[Therapeutic indications for percutaneous laser in patients with vascular malformations and tumors]. / Indications thérapeutiques du laser percutané dans les malformations vasculaires et les tumeurs vasculaires.

Lasers are increasingly used to treat vascular abnormalities. Indeed, this technique is non-invasive and allows a specific treatment. The aim of this review is to present some biophysical principles of the lasers, to describe the different sorts of lasers available for treatment in vascular medicine indications. Three principal lasers exist in vascular medicine: the pulsed-dye laser, for the treatment of superficial pink lesions, the NdYAG-KTP laser for purple and bigger lesions, and the NdYAG long pulse laser for even deeper and bigger vascular lesions. In vascular malformations, port wine stains can also be treated by pulsed-dye laser, KTP or NdYAG when they are old and thick. Telangiectasias are good indications for the three sorts of lasers, depending on their depth, color and size. Microcystic lymphatic malformations can be improved by laser treatment. Arterio-venous malformations constitute a contraindication of laser treatment. In vascular tumors, involuted infantile hemangiomas constitute an excellent indication of pulsed-dye laser treatment. Controlled studies are necessary to evaluate and to compare the efficacy of each laser, in order to determine their optimal indications and optimal parameters for each machine.

Mondor's disease: what's new since 1939?

Mondor's disease (MD) is a rare and self-limited benign disease first described in 1939. Originally its clinical presentation was a superficial vein thrombosis (SVT) without contiguous skin inflammation of the chest wall veins. Over time its definition has evolved and now also includes subcutaneous thrombosis of the dorsal vein of the penis but also retractile scarring of the fascia after breast surgery without concomitant SVT. In all cases clinical examination constitutes the first step of diagnostic management. It is followed by an ultrasound exploration (US) to search for a thrombus. In about half of all cases the disease is considered as idiopathic and cancer is rare. Whatever the location considered, the follow-up is usually uneventful with low rates of recurrence and of subsequent cancer. Treatment is debated and ranges from therapeutic abstention to anticoagulants or even surgery. It is likely that the new locations and mechanisms (without thrombosis) of the MD have lead to the constitution of a heterogeneous entity precluding from a consensual mode of care.

[Atypical skin lesions of the lower limbs in patients with chronic venous insufficiency: a case of granulomatous fungoid mycosis]. / Lésions cutanées atypiques des membres inférieurs sur insuffisance veineuse chronique: à propos d'un cas de mycosis fongoïde granulomateux.

In vascular medicine, venous insufficiency, ocre dermatitis, stasis dermatitis, or lipodermatosclerosis (level C4 in CEAP) may lead to skin lesions involving the lower limbs. Generally, symptoms resolve with etiologic treatment using medical compression, varicosis treatment, or dermocorticoids. However, some skin lesions progress, suggesting another diagnosis, including a specific dermatosis. The diagnosis is based on clinical, biological, radiological and histological criteria. Referral to a dermatologist may be necessary to determine the appropriate etiological treatment.