LETTERS TO THE EDITOR
© 2008 The Authors
JEADV 2009, 23, 441–496Journal compilation © 2008 European Academy of Dermatology and Venereology
Our experience supports that CO2 laser is an effective and safe
therapy for superficial microcyst vascular LM. It should be
considered when surgery or sclerosis is contraindicated. CO2
laser can be used in combination with Diode laser, Nd:YAG laser
and PDL laser when a haematological component is present.
Nevertheless, laser therapy is not curative since it cannot
eliminate the deep areas of the LM, and the lesion might recur.10
Therefore, a close follow-up is important in order to detect the
relapses of the disease.
S Beà-Ardébol,* P Boixeda, L Bagazgoitia, JL Santiago
Sánchez-Mateos, L Pérez-Carmona, P Jaén
Dermatology Department, Ramon y Cajal Hospital, University of Alcala de
Henares, Madrid, Spain
*Correspondence: S Beà-Ardébol. E-mail:
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of lymphatic malformations. Ann Chir Plast Esthet 2006; 51: 433–439.
2 Hsu T-S, Weiss RA. Foam sclerotherapy. A new era. Arch Dermatol 2003;
3 Huilgol SC, Neill S, Barlow JR. CO2 laser therapy of vulval lymphangiectasia
and lymphangioma circumscriptum. Dermatol Surg 2002; 28: 575–577.
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lymphangiectasias of the thigh and vulva with a carbon dioxide laser. Acta
Derm Venereol 1999; 79: 335.
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the vulva: palliative treatment by means of laser vaporization carbon dioxide.
Arch Dermatol 1990; 126: 967–968.
7 Redondo P. Vascular malformations (II) Diagnosis, pathology and
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with pulsed dye laser. Pediatr Dermatol 2001; 18: 509–510.
9 Wang LC, Krunic AL, Medenica MM et al. Treatment of hemorrhagic
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XXX Letters to the EditorLetters to the EditorLetters to the Editor
LETTERS TO THE EDITOR
Neutrophilic dermatosis of the
dorsal hands: an emerging entity
Neutrophilic dermatoses are a collection of diseases of which
Sweet’s syndrome is a protoptype. Clinical features of Sweet’s
syndrome include acute onset of painful erthematous papules,
plaques or nodules accompanied by fever and peripheral neutrophil
leucocytosis. Histologically, a dense neutrophilic infiltrate without
evidence of primary vasculitis is found.1 An acral form of Sweet’s
syndrome is recognized and now termed neutrophilic dermatosis
of the dorsal hands (NDDH).2 We report here two cases of NDDH.
The first patient was an 80-year-old Chinese woman with newly
diagnosed myelodysplastic syndrome. She developed a bulla on
the dorsum of her right hand and a purplish, bruise-like patch
over the dorsum of her left hand. Both areas were previous sites
of intravenous (IV) cannulation. Within a few days, the lesions on
both hands expanded into large haemorrhagic, oedematous plaques
(Fig. 1). Her C-reactive protein and erythrocyte sedimentation
rate were markedly raised. A skin biopsy revealed dermal oedema
and an infiltrate of neutrophils, lymphocytes with extravasated
red blood cells. Tissue cultures were negative. Based on the clin-
ical and histological findings, NDDH was diagnosed. High-dose
prednisolone and cyclosporine failed to control the skin lesions.
She was subsequently given IV immunoglobulin for refractory throm-
bocytopaenia. With this regimen, the plaques finally began to resolve.
Unfortunately, she subsequently died from nosocomial pneumonia.
Figure 1 Eyelid lymphangiectasia before treatment.
Figure 2 Eyelid lymphangiectasia after treatment.