Ann Dermatol Vener
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PELVIS or SACRAL syndrome denotes the association of local haemangioma and malformation in the pelvic region. In this paper, we report a case noteworthy on account of the initially livedoid appearance of the haemangioma as well as associated amniotic banding of an upper limb. ⋯ Segmented haemangiomas are commonly associated with extracutaneous abnormalities. By analogy with PHACE syndrome, defined as association of segmented facial haemangioma with cerebral, ocular and cardio-aortic abnormalities, PELVIS/SACRAL syndrome denotes the association of segmented haemangioma of the loins (sacrolumbar region, buttocks or perineum=napkin haemangioma) with spinal dysraphia affecting the sacrolumbar spine, the terminal medullary cone, the genitourinary organs and the anal region to different degrees. Diagnosis of haemangioma associated with PELVIS/SACRAL syndrome may be delayed or complicated due to the macular, telangiectasic or livedoid appearance commonly seen. To our knowledge, there have been no reports to date of an association of amniotic banding with haemangioma or perineal dysraphia.
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Pemphigus vulgaris is a rare autoimmune blistering disease seen only, rarely, in children. ⋯ Juvenile pemphigus vulgaris is rare and its occasionally clinically atypical presentation can result in delayed diagnosis and management. Firstline therapy generally comprises systemic corticosteroids. Some cases of recalcitrant pemphigus vulgaris in adults with a refractory course, despite adequate systemic corticosteroids, have been successfully treated with rituximab, as in our case 2. To our knowledge, only two other cases of juvenile pemphigus vulgaris treated with rituximab have been reported.