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Introduction A disintegrin and metalloproteinase-17 (ADAM17) plays an important role in biological activity in different cancers. Its expression and prognostic value have not been studied in clear cell renal cell carcinoma (cRCC). The objective of this study was to explore the prognostic value of ADAM17 in patients with cRCC. Materials and methods A total of 131 patients with cRCC were studied. There were 90 men and 41 women, with an average age of 67 years (range: 34–93 y). There were 110 patients with localized disease and 21 patients with metastatic disease. The expression of ADAM17 was evaluated by immunohistochemistry with a monoclonal antibody. The follow-up varied from 4.2 to 184 months, with a median of 72 months for patients with localized disease. Kaplan-Meier with a log-rank test was performed to compare the progression-free survival after surgery. The univariate and multivariate analyses were performed to examine the significance of ADAM17 expression for the patient’s progression-free survival. Results The ADAM17 expression was found in 109/131 tumors. The ADAM17 expression was found in 20/21 metastatic tumors and in 89/110 localized tumors. Regarding patients with localized tumors, 31 patients experienced a recurrence or death during follow-up. The Kaplan-Meier analysis revealed that the high expression of ADAM17 was associated with a reduced progression-free survival ( P = 0.005). The univariate logistic regression analysis indicated that the high expression of ADAM17 was associated with the disease progression (hazard ratio = 2.826; 95% CI: 1.324–6.034; P = 0.007). The high expression of ADAM17 remained a significant factor for decreased progression-free survival in multivariate analysis. Conclusion ADAM17 was frequently expressed in cRCC. The high expression of ADAM17 was correlated with a worse outcome for patients with cRCC. ADAM17 is a new biomarker for the management of patients with cRCC.

a 1b, route de Saint-Marcellin, 42170 Saint-Just-Saint-Rambert, France b 62 bis, route Morieres, 84000 Avignon, France c Service d’anatomopathologie, hopital Ambroise-Pare, universite de Versailles-Saint-Quentin-en-Yvelines, CHU Paris-Ile-de-France Ouest, Assistance publique-Hopitaux de Paris, 9, avenue Charles-de-Gaulle, 92104 Boulogne-Billancourt, France d Technopole pathologie, 3, rue de la Robotique, 42000 Saint-Etienne, France e Service d’anatomopathologie, CHRU Caremeau, place du Professeur-Robert-Debre, 30029 Nimes cedex 9, France f Service de dermatologie, CHRU Caremeau, place du Professeur-Robert-Debre, 30029 Nimes cedex 9, France g Service de dermatologie, hopital Ambroise-Pare, universite de Versailles-Saint-Quentin-en-Yvelines, CHU Paris-Ile-de-France Ouest, Assistance publique-Hopitaux de Paris, 9, avenue Charles-de-Gaulle, 92104 Boulogne-Billancourt, France h 2, place Andre-Malraux, 78100 Saint-Germain-en-Laye, France

