Primary Cutaneous Hodgkin's Lymphoma: An Extremely Rare Entity.

Skin involvement in Hodgkin's lymphoma (HL) is rare. The diagnosis can be difficult, mainly due to the wide range of cutaneous lesions that can be observed, but also due to the differential diagnosis, even after the immunohistochemical staining. We present the case of a 30-year-old man who presented with a painful cutaneous nodular lesion; biopsy and immunohistochemical stains were consistent with classic HL. The patient was treated with adriamycin, bleomycin, vinblastin, and dacarbazine (ABVD) with complete remission.

Leser-Trelat sign preceding male breast cancer.

INTRODUCTION: Leser-Trelat sign is a paraneoplastic marker characerized by the abrupt appearance of seborrheic keratoses. It is described in association with many underlying malignant diseases. CASE REPORT: We report a case of coexistence of two rare entities, represented by the Leser-Trelat sign occurring with male breast cancer. DISCUSSION: The asscociation of male breast cancer and LT sign is decidedly unusual. To our knowledge, our case report is the second to describe the association of these two rare entities. CONCLUSION: A proper dermatological examination and a good knowledge of cutaneous paraneoplastic syndromes can be of great help in screening for multiple skin cancers.

Healthcare resource utilization and costs associated with anogenital warts in Morocco.

BACKGROUND: Human papillomavirus (HPV), primarily genotypes 6 and 11, cause the majority of cases of anogenital warts (AGW). Although benign, AGW are associated with a substantial economic and psychosocial burden. Several vaccines have been developed to prevent HPV. The objective of this study was to describe the epidemiology and healthcare resource utilization of AGW in Morocco, as well as the associated costs of treatment from the public healthcare perspective. METHODS: This was a descriptive analysis of questionnaire data obtained via a Delphi panel. The panel consisted of 9 physicians practicing in public hospitals in Morocco (4 dermatologists and 5 obstetricians/gynecologists). The questionnaire collected data on physician and practice characteristics, diagnostic tests and procedures, treatments, and follow-up (including recurrence) of patients with AGW. Questionnaire items on which ≥ 70% of respondents agreed were considered as having consensus. Costs associated with diagnosis, treatment, and follow-up were calculated in Moroccan dirham (MAD) and converted to euros (€) based on official national price lists for public hospitals and the HCRU estimates from the questionnaire. RESULTS: The physician-estimated prevalence of AGW in Morocco was 1.6%-2.6% in women and 2.0%-5.3% in men. A mean (median) of 6.4 (4) patients per month per physician sought medical attention for AGW. Simple observation was the most common diagnostic method for AGW in both men and women, and excision was the most prescribed therapy (75%), requiring a mean of 2 visits. Recurrence occurred in approximately 27% of patients. The cost per case of managing AGW, including recurrence, was estimated at 2182-2872 MAD (€207-272) for women and 2170-2450 MAD (€206-233) for men. The total annual cost of medical consultations for AGW in Morocco ranged from 3,271,877 MAD to 4,253,703 MAD (€310,828-404,102). CONCLUSIONS: Expert consensus indicates that AGW represent a significant burden to the Moroccan public healthcare system. These data can inform policy makers regarding this vaccine-preventable disease.

When an uncommon condyloma revealed a multiple myeloma: Case report.

INTRODUCTION AND IMPORTANCE: Condyloma are a common and easily diagnosticated condition that could affect the area around and inside the anus. But a nodular perianal lesion is not always a simple condyloma. CASE PRESENTATION: We report a case of a 61-year-old patient with nodular perianal lesions mimicking condyloma that has revealed an amylosis and a multiple myeloma. CLINICAL DISCUSSION: The cutaneous manifestations of amyloidosis are diverse. Perianal nodular lesions were indicative of cutaneous amyloidosis in our patient. It is imperative to screen systemic involvement for amyloidosis. CONCLUSION: Our case report highlights the importance of minitious physical examination because some simple lesions can hide dangerous affections.

Half and half nail, is it a marker of severe COVID-19 infection?

INTRODUCTION: Several cutaneous manifestations have been described during COVID-19 infection, however ungual signs remain neglected. Half and half nail or Lindsay nails is a rare clinical finding, frequently seen in chronic renal failure, and many other disorders. CASE REPORT: We report 2 cases of half and half nail aspect occurring during severe COVID-19 infection, without a history of kidney disease, suggesting that 'Lindsay Nails' can be considered as a severity marker. DISCUSSION: An increasing number of nails changes has been reported since the COVID-19 outbreak. As well as the acral manifestations of COVID-19, the acute appearance of Half and half nail sign can be explained by a vascular involvement that may induce a transient matrix injury. CONCLUSION: We report the first description of acute onset of half and half nails during COVID-19 severe infection in 2 patients without a history of kidney failure or any other condition previously described, suggesting that it can be considered as a severity marker.

