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ABSTRACT: Background: Depilatory radiotherapy was used in the sixties as a treatment for ringworm in Tunisia. Subsequently some of these patients developed radio-induced carcinomas of the scalp. aim: To present the epidemiological, clinical, pathological,therapeutic features and out come of radio-induced cutaneous carcinomas. methods: We conducted a retrospective study performed in the dermatology department of the La Rabta hospital of Tunis over a 6- year-period recording all histologically confirmed carcinomas in patients irradiated in childhood for tinea capitis. results: Thirty one patients were included with 49 tumors: 47 basal cell carcinomas and 2 squamous cell carcinomas. The average latent period between the irradiation and the appearance of the carcinomas was of 35.7 years. The average age was 53 years. A male predominance was noted, with a sex ratioM/F of 6.75. Clinically, basal cell carcinomas were nodular in all cases. Surgery was indicated in 90% of cases. Cryosurgery and radiotherapy were used respectively in 1 and 2 patients. Conclusion: Our study shows that radio-induced cutaneous carcinomas are widely dominated by basal cell carcinoma. They arise, approximately, ten years earlier than carcinoma in patients with no history of scalp irradiation. However X-ray exposure does not seem to influence clinical or histological presentation, therapeutic modalities nor prognosis of these tumors. The prognosis of radioinduced cutaneous carcinomas was globally similar to that of other cutaneous carcinomas with same histological type and equivalent degree of invasion.
La Tunisie médicale 03/2013; 91(3):191-5.
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ABSTRACT: Background: Squamous cell carcinoma (SCC) is one of the most common malignant tumors of the lips (90%). The prognosis of these SCC seems to be poor thus here periorificial localization. Aim: To present the epidemiological, clinical, pathological, therapeutic features and out come of SCC of the lips. Methods: we conducted a retrospective study performed in the dermatology department of the La Rabta hospital of Tunis over a 11-year-period [2000-2010] recording patients with histologically confirmed SCC of lips. Results: Thirty patients were included (26 men and 4 women) with an average age of 63 years. The most frequent risk factors were smoking and chronic sunlight exposure. The occurrence of the labial SCC on a precursor lesion was noted in 11 cases. It occurred more frequently on the lower lip (80%). Tumor was ulcero-vegetant in 21 patients. Twenty patients had a commune SCC, 19 of them were well-differentiated. Surgery was indicated in 18 cases and 10 patients were treated by exclusive radiotherapy. Lymph nodes metastases were noted in 2 cases. No visceral metastasis was observed. During the period of follow-up (20.12 months), two patients died. Conclusion: The diagnosis of SCC of the lips is late and the treatment often mutilating. The improvement of the prognosis depends not only on the early diagnosis and the treatment of the precursors, but also on the photo protection and alcohol and smoking eviction.
La Tunisie médicale 02/2013; 91(2):148-53.
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ABSTRACT: Lichen planus pemphigoides (LPP) is a rare autoimmune blistering disease. It appears to be combination of lichen planus and bullous pemphigoid. We describe four new cases of LPP and discuss the epidemiological, clinical, pathological, and therapeutic features of this singular association through a review of the 74 published cases within the English literature. We report four cases of LPP (three women aged respectively 47, 51, and 53 years old, and a 53-year-old man). All patients presented with bullae on lichenoid and normal skin, predominately on the extremities. The diagnosis was confirmed by immunohistological findings. Our patients were treated with oral corticosteroids with a good response. Our review of the literature of 78 cases of LPP (65 adults and 13 children) showed that it involved adults (mean age: 54 years), with a slight female preponderance. A mean lag time between LP and the development of LPP was 8.3 months. LPP is characterized by developing blisters on lichenoid lesions and on uninvolved skin with more acral distribution of bullous lesions. Involvement of palms and soles was more frequent in children. The diagnosis is based on pathological and immunological confrontation. LPP is usually idiopathic, but some cases were reported in association with various drugs. There have also been reports of association with internal malignancy. Most cases of LPP are successfully treated with systemic corticosteroids. In most cases, the prognosis was good.
International journal of dermatology 01/2013; · 1.18 Impact Factor
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A Hawilo,
Amel Mebazaa,
Sonia Trojjet,
H Zribi,
Rim Cheikh Rouhou, Ines Zaraa,
H Azzouz,
Dalenda El Euch,
Amel Ben Osman,
Moncef Zitouna,
Mourad Mokni
La Tunisie médicale 06/2012; 90(6):499-501.
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ABSTRACT: Kaposi's sarcoma (KS) is a mutifocal angiogenic process characterized by cellular and vascular proliferation.
To identify the epidemio-clinical, histological and therapeutic features of KS.
Retrospective study of 75 cases of KS at the dermatology department of Rabta hospital in Tunis during a period of 25 years (1982-2007).
Three epidemio-clinical forms of KS were observed in our study: the classic KS (70 cases), the AIDS-related KS (4 cases) and the iatrogenic KS (1 case). The mean age of our patients at diagnosis was 69.16 years with a sex ratio of 2.33. Elective site of cutaneous lesions in the classic KS was the limbs (87.1%). The cephalic part was concerned in 17.1% of cases. Mucosal involvement was found in 28.5% of patients. Extra dermatological localizations of KS were observed in 32.9%.