CA9 is proven to be a powerful marker for clear cell renal cell carcinoma. The studies on CA9 have been limited to solid renal cell carcinomas (RCC). We have conducted a study of CA9 expression in renal cystic tumors. The purpose of the present study was to extend the utility of CA9 for cystic renal tumors.Immunohistochemistry and enzyme-linked immunosorbent assay (ELISA) were used to detect CA9 expression in cystic renal tumors. Forty-three cystic renal tumors (22 benign and 21 malignant) were included for the immunohistochemical staining. Thirty-six patients with a cystic renal mass (20 malignant and 16 benign cystic tumors) were studied to measure CA9 level in the fluid by ELISA. Sixteen cysts (9 malignant and 7 benign cysts) were subjected both to immunohistochemistry and CA9 measurement in the fluid.Using immunohistochemical staining, all the benign cystic renal tumors including the 18 simple cyst and 4 benign multilocular cystic nephromas did not express CA9. All 13 cystic clear cell RCC were scored as strong staining for CA9. For 8 multilocular clear cell RCC, 7 were scored as strong staining for CA9 and the other one was negative. There was a significant difference in positive percentage (P0.001) between the 2 groups of malignant and benign cysts. For the 16 benign cysts, the mean concentration of CA9 in the fluid of cyst was 162 ± 133 pg/ml (median: 0 pg/ml; range: 0-2140 pg/ml). For the 20 malignant renal cystic tumors, the mean concentration of CA9 in the fluid of cyst was 2043 ± 62 pg/ml (median: 2,140 pg/ml; range: 1,112-2,140 pg/ml). There was a significant difference in mean concentration of CA9 between the two groups of malignant and benign cysts (P0.001). The presence or absence of CA9 expression measured by immunohistochemistry and ELISA test was concordant in 14 out of 16 cases (88%).Malignant cystic renal tumors expressed strongly CA9 while the benign renal cysts did not express CA9. CA9 can be detected in the fluid of malignant cystic renal tumors. CA9 is a promising molecular marker to differentiate the malignant cystic renal tumors from the benign cysts.

Resume La splenose correspond a une autotransplantation de tissu splenique consecutive a une plaie de la rate traumatique ou chirurgicale. Elle est habituellement localisee dans la cavite peritoneale mais des atteintes intrathoraciques sont egalement possibles, lorsqu’il existe une breche diaphragmatique concomitante. Cette breche peut passer inapercue. Les nodules sont generalement asymptomatiques et decouverts fortuitement par l’imagerie ou en peroperatoire dans la majorite des cas. Nous rapportons le cas d’un patient presentant une splenose pleurale et pulmonaire, mimant une atteinte pleuropulmonaire metastatique d’un melanome dorsal.

OBJECTIVES To hypothesize that serum cell-free DNA integrity may be clinically useful for prediction of clear cell renal cell carcinoma (cRCC). The integrity of cell-free DNA released from cancer cells was different from that released from apoptotic cells. METHODS We collected peripheral blood samples from 78 patients before surgery; among these patients, 22 with tumor, both pre- and postoperation, and 42 controls without tumor. After the column extraction of DNA, we performed conventional polymerase chain reaction using different sizes of primers (size of products: 109, 193, 397, and 456 bp) of the housekeeping gene, glyceraldehyde-3-phosphate dehydrogenase for measurement of serum cf-DNA integrity. RESULTS Age and gender were not associated with cf-DNA integrity in controls (P = .136 and P = .345). Among the cRCC patients, we observed no significant association between cf-DNA integrity and gender, age, tumor grade (P = .510, P = .618 and P = .052), except tumor stage and size (P = .001 and P = .001). All specimens contained 109 bp products. The 193 bp product was detected in 75 of 78 cRCCs and 37 of 42 controls (P = .091), 21 of 22 patients preoperation and 19 of 22 postoperation (P = .294). The 397 bp product was detected in 71 of 78 cRCCs and 0 of 42 of controls (P = .001), 18 of 22 patients preoperation- and 7 of 22 postoperation (P = .003). The 456 bp product was detected in 69 of 78 of cRCCs and 0 of 42 of controls (P = .001), 18 of 22 preoperation and 3 of 22 postoperation (P = .002). CONCLUSIONS Serum cf-DNA integrity may be a potential tool for the detection of clear cRCC.

