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Elfatoiki F.-Z.,Service de Dermatologie Venerologie | Zouhair K.,Service de Dermatologie Venerologie | Belhaj S.,Service dAnatomie Pathologique | Marnissi F.,Service dAnatomie Pathologique | Benchikhi H.,Service de Dermatologie Venerologie
Nouvelles Dermatologiques | Year: 2013

Papular mucinosis is a rare dermatological disorder defined by papules, nodules or plaques resulting from mucin deposits in the dermis. We report the case of papular mucinosis reveal-ing dermatomyositis. The treatment based on oral corticosteroids 1 mg/kg/j associated to topical corticosteroids induced remission. © 2013 Nouv Dermatol.


Bouras M.,Service de Dermatologie venerologie | Hali F.,Service de Dermatologie venerologie | Khadir K.,Service de Dermatologie venerologie | Addi H.,Service dEndocrinologie | And 2 more authors.
Annales de Dermatologie et de Venereologie | Year: 2014

Background Herein we report a rare case of acquired palmoplantar keratoderma in association with myxoedema and hypothyroidism. Patients and methods A 53-year-old woman presented with palmoplantar keratoderma, dry skin, muscular weakness and cramps for 9 months. The laboratory work-up revealed autoimmune thyroiditis with hypothyroidism. Skin biopsy showed chronic eczema. Other causes of acquired palmoplantar keratoderma were ruled out. Rapid improvement was achieved within 3 weeks of institution of hormone replacement therapy. Discussion Although this association is very rare, hypothyroidism must be suspected in patients with acquired palmoplantar keratoderma, particularly when it occurs in association with systemic symptoms. © 2013 Elsevier Masson SAS. All rights reserved.


PubMed | Service de dermatologie venerologie and Service de pediatrie 5
Type: Journal Article | Journal: Archives de pediatrie : organe officiel de la Societe francaise de pediatrie | Year: 2016

Juvenile dermatomyositis (JDM) is a rare disease, with a mean age of onset of 7years. We report a case of JDM in a 13-month-old infant.A 13-month-old infant presented with an edema of the upper lip, 4days after receiving amoxicillin-clavulanate. The patient was treated with betamethasone and an antihistamine. Progression was marked by the appearance of a white edema of the periorbital area and the upper lip, with purpuric lesions, aphthoid ulcerations, and a drooping head. Very high muscle enzymes, a myogenic electromyogram, and hypertrophic cardiomyopathy were found and diagnosis of JDM was retained. The patient was treated with a high dose of corticosteroids and methotrexate. Before the installation of dysphagia, dysphonia, and axial hypotonia, the bolus of cyclophosphamide was administered, with clear improvement. Corticosteroids and methotrexate were then kept over the long term.The originality of this observation of JDM resides in the very young age of onset of the disease, its unusual cutaneous signs including labial edema extending to the regions around the eyes, its severe muscle manifestations causing axial hypotonia, and finally, in its association with hypertrophic cardiomyopathy. Early initiation of treatment (12 days after the onset of symptoms) greatly improved the prognosis of this form of JDM, which is very severe and refractory to first-line therapy.


Chiheb S.,Service de Dermatologie venerologie | Oudrhiri L.,Service de Dermatologie venerologie | Zouhair K.,Service de Dermatologie venerologie | Soussi Abdallaoui M.,Laboratoire Of Parasitologie Mycologie | And 2 more authors.
Annales de Dermatologie et de Venereologie | Year: 2012

Introduction: Cutaneous leishmaniasis (CL) is a parasitic infection characterized by significant clinical variability. Unusual and atypical clinical aspects of infection have been reported in immunodeficient patients or associated with particular parasite species. We report three cases of CL from foci of Leishmania major with a particular clinical presentation in diabetic patients. Observations: Patient 1: a 37-year-old man was admitted to the dermatology department for cutaneous vegetative ulcers spreading to the dorsal surface of the foot. History-taking revealed a stay in Er-Rachidia (East of Morocco, a known focus of CL L. major) six weeks earlier. Diabetes mellitus type I was discovered during hospitalization. The patient's 43-year-old sister (patient 2), diabetic for 6 years, consulted for a single leg ulcer appearing 3 months after the same trip to Er-Rachidia. Patient 3: a 61-year-old patient with a 7-year history of diabetes and under oral antidiabetics presented an extended vegetative lesion of the posterior surface of the leg 2 months after staying in Er-Rachidia. A diagnosis of CL was retained on the basis of epidemiology and history (living in an endemic areas of leishmaniasis), coupled in patients 1 and 3 with microbiological evidence involving identification of Leishmania bodies in skin smears or skin biopsies. All patients were treated with two intra-lesional injections per week of meglumine antimony (Glucantime®) for 6 weeks. The outcome was marked in all cases by healing of lesions and persistent pigmented scarring. Discussion: We described three particular clinical aspect of CL emerging from a known focus of L. major, where infection is classically associated with vegetative or ulcero-vegetative lesions. This unusual profile suggests the role of factors related to parasite species and/or diabetes found in our three patients. © 2012 Elsevier Masson SAS. Tous droits r éservés.


