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Background Xanthelasma palpebrarum (xanthelasma) is a common disease involving the eyelids. It consists of yellowish plaques of esterified cholesterol situated in the middle and superficial layers of the dermis. Many techniques, including laser treatments, have been proposed to destroy these lesions. A preliminary study demonstrated the efficacy of 1064-nm Q-switched Nd:YAG laser in treating xanthelasma. Objectives To present the results of a prospective study using 1064-nm Q-switched Nd:YAG laser to treat xanthelasma. Methods Thirty-eight lesions in 11 patients were treated. Results The results observed after a single treatment by Q-switched Nd:YAG laser were scored as good or excellent in eight patients, i.e. for 26 of 38 lesions. Conclusions The treatment of xanthelasma by 1064-nm Q-switched Nd:YAG laser is a valuable treatment option to eliminate lesions, with rapid and good quality healing. The absence of any associated skin destruction allows treatment to be repeated when necessary. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor about ulcerative esophagitis during primary HIV infection.

Complications related to tattoo practice. Tattooing can result in a wide variety of complications, whose prevalence and incidence remain still unclear. Hypersensitivity reactions (or allergies) to tattoo pigments are currently the most common complication on a tattoo, however are not predictable. Infections are nowadays directly related to the lack of asepsis and hygiene during the tattooing procedure or during the healing phase. Patients with a known cutaneous disease should be warned of a potential risk of localization of their disease to the tattoo. Patients with chronic conditions and/or impaired immunity should discuss with their physician about the possibility and when to have a tattoo. Laser removal is the gold standard for tattoo removal and include Q-switched, picoseconds and CO2 lasers. However, a complete disappearance of the tattoo is not always possible., Competing Interests: N. Kluger déclare : interventions ponctuelles (essai clinique NAOS Bioderma [2019] ; expertise : Bayer [2016], Biersdorf [2018], colloques Galderma [2019], SVR [2019] ; prise en charge pour un congrès : AbbVie [2019]. T. Fusade déclare n’avoir aucun lien d’intérêts.

Introduction: "Café au lait" spots (CLS) are pigmented skin lesions principally located at the trunk and the limbs. Histologically, CLSs consist in an excessive pigmentation of the epidermis, with no risk of malignant transformation. The "kissing" nevus is a rare pigmented congenital nevus affecting both lower and upper eyelids in a mirror layout. As other nevi, it presents a theoretical risk of malignant transformation. These two pigmented lesions are responsible for aesthetic discomfort when affecting the face., Observation: Three patients presenting with a congenital pigmented lesion affecting the two eyelids in a mirror layout are presented. In two cases, the lesions, initially considered as "kissing" nevi, were classified as CLSs. The diagnosis of CLS was made on a biopsy in one patient and after surgery in the other one., Discussion: Pigmented mirror layout lesions, called "kissing" lesions, are exclusively described for the nevi. We describe two cases of CLSs affecting the eyelids in a mirror layout. Difficulties in diagnostic are exposed and the possible treatments are discussed., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Background: Nevus of Ota can be effectively and safely treated since the arrival of q-switched lasers in dermatology. However, available literature is scarce regarding the treatment of Nevus of Ota in skin types darker than IV., Objectives: We report about four Fitzpatrick phototype V patients treated for Nevus of Ota with a q-switched Nd:YAG laser at 1,064 nm., Methods: Four patients with Fitzpatrick phototype V were treated for Nevus of Ota with a q-switched Nd:YAG laser at 1,064 nm in a private practice setting. Pulse diameter for the treatments was 2 mm and pulses were applied typically in a non-overlapping fashion. Treatment energies ranged from 4.1 to 9.5 J/cm(2) ., Results: All four patients of this case series showed significant cosmetic improvement. Improvement ratings, based upon pre- and post-treatment photographs rated by blinded investigators, were in between 6 and 10 with a mean of 8.5 on a 10-point scale. Side effects were mostly short termed and typical for this laser technique. No post-inflammatory hyperpigmentation was observed however one case of permanent drop-like hypopigmentation was encountered., Conclusions: A 1,064 nm q-switched Nd:YAG laser treatment could be an effective and reasonably safe treatment for patients with Nevus of Ota and Fitzpatrick skin type V. Patients should be counselled before treatment regarding the risk of permanent hypopigmentation., (Copyright © 2011 Wiley Periodicals, Inc.)

Introduction: Cutaneous Bowen's disease is an intra-epidermal squamous cell carcinoma., Patients and Method: Ten cases of cutaneous Bowen's disease diagnosed among 8 patients were treated by scanned high energy carbon dioxide laser between November 1996, and March 1998. A biopsy was performed in all patients before treatment., Results: The post-treatment follow-up extended from 1 to 4 years with an average follow-up of 2 years and 11 months. Only one patient, whose lesion was located on the auricle, presented a recurrence after one year. The remaining patients did not present any recurrence during their last control: six patients were followed for two years or more and one patient for one year. We demonstrate a histological and clinical correlation between the number of carbon dioxide laser passes before a clinical endpoint and the thickness of the epidermal carcinoma treated., Discussion: This new treatment has comparable efficacy to other treatments. It can be applied to extensive lesions without sequelae except for the risk of residual hypopigmentation.

