Bilateral inguinal hernia with dislocation of great saphenous vein as complication of long‐standing granulomatous slack skin: a case report

• Published in: Journal of the European Academy of Dermatology and Venereology Vol. 20; no. 5; pp. 595 - 598
• Main Authors: Benedetti, M, Niebel, T, Tinozzi, FP, Vassallo, C, Brazzelli, V, Paulli, M, Borroni, RG, Borroni, G
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.05.2006
• Subjects: Dermatologic Surgical Procedures; elastolysis; Granuloma - complications; Granuloma - pathology; Granuloma - surgery; hernia; Hernia, Inguinal - etiology; Hernia, Inguinal - pathology; Hernia, Inguinal - surgery; Humans; interferon alpha2a; life style; Male; Middle Aged; mycosis fungoides; Mycosis Fungoides - complications; Mycosis Fungoides - pathology; Mycosis Fungoides - surgery; Recurrence; Saphenous Vein - pathology; Skin - pathology; Skin Neoplasms - complications; Skin Neoplasms - pathology; Skin Neoplasms - surgery; slack skin
• ISSN: 0926-9959; 1468-3083
• DOI: 10.1111/j.1468-3083.2006.01575.x

Granulomatous slack skin (GSS) represents a rare variant of mycosis fungoides, histologically characterized by a variably deep T helper lymphocytes infiltrate with alteration of the dermal elastic tissue and consequent elastolysis, elastophagocytosis and numerous giant cells. Clinically, a development of unelastic, slack skin, especially on flexural areas, is observed. Hereby, we describe a man with a 12‐year history of GSS. In 2002, for practical (limitation of movement, deambulation) and cosmetic reasons, he underwent the surgical excision of loose and sagging skinfold over inguinal area, and, afterwards, of the opposite affected inguinal skin. The surgical treatment of bilateral inguinal hernia with reposition of inguinal dislocated vasculature is also reported. In both cases the excised material confirmed the former diagnosis of GSS and revealed a very deep, muscular infiltrate of neoplastic lymphocytes. One year later, a new excision of GSS on the axillae was made. Now, after 2 years, deambulation keeps improving, although an initial relapse of the inguinal slack skin has been observed.