Background: The naevoid basal cell carcinoma syndrome (NBCCS) is a therapeutic challenge due to the multiplicity of cutaneous tumours. Photodynamic therapy (PDT) is increasingly used as an alternative treatment for superficial and in some countries nodular basal cell carcinomas (BCC). Objective: To study the safety and efficiency of PDT in NBCCS. Methods: We reviewed retrospectively the evolution of 62 lesions from patients with multiple BCC treated with PDT. Results: The initial response rate (85.4%, 53/62) and recurrence rate (7.5%) appeared comparable to literature values in NBCCS and to those reported in the treatment of sporadic BCC. The clearance rate without recurrence was 79% (49/62), during a mean follow-up period of 13 months. The cosmetic outcome was excellent. Recurrences were found almost 2 years after treatment. Conclusion: PDT is a suitable therapeutic option in the management of NBCCS patients but requires a strict and long follow-up.

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Atopic dermatitis (AD) is not regarded as a predisposing condition for cutaneous T cell lymphoma. Cyclosporine (CsA) is an efficient therapy in AD, and its side effects, including lymphocytic proliferation, are rare at the low dose used in such cases. So far 3 cases of patients who developed cutaneous T cell lymphoma under CsA treatment for atopy have been described. An adult patient with a history of AD received CsA therapy because of an atypical flare-up of his eruption. He rapidly developed papular atypical lesions, then followed by the onset of a voluminous cutaneous tumor leading to the diagnosis of mycosis fungoides (MF) transformed in CD30+ large cell lymphoma with nodal and blood involvement. No improvement occurred after withdrawing of CsA, and he required a polychemotherapy and an allograft. This case illustrates the dramatic evolution of an MF under CsA given in the hypothesis of AD. It stresses the fact that skin biopsies should be taken in case of atypical AD to rule out MF and avoid such an aggressive evolution under immunosuppressive therapy.

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