Erythema scarlatiniforme desquamativum recidivans (Féréol-Besnier)--report of three cases localized to the thumb.

Case Reports Patient 1. A 22-year-old woman, without notable medical history, without current medication, had complained for 1 year of recurrent episodes of erythema, followed by swelling, itching and desquamation to the distal portion of the right thumb ( fig. 1 a–c). The disease lasts about 2 weeks, it is self-remitting, and relapses are observed every month. The patient does not describe any trigger factor, in particular neither infections nor drugs, and does not present any prodromal phase. Blood analysis including white blood cell count, liver and renal function were normal, except a slight elevation of the blood sedimentation rate (38 mm/h). Bacterial culture of the pharyngeal cavity revealed a normal flora. Patient 2. A 66-year-old man was referred in April 2001 to our consultation due to recurrent episodes of erythema, swelling and lamellar peeling of his left thumb for 3 years ( fig. 2 ). He had recently been operated for a tubulovillous adenoma of the ileocaecal valve. These manifestations were just preceded by a slight general malaise, and no clear trigger factor was identified. The patient has presented about 5 episodes per year, and the evolution was spontaneously favourable in each case. Topical treatment with topical corticosteroids, vitamin D derivates or salicylic acid creams did not change the course of the disease. All the laboratory findings (blood count, blood sedimentation rate, liver thyroid and renal function, prostate and bowel tumour markers) and the swab of the pharyngeal cavity were normal. Patient 3. A 65-year-old woman had developed her first episode of erythema, swelling and scarlatiniform peeling of the right thumb ( fig. 3 ) in January 2006, without prodromal phase. No trigger factor was identified except a dental operation 6 weeks before.