Primary central nervous system lymphoma (PCNSL) is a rare subtype of non-Hodgkin lymphoma (NHL) with extranodal location affecting only the CNS, meninges and eye, without visceral or lymph node involvement. Its incidence has increased sharply over the past three decades, especially in immunocompetent subjects. Most PCNSL cases are diffuse large B-cell lymphomas (DLBCLs). However, it differs from nodal DLBCL in that it has a worse prognosis. DLBCLs are a heterogeneous entity and according to new genomic discoveries, classifications into prognostic subgroups have been embarked upon. Two prognostic algorithms were then prepared using a panel of immunohistochemical markers (CD10, Bcl6, MUM1/IRF-4, and Bcl2), thus categorizing DLBCL into two subgroups, GCB (germinal centre B-cell-like) or non-GCB, and into Group 1 or Group 2. Our goal is to apply both of these two sub-classifications to 39 PCNSLs, in order to assess their usefulness and prognostic relevance. 74.3% of our PCNSLs were of a non-GCB phenotype, corresponding to an activated postgerminal origin. They were evenly distributed across G1 and G2. Two- and 5-year overall survival rates were 34.8% and 19.6%, respectively. Younger age (

Purpose: We explored the clinical usefulness of serum carbonic anhydrase 9 as a potential biomarker for conventional renal cell cancer.Materials and Methods: This study included 91 patients with conventional renal cell cancer and 32 healthy individuals. Enzyme linked immunosorbent assay was used to measure the carbonic anhydrase 9 level. A followup (median 38 months) was performed to track early recurrence after surgery for patients with localized disease. Recurrence-free survival curves were calculated by the Kaplan-Meier method and compared using the log rank test.Results: The mean serum carbonic anhydrase 9 level in patients with metastatic conventional renal cell cancer (216.68 ± 67.02 pg/ml) or localized conventional renal cell cancer (91.65 ± 13.29 pg/ml) was significantly higher than in healthy individuals (14.59 ± 6.22 pg/ml, p

OBJECTIVE To assess the expression of the tumour markers stromelysin 3, MUC1, p53 and cytokeratin-7 in papillary renal cell carcinoma (pRCC, for which two histological subtypes are distinguished, i.e. type 1 and type 2, the latter appearing to be associated with a poorer prognosis) and to determine whether any of these markers might be of prognostic value. PATIENTS AND METHODS In a retrospective study of 50 patients, the type and nuclear grade of tumours was determined by histological analyses, the presence of microvascular emboli detected, and the markers assessed by immunohistochemical analysis using anti-stromelysin 3, anti-MUC1, anti-p53 and anti-cytokeratin-7 antibodies. RESULTS Twenty-five patients each had a type 1 or type 2 tumour. MUC1 and cytokeratin-7 were principally expressed in type 1 tumours, being detected in 76% and 84%, respectively. By contrast, p53 accumulated principally in type 2 tumours (36%); the accumulation of p53 was also associated with poorer survival. In patients with type 2 tumours with a more unfavourable development, stromelysin-3 expression was associated with a more advanced stage and a higher risk of metastases. CONCLUSION Subtyping pRCC according to the recommended morphological criteria appears to be worthwhile, and can be reinforced by immunohistochemical tests capable of detecting cytokeratin-7 and MUC1 expression. Immunohistochemical detection of p53 is of prognostic value, as accumulation of this factor is associated with poorer survival.

Objective To evaluate the predictive value of seminal inhibin B and anti-Mullerian hormone (AMH) on the outcome of testicular sperm extraction (TESE) in patients with nonobstructive azoospermia. Design Prospective study. Setting Reproductive biology department. Patient(s) Forty-seven normospermic, 28 oligozoospermic, and 68 azoospermic patients. Intervention(s) Testicular sperm extraction. Main Outcome Measure(s) Seminal inhibin B and AMH measure. Result(s) The seminal values of inhibin B and AMH are widely dispersed. Both inhibin B and AMH seminal values are significantly different between the three groups. The average rates of seminal AMH (not inhibin B) differ significantly according to the etiology of the azoospermia. Both seminal markers are correlated. A significant positive correlation could be observed between the seminal inhibin B and the sperm count, but not for AMH. A significant correlation also exists between seminal and serum inhibin B. The predictive value for TESE outcome of each parameter is rather low. Conversely, a logistic regression combining serum FSH, seminal inhibin B, and AMH produced a satisfying area under the curve of 0.985. Conclusion(s) Seminal inhibin B and AMH values are proposed. Separately, seminal markers are poor predictors of TESE outcome. A logistic regression model led to a satisfying area under the curve of 0.985.

