[A case of «â€ peau d'orange†¼ in the absence of cancer]. / Un cas de «â€ peau d'orange†¼ sans cancer.

A 57-year old female patient initially consulted a gynecologist for a cutaneous lesion on her left breast present since 6 weeks. The gynecologist described a plaque-like lesion in the sense of «â€…peau d'orange ¼. Imaging and a biopsy did not reveal evidence for a malignancy. When she presented in our «â€…walk-in ¼ outpatient clinic for a second opinion, a borreliosis was suspected based on the clinical appearance of the lesion. This hypothesis was confirmed by the -re-evaluation of the skin biopsy by a dermatopathologist and -further substantiated by positive serology. Thus, oral doxycycline (2 x 100 mg/day) for 28 days was prescribed as treatment, resulting in resolution of the lesion. We wish to encourage colleagues to contact a dermatologist for any unclear pathology of the skin and to send skin biopsies to a dermatopathologist, particularly if inflammatory or infectious diseases are suspected.

Une patiente de 57 ans a consulté initialement un gynécologue pour une lésion cutanée au niveau du sein gauche qui était présente depuis six semaines. Le gynécologue a décrit un placard de peau d'orange. Une biopsie cutanée n'a pas montré de lésion suspecte. Quand elle s'est présentée dans notre consultation, une borréliose a été suspectée sur le plan clinique. Une relecture des lames de la biopsie par un dermatopathologue a confirmé ce diagnostic. Etant donné la présence d'une sérologie positive, un traitement per os avec doxycycline pendant 28 jours a été réalisé. Nous encourageons nos collègues à solliciter un avis dermatologique, s'il y a un doute par rapport au diagnostic d'une ­pathologie qui touche la peau, et de profiter de l'expertise d'un dermato­pathologue pour lire les lames des biopsies cutanées.

[Recurrent erysipelas and cellulitis: management]. / Erysipèle et dermohypodermite récidivants: prise en charge.

Erysipelas and infectious cellulitis are skin infections that develop following the entry of bacteria through gaps in the skin. The most common complication is recurrence. Control of predisposing factors remains essential to prevent it. Prophylactic antibiotics are sometimes prescribed, but this approach is based on small studies and expert opinion. This article reflects the current state of knowledge and the standard of care.

Mohs Micrographic Surgery for Cutaneous Squamous Cell Carcinoma.

BACKGROUND: The first-line treatment of the localized form of cutaneous squamous cell carcinoma (cSCC) remains surgical excision. Either conventional excision (CE) with margins or Mohs micrographic surgery (MMS) may be preferred, depending on the risk factors of cSCC, the characteristics of the tumor, and the available technical facilities. METHODS: This article presents a systematic review of the current literature spanning from 1974 to 2023, comparing outcomes of cSCC treated with MMS versus cSCC treated with conventional excision. RESULTS: Out of the 6821 records identified through the database search, a total of 156 studies were screened, of which 10 were included in the review. The majority of the included studies showed that treatment of cSCC with MMS consistently exhibits a significantly lower risk of recurrence compared to treatment with CE. In addition, MMS is emerging as the preferred technique for the resection of cSCC located in aesthetically or functionally challenging anatomical areas. CONCLUSION: The studies generally demonstrate that MMS is a safer and more effective treatment of cSCC than CE. Nevertheless, outcomes such as recurrence rates and cost-effectiveness should be assessed more precisely, in order to allow for a more tailored approach in determining the appropriate indication for the use of MMS.