Circumferential skin folds in a child: a case of Michelin tire baby syndrome.

A six-month-old girl who presented with dermatitis was found to have multiple, symmetric, deep, gyrate skin folds involving her trunk and similar circumferential lesions on her extremities since birth. She had a characteristic round face with hypertelorism, depressed nasal bridge, thin, down-turned vermillion border of upper lip and short neck. Skin biopsy demonstrated increased smooth muscle fibers in the deeper dermis. A diagnosis of Michelin tire baby syndrome was made. Clinical features, histopathology, differential diagnosis and prognosis of this rare disorder have been discussed.

Encephalocraniocutaneous lipomatosis: a rare neurocutaneous syndrome.

Encephalocraniocutaneous lipomatosis is a congenital hamartomatous disorder with unique ocular, cutaneous and neurological features. A 13-year-old boy presented with history of mental retardation and delayed developmental milestones. Bulbar conjunctiva of left eye showed hypertrophy with a soft reddish limbal nodule encroaching on the cornea. Dermatological examination showed multiple patches of alopecia, soft papules in the left perioral and periorbital areas, soft masses over the right axilla, trunk and in the lumbosacral region suggestive of lipomas. The CT scan of the brain revealed well-defined, hypodense lesions in both the cerebellar hemispheres suggestive of lipomas. The constellation of these findings led us to a diagnosis of encephalocraniocutaneous lipomatosis.

Study of mast cells in non-neoplastic skin lesions.

Sixty non-neoplastic skin lesions were studied for mast cells by toluidine blue stain. The highest numbers of mast cells were seen in the viral infections of the skin (50/mm2) and lowest number of mast cells in congenital diseases (17/mm2). Out of the cutaneous bacterial infections, highest numbers of mast cells were seen in leprosy (44/mm2) while in lupus vulgaris they were much less (37/mm2). In leprosy cases it was observed that as the lesions moved from indeterminate to both polar tuberculoid and lepromatous, the mast cell count increased. It could therefore be summarised that periodic follow-up of indeterminate and borderline lesions for mast cell count might help in predicting stability of lesions. In non-infectious squamous and papular lesions the mean mast cell count was 39/mm2. The highest numbers of mast cells in the non-infectious vesicular and bullous lesions were in bullous pemhigoid (57/mm2) and lowest in dermatitis (38/mm2).