Umbilical cord care in neonates

Society

SM4 r-I

12

Clear cell syringofibroadenoma: tumour of the nail

B. Fouilloux’, Nerd,

meeting

M. Dutoit’, C. Per&,

St-Etienne;

2Hipital

Pasteup

SM5. Eumpean

A rare

Distal digital 12 cases

keratoacanthoma:

R. Baran’, S. Goettmann. ‘Nail Disease Serbes

Canrtes;

Hopital

Bichat,

Paris,

Centre, France

Report

of

42, Rue des

Distal digital keratoacanthoma (DKA) is a rare, destructive variant of keratoacanthoma (KA) that may be solitary, eruptive, multiple and sometimes familial. It has so far only been reported in white patients. We have observed twelve cases (8 males and 4 females; age range from 42 to 76 years) with a predilection for the three first fingers, especially the thumb. DKA involved the toes in 3 patients. Characteristically, this often painful tumour, occurs in the distal nail bed and may produce a paronychia-like lesion. The tumour itself is drastically altered clinically by the superficially limiting effects of the overlying nail plate. The hallmark of DKA is its rapid growth. Spontaneous resolution has been noted in only one patient. The radiographic appearance of DKA consists of a punched out area of bone destruction in the terminal phalanx. In our typical cases the histology changes of DKAs have the same general configuration as Kas elsewhere, but tend to be more vertically orientated and have more dyskeratotic cells. The link between DKA and subungual tumours in incontinentia pigmenti is discussed; these entities are indistinguishable. Local excision and curettage are sufficient and the initial treatment of choice. Only one patient underwent amputation because of the aggressive nature of the lesion. SM4-14

lntraoperative differential onychomatricoma

E. Haneke. Dept Dermatol,

Univ

s119

Dermutology

France

We report one case of a very rare tumour of the nail apparatus, a clear cell syringofibroadenoma. This tumour is discovered in front of a longitudinal dystrophic band (2 mm wide) in a 7 I year old woman. SM4-13

of Pediatric

These clinical cases showed remarkable features in common, however, close observation in addition with their histopathological aspects permitted the correct diagnosis.

P. Versini’. ‘Hophal Nice,

Society

diagnosis

Witten/Hetdecke,

of

SMS.

I SM5

European Society of Pediatric Dermatology

1 Umbilical

J. Ph. Lacour. Department

cord care in neonates of Dermatology,

Nice,

France

The infection of the umbilicus of the neonate by S. aureus may occasion severe infectious complications. Furthermore topically applied drugs may have serious side-effects. A survey was conducted in 57 maternities and departments of neonatology in the region of Provence-Alpes-C&e d’Azur. Fifty units answered the questionnaire. Six different groups of topical products were used, corresponding to 19 distinct commercial preparations. The association of several products was done 35 times out of 50: 2 products 29 times, 3 products 6 times. Eosin was the most frequently used (60%). Alcohol was used in 28 centers (56%); it was associated 22 times. Chlorexidine was used in 16 units, twice alone, with another topic 14 times. Ektogan@ (a powder of Zn and Mg peroxide and Zn oxide) was used in 10 centers, always in association. Hexamidine was used in 4 units, once in association. Silver nitrate, Milian solution, iodinated alcohol, povidone iodine were respectively used once. This survey shows a great varieties of umbilical cord care modalities that do not follow the recommendations for antiseptic treatment in small children. The large use of eosin (a weak disinfectant) contrasts with its frequent association with another topic. Ethanol comes in second position. Because of its lack of sustained action, the risk of ethanol intoxication and of skin hemorrhagic necrosis, we do not recommend its use. The role of Ektogan@ is unclear and powders may predispose to skin superinfection. Although chlorexidine has been proven to be the most suitable disinfectant, well tolerated in neonates, it comes only in 3rd position and is used in association in 95% of the cases. This study should be extended to an international level and should lead to interdisciplinary guidelines for umbilical cord care.

Wuppertal,

Germany

Onychomatricoma is a tumorous lesion recently identified by Baran and Kint. It is clinically characterised by a thickened, often funnel-shaped yellowish nail. During operation, the cautiously avulsed nail shows canal-like hollows which are due to long villous projections of the matrix. These three symptoms allow the correct diagnosis to be made almost instantaneously. We have observed a case of hypertrophic subungual Bowen’s disease with a yellowish, markedly thickened, transversely overcurved nail plate and villous projections of the nail bed; however, the latter were based distally in contrast to the proximally based filiform processus of onychomatricoma. In a case of isolated Koenen’s tumours of all toenails without any other clinical sign of tuberous sclerosis, the nail plates of the great toes were grossly distorted by long slender fibromas lying on, in, and under the nail plate thus also forming long hollows in the plate.

1SM5-3

Treatment of ulcerative polyurethane film

hemangiomas

with

A.P Oranje’, F.B. de Waard-van der Spek’, A. Devillets’, P de Laatsa4, G.C. Madem3Q4. ‘Departments of Dermato-Venereology; ‘Pediatrics; jPediatric surgery, University Hospital Rotterdam; Erasmus University Rotterdam, Rotterdam; 4 WEVAR (Work group on vascular abnormalities Rotterdam), the Netherlands

The most common complication of hemangiomas, occurring in lo%, is ulceration. We report involutive and healing effects of Opsite Flexigrida in ulcerative hemangiomas. Methods and Materials: A protocol of using Opsite Flex&id@ dressing film in ulcerative hemangiomas is applied. Results: Eight children suffering from ulcerative hdmatigiomas were enrolled. Most turnout-s were located in the napkin