[Erythema palmare hereditarium (Lane's disease): Report of a paediatric case]. / Érythème palmaire héréditaire (maladie de Lane) : observation chez un enfant.

BACKGROUND: Palmar erythema may be either congenital or acquired, hereditary or non-hereditary. Its diagnosis and management differs according to whether or not it is acquired, hereditary or associated with symptoms. Herein, we report the case of a child with hereditary palmoplantar erythema (Lane's disease). OBSERVATION: A 2½-year-old girl consulted for palmar erythema, present since birth, predominantly on the thenar and hypothenar eminences and on the palmar aspect of her fingers. She also presented mild diffuse erythema on the soles of her feet. Both her mother and grandmother had similar signs. The girl had neither impairment nor pain linked to this erythema, and she had no associated symptoms. Physical examination was otherwise normal, as were the results of standard laboratory tests. DISCUSSION: We diagnosed Lane's disease based on the girl's hereditary erythema with autosomal dominant transmission, and the congenital and asymptomatic nature of her palmoplantar erythema. Nine publications have reported cases of Lane's disease, but this condition is probably highly under-reported.

[Mastitis revealing Churg-Strauss syndrome]. / Mastite révélatrice d'un syndrome de Churg-Strauss.

BACKGROUND: Churg-Strauss syndrome often involves the skin, and this may sometimes reveal the disease. OBSERVATION: A 25-year-old woman was referred to a gynaecologist for inflammation of the right breast with breast discharge. Cytological analysis of the liquid showed numerous inflammatory cells, particularly polymorphonuclear eosinophils and neutrophils. Ultrasound examination of the breast was consistent with galactophoritis. CRP was normal, and hypereosinophilia was seen. The patient was subsequently referred to a dermatology unit. Skin examination revealed inflammation of the entire breast, which was painful, warm and erythematous; the border was oedematous with blisters. Necrotic lesions were also present on the thumbs and knees. Skin biopsy of the breast showed a dermal infiltrate with abundant infiltrate of polymorphonuclear eosinophils, including patchy necrosis and intraepidermal vesicles. Histological examination of a biopsy sample from a thumb revealed eosinophilic granuloma and leukocytoclastic vasculitis. The patient was also presenting asthma, pulmonary infiltrates and mononeuropathy at L3, consistent with Churg-Strauss syndrome. DISCUSSION: Breast involvement in Churg-Strauss syndrome is very rare (only one other case has been reported). This is the first case in which the breast condition revealed the disease. Cutaneous involvement of the breast is, however, also compatible with Wells' cellulitis. The lesions quickly disappeared with 1mg/kg/d oral prednisolone.

[Atypical eruptive collagenoma: two cases]. / Collagénomes éruptifs atypiques: deux cas.

BACKGROUND: Eruptive collagenoma is a rare cutaneous lesion seen in young adults. It consists of asymptomatic, flesh-coloured papules that are usually localised on the trunk and the root of the upper limbs. Herein we report two cases on account of the atypical topography of the lesions and the advanced age of the patients. CASE REPORTS: Case n 1: a 69-year-old man consulted for firm, whitish papules on the wrists, elbows, popliteal fossae and groin without associated signs, and which first appeared several years earlier. The standard laboratory assessment and ocular fundus test were normal. Case no 2: a 69-year-old woman had very firm, flesh-coloured papules on the trunk and the root of the limbs, which appeared after the age of 40. The results of ocular fundus, cardiovascular investigation and laboratory examinations were normal. The histology of papules was similar in both cases and revealed a nodular zone in the reticular dermis, comprising disorganized collagen bundles and excessive quantities of elastic fibres, without elastorrhexis. This histology was consistent with collagenoma. DISCUSSION: We report two singular cases that were atypical in terms of patient age and localisation in the flexion folds. Histological analysis of a papule enables a diagnosis of collagenoma to be made. Such analysis usually reveals a hamartoma in which the amount of collagen is increased, with variable quantities of elastic tissue, though often decreased. The principal differential diagnoses are elastoma and pseudoxanthoma elasticum.