Cheikhrouhou F.,Laboratoire Of Parasitologie Mycologie | Makni F.,Laboratoire Of Parasitologie Mycologie | Masmoudi A.,Service de dermatologie venerologie | Sellami A.,Laboratoire Of Parasitologie Mycologie | And 2 more authors.
Annales de Dermatologie et de Venereologie | Year: 2010

Background: Dermatophytic disease is a rare chronic infection caused by dermatophytes and characterised by cutaneous and visceral invasion. It is observed in North Africa. It is associated with cellular immunodeficiency and refractoriness to drug treatment. Case Report: We report a new case of dermatophytic disease in a 26-year-old Tunisian woman. The patient's parents were first cousins; no other family members had a similar disease state. At the age of 3 years, the patient developed extensive tinea corporis associated with onychomycosis resistant to the usual antifungal drugs. The patient was hospitalised for multiple subcutaneous vegetative and ulcerative lesions of the scalp, face and chest associated with multiple adenopathies, occasionally fistular, of the axillary, cervical, mammary and inguinal areas. Mycology and histology confirmed the presence of fungal hyphae. Trichophyton violaceum was isolated in cultures of various skin lesion and lymph node biopsy samples. Investigations showed no evidence of immunodeficiency. Although the patient initially responded well to itraconazole (Sporanox®, 400 mg/day), her condition worsened with obstruction and dyspnoea due to retropharyngeal pus collection requiring repeated surgical evacuation, and ultimately leading to a fatal outcome. Discussion: Dermatophytic disease remains a severe disease due to the possibility of potentially life-threatening visceral involvement and antifungal drug resistance. © 2010 Elsevier Masson SAS. All rights reserved.


Chiheb S.,Service de Dermatologie venerologie | Haim H.,Service de Dermatologie venerologie | Ouakkadi A.,Service dAnatomopathologie | Benchikhi H.,Service de Dermatologie venerologie
Annales de Dermatologie et de Venereologie | Year: 2015

Background.-Nail lichen planus (NLP) occurs in 10% of patients with disseminated disease butit can also occur in isolation. The outcome of treatment is usually disappointing and data aboutits long-term prognosis are lacking.Study aim.-To study clinical features, response to treatment and follow-up of a series of 20patients with NLP.Patients and methods.-A descriptive study was conducted of 20 patients with histologicallyconfirmed NLP seen at consultations for nail disorders between September 2009 and April 2013.Results.-The mean age was 35 years (9-56 years) with no gender preponderance. Fortypercent of patients were children. Stress was an evident triggering factor in 20% of patients.The mean duration was around 48 months (2 months to 10 years). Only 25% of patients hadextra-ungual lesions. All 20 nails were affected in 55% of patients. Nail matrix involvement wasobserved in 85% of cases and 55% had nail-bed involvement. Twenty-five percent of patientswere presenting severe involvement such as pterygium or anonychia. Intramuscular corticos-teroids were given to 10 patients. In 80% of patients, the NLP was limited or regressed rapidlyfrom the third injection. The average follow-up was 24 months.Discussion.-Our study highlights the frequency of paediatric forms and of often aestheticallyunacceptable nail scarring. Early diagnosis of NLP, notably in children, would allow initiation ofadequate treatment that could perhaps limit the risk of such sequelae. © 2014 Elsevier Masson SAS. All rights reserved.


Kourouma S.,Service de dermatologie venerologie | Sangare A.,Service de dermatologie venerologie | Kaloga M.,Service de dermatologie venerologie | Kouassi I.,Service de dermatologie venerologie | And 6 more authors.
Medecine et Sante Tropicales | Year: 2014

Background: Cutaneous bullous adverse drug eruptions are a dreaded complication of drug use. Objective: The purpose of this study was to document the epidemiological features, outcomes, and causes of these reactions, in particular, Stevens-Johnson syndrome and toxic epidermal necrolysis (Lyell disease), in a teaching hospital in Abidjan (Côte d'Ivoire). Patients and Methods: A retrospective study reviewed the records of severe cutaneous drug reactions in patients managed in the dermatology department of the University Hospital of Treichville (Abidjan) over a period of ten years (from September 2000 through August 2010). Results: These diseases were diagnosed in 185 patients during the study period. Their mean age was 31.8 years (range: 2-70 years) and the M/F sex ratio was 0.6 The most frequent reactions, as expected, were Stevens-Johnson syndrome (73%) and toxic epidermal necrolysis (27%). The drugs most commonly involved were the antibacterial sulfonamides (22.1%), followed by the antiviral nevirapine (11.1%), and the antimalarial agent, sulfadoxine/pyrimethamine. The fatality rate was 22.5%, including 46% of the patients with toxic epidermal necrolysis and 14.6% of those with Stevens-Johnson syndrome. Respiratory distress (39.5%) and dehydration (23.4%) were the primary direct causes of death. Conclusion: Antibacterial sulfonamides are the leading drugs implicated in the occurrence of bullous drug eruptions in Abidjan.


