCUSSION: Apocrine hidrocystomas are rare benign adnexal tumors that develop from apocrine sweat glands. They are considered as cystic proliferations of the apocrine glands rather than simple retention cysts. The main differential diagnosis of the rare cases of multiple apocrine hidrocystomas are eccrine hidrocystomas. The treatment of such lesions is based on surgical excision if they are isolated, daily application of topical atropine 1%, or CO2 laser for multiple apocrine hidrocystomas.

[A case of Sweet syndrome in a patient receiving erlotinib for lung adenocarcinoma]. / Syndrome de Sweet chez une patiente traitée par erlotinib pour un adénocarcinome bronchique.

INTRODUCTION: Sweet syndrome is a neutrophilic dermatosis and is often idiopathic, although its onset may be drug-induced or paraneoplastic. The purpose of this case report is to describe the very first occurrence of Sweet syndrome following erlotinib intake in a patient diagnosed with lung adenocarcinoma. PATIENTS AND METHODS: We observed Sweet syndrome, as assessed by clinical, laboratory and histological examination, in a middle-aged female patient presenting lung adenocarcinoma diagnosed three years prior to her cutaneous symptoms. DISCUSSION: Given the extremely long time between the diagnosis of lung cancer and the onset of Sweet syndrome, as well as the occurrence of skin lesions during administration of the medication and their subsidence after drug withdrawal, we suggest a possible link between this particular EGFR tyrosine kinase inhibitor and the patient's neutrophilic dermatological signs. To our knowledge this association has not previously been described in the medical literature.

[Annular lichenoid dermatitis of youth: A case report and literature review]. / Dermatite lichénoïde annulaire du sujet jeune : un cas et revue de la littérature.

BACKGROUND: Annular lichenoid dermatitis of youth (ALDY) is a rare form of dermatitis mainly affecting children and young people. All cases reported show a consistent clinical and histological picture. This is the first case described in the French literature. PATIENTS AND METHODS: A 5-year-old girl presented an annular isolated patch of the lower abdomen with an erythematosquamous border and central hypopigmentation for one year. Topical corticosteroids and pimecrolimus proved effective but relapse occurred after treatment withdrawal. DISCUSSION: Over sixty cases of ALDY are described in the English-language medical literature. The main differential diagnosis is childhood mycosis fungoides, particularly the hypopigmented variant. Biopsy is necessary for diagnosis since it can reveal typical histological features. Histopathology in all cases shows lichenoid reaction with CD4+ and CD8+ polyclonal lymphocytes. It is limited to the tips of rete ridges and associated with apoptosis of keratinocytes resulting in quadrangular-shaped rete ridges. Our case does not demonstrate either epidermotropism or atypical lymphocytes. CONCLUSION: Annular lichenoid dermatitis of youth (ALDY) is a poorly known distinctive entity within the lichenoid dermatitis family. Clinical-histological correlation is essential to diagnosis. The etiology is still unknown and the course is mostly chronic.

[Multiple cephalic deep granuloma annulare of children]. / Granulomes annulaires profonds multiples céphaliques de l'enfant.

BACKGROUND: Deep granuloma annulare is a fairly rare variety of granuloma annulare. It is seen predominantly in children and mainly affects the anterior aspect of the legs and the top of the feet; cephalic presentation is rare. Below, we report three cases of deep granuloma annulare in children presenting solely at the cephalic extremity. PATIENTS AND METHODS: Case 1: a six-year-old boy presented 7 cutaneous nodules measuring 1 to 2cm that were flesh-coloured, insensitive to palpation, of hard consistency and deeply attached. The lesions were grouped together on the anterior half of the left temporal fossa. While spontaneous regression of the three nodules was noted in the month following cutaneous biopsy, these nodules recurred a few months later. Case 2: a four-year-old girl with five deep cephalic nodules measuring around one centimetre and the colour of normal skin were seen on her right temporal fossa. The child was lost to follow-up after biopsy. Case 3: a four-month-old infant was presenting some 15 deep cutaneous nodules arranged in linear fashion on the forehead next to the left temporal fossa. These nodules regressed spontaneously one month after biopsy. In all three cases, histological examination confirmed the diagnosis of deep granuloma annulare. DISCUSSION: There have been few published cases of multiple, cephalic, deep granuloma annulare at a single site in children. The condition has an extensive differential diagnosis that includes malignant tumours; in addition, histological confirmation is normally essential. Treatment is not qualified and therapeutic extension with clinical monitoring alone may frequently be recommended.

[Pyoderma gangrenosum associated with anti-proteinase 3 antineutrophil cytoplasmic antibodies (PR3-ANCA) induced by propylthiouracil]. / Pyoderma gangrenosum avec anticorps anti-cytoplasme des neutrophiles de type anti-protéinase 3 (PR3-ANCA) induits par le propylthiouracile.

BACKGROUND: Synthetic antithyroid drugs are often used in the treatment of hyperthyroidism, regardless of aetiology. They may cause various side effects, including the development of anti-neutrophil cytoplasmic antibodies (ANCA), ANCA-associated vasculitis, and neutrophilic dermatoses. Propylthiouracil (PTU) is the antithyroid drug most frequently implicated in ANCA-associated diseases specifically involving anti-myeloperoxidase ANCA (MPO-ANCA). To our knowledge, there are no clinical reports describing the association of pyoderma gangrenosum (PG) and anti-proteinase3-ANCA (PR3-ANCA) induced by PTU, with ANCA levels decreasing after antithyroid drug withdrawal. PATIENTS AND METHODS: A 68-year-old woman was treated with propylthiouracil (PTU) for toxic multinodular goitre. She presented necrotic ulceration of the lower abdomen. The patient's history, physical examination, and bacteriological and histological samples led to a diagnosis of pyoderma gangrenosum. This pyoderma involved ANCA with antigenic specificity for proteinase 3. Withdrawal of PTU and a short course of corticosteroids and cyclosporine resulted in rapid and complete resolution of the pyoderma gangrenosum as well as a decrease in ANCA. No relapse was observed one year after cessation of treatment. DISCUSSION: We report a case of PG associated with PR3-ANCA induced by PTU, without any demonstrable vasculitis.

Desloratadine 5 mg once daily improves the quality of life of patients with chronic idiopathic urticaria.

BACKGROUND: Chronic urticaria is known to debilitate a person's quality of life via sleep disruption, itching lesions, fatigue, social isolation, energy loss and emotional/sexual difficulties. Once-daily desloratadine significantly improved the signs and symptoms of CIU. OBJECTIVE: Assess the effect of desloratadine 5 mg once daily on the quality of life of patients suffering of chronic idiopathic urticaria (CIU). Study population One-hundred twenty-one consecutive patients with CIU present for at least 6 weeks prior to inclusion and with a current flare of at least 3 weeks, were included in the study in 24 Belgian centres. RESULTS: The mean dermatology life quality index (DLQI) significantly decreased from baseline to day 7 and further to day 42. Sixty per cent and 77% of patients had a clinically significant change (i.e. a decrease of at least 2 points) at day 7 or day 42, respectively, as compared with that of day 0. Change in pruritus and size of the hives significantly correlated with the change in the score of the quality of life. One-third of patients experienced complete relief whereas in 1 of 10 patients no effect was experienced. CONCLUSIONS: Desloratadine significantly improves the quality of life of patients with chronic idiopathic urticaria as reflected by the dermatology life quality index (DLQI).