Karima Senouci’s research while affiliated with Mohammed V University and other places

Phytophotodermatitis are skin eruptions caused by contact with a plant substance and exaggerated by exposure to sunlight. They are due to the presence of furocoumarins (psoralens, xanthotoxins, and bergaptenes) in the plant and involve 2 mechanisms of skin photosensitivity: phototoxicity or photoallergy.

Drug-induced hypersensitivity syndrome or drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe drug-induced reaction that represents a life-threatening condition. The histopathologic appearance of the skin biopsy is nonspecific but may exceptionally show an atypical intralymphatic lymphocytic infiltrate, and mimic an intravascular lymphoma. Through this article, we will report an exceptional case of a patient presenting with skin lesions pointing to a dress, but whose histological appearance, in the presence of adenopathy during physical examination, can lead, by mistake, to the diagnosis of an intralymphatic lymphoma. We aim to highlight the various diagnostic indices allowing the distinction between these two entities, including the immunohistochemical study, the search for the TcR clonal rearrangement and the anatomo-clinical correlation.

Background: The aim of this study was to investigate the association between pemphigus and cancer and to analyze the characteristics of pemphigus in which a neoplasm occurs. Materials and Methods: This was a retrospective, descriptive study conducted at the Dermatology Department of Ibn Sina Hospital in Rabat from January 1993 to December 2022, including all pemphigus cases in which cancer was diagnosed before, during, or after the onset of pemphigus. Results: Among 302 pemphigus cases, 13 patients presented an associated cancer (4,3%). Only one patient had a paraneoplastic pemphigus. There was an increased incidence of various solid cancers (11/13) in deep pemphigus types yet without temporal relationship. When hematological malignancy occurred (3/13), it was mainly non-lymphoproliferative and preceded deep pemphigus types with good prognosis. Patient comorbidities and immunosuppressive treatments did not influence the onset of cancer. Conclusion: Our manuscript suggests an increased incidence of solid cancers in deep pemphigus subtypes, independently of the timeline of the latter onset. These pemphigus cases carry a good prognosis. Key words: Pemphigus, Cancer, Paraneoplastic pemphigus, Paraneoplastic autoimmune multiorgan syndrome

Mycosis fungoides is the most common variant of primary cutaneous T-cell lymphoma. Large cell transformation in mycosis fungoides is the histopathological transformation of neoplastic small lymphocytes to a clonally identical large cell phenotype. It is associated with a poor prognosis, although some patients have indolent disease. Clinically, it is manifested by ulcerated, tumoral lesions that may affect the entire body. The location in the external auditory canal has never been described before. Herein, we report the first case of transformed mycosis fungoides located in the external auditory canal. Key words: External auditory canal; Large cell transformation; Mycosis fungoides

Deep dermatophytosis is a dermal infection caused by Dermatophytes. It can cause deeper dermal dermatophytosis, Majocchi's granuloma, dermatophytic pseudomycetoma or a widespread infection. CARD9 deficiency is a known risk factor in the Mediterranean region, first reported in 1964 in Morocco. We report a case of 23-year-old man with a scarring alopecia who presented with subcutaneous abscesses topped off with a large ringworm infection. Mycotic analysis revealed a Trichophyton Rubrum deep dermatophytosis. The molecular study revealed a CARD9 mutation confirming dermatophytosis with parotid and lymph nodes involvement. The patient underwent successful drainage surgery of the abscesses alongside medical treatment including antifungal agents and he was discharged after an uneventful postoperative course.

A thirty-year-old patient presented with an erythematous papule on the left nostril evolving for ten months. A clinical examination revealed an infiltrated, erythematous, well-limited plaque with a raised border, covered with multiple open and closed comedones. On dermoscopy, there was an erythematous background with some fine telangiectasias and horny plugs at the follicular orifices. A skin biopsy was performed, revealing orthokeratotic hyperkeratosis sinking into the follicular orifices dilated by sebum clumps with basal vacuolation associated with a subepidermal and periadnexal/perivascular lymphocyte band infiltrate. Direct immunofluorescence staining for immunoglobulin M was positive. The diagnosis of lupus comedones was retained, and the patient was put on topical tacrolimus 0.1% twice a day. A systemic damage assessment was negative. Our case highlighted, the importance of recognizing this rare variant of cutaneous lupus, confused with acne vulgaris, hence the delayed diagnosis, which may also be an early sign of a concomitant systemic involvement. Key words: Acne; Chronic Cutaneous Lupus Erythematosus; Comedonal Variant; Discoid Lupus Erythematosus

Orf is a rare viral zoonosis due to Parapoxvirus infection. Transmission to humans occurs through contact with infected goats and sheep. It may be complicated by fever, lymphangitis, lymphadenopathy, bacterial infection, and erythema multiforme. Only several cases of autoimmune bullous dermatoses have been described. Bullous pemphigoid secondary to an orf was found in ten patients. Herein, we report one case of a human orf complicated by bullous pemphigoid. This is an occasional complication following an orf. Knowledge of co-occurrence allows for the better management of the affected patient. This case is reported for its rare association. Key words: Bullous Pemphigoid; Orf; Orf-Induced Immunobullous Disease