Our study identified some epidemio-clinical features of the classic KS especially the high frequency of mucosal and cephalic involvement as well as extra dermatological localizations. Thus further exploration is required even without alarm signs.
La Tunisie médicale 02/2012; 90(2):116-21.
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ABSTRACT: Retronychia, described in 1999, is a rare entity of ingrown toenails. Embedding of the nail into the proximal nail fold (PNF) leads to chronic inflammatory changes. Herein, we report a new case that exhibited persistent paronychia in a 23-year-old woman. Retronychia usually does not recur once treated with avulsion. It should be suspected in the event of chronic proximal paronychia.
Dermatology online journal 01/2012; 18(6):9.
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ABSTRACT: the erythrodermic psoriasis (EP) is a rare but severe form of psoriasis that may be potentially life-threatening.
To study the characteristics of this severe form of psoriasis.
We present a retrospective study, including all cases of EP followed in the dermatology department of the La Rabta hospital of Tunis over a 31-year-period from January, 1980 to June, 2010.
sixty patients were included, concerning 46 men and 14 women, with an average age of 53.7. A history of psoriasis was reported in 78 % of the cases. A triggering factor was found in 53 % of the cases. Systemic treatments were required in 55 % of cases. An improvement was noted in 69.4 % of the cases. A recurrence of the EP was observed in 15% of the cases. Three cases of sepicemia and one of stroke were noted.
Erythrodermic psoriasis is the most common etiology of erythroderma. It represents more than half of severe psoriasis. As shown in our study it affects mainly adults' males. It complicates usually a common psoriasis. Septic and thromboembolic complications ones justify a close follow up.
La Tunisie médicale 11/2011; 89(11):841-7.
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ABSTRACT: Autoimmune bullous dermatoses (ABD) are a rare but significant group of cutaneous disorders posing great diagnostic and therapeutic challenges to the treating dermatologist. Few surveys have been carried out to describe the whole spectrum of ABD in a region.
To determine the clinicoepidemiological features of various ABD.
We retrospectively recruited all ABD cases seen during an 11-year period (1997-2007).
One hundred and seventy-four patients were involved (16.3 cases/year). Pemphigus was observed to be the most common ABD (53%), with the majority being pemphigus vulgaris (61%) vs. 36% of pemphigus foliaceus (Tunisian pemphigus).
Most epidemiological surveys have focused on a single or just one group of ABD. In our series, pemphigus foliaceus was relatively more prevalent than in occidental data. The frequencies of subepidermal immunobullous dermatoses in our study were in agreement with those in the literature.
International journal of dermatology 08/2011; 50(8):939-44. · 1.18 Impact Factor
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ABSTRACT: Background Autoimmune bullous dermatoses (ABD) are a rare but significant group of cutaneous disorders posing great diagnostic and therapeutic challenges to the treating dermatologist. Few surveys have been carried out to describe the whole spectrum of ABD in a region.Objective To determine the clinicoepidemiological features of various ABD.Methods We retrospectively recruited all ABD cases seen during an 11-year period (1997–2007).Results One hundred and seventy-four patients were involved (16.3 cases/year). Pemphigus was observed to be the most common ABD (53%), with the majority being pemphigus vulgaris (61%) vs. 36% of pemphigus foliaceus (Tunisian pemphigus).Discussion Most epidemiological surveys have focused on a single or just one group of ABD. In our series, pemphigus foliaceus was relatively more prevalent than in occidental data. The frequencies of subepidermal immunobullous dermatoses in our study were in agreement with those in the literature.
International journal of dermatology 07/2011; 50(8):939 - 944. · 1.18 Impact Factor
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La Presse Médicale 06/2011; 40(12 Pt 1):1203-4. · 0.67 Impact Factor
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ABSTRACT: Erythema nodosum (EN) in association with kerion celsi is a rare condition in children, with only 11 cases having been reported in the English literature. We describe a new case in a 7-year-old boy in whom the disorder had begun 2 months before. He had many inflamed, boggy, suppurative nodules over the left occipitoparietal area of the scalp and, 2 weeks later, developed multiple painful, erythematous subcutaneous nodules of the shins, thighs, and upper limbs. EN was confirmed by histologic examination. Our review of the literature of all cases of EN during kerion showed that it usually occurs at or slightly after the height of infection or after drug introduction. Trichophyton mentagrophytes was involved in the majority of cases, and improvement of EN usually occurs with griseofulvin.
Pediatric Dermatology 06/2011; 29(4):479-82. · 1.07 Impact Factor
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Acta Dermato-Venereologica 03/2011; 91(3):380, 384.
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ABSTRACT: Drug-induced lupus erythematosus is defined as a lupus-like syndrome temporally related to a drug exposure. We report a 34-year-old woman with multiple sclerosis who developed, while being treated with interferon β-1a, myalgia and associated with wrist synovitis. Clinical and immunologic investigations were in favor of systemic lupus erythematosus. Interferon therapy was maintained. Under corticosteroids and antipaludeen treatment, the patient did not develop any other lupic manifestations.
