Atypical Cellular Blue Nevus of the Foot: A Case Report.

Blue nevus is a congenital and acquired melanocytic proliferation that includes different histological types. The atypical cellular type has been rarely described and it classically has a benign course. However, because of its intermediate features between common blue nevus and malignant blue nevus, long-term clinical follow-up is required. Here we report the case of a 28-year-old woman who presented with an atypical cellular blue nevus on the right foot.

[When hair starts to fall out]. / Quand les cheveux se cassent.

Hair loss causes physical and psychological distress and represents a common motive of consultation both in general practice and dermatology. Causes of hair loss are highly diverse and can lead to a challenging diagnosis, which can delay its management. Knowledge of the main causes and their different mechanisms are thus necessary in order to optimize both the diagnosis and treatment. The purpose of this paper is to describe the main causes of hair loss in order to improve its diagnosis and management.

Du fait de l'impact physique et psychologique engendré, la perte de cheveux est un motif de consultation fréquent en médecine de premier recours et en dermatologie. Cependant, en raison de la diversité étiologique dont découle cette perte de cheveux, une connaissance des différents mécanismes et des différentes causes est nécessaire afin d'instaurer le traitement le plus approprié et le plus rapidement possible. Nous détaillerons dans cet article les principales étiologies afin de faciliter l'orientation et la prise en charge.

[Sweet's syndrome, a diagnosis to keep in mind]. / Syndrome de Sweet : un diagnostic à ne pas manquer.

Sweet's syndrome is a rare neutrophilic dermatosis. Typically, patients present with a sudden onset of tender erythematous skin lesions (papules, nodules, and plaques), of asymetrical distribution, located preferentially on the superior limbs, face and neck, associated whith high fever and neutrophilia. Histologicaly, there is a diffuse infiltrate of neutrophils located in the dermis. Most of the time idiopathic, it may be associated with a respiratory or gastro-intestinal infection, with inflammatory bowel disease, pregnancy and vaccination. A drug-induced form and a malignancy-associated form have been described. Based on illustrations and two clinical cases, we wish to focus on the diagnostic strategy and the management of this disease.

Le syndrome de Sweet est une dermatose neutrophilique rare. Les patients présentent classiquement une apparition brutale de lésions cutanées douloureuses sous forme de papules, nodules ou plaques érythémateuses asymétriques localisées préférentiellement sur les extrémités supérieures, le visage et le cou, associées à une fièvre élevée, une neutrophilie et, à l'histologie, un infiltrat diffus de neutrophiles dans le derme. Le plus souvent idiopathique, il peut être en lien avec des infections respiratoires et gastro-intestinales, avec des maladies inflammatoires de l'intestin, avec une grossesse ou une vaccination. Des formes médicamenteuses et paranéoplasiques ont été rapportées. A l'aide d'images cliniques et de deux cas cliniques, nous souhaitons rappeler les points essentiels nécessaires au diagnostic et à la prise en charge de cette maladie.

[Evaluation and management of hyperhidrosis]. / Evaluation et prise en charge de l'hyperhidrose.

Hyperhidrosis is excessive sweating beyond what is expected for thermoregulatory needs. Nearly 3 % of the population has hyperhidrosis. It may be primary or secondary to medications or general medical conditions, including diabetes mellitus, hyperthyroidism, Parkinson disease, etc. History taking and clinical examination are essential to differentiate primary from secondary origins. Blood tests and a consultation with a specialist (endocrinologist, neurologist) is sometimes necessary to establish the diagnosis. The management of secondary hyperhidrosis involves the treatment of the underlying cause. For primary hyperhidrosis, it depends on its severity and the sites affected. This article will review the treatments for primary hyperhidrosis.

L'hyperhidrose est définie par une production de sueur qui dépasse les quantités nécessaires à la thermorégulation. Elle toucherait jusqu'à 3 % de la population. Elle peut être primaire (idiopathique), ou secondaire à un médicament ou diverses affections médicales, telles que le diabète, l'hyperthyroïdie, la maladie de Parkinson, etc. Une anamnèse et un examen clinique complets permettent de détecter les origines secondaires. Un bilan biologique et éventuellement une consultation par un spécialiste (endocrinologue, neurologue) seront parfois nécessaires pour le diagnostic. La prise en charge de l'hyperhidrose secondaire passe par le traitement de la cause sous-jacente, tandis que pour l'hyperhidrose primaire, elle dépend de sa sévérité et des sites touchés. Cet article passera en revue les différents traitements reconnus de l'hyperhidrose primaire.

[Pityriasis rubra pilaris]. / Pityriasis rubra pilaire: une dermatose mal connue.

Pityriasis rubra pilaris is a rare heterogeneous disorder characterized by follicular keratosis, perifollicular erythema and palmoplantar hyperkeratosis. The aetiology is still unknown. In the majority of cases some triggering factors are found such as trauma or bacterial infection, possibly on a predisposed condition. In other cases, some immunological disorders are associated, and in familial cases a genetic disorder of keratinization has been suggested. The evolution is variable according to the clinical type. The treatment is not well defined, and there is a lack of clinical trials. The best results however are obtained with oral retinoids, methotrexate or ciclosporine as alternative therapy. New TNF inhibitors and anti-IL-12/23 showed a good result and could be have interest in the future.

Isothiazolinones: sensitizers not to miss in children.

Isothiazolinone is known to be a sensitizer and a frequent cause of contact dermatitis in adults. Cases of contact dermatitis have also recently been reported in children. Derivatives of isothiazolinone, such as methylisothiazolinone (MI) and methylchloroisothiazolinone (MCI), are commonly used in the care products of babies and children. This allergen should not be missed.