BACKGROUND--Histiocytosis of Langerhans cells includes a range of clinical manifestations that have been described as bone eosinophilic granuloma, Hand-Schüller-Christian syndrome, Letterer-Siwe syndrome and Hashimoto-Pritzker histiocytosis. These syndromes represent a spectrum of severity and prognosis of the same underlying disorder which is usually sporadic. It has occurred in monozygotic twins and in a familial pattern. This report describes monozygotic twins who developed the disease a few months after their father was found to be suffering from Hodgkin's disease. Case n. 1.--A 4 month-old girl was admitted because of fever, disseminated lymphadenopathy and hepatomegaly. She also had interstitial pneumonia. Infiltrating abnormal histiocytes were demonstrated in lymph node and bone marrow biopsies. X-rays showed lytic areas in the skull. Serology for EBV infection was negative. Special studies with immune markers of lymph node histiocytes confirmed the diagnosis of Langerhans cell histiocytosis, and more precisely, Letterer-Siwe syndrome. The patient was given prednisolone followed by vinblastine without success. She was given etoposide 11 weeks later, which induced remission. This treatment was replaced by vinblastine when the patient was aged 2 years 9 months. Case n. 2.--The monozygotic twin of the case n. 1 was also admitted at 4 months of age because of the same manifestations. Laboratory findings were identical to those of her sister, as was her response to the same drugs. The father was diagnosed as having Hodgkin's disease 3 months before the first manifestation of Langerhans cell histiocytosis in his daughters. His maternal uncle had also been treated for Hodgkin's disease. Immunologic studies of the twin were negative. CONCLUSION--These cases of Langerhans cell histiocytosis in monozygotic twins have no apparent relationship with the Hodgkin's disease of their father. Etoposide seems to be useful for treating such severe forms of the disease.

A case of basal cell carcinoma in a 17-year old male patient complicated, 5 years later, by inguinal and pulmonary metastases is reported. This clinical case raises two problems: the reality of the entity and the long-term follow-up of this type of tumours.

A case of cutaneous and nail infection due to Hendersonula toruloidea (HT), in a Senegalese woman who had been living in France for 7 years is reported. This patient presented with keratotic lesions of the palms and distal and lateral onycholysis. Culture of clinical specimens on Sabouraud's medium without cycloheximide resulted in the isolation of HT. This rare fungal infection is often misdiagnosed.

Heterozygous Fabry's disease has an inconstant expression and very few complications. The theory of X-chromosome inactivation which, according to Lyon, occurs hazardly, is illustrated by the fact that the disease is expressed even in hemizygous women. Ophthalmic manifestations, as detected by the slit lamp method, are almost constant, 80 p. 100 of women with the disease having a verticillate cornea. Angiokeratoma is present in 20 p. 100 of the cases. Episodes of paraesthesia of the hands and feet are less common; in most cases they are attributed to the disease retrospectively, during family investigations. In two girls aged 10 and 11 years respectively and without history of Fabry's disease the only symptom suggestive of the diagnosis was paroxysmal acroparaesthesia. In one of the girls acroparaesthesia was associated with acrocyanosis, livedo and acro-osteolysis, but concordance was the only argument in favour of a link with Fabry's disease. Alterations of the extremities have been reported in this disease, including palmar erythema and a bluish discoloration of the palms due to dilatation of the superficial veins. Only two cases of livedo have been published. Acrosteolysis has never been documented in Fabry's disease, and its presence must be confirmed in further cases. The diagnosis of heterozygous Fabry's disease in these 2 girls was confirmed by the finding of ceramide trihexoside in urine and by leucocyte alpha-galactosidase levels that were 25 to 30 p. 100 of values obtained in controls. A study of the family of one of the girls showed that the father was involved; this hemizygous type of the disease with a 10 p. 100 alphagalactosidase level was totally asymptomatic.(ABSTRACT TRUNCATED AT 250 WORDS)

A 68-year old man presented with erythemato-telangiectatic nodules on his right lumbar fossa, associated with right-sciatica. A skin biopsy was performed. Microscopic examination showed tumour embolism in the lumen of the dermal vessels. Immunohistochemical staining and electron microscopy confirmed the diagnosis of angiosarcoma metastasis. An arteriography showed the primary neoplasm as a polypoid tumour with anterior pedicle, narrowing the aortic lumen below the renal arteries. The patient died a few months later, with multiple metastasis in the lower half on his body. To our knowledge, this is the twelfth case of arterial primary angiosarcoma reported in the literature and the fifth one with skin metastasis. The previously published cases are reviewed.