Nous rapportons la prise en charge, dans un contexte d’urgence oncologique, de deux patients adresses pour autoconservation de gametes avant castration sur testicule unique, pour lesquels une azoospermie a ete decouverte le jour de l’autoconservation. Dans les deux cas, des biopsies testiculaires ont ete realisees de facon synchrone a l’orchidectomie et ont permis la congelation de spermatozoides. Une etude anatomo-pathologique de la piece tumorale et une analyse de la spermatogenese pour les biopsies en zone saine ont ete realisees. Un bilan genetique (caryotype, recherche des microdeletions du chromosome Y) a ete effectue. Apres la fin du traitement oncologique, une TESE (testicular sperm extraction) ICSI (intracytoplasmic sperm injection) a ete effectuee pour l’un des couples. Une grossesse gemellaire a ete obtenue, un garcon et une fille sont nes en bonne sante. Ces deux observations d’azoospermie de decouverte fortuite dans le cadre d’une indication d’autoconservation de gametes avant castration pour cancer sur testicule unique, soulignent l’importance de proposer la realisation de biopsies testiculaires synchrones le jour de l’orchidectomie.

Many cancers cause malignant effusions. The presence of malignant cells in effusions has implications in diagnosis, tumour staging and prognosis. The detection of malignant cells currently presents a challenge for cytopathologists. New adjunctive methods are needed. Although the effusions provide excellent materials for molecular assay, the available molecular markers are extremely limited, which hinders its clinical application. MN/CA9 has proved to be a valuable marker in many cancers such as lung, breast, colon, kidney, etc. The present study was to evaluate MN/CA9 as a new molecular marker for the detection of cancer cells in pleural effusions. Seventy-one pleural effusions including 59 malignant effusions from patients with cancer, and 12 patients with benign diseases as a control, were subjected to RT-PCR for detection of MN/CA9 gene expression. MN/CA9 gene expression was detected in 53/59 (89.8%) pleural effusions from cancer patients (15/16 for breast cancers, 10/11 for lung cancers, 4/4 for ovary cancers, 2/3 for colon-rectal cancers, 5/6 for cancers of unknown site, 7/8 for mesothelioma and 10/11 for other cancers). Furthermore, MN/CA9 was positive in 13/18 (72.2%) of cytologically negative effusions of cancer patients. MN/CA9 was detected in only 1/12 (8.3%) effusions from the control patients (p < 0.01). The sensitivity and specificity of MN/CA9 gene expression were, respectively, 89.8% and 91.7%. Our preliminary results suggest that MN/CA9 could be a potential marker for the detection of malignant cells in effusions. A large-scale study is needed to confirm these results.

Objectifs Le but de notre etude est tout d’abord d’etablir des valeurs de reference pour les concentrations d’inhibine B et d’AMH dans le plasma seminal chez des sujets presentant des parametres spermatiques normaux et alteres. Une analyse preliminaire sera egalement effectuee afin d’evaleur l’interet de ces dosages comme facteur predictif de biopsie testiculaire positive en cas d’azoospermie non obstructive.

Resume Introduction. – Les anevrismes coronariens pseudotumoraux sont rares et souvent pris pour des tumeurs cardiaques. Observation. – Nous rapportons une observation d'un tel anevrisme sur la coronaire droite, survenu chez un homme de 56 ans et complique d'une thrombose a l'origine d'un infarctus etendu, revele par des signes d'insuffisance cardiaque congestive, dont le diagnostic formel d'anevrisme atheromateux a ete realise a l'examen histologique apres exerese chirurgicale. Discussion. – Ces anevrismes peuvent etre associes a de nombreuses maladies inflammatoires ou dysplasiques, mais l'atherosclerose reste l'etiologie la plus frequente. Les differentes techniques d'imagerie completent utilement le bilan preoperatoire de ces formes pseudotumorales, dont le diagnostic n'est souvent possible que par l'examen anatomopathologique.

