Kératoacanthomes et xeroderma pigmentosum

A girl with xeroderma pigmentosum has developed seven successive keratoacanthomas on the face, since the age of 5, during a period of two and a half years. The clinical diagnosis of keratoacanthoma was obvious for most lesions. Three keratoacanthomas have been removed and the diagnosis has been confirmed histologically. The four more recent lesions have regressed without any surgical treatment. No impairment of the cell-mediated immune function has been noticed (there is no failure in D.N.C.B. sensitization; the level of the blastogenic transformation after phytohaemagglutinin stimulation lies within limits of normal values obtained from control subjects). Keratoacanthoma is an uncommon complication of xeroderma pigmentosum, since only 15 other cases (2 of them are successive keratoacanthomas) have been reported in the literature. In a recent publication, it has been stressed that a deficit of cell mediated immunity can be associated with xeroderma pigmentosum. Such a deficit has also been observed in a patient with multiple keratoacanthomas. In contrast with those reports, no failure of cell mediated immunity has been observed in our patient, as far as provocative tests are concerned.