{'fraction_non_alphanumeric': 0.025241276911655532, 'fraction_numerical': 0.005196733481811433, 'mean_word_length': 5.401425178147268, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Acroangiodermatitis with pincer nail of the finger due to venous hypertension from hemodialysis arteriovenous shunt

given low-dose oral etoposide, 50 mg three times a week. A rapid and spectacular response was noticed after three days of treatment with complete regression of the pruritus. However, he developed many infections, therefore etoposide was interrupted, each time followed by a rapid relapse of the pruritic eruption. Finally, after six months of treatment, we noticed regrowth and repigmentation of his hair, even though this elderly patient had been bald and grey-haired for several years (figure 1). Hair texture was not modified. Unfortunately, he died from haematological acutisation due to the MDS, 30 months after the diagnosis. In 2013, a group of non-blastic MDS skin lesions was identified and referred to as “myelodysplasia cutis” [4]. Typical clinical features are erythematous plaques with an annular pattern, associated with fever and arthralgia. They may precede MDS diagnosis by several months. In our patient, pruritus, refractory to topical treatments, was the main concern, a presentation not previously described, and the clinical presentation resembled that of chronic myelomonocytary leukaemia with cutaneous affected areas. Treatment is difficult, as the haematological disorder is classified as an indolent disease, therefore chemotherapy is usually not given. High-dose oral prednisone was shown to be effective, but with steroid dependence. Etoposide is an antineoplasic drug used mostly as polychemotherapy for testicular and lung cancers, or in a bone marrow transplant setting. Low-dose oral etoposide has shown a 42% haematological response rate in patients with MDS or chronic myelomonocytic leukaemia, with a median response of nine months [5]. It has not previously been proposed for cutaneous MDS. Rapid improvement after treatment introduction supported the effectiveness of etoposide for cutaneous MDS, however, it failed to stop medullar progression and its effect appeared limited in time, as the patient relapsed following each interruption of the treatment. Cytotoxic alopecia is a frequent and transitory side effect of etoposide, linked to inhibition of mitosis, however, hair regrowth has not previously been reported. In addition, we observed a modification in hair colour, a finding previously described with tyrosine kinase inhibitors or thalidomide [6]. The physiopathology of drug-induced recolouration is poorly understood. A direct effect from MDS cells through cytokines may have been at the origin of hyperpigmentation and hair regrowth. However, there is no evidence in the literature regarding hair changes associated with MDS.