Lymphangioma circumscriptum of the scrotum: Case report.

INTRODUCTION AND IMPORTANCE: Lymphangioma circumscriptum (LC) is the most common form of cutaneous lymphangioma. However, scrotal LC is rare. CASE PRESENTATION: We report a case of a 37-year-old patient with a complaint of a slow growing painless scrotal grouped lesions present for the past ten years diagnosed as LC. CLINICAL DISCUSSION: The disorder is clinically identified by translucent or hazy vesicles of different sizes which are grouped like frog spawn or, less commonly, as diffuse swelling to a particular area. The definitive diagnosis is usually made by biopsy. LC tends to be asymptomatic. However, it can be complicated. The treatment involves medical and surgical procedures. CONCLUSION: Scrotal LC is rare and tends to mimic certain infectious diseases. The clinicians should be aware of LC in adult males without a prior disease to avoid missing the diagnosis and to prevent inappropriate treatment.

Erythema multiforme eruption due to SARS-COV 2: Case report.

INTRODUCTION: and importance: The COVID-19 is a global pandemic that is now responsible for more than 3 million deaths around the world. Its cutaneous manifestations in patients are being increasingly reported. This case brings additional data implementing the knowledge on the dermatological signs during COVID-19. CASE PRESENTATION: We report a new pattern with erythema multiforme (EM) lesions in a healthy patient with COVID-19 infection and no other medical background. CLINICAL DISCUSSION: We are facing challenging times in Dermatology. New information and cutaneous manifestations possibly related to COVID-19 are emerging every day. There are only a few case reports describing EM in patients with COVID-19. CONCLUSION: We suggest that this EM might be another pattern of exanthem associated with COVID-19 infection. Further studies are needed to evaluate whether these lesions are associated with the virus, the drug intake or any other conditions.

Morocco's First Biobank: Establishment, Ethical Issues, Biomedical Research Opportunities, and Challenges.

BACKGROUND: Biobanks are highly organized infrastructures that allow the storage of human biological specimens associated with donors' personal and clinical data. These infrastructures play a key role in the development of translational medical research. In this context, we launched, in November 2015, the first biobank in Morocco (BRO Biobank) in order to promote biomedical research and provide opportunities to include Moroccan and North African ethnic groups in international biomedical studies. Here, we present the setup and the sample characteristics of BRO Biobank. METHODS: Patients were recruited at several departments of two major health-care centers in the city of Oujda. Healthy donors were enrolled during blood donation campaigns all over Eastern Morocco. From each participant, personal, clinical, and biomedical data were collected, and several biospecimens were stored. Standard operating procedures have been established in accordance with international guidelines on human biobanks. RESULTS: Between November 2015 and July 2020, 2446 participants were recruited into the BRO Biobank, of whom 2013 were healthy donors, and 433 were patients. For healthy donors, the median age was 35 years with a range between 18 and 65 years and the consanguinity rate was 28.96%. For patients, the median age was 11 years with a range between 1 day and 83 years. Among these patients, 55% had rare diseases (hemoglobinopathies, intellectual disabilities, disorders of sex differentiation, myopathies, etc.), 13% had lung cancer, 4% suffered from hematological neoplasms, 3% were from the kidney transplantation project, and 25% had unknown diagnoses. The BRO Biobank has collected 5092 biospecimens, including blood, white blood cells, plasma, serum, urine, frozen tissue, FFPE tissue, and nucleic acids. A sample quality control has been implemented and suggested that samples of the BRO Biobank are of high quality and therefore suitable for high-throughput nucleic acid analysis. CONCLUSIONS: The BRO Biobank is the largest sample collection in Morocco, and it is ready to provide samples to national and international research projects. Therefore, the BRO Biobank is a valuable resource for advancing translational medical research.

Giant squamous cell carcinomas of the shoulder.

Giant squamous cell carcinomas (SCC) larger than 5 cm in diameter are uncommon; there is no guideline on the size of an SCC that is considered giant. Treatment may be difficult with the need for large tissue resections and complex surgical reconstruction. We report a rare case of giant squamous cell carcinoma of the shoulder attached to deep anatomic planes. The entire mass was removed, resulting in a large defect that was repaired with myocutaneous flap rotation of the latissimus dorsi. Three courses of radiotherapy were performed after surgery. Fifteen months after the operation, the patient is well and working without any local recurrence and metastasis.

Skin involvement as the presenting sign of a male breast cancer.

Male breast cancer is a rare disease with an unknown etiopathogenesis. We report a case of a 50-year-old man with a breast cancer revealed by skin involvement.