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Competing Interests: Conflict of interest None disclosed.

Competing Interests: Conflict of interest None disclosed.

Background: Cutaneous polyarteritis nodosa (cPAN) is a skin medium vessel neutrophilic arteritis with livedo, nodules, and ulcerations. Macular lymphocytic arteritis (MLA) is a small arteritis with erythematous or pigmented macules and typical histologic features (a lymphocytic infiltrate, concentric fibrin ring, no disruption of the internal elastic lamina)., Objective: We sought to assess the frequency of clinical and histologic features of MLA in patients with cPAN., Methods: This was a monocentric retrospective analysis of patients given the diagnosis of cPAN with blinded assessment of skin biopsy specimens., Results: All 35 patients included had an infiltrated livedo, nodules, or both. Ulceration was rare. Erythematous or pigmented lesions were present in 54% of patients. Predominantly lymphocytic arteritis, a paucity of neutrophils, concentric fibrin ring, and absence of internal lamina elastic disruption were present in 60%, 20%, 18%, and 23% of patients, respectively. Median follow-up was 11 years. None of the patients had systemic involvement, and 57% had a complete remission. The incidence of complete remission was not different between patients having a predominant lymphocyte infiltrate or few neutrophils., Limitations: This was a retrospective, monocentric study without a control group of patients with MLA., Conclusions: Our data do not favor the classification of cPAN and MLA as distinct entities., (Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: A rare variant of mycosis fungoides (MF), syringotropic MF (STMF) is characterized by a particular tropism of the lymphocytic infiltrate for the eccrine structures, and included in the follicular subtype of MF in the World Health Organization-European Organization for Research and Treatment of Cancer classification of cutaneous lymphomas., Objective: We sought to determine the clinicopathologic features and disease course of patients with STMF., Methods: A retrospective study was conducted to identify patients with STMF from 1998 to 2013., Results: Nineteen patients were included: 15 men and 4 women, mean age 55 years (range, 24-86). Most had multiple lesions (n=16, 84%) with associated alopecia (n=12, 63%) and/or punctuated aspect (n=12, 63%). Palms or soles were involved in 10 cases (53%). Folliculotropism was found in 13 cases (68%). After a median follow-up of 70 months (range, 2-140), 3 patients died, 1 from disease-related death. The 5-year overall and disease-specific survival were 100%. The disease-specific survival was significantly higher than in 54 patients with folliculotropic MF without syringotropism (5-year disease-specific survival, 74%; 95% confidence interval, 58%-94%, P=.02)., Limitations: Retrospective setting is a limitation., Conclusions: In the spectrum of adnexotropic MF, STMF appears as a distinct entity from follicular MF, with peculiar clinical characteristics and natural history., (Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Scabies is a contagious skin infestation caused by the human mite Sarcoptes scabiei. The usual reference method for definitive diagnosis is ex vivo identification of the mite with microscopic examination of skin scrapings. We compared diagnostic accuracy of in vivo dermoscopic (DS) mite identification using a pocket handheld low-magnification DS with the reference method., Methods: We conducted a prospective, nonrandomized, evaluator-blinded, noninferiority study to compare sensitivities (main outcome) and other diagnostic properties of DS and microscopic examination of skin scrapings. Among 756 patients with a presumptive diagnosis of scabies consulting in one center, 238 were sequentially submitted to the two diagnostic procedures. Three dermoscopists (one expert, two inexperienced) were involved. Diagnostic strategies using clinical skills only, DS results, and a combination of both were compared., Results: Sensitivities were 91% (95% confidence interval: 86-96) for DS and 90% (95% confidence interval: 85-96) for microscopic examination of skin scrapings (P = .005 for noninferiority). Specificities were 86% (95% confidence interval: 80-92) for DS and 100% (by definition) for microscopic examination of skin scrapings. DS sensitivities were similar for the expert and inexperienced dermoscopists, whereas differences were observed in specificities. However, diagnostic accuracy of inexperienced dermoscopists steadily increased during the study. Compared with clinical-based, DS-based treatment decision rule minimized the number of false-positive and false-negative findings, whereas a treatment decision rule based on combination of clinical presumption and DS result drastically reduced the number of patients with scabies left untreated., Limitations: There is no definitive standard for ruling out the diagnosis of scabies., Conclusions: Standard DS with a handheld DS is a useful tool for diagnosing scabies, with high sensitivity, even in inexperienced hands. It greatly enhances clinical skills for making treatment decisions.

Background: Complications caused by skin lightening practices have not been systematically studied in Europe., Objective: Our aim was to assess the complications of skin lightening among people of African descent living in Paris., Methods: This was a descriptive study. All patients presenting with complications from skin lightening procedures underwent a complete clinical examination and were questioned about their practice., Results: Forty-six patients from various African countries (39 women, 7 men) presented with skin changes suggestive of side effects from skin lightening practices. The complications seemed mainly related to the use of clobetasol and hydroquinone., Limitations: The selection bias does not allow assessment of uncomplicated skin lightening., Conclusion: Complications arising from skin lightening practices represent a significant health problem for people of African descent living in Paris.