Cortical resection for epilepsy in children with linear sebaceous nevus syndrome

Linear sebaceous nevus syndrome (LSNS) is a rare neurocutaneous syndrome that is associated with seizures and mental retardation. The cortical abnormalities that are associated with this syndrome include focal cortical dysplasia, partial hemimegalencephaly and holohemispheric hemimegalencephaly. Few reports have addressed the utility of cortical resections for epilepsy treatment in the setting of LSNS. We report 3 children with this syndrome who underwent extensive cortical resections and experienced significant improvement in seizure frequency. Our results support the utility of extensive cortical resections for children with this condition.

Atypical mole syndrome and congenital giant naevus in a patient with celiac disease

We describe a case of a 28-year-old woman affected by celiac disease (CD) associated with rare multiple disorders of the cutaneous pigmentary system: atypical mole syndrome and congenital giant naevus. Some other rare skin lesions have been reported in association with celiac disease such as cutaneous sarcoidosic granuloma, bullous pemphigoid, ichthyosis, alopecia areata, erythema elevatum diutinum, sclero-atrophic lichen and primary cutaneous amyloidosis. This is the 1(st) report concerning celiac disease and congenital disorders of the pigmentary system.

A case of unilateral, systematized linear hair follicle nevi associated with epidermal nevus-like lesions

Multiple hair follicle nevi are an extremely rare condition. In 1998, a case of unilateral multiple hair follicle nevi, ipsilateral alopecia and ipsilateral leptomeningeal angiomatosis of the brain was first reported from Japan. Very recently, hair follicle nevus in a distribution following Blaschko's lines has also been reported. In this paper, we observed a congenital case of unilateral, systematized linear hair follicle nevi associated with congenital, ipsilateral, multiple plaque lesions resembling epidermal nevi but lacking leptomeningeal angiomatosis of the brain. These cases implicate the possibility of a novel neurocutaneous syndrome. Additional cases should be sought in order to determine whether this condition is pathophysiologically distinct.

Linear sebaceous naevus syndrome and resistant rickets

The association between vitamin-D-resistant rickets and linear sebaceous naevus syndrome is extremely rare. Only eight cases have been described in the English literature and in none were the skeletal aspects addressed. We present three new cases and describe the musculoskeletal features. The details and outcome of surgery for correction of the deformities are discussed. The disturbances of metabolism of vitamin D and the effects of pharmacological treatment are also described.

Cobb syndrome in an infant: treatment with endovascular embolization and corticosteroid therapy: case report

OBJECTIVE AND IMPORTANCE

Cobb syndrome is a rare clinical entity characterized by the combination of a vascular skin nevus and an angioma in the spinal canal at the same metamere. We present a case report of an infant with Cobb syndrome.

CLINICAL PRESENTATION

A 5-month-old girl presented with cutaneous hemangioma of the thoracolumbar region (T5-T12) and paraparesis. The infant was examined by magnetic resonance imaging and aortography and was diagnosed with Cobb syndrome.

INTERVENTION

The patient received orally administered prednisolone therapy and underwent endovascular embolization of paravertebral and spinal angiomas with the use of n-butyl-2-cyanoacrylate. Her symptoms improved by combined treatment with liquid embolization and corticosteroid therapy.

CONCLUSION

Although Cobb syndrome has been reported in older children, it is extremely rare in infants. To our knowledge, this is the first report of an infant with Cobb syndrome treated with endovascular embolization and corticosteroid therapy. The combined treatment with corticosteroid therapy and endovascular embolization of cutaneomeningospinal angioma in Cobb syndrome seems effective in alleviating symptoms and minimizing morbidity.

[Epidemiology of melanoma]

A WORRYING INCIDENCE: In frequency, the melanoma, is placed just after breast, colic and pulmonary cancer with around 6 000 new cases per year in France. Moreover, it is the tumour that is increasing the most and its frequency has doubled over the past 10 years. It is presently estimated as 7 to 9/100 000 in France. THE IMPACT OF PREVENTIVE MEASURES: Primary and secondary prevention is therefore crucial, as is the identification of patients at risk. However, till now, the impact of educational and preventive campaigns with regard to sun exposure, which plays a major role in the development of a melanoma, are still insufficient

Sebaceous carcinoma arising from nevus sebaceus: a case report

BACKGROUND

Sebaceous carcinoma (SC) is a rare, aggressive, malignant tumor that is derived from adnexal epithelium of sebaceous glands that are distributed mostly in the skin of the head, neck, and hair-bearing regions of the body.

OBJECTIVE

To discuss the clinical and histologic features and the prognosis of the extraocular SC.

METHOD

We report a case of SCs of the scalp arising from a previous lesion clinically compatible with a nevus sebaceous. The lesion was surgically excised completely.

RESULTS

The postoperative course was free of complications, and the patient was clinically free of disease at her recent follow-up 2 years after treatment.

CONCLUSIONS

The absence of metastasis or cutaneous recurrence in our patient, notwithstanding the size of the lesion and its late removal, almost 25 years after the first signs of its growth, confirms a much improved prognostic behavior for extraocular SCs.

