[Nail alterations in children]. / Altérations unguéales de l'enfant.

Alterations of the nail unit in children may be congenital or acquired, may be an isolated finding or part of a systemic problem or a syndrome. In this article we describe the most common childhood nail changes and underscore some important clinical clues that should motivate further investigations. Moreover we give a brief overview of the management of these nail pathologies.

Parmi les atteintes unguéales chez l'enfant, on différencie les atteintes congénitales des acquises et les affections isolées des manifestations témoignant d'une