Objective: Small solid renal tumors are increasingly encountered. It is important to determine the malignancy of solid renal tumors for the choice of treatment. MN/CA9 is expressed in malignant renal cells but absent in normal cells. MN/CA9 is one of the most powerful gene markers available for RCC. The objective of this pilot study is to utilize MN/CA9 gene expression in FNA biopsy to determine the malignancy of imaging-indeterminate solid renal tumors. Methods: A total of 35 patients with an imaging-indeterminate solid renal mass entered into this study. The molecular protocol consisted of a rapid column extraction of RNA and one-step RT-PCR for the detection of MN/CA9 gene expression. The preoperative molecular diagnosis was compared with postoperative pathology. Results: There were 28 RCCs (19 clear cell carcinomas, 7 papillary carcinomas and 2 chromophobe carcinomas) and 7 benign tumors proved by postoperative pathology. The overall sensitivity and specificity for MN/ CA9 were respectively 68% and 100%. MN/CA9 was positive in 16/19 (84%) FNA biopsies of clear cell RCCs. No false positive appeared for MN/CA9 gene expression. Moreover, MN/CA9 gene expression was positive in 8/13 (62%) of false negative or suspect cytology. Conclusion: Detection of MN/CA9 gene expression in FNA biopsy is possible. Its detection can be helpful in identifying the malignancy among renal tumors.

Purpose: Our main goal was to evaluate a panel of molecular markers for the detection of cancer cells in serous effusions and to determine their value as an adjunctive reverse transcription-PCR (RT-PCR) test to cytologic examination. Experimental Design: One hundred fourteen serous effusions from 71 patients with tumors and 43 patients with benign diseases were subjected to RT-PCR for expression of carcinoembryonic antigen (CEA), epithelial cell adhesion molecule (Ep-CAM), E-cadherin, mammaglobin, mucin 1 (MUC1) isoforms MUC1/REP, MUC1/Y, and MUC1/Z, calretinin, and Wilms' tumor 1 susceptibility gene. Results: CEA, Ep-CAM, E-cadherin, and mammaglobin were specifically expressed in malignant effusions. The sensitivity of RT-PCR in cytologically negative malignant effusions was 63.1% combining CEA and Ep-CAM (with 100% specificity) and reached 78.9% adding MUC1/Y or MUC1/Z (with 93% specificity). In the whole population of effusions, the combination of cytology with RT-PCR of CEA and Ep-CAM yielded a 90.1% sensitivity, a specificity and a positive predictive value of 100%, and a 86% negative predictive value for malignancy. Adding MUC1/Y or MUC1/Z to the panel, the sensitivity was 94.5% with 93% specificity, 95.7% PPV, and 90.9% negative predictive value. Moreover, CEA and mammaglobin were specifically expressed in epithelial malignancies, and mammaglobin was mainly expressed in effusions from breast carcinoma (97.3% of specificity). Conclusions: A combination of cytology and RT-PCR analysis of CEA and Ep-CAM significantly improved the detection sensitivity of tumor cells in serous effusions. RT-PCR analysis of CEA, Ep-CAM, and mammaglobin in serous effusions could be a beneficial adjunct to cytology for the diagnosis of malignancy.

Aim The aim of this study is to evaluate the S100A1 and KIT as gene markers for the differentiation of common subtypes of renal tumours. Methods Fifty-five tissue samples (15 clear cell RCCs, 15 papillary RCCs, 7 chromophobe RCCs, 8 oncocytomas and 10 normal renal tissues) were studied The gene expressions of S100A1 and KIT were analysed by one-step RT-PCR by using the specific primers. Results S100A1 was expressed in 2/15 clear cell RCCs, 11/15 papillary RCCs, 7/8 oncocytomas and in 0/7 chromophobe RCCs. KIT gene was expressed in 6/7 chromophobe RCCs and 7/8 oncocytomas while 0/15 clear cell RCCs and 1/15 papillary RCCs expressed kit gene. Normal tissue expressed neither S100A1 nor KIT gene. Conclusion S100A1 and KIT can be used as gene markers for the differentiation of common subtypes of renal tumours.