PubMed | Center hospitalier Aioun, Service de dermatologie venerologie, Service des maladies infectieuses et tropicales and Departement de sante publique Hopital national Donka.
Type: Journal Article | Journal: Medecine et sante tropicales | Year: 2017

Anthrax disease is an anthropozoonosis caused by a Gram-positive bacterium, Bacillus anthracis. Our objective was to describe the epidemiological, clinical and therapeutic features of the 2014 epidemic in Koubia prefecture. This retrospective study examined all of the anthrax cases reported in Fafaya, Koubia Prefecture. In March and April 2014, there were 39 cases of human anthrax reported, for an incidence of 1.135%. The mean age was 20.9 ( 18.3) with a sex ratio of 2.54 (28/11) in favor of men. Seventy-six percent (23/39) were single. More than one half were students (53.8%). The main clinical signs were fever in 71, 8% (n = 28 /), papules 59% (n = 23), vesicles of 59% (n = 23) Digestive and cutaneous signs represented 35.9 % and 64.1% respectively; 35% had ingested contaminated meat and 17.95% were in direct contact with a sick animal. We didnt find any correlation between the mode of infection and onset of signs. The fatality rate was 28.21%. The 2014 epidemic of anthrax disease in the Koubia prefecture was marked by a high incidence and lethality. Clinical manifestations were cutaneaous and digestive. These results may serve further interventions to fight against anthrax disease. They should mainly focus on an awareness of peasants, surveillance and vaccination of cattle. Other studies seem to be necessary.


PubMed | Service de dermatologie venerologie
Type: Case Reports | Journal: Annales de dermatologie et de venereologie | Year: 2012

A cutaneous adverse drug reaction is a skin eruption secondary to the intake of a drug, be it prescribed by a medical practitioner or taken as auto-medication for a given ailment. In this document we present an original case of Stevens-Johnsons syndrome secondary to the ingestion of gunpowder.A 22-year-old female student was hospitalised for diffuse and painful skin eruptions for the previous three days. She had complained six days earlier of an allergic reaction to pineapples, an allergy she had presented for quite a long time. In an attempt to remedy the situation, her mother made her drink a solution made of gunpowder bought at a market mixed with some water. On the third day of this treatment, the patient noticed eruptions on her skin. These were initially maculopapular, later becoming erosive, and she had a mild fever. Later, a variety of eruptions appeared on the skin, from hyper-pigmented macular papules to blisters and erosive lesions with no Nicolsky sign. These lesions spared the palms of the hands and the soles of the feet. The mucosa of the conjunctivae, nose, buccal cavity, vulva, vagina and anus were severely affected. This clinical presentation was typical of Steven Johnson syndrome. The patient had stopped taking the treatment when she noticed the first lesions. On therapy, the outcome was favourable, except for severe complications such as synechiae with diffuse dyschromia.To the best of our knowledge this is the first time gunpowder has been incriminated in Stevens-Johnsons syndrome.


PubMed | Service de dermatologie venerologie
Type: Case Reports | Journal: Annales de dermatologie et de venereologie | Year: 2012

Cutaneous leishmaniasis (CL) is a parasitic infection characterized by significant clinical variability. Unusual and atypical clinical aspects of infection have been reported in immunodeficient patients or associated with particular parasite species. We report three cases of CL from foci of Leishmania major with a particular clinical presentation in diabetic patients.Patient 1: a 37-year-old man was admitted to the dermatology department for cutaneous vegetative ulcers spreading to the dorsal surface of the foot. History-taking revealed a stay in Er-Rachidia (East of Morocco, a known focus of CL L.major) six weeks earlier. Diabetes mellitus type I was discovered during hospitalization. The patients 43-year-old sister (patient 2), diabetic for 6 years, consulted for a single leg ulcer appearing 3 months after the same trip to Er-Rachidia. Patient 3: a 61-year-old patient with a 7-year history of diabetes and under oral antidiabetics presented an extended vegetative lesion of the posterior surface of the leg 2 months after staying in Er-Rachidia. A diagnosis of CL was retained on the basis of epidemiology and history (living in an endemic areas of leishmaniasis), coupled in patients 1 and 3 with microbiological evidence involving identification of Leishmania bodies in skin smears or skin biopsies. All patients were treated with two intra-lesional injections per week of meglumine antimony (Glucantime()) for 6 weeks. The outcome was marked in all cases by healing of lesions and persistent pigmented scarring.We described three particular clinical aspect of CL emerging from a known focus of L.major, where infection is classically associated with vegetative or ulcero-vegetative lesions. This unusual profile suggests the role of factors related to parasite species and/or diabetes found in our three patients.

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