Squamous cell carcinoma complicating naevus sebaceous of Jadassohn in a child

We present a case of squamous cell carcinoma arising in a naevus sebaceous of Jadassohn (NSJ) in a 15-year-old girl. Both these events are rare, and this is the first reported case of a squamous cell carcinoma developing in NSJ in a child. The previous literature on sebaceous naevi and malignancies arising thereof is reviewed and discussed. Early excision is recommended in any cases of nodular change in sebaceous naevi in all age groups.

A patient with congenital ichthyosis hystrix (disseminated congenital naevus) and acute lymphoblastic leukaemia

Congenital ichthyosis is an uncommon spectrum of hereditary and sporadic hyperkeratotic epidermolytic disorders that may occur in isolation or in association with other clinical syndromes. The pattern of distribution of the hyperkeratotic lesions and family history form the basis of diagnosis. Ichthyosis may be a marker for immune deficiency and cancer prone conditions. We report a 16-year old Chinese patient with a diagnosis of ichthyosis hystrix hystrix (disseminated congenital naevus) since birth who presented with T cell acute lymphoblastic leukaemia with tetraploid clones. There are four reports of acute leukaemia complicating ichthyosis, all involving paediatric acute lymphoblastic leukaemia. The possible mechanisms involved are discussed.

Osteomas of the skin revisited: a clinicopathologic review of 74 cases

Cutaneous ossification is an unusual event that may be primary or secondary to either inflammatory or neoplastic processes. It is classified as primary when it occurs in the absence of a demonstrable preexisting lesion. Secondary lesions have been most commonly reported occurring with pilomatricoma, basal cell carcinoma, acne vulgaris, and melanocytic nevi (nevus of Nanta). Histologically, the osteomas are composed of well-formed bony spicules with prominent cement lines and calcification. They may demonstrate osteoblasts, osteoclasts, and osteocytes and occasionally may even demonstrate bone marrow elements. We searched the files of a reference dermatopathology laboratory to identify cases of either primary or secondary cutaneous ossification. We present a series of 74 cases of primary and secondary cutaneous ossification. Most cases were secondary in nature. Lesions were more common on the head and neck and in whites. Lesions were also more commonly identified in female patients. In addition, included in our series are 19 cases of nevus of Nanta. To our knowledge, this represents the largest series of such cases in the English literature. Cutaneous ossification is seen both in primary and, more commonly, in secondary conditions involving the skin. Benign neoplasms, especially melanocytic nevi, represent the most common cause of secondary osteoma formation. Women are more commonly affected than men, but the reason for this is unclear. The exact reason why osteoma formation occurs is unclear and requires further study.

[Actinic keratosis seborrheic wart and nevus: three distinct cutaneous eyelid skin lesions in a single patient]

A 67-year-old woman had three different tumors of the eyelids. The most prominent one was a nevus of the free margin of the inferior left eyelid. The nevus was followed for 18 months without change while two epidermal papillomatous tumors grew and were surgically removed. Histopathology disclosed that one tumor was a seborrheic keratosis and the other was a pre-epitheliomatous keratosis. Histologic evaluation of the margins showed that surgical removal was complete. A regular examination of the scars was recommended to the patient.

Sebaceous nevus syndrome as the underlying cause of intractable seizures in a one-month-old infant

A one-month-old male infant with generalized seizures since 2 days old was evaluated at the Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. His seizures were initially characterized as focal movement of the right upper and lower limbs followed by generalized tonic. Initially, phenobarbital was administered but failed to control his seizures. Physical examination revealed generalized mild hypotonia with a hyperpigmented brownish patch affecting the left side of his face. The initial diagnosis was sebaceous nevus syndrome which is one of the neurocutaneous syndromes. The diagnosis was confirmed by skin biopsy of the affected lesion. The literature was reviewed and discussed. The authors emphasized the importance of thorough physical examination including evaluation of specific skin lesion which would be a leading clue in making the diagnosis of symptomatic epilepsy in infants.

[Polypoidal choroidal vasculopathy in a patient with a melanocytoma of the optic nerve]

PURPOSE/METHOD

The choroidal neovascularization (CNV) may be associated with several types of choroidal tumors. The polypoidal choroidal vasculopathy (PVC) is a variant of the choroidal neovascularization. We present a case of PCV associated with melanocytoma of the optic nerve.

RESULTS/CONCLUSIONS

Although we cannot rule out that these two entities are independent of each other, the reported cases of choroidal tumors with CNV, the publication of a similar case and the epidemiological similarity between melanocytoma and PCV leads us to think that they may be related. We confirm the efficacy of laser argon treatment (Arch Soc Esp Oftalmol 2002; 77: 455-458).

Seborrheic keratosis with compound nevus, junctional nevus and basal cell carcinoma in the same lesion

Seborrheic keratosis can be associated with different neoplasms such as basal cell carcinomas, squamous cell carcinomas and melanomas. We describe an unusual case of a man who presented with a brown plaque on his back. The clinical diagnosis was melanoma. Histopathologic examination of the lesion revealed four neoplasms: a compound nevus, a junctional nevus, a superficial basal cell carcinoma and a seborrheic keratosis. Although this association most likely represents a chance phenomenon, we discuss the possibility that the seborrheic keratosis developed from the nevus, and that subsequently the junctional nevus and the basal cell carcinoma developed from the seborrheic keratosis.