[Cutaneous lymphangioma. Value of the scanner. Pathogenic hypothesis and therapeutic implications]

The authors report the case of a 10-year-old child with a cutaneous lesion of the thigh present since birth and made up of small translucid raised areas grouped in clumps. The association with these pseudo-vesicles of erysipelatous exacerbations 3 or 4 times a year and the discharge of clear fluid indicative of lymphorrhoea led to a clinical diagnosis of complicated cutaneous lymphangioma. CT scan of the thigh showed absence of spread to deeper layers. This case serves as a basis for discussion of the pathogenic hypothesis of Whimster suggesting that the superficial vesicles are connected to larger lymphatic chambers in the subcutaneous tissue and that the course depends upon pressure variations within these chambers. If this were the case, surgical excision of these lymphatic chambers would be a logical alternative to symptomatic medical treatment of inflammatory episodes.