To cite this article: Bouchouicha S, et al. Giant nevus lipomatosus cutaneous superficialis. Presse Med. (2015), http://dx.doi.org/ 10.1016/j.lpm.2014.11.009 Presse Med. 2015; //: ///
Images
en ligne sur / on line on www.em-consulte.com/revue/lpm www.sciencedirect.com
Giant nevus lipomatosus cutaneous superficialis Sana Bouchouicha 1, Talel Badri 1, Houda Hammami 1, Wafa Koubaa 2, Samy Fenniche 1
Available online:
1. Hôpital Habib Thameur, service de dermatologie, LR12SP03, université de Tunis El Manar, faculté de médecine, 1008 Tunis, Tunisia 2. Hôpital Habib Thameur, laboratoire d'anatomie pathologique, université de Tunis El Manar, faculté de médecine, 1008 Tunis, Tunisia
Correspondence: Talel Badri, Hôpital Habib Thameur, service de dermatologie, 8, rue Ali Ben Ayed, 1008 Tunis, Tunisia. [email protected]
Hamartome lipomateux géant
A
Figure 1 Large (30 15 cm), cerebriform, flesh-colored tumor, with multiple comedones and satellite plaques
36-year-old man presented with asymptomatic, fleshcolored lesions of the left buttock, which had occurred 20 years ago and had progressively increased in size, causing a constant discomfort. There was no preceding lesion or trauma. The patient was otherwise in good health, and his medical history was not significant. No other family members were affected with similar lesions. Dermatological examination revealed a cerebriform, soft, non-tender tumor, 30 15 cm in size, with an overlying skin which was dotted with multiple comedones. There were also homolateral smaller plaques, having a metameric arrangement, composed of multiple papules, sometimes coalescent, which were similar to the biggest lesion. Isolated long black hairs were noticed within and around the lesions (figure 1). Neither regional lymphadenopathy nor other cutaneous abnormalities were present. Histological examination of an incisional biopsy specimen taken from the main tumor showed dermal proliferation of mature fat cells in the papillary dermis around blood vessels (figure 2). Based on the clinical and histopathological features, the diagnosis of nevus lipomatosus cutaneous superficialis (NLCS) was made. The patient was referred to the plastic surgery department for surgical excision.
1
tome xx > n8x > mois année http://dx.doi.org/10.1016/j.lpm.2014.11.009 © 2015 Elsevier Masson SAS. All rights reserved.
LPM-2704
To cite this article: Bouchouicha S, et al. Giant nevus lipomatosus cutaneous superficialis. Presse Med. (2015), http://dx.doi.org/ 10.1016/j.lpm.2014.11.009
Images
S. Bouchouicha, T. Badri, H. Hammami, W. Koubaa, S. Fenniche
Figure 2 Dermal proliferation of mature fat cells in the papillary dermis around blood vessels (haematoxylin eosin)
Discussion
our case. There is no familial or sex predilection [1]. The lesions may present as multiple papules, and in this case, they usually appear simultaneously and vary in size. The lesions usually remain unchanged once formed [1,2]. The predilection areas for NLCS are the flanks, buttocks, and the upper posterior aspect of the thighs [3]. The presence of hairs, as seen in our patient, has rarely been reported [4]. No systemic abnormalities or malignant changes have been noticed with NLCS [1,2]. The diagnosis can be suspected by clinical examination and confirmed by histopathology. This latter shows the presence, in the dermis, near blood vessels, of mature ectopic adipose tissue, the proportion of which varying from 10 to 70% [1]. Changes in the connective tissue, blood vessels, and skin appendages may also be seen [1]. Differential diagnosis includes plexiform neurofibroma, connective tissue nevus, vascular malformation or lipomatosis [5]. Treatment is not necessary other than for cosmetic reasons. Excision is usually curative and recurrence after surgery seems to be rare [5]. Patients in whom surgery is impossible may undergo cryotherapy or CO2 laser ablation, which could give satisfactory results [2].
As seen in our patient, NLCS is usually unilateral and may have a band-like or zosteriform distribution [1,2]. It is often seen at birth but may appear during the first two decades of life, as in
Disclosure of interest: the authors declare that they have no conflicts of interest concerning this article.
References [1] [2]
2
[3]
Shinde GB, Viswanath V, Torsekar RG. Multiple yellowish plaques in cerebriform pattern on the right elbow. Int J Dermatol 2012;51:662–4. Fatah S, Ellis R, Seukeran DC, Carmichael AJ. Successful CO2 laser treatment of naevus lipomatosus cutaneous superficialis. Clin Exp Dermatol 2010;35:559–60. Finley AG, Musso LA. Naevus lipomatosus cutaneous superficialis (Hoffman-Zurhelle). Br J Dermatol 1972;87:557–64.