Fundamental and Clinical Pharmacology 02/2011; 26(2):210-1. · 1.80 Impact Factor
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ABSTRACT: Chronic urticaria (CU) is a common condition. Usually benign, it can be debilitating. The main step was to identify the potential causes of CU to institute the strategy for management of patients.
To present the epidemiological, clinical and therapeutic features of CU.
233 cases of CU were enrolled through a retrospective study conducted in the dermatology department of La Rabta hospital during 10 years (1997-2006).
The mean age of our patients was about 36 years with a sex ratio of 2.28. The mean duration of the CU before the consultation was 21 months. Inducing Factors were reported in 109 cases, dominated by physical factors (73 cases). Severe symptoms as facial edema were observed in 44 cases. The CU was considered as idiopathic in 179 cases (77%). An etiology was found in 54 cases, dominated by physical origin, noted in 25 cases. All patients were treated by antihistaminic. Systemic corticosteroids were associated in 41 patients. Partial improvement was the mainly outcome (166 cases).
CU is a frequent disease which the diagnosis is based on clinical exam. The causes of CU were numerous and sometimes intricate, that gives the etiologic courses difficult and usually disappointing.
La Tunisie médicale 11/2010; 88(11):794-8.
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International journal of dermatology 07/2010; 49(7):790-3. · 1.18 Impact Factor
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International journal of dermatology 03/2010; 49(3):298-302. · 1.18 Impact Factor
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ABSTRACT: Langerhans cell histiocytosis (LCH) and malignancy occurring in the same individual is unusual and has generally been the subject of isolated case reports. LCH is a rare condition in adults. Its cause is uncertain but, with the recent demonstration of clonality and its association with malignant disease, there has been a renewal of interest. We report a singular case of Letterer-Siwe disease associated with a chronic myelomonocytic leukemia developing in an elderly woman. The simultaneous occurrence of both malignant disorders supports the hypothesis of a common genetic origin.
Acta dermatovenerologica Alpina, Panonica, et Adriatica 03/2010; 19(1):45-8.
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ABSTRACT: Linear IgA bullous dermatosis (LAD) of children is relatively frequent in Africa. We undertook this study to evaluate the frequency of this disease among autoimmune bullous diseases (AIBD) in Tunisian children.
We present a 32-year retrospective study (January 1976 to December 2007). Children with chronic acquired bullous diseases seen at the Charles Nicolle Hospital of Tunis and for whom direct immunofluorescence (DIF) of the perilesional skin demonstrated linear IgA immunoglobulin deposits were included in the study population.
Thirty-one children with LAD were collected representing 65.9 percent of all AIBD of children collected in the same period, with a mean age of 5.5 years and a sex ratio M/F of 2.4. Most of the children had a generalized eruption (28/31) but more profuse on the face, pelvic region, buttocks, and limbs. Mucosal lesions were present in only 4 children (12.9%). The mean duration of the disease was 14 months. Direct immunofluorescence demonstrated predominantly linear IgA deposits along the dermal-epidermal junction in all patients. Faint IgG, IgM, and complement were also seen (20/31). Indirect immunofluorescence was negative in 67 percent of cases. Eight patients responded to Dapsone, but prednisone had to be added in 7 children and erythromycin in 4 others to control the disease. A long term remission period (34 months) was achieved in 61.9 percent of patients.
This study confirms that LAD is the most common AIBD in children in Tunisia and it frequently occurs in preschool-aged males. Independently of the medication chosen for treatment, a long term remission is frequently observed.
Dermatology online journal 01/2010; 16(1):2.
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ABSTRACT: Behçet's disease (BD) is a systemic inflammatory disease involving many systemic lesions characterized by vasculitis as a common basic pathologic process. Mucocutaneous (MC) features are considered as the diagnostic hallmarks.
To retrospectively determine the epidemiological and clinical aspects of BD mucocutaneous symptoms in Tunisia compared to those found in the literature.
Twenty-eight patients were involved in a single-center dermatological recruitment for a 27-year period (1980-2007) on the basis of international BD criteria.
Our series included 19 males and 9 females. The mean age at onset was 28 years and the mean age at diagnosis was 37.9 years. The frequency of MC manifestations was as follows: oral ulcers (100%), genital ulcers (92.8%), other cutaneous signs (82.1%) such as papulopustular lesions (53.5%), and dermohypodermal nodes (11.53%), aphthous cutaneous ulcers (17.8%), and other lesions (leg ulcer: three cases, erythema multiform: one case, and infected pyodermatitis: one case). Systemic manifestations were present in 18 patients.
MC manifestations are hallmarks of the disease and usually the onset symptoms. The frequencies of the various MC signs seen in our study broadly match those found in the literature.
Acta dermatovenerologica Alpina, Panonica, et Adriatica 01/2010; 19(2):11-5.
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International Journal of Infectious Diseases 10/2005; 9(5):288-9. · 1.94 Impact Factor
