[Basal cell carcinoma of the first toenail]. / Carcinome basocellulaire de l'appareil unguéal de l'hallux.

BACKGROUND: Basal cell carcinoma is a very common form of skin cancer but its occurrence on the toenail unit is very rare. We report such a case of basal cell carcinoma localized on the proximal nail fold of the right hallux. CASE REPORT: A 67-year-old woman had a 7-year history of a non-healing ulcer on the proximal nail fold of the right hallux after antibiotics and treatment of her onychomycosis. Bowen's disease and squamous cell carcinoma were suspected. Histopathologic examination of a biopsy specimen revealed infiltrative basal cell carcinoma. The lesion was surgically excised with a 0.5 cm margin and the defect was repaired by full-thickness skin graft with good functional and cosmetic results. DISCUSSION: Basal cell carcinoma is the most common skin cancer but its localization on fingers, toes and nail units is very rare. Only six cases of basal cell carcinoma on the toe nail unit have been reported to date in the literature. Clinical aspects often mimic benign processes, resulting in misdiagnosis. Treatment requires simple excision or Mohs micrographic surgery. Our case emphasizes the value of biopsy for all nail unit lesions of atypical appearance, course or therapeutic response.

[Palmoplantar lichen nitidus: a rare cause of palmoplantar hyperkeratosis]. / Lichen nitidus palmoplantaire. Une cause rare de kératodermie palmoplantaire.

BACKGROUND: Lichen nitidus is a rare condition, which may be a cause of palmoplantar hyperkeratosis. We report two cases. CASE REPORTS: A 53 year-old woman presented with a dry and fissured palmoplantar hyperkeratosis. Histological examination of a biopsy showed the typical features of lichen nitidus. Significant improvement was obtained with acitretin. A few months later, multiple lichen nitidus papules appeared on the limbs and the abdomen. A 67 year-old woman was referred to us for a fissured, disabling palmoplantar hyperkeratosis refractory to topical steroids. Histological examination led to the diagnosis of lichen nitidus. Local PUVA therapy resulted in the cleaning of her lesions. Later, typical papules of lichen nitidus appeared on her elbows. DISCUSSION: Nineteen cases of palmoplantar localization of lichen nitidus have been described. The features are usually tiny yellow papules but sometimes a non-specific keratoderma resembling chronic eczema. Palmoplantar involvement of lichen nitidus may be isolated or associated with cutaneous lesions on unusual sites. Oral retinoids and local PUVA are effective treatments.

[Congenital or acquired unilateral nevoid stellar telangiectasias. About 5 cases (author's transl)]. / Télangiectasies stellaires naevoïdes unilatérales acquises ou congénitales. A propos de 5 cas.

Based on five personal cases (one neo-natal case, one in childhood, and three cases in pregnant women) and sixteen published cases, this study remind us of the essential caracteristics of unilateral nevoid telangiectasis. Prevalence in women is noticeable appearance during pregnancy, with complete regression during post-partum, is quasi constant. If their nosological place is not clear among the essential telangiectasias, they seem to be quite different from Hutchinson's serpiginious angioma (verrucous telangiectasis), from Osler-Rendu's disease, from Brocq's telangiectasias and from generalizated telangiectasias. The true signification of all these diseases is still completely unknown.

[Lichen aureus or lichen purpuricus; about 5 cases; ultrastructural study]. / Lichen aureus ou lichen purpuricus. a propos de 5 cas intérêt de l'étude ultra-structurale.

Clinical, histological and ultrastructural features in five cases of lichen aureus are descirbed. This rare condition with ages ranging here from 6 to 31 consists of a pigmented papular and purpuric eruption. Unilaterally, trunk or limb may be involved, in a possible systematized distribution. The microscopic picture is characterized by a dense histiocytic and lymphocytic infiltration in the upper part of the dermis; extravasation of erythrocytes and iron pigment in the histiocytes are often noticed. In fine structure most cells of the dermal infiltrate are histiocytes (or macrophages) with numerous worm-like structures and even typical Langerhans granules in three cases; histiocytic cells; histiocytes are frequently seen in apposition to lymphocytes. In all these cases, no sign of histiocytosis X is found. Classification of lichen aureus in the group of idiopathic pigmented purpuric eruption is proposed.