[4]
[5]
Kang H, Kim SE, Park K, Son SJ, Song KY. Nevus lipomatosus cutaneous superficialis with folliculosebaceous cystic hamartoma. J Am Acad Dermatol 2007;56:S55–7. Pujani M, Choudhury M, Garg T, Madan NK. Nevus lipomatosus superficialis: a rare cutaneous hamartoma. Indian Dermatol Online J 2014;5:109–10.
tome xx > n8x > mois année
Images
en ligne sur / on line on www.em-consulte.com/revue/lpm www.sciencedirect.com
Giant nevus lipomatosus cutaneous superficialis Sana Bouchouicha 1, Talel Badri 1, Houda Hammami 1, Wafa Koubaa 2, Samy Fenniche 1
Available online:
1. Hôpital Habib Thameur, service de dermatologie, LR12SP03, université de Tunis El Manar, faculté de médecine, 1008 Tunis, Tunisia 2. Hôpital Habib Thameur, laboratoire d'anatomie pathologique, université de Tunis El Manar, faculté de médecine, 1008 Tunis, Tunisia
Correspondence: Talel Badri, Hôpital Habib Thameur, service de dermatologie, 8, rue Ali Ben Ayed, 1008 Tunis, Tunisia. [email protected]
Hamartome lipomateux géant
A
Figure 1 Large (30 15 cm), cerebriform, flesh-colored tumor, with multiple comedones and satellite plaques
36-year-old man presented with asymptomatic, fleshcolored lesions of the left buttock, which had occurred 20 years ago and had progressively increased in size, causing a constant discomfort. There was no preceding lesion or trauma. The patient was otherwise in good health, and his medical history was not significant. No other family members were affected with similar lesions. Dermatological examination revealed a cerebriform, soft, non-tender tumor, 30 15 cm in size, with an overlying skin which was dotted with multiple comedones. There were also homolateral smaller plaques, having a metameric arrangement, composed of multiple papules, sometimes coalescent, which were similar to the biggest lesion. Isolated long black hairs were noticed within and around the lesions (figure 1). Neither regional lymphadenopathy nor other cutaneous abnormalities were present. Histological examination of an incisional biopsy specimen taken from the main tumor showed dermal proliferation of mature fat cells in the papillary dermis around blood vessels (figure 2). Based on the clinical and histopathological features, the diagnosis of nevus lipomatosus cutaneous superficialis (NLCS) was made. The patient was referred to the plastic surgery department for surgical excision.
1
tome xx > n8x > mois année http://dx.doi.org/10.1016/j.lpm.2014.11.009 © 2015 Elsevier Masson SAS. All rights reserved.
LPM-2704
To cite this article: Bouchouicha S, et al. Giant nevus lipomatosus cutaneous superficialis. Presse Med. (2015), http://dx.doi.org/ 10.1016/j.lpm.2014.11.009
Images
S. Bouchouicha, T. Badri, H. Hammami, W. Koubaa, S. Fenniche
Figure 2 Dermal proliferation of mature fat cells in the papillary dermis around blood vessels (haematoxylin eosin)
Discussion
our case. There is no familial or sex predilection [1]. The lesions may present as multiple papules, and in this case, they usually appear simultaneously and vary in size. The lesions usually remain unchanged once formed [1,2]. The predilection areas for NLCS are the flanks, buttocks, and the upper posterior aspect of the thighs [3]. The presence of hairs, as seen in our patient, has rarely been reported [4]. No systemic abnormalities or malignant changes have been noticed with NLCS [1,2]. The diagnosis can be suspected by clinical examination and confirmed by histopathology. This latter shows the presence, in the dermis, near blood vessels, of mature ectopic adipose tissue, the proportion of which varying from 10 to 70% [1]. Changes in the connective tissue, blood vessels, and skin appendages may also be seen [1]. Differential diagnosis includes plexiform neurofibroma, connective tissue nevus, vascular malformation or lipomatosis [5]. Treatment is not necessary other than for cosmetic reasons. Excision is usually curative and recurrence after surgery seems to be rare [5]. Patients in whom surgery is impossible may undergo cryotherapy or CO2 laser ablation, which could give satisfactory results [2].
As seen in our patient, NLCS is usually unilateral and may have a band-like or zosteriform distribution [1,2]. It is often seen at birth but may appear during the first two decades of life, as in
Disclosure of interest: the authors declare that they have no conflicts of interest concerning this article.
References [1] [2]
2
[3]
Shinde GB, Viswanath V, Torsekar RG. Multiple yellowish plaques in cerebriform pattern on the right elbow. Int J Dermatol 2012;51:662–4. Fatah S, Ellis R, Seukeran DC, Carmichael AJ. Successful CO2 laser treatment of naevus lipomatosus cutaneous superficialis. Clin Exp Dermatol 2010;35:559–60. Finley AG, Musso LA. Naevus lipomatosus cutaneous superficialis (Hoffman-Zurhelle). Br J Dermatol 1972;87:557–64.
[4]
[5]
Kang H, Kim SE, Park K, Son SJ, Song KY. Nevus lipomatosus cutaneous superficialis with folliculosebaceous cystic hamartoma. J Am Acad Dermatol 2007;56:S55–7. Pujani M, Choudhury M, Garg T, Madan NK. Nevus lipomatosus superficialis: a rare cutaneous hamartoma. Indian Dermatol Online J 2014;5:109–10.
tome xx > n8x > mois année
