[Predictive factors for pain in technical dermatological procedures]. / Facteurs prédictifs de la douleur dans les gestes techniques dermatologiques.

BACKGROUND: Technical procedures in dermatology are painful. AIM: The aim of the study was to determine predictive factors for pain in such procedures. PATIENTS AND METHODS: This observational study evaluated pain by means of a numerical pain rating scale and a questionnaire about the circumstances of the pain and the use of analgesic methods. Data were analysed using Excel and SAS software. RESULTS: Five hundred and forty-six questionnaires were analysed. Among the patients, 45.4% had mild pain, 34.5% moderate pain and 20.1% severe pain. The least painful procedures were cryotherapy, surgical excision and biopsy, debridement and curettage. Procedures causing moderate to severe pain were treatments involving laser and lights as well as injections (hyaluronic acid, intralesional corticosteroids, botulinum toxin). Pain scores were higher for procedures involving fingers, toes and armpits, while the least painful areas were the trunk and limbs. Among the patients, 62.5% had no preventive analgesia before the procedure, 37.5% had preventive analgesia and 34.2% underwent local or topical anaesthesia (3.7% by cold, 2.0% by oral premedication, 0.5% by hypnosis and 0.4% by nitrous oxide). CONCLUSION: Awareness of predictive factors for pain could allow better use of analgesic methods to offer the patient relief and improve the quality of the procedure.

Eczema craquelé as a pointer of internal malignancy--a case report.

A case of eczema craquelé associated with gastric adenocarcinoma is reported. There are localized and generalized forms of eczema craquelé, the generalized forms differing from the localized types because they can be signs of metabolic or internal disease such as cancer. The patterns of the condition are reviewed based on the literature and personal observations.

[Pachydermodactyly in adolescents: a sign of discomfort?]. / Pachydermodactylie de l'adolescent: expression d'un mal-être?

BACKGROUND: Pachydermodactyly is an acquired dermatosis related to psychological disturbances. CASE REPORT: A 16 year-old boy presented with fibrous skin hypertrophy of proximal interphalangeal joint areas of both hands suggestive of pachydermodactyly. Skin biopsy confirmed the fibromatous nature of hypertrophy. The personal history of the child confirmed that pachydermocactyly was due to compulsive rubbing stretching movements in a patient with psychological troubles. CONCLUSIONS: Pachydermodactyly, mainly observed among male teenagers, must be considered as an induced dermatosis and distinguished from primary fibromatosis.

[Darier-Ferrand dermatofibrosarcoma in children]. / Dermatofibrosarcome de Darier-Ferrand de l'enfant.

BACKGROUND: Dermatofibrosarcoma is a tumor relatively ignored in childhood. CASE REPORT: A 11 year-old boy was referred because he suffered from a tumor of the neck, which had progressively developed after a cervical traumatism occurring 4 years earlier. Examination showed a tumor moderately infiltrated, attached to the overlying erythematous skin. Biopsy showed ill-limited dermal and hypodermal proliferation of fusiform cells with a storiform arrangement. Two successive excisions were necessary and the patient is well 2 years later. CONCLUSION: This case confirms responsibility of previous traumatism, progressiveness of course and necessity of large excision.

[Association of IgA linear dermatitis and non-Hodgkin's malignant lymphoma]. / Association d'une dermatose à IgA linéaire et d'un lymphome malin non hodgkinien.

The association between linear IgA dermatosis and neoplasia has been the subject of several publications which suggest that the association is not fortuitous. We report a new case in which a non-Hodgkin's lymphoma was associated with a linear IgA dermatosis and underline the need for full evaluation in search of an associated neoplasia. However, the neoplasia-LAD association is not a true paraneoplastic syndrome since the two pathologies seldom follow a parallel course.