We report four cases of superficial angiomyxomas, including two cutaneous tumors and two subungueal tumors. Histological analysis revealed a recently described tumor, so called superficial angiomyxoma. This is a myxoid paucicellular tumor lobulated and poorly circumbscribed, containing numerous small blood vessels surrounded by a mixed inflammatory cell infiltrate with notable neutrophils. Those tumors are positive for CD34. The differential diagnosis includes myxoid neurothecoma, myxoid neurofibroma and, for ungueal tumors, superficial acral fibromyxoma.

Objectives: The common subtypes of renal tumors are conventional or clear cell carcinoma, papillary carcinoma, chromophobe carcinoma and oncocytoma. Each subtype has its distinct histogenesis and clinical evolution. DNA ploidy is viewed as a marker of gross genomic aberrations. The aim of this study is to evaluate the DNA ploidy in the common subtypes of renal tumors to increase our understanding of renal tumor biology and to broaden clinical application of DNA ploidy. Methods: 38 renal tumor samples (13 clear cell RCCs, 12 papillary RCCs, 7 chromophobe RCCs, and 6 oncocytomas) were studied. Five biopsies of different parts of each fresh tumor were subjected to a flow cytometric analysis of DNA ploidy. Results: All tumors except one papillary RCC generated interpretable DNA histograms. Flow cytometric analysis of oncocytomas showed the diploid pattern (29/30 frequencies) while the chromophobe RCC never showed the diploid pattern (0/55 frequencies) (p < 0.01). 3/7 chromopbobe RCCs possessed the hypodiploid stemline. The hypodiploid stemline appeared neither in conventional RCCs (0/63 frequencies) nor in papillary RCCs (0/50 frequencies). The diploid pattern was dominant in conventional and papillary RCCs. 10/13 (76.9%) of clear cell RCCs and 9/11 (81.8%) of papillary RCCs possessed a homogeneous DNA ploidy pattern while only 1/7 (14.3%) has a homogeneous DNA ploidy pattern. 6/7 chromophobe RCCs had multiple aneuploid stemlines. Conclusions: Flow cytometric analysis reveals that conventional and papillary RCCs are more homogeneous than chromophobe RCC. Each subtype of renal tumors possesses a specific DNA ploidy pattern. The analysis of DNA ploidy is useful for the differentiation of common subtypes of renal tumors in morphologically difficult cases.

Le syndrome de l’X fragile est lie a l’expansion d’une sequence repetitive de triplets CGG dans la region 5’ du gene FMR1. II en resulte l’absence de production de la proteine FMRP par blocage de la transcription du gene FMR1. Nous rapportons une etude hormonale, histologique et immunohistochimique d’un cas, centree sur les fonctions testiculaires et l’origine du macroorchidisme. Le syndrome de l’X fragile ’saccompagne d’une spermatogenese normale ou incomplete ou encore presentant des lesions aux stades tardifs. Ces lesions tardives associees a l’œdeme interstitiel s’apparentent aux lesions observees chez les vasectomises ce qui a fait soulever l’hypothese du role d’une hyperpression peritubulaire et/ou d’anticorps anti-spermatozoides. Dans notre observation, la negativite des anticorps anti-spermatozoides et la discretion de l’œdeme ne sont pas en faveur de cette hypothese. L’histologie retrouve l’existence d’une hyperplasie du tissu interstitiel, d’un epaississement de la membrane basale peritubulaire et d’une augmentation du diametre externe des tubes seminiferes sans anomalie morphologique des cellules de Leydig ou des cellules de Sertoli. Les immunomarquages realises montrent la presence de la proteine FMRp dans les cellules germinales ce qui indique que ces cellules ne sont pas porteuse de la mutation complete. Cette expression de la proteine FMRp dans le testicule peut permettre d’expliquer la conservation de la spermatogenese alors meme qu’il a ete suggere que la proteine FMRp soit necessaire la survie des cellules germinales. Nos resultats sont compatible avec l’hypothese que les atteintes differentes de la spermatogenese selon les patients attients du syndrome puissent etre liees au nombre de cellules germinales touchees par la mutation complete. Des travaux complementaires sont toutefois necessaires pour comprendre la variabilite des atteintes de la spermatogenese et la physiopathologie du macroorchidisme dans le syndrome de l’X fragile.

