[Giant seborrhoeic keratosis in an unusual site]. / Kératoses séborrhéiques géantes de siège inhabituel.

BACKGROUND: Seborrhoeic keratoses (SK) are benign tumours preferentially located on the head and trunk. We report a case of giant SK at an unusual site. PATIENTS AND METHODS: An 85-year-old man consulted for pigmented genital lesions present for 10 years. Clinical examination revealed small pigmented formations evoking SK and other pigmented, confluent and hyperkeratotic bordering plaques with a circinate contour. The latter lesions were biopsied, and histological findings were characteristic of SK and showed epidermal acanthosis associated with orthokeratotic invagination of the mucosa, resulting in the formation of characteristic wells. Treatment by electrocoagulation curettage was undertaken. DISCUSSION: SK are benign tumours that occur primarily in patients aged over 50 years. They are preferentially located in the trunk, head and neck. A genital site of SK is very unusual, with no more than 10 published cases. The cause of genital SK is as yet unknown, but data in the literature point to a possible role of chronic friction and HPV.

[A new location of angiokeratoma circumscriptum]. / Une nouvelle localisation de l'angiokératome circonscrit næviforme.

BACKGROUND: Angiokeratomas are papular telangiectasias having a common histology of ectasia of the superficial dermal vessels surmounted by a hyperkeratotic epidermis. PATIENTS AND METHODS: The patient was a 9-year-old girl born of non-consanguineous parents after a well-followed pregnancy with problem-free delivery at term. From birth, she had a tumefaction of the left side of the nose and the left half of the upper lip that gradually increased in size without obstructing the nasal orifice and bled easily. Examination revealed the presence of tumefaction of the left nostril and the left half of the upper lip projecting towards the contralateral side especially in the nose. It was soft and painless, with the presence at the surface of dull red keratotic papules of 1 to 2 mm in diameter. Examination of the nasal mucosa revealed the same appearance of papules. DISCUSSION: Angiokeratoma circumscriptum is a rare congenital malformation, the rarest of five types. Since its initial description in 1890, few cases have been reported. However, female predominance has been noted with a male/female sex ratio of 1/3. It appears to be due to a genetic mutation that is probably autosomal, but the site of which is still unknown. In view of the special features of this case, several diagnoses were suggested, including Rendu Osler's disease, superficial lymphangioma and verrucous angioma. CONCLUSION: The particularity of this case is that it includes the first description of this site, which posed a therapeutic problem, especially concerning the choice of laser type to be used.