This study assessed the expression of leukocyte integrins and macrophage-associated antigens in meningiomas. Fourteen benign meningiomas, ten atypical/anaplastic meningiomas, two hemangiopericytomas and one solitary fibrous tumour (SFT) were included. Frozen sections were immunostained using antibodies directed against leukocyte integrins, CD68, CD14, CD2, CD1a, DRC1 and CD34. Their expression was evaluated semi-quantitatively. Ki67 positive cells were counted. Arachnoid membranes served as controls. Arachnoid cells expressed the beta2-integrin subunit and KP1. Beta2 was detected in the tumour cells of 14 meningiomas. In nine cases, this was associated with an alpha-integrin subunit. There was no statistical difference in the expression of beta2 between benign and atypical/anaplastic meningiomas. KP1 was constantly expressed by the tumour cells of meningiomas. It was not expressed by other meningeal tumours. CD34 was detected in the fibrous meningiomas, hemangiopericytomas and the SFT. In each tumour, macrophages were more numerous than T lymphocytes. There was no statistical difference in the density of macrophages and T lymphocytes between the benign and atypical/anaplastic meningiomas. There was no correlation between the Ki67 proliferation index and macrophage infiltration. Meningiomas, through the expression of leukocyte antigens, have a very particular phenotype. The expression of beta2 integrins could play a role in the attraction of immunocompetent cells in the stroma of meningiomas.

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Granuloma annulare is a benign, common, inflammatory skin lesion of unknown etiology that is seen in both adults and children. The typical lesions are single or multiple small cutaneous papules with an annular distribution. The histology is consistent with an area of fibrinoid degeneration of collagen, surrounded by palisading histiocytes and inflammatory cells. There are four clinically distinct subtypes: localized, generalized, subcutaneous and perforating. Usually a spontaneous resolution is expected. Many medical treatments have been proposed but without evidence of efficacy. The association with insulin dependent diabetes is still being discussed.

Psoriasis is a common chronic disease in childhood of yet unclear etiology. Thirty per cent of psoriatic patients experience onset of their disease before 15 years of age. Psoriasis is exceptionally congenital but may present in infancy as a napkin dermatitis. There are specific pediatric clinical forms, but at the beginning the eruption is usually discrete, and the diagnosis can be difficult. Pustular, erythrodermic and arthropathic forms are rare. Treatment must weigh the advantages and disadvantages of the possible therapies and be kept to the minimum compatible with asymptomatic control.

Summary Congenital pigmented new are found in approximately 1 % of newbom infants. Two main factors determine their management: 1) thenskofmalignancy (melanoma); 2) the aesthetic consequences, these factors being themse Ives dependent upon the size and the localization of the nevi. Thus, if the systematic resection of small new is not required, early treatment of giant nevi which cany a high risk of malignancy before the age of ten years, is highly recommended. Main methods of treatmentare surgicalresection (with the help of skin grafts, orcutaneous expansion or mobilization, in giant nevi), dermabrasion and curettage. n˦vus pigmentaire congenital naevus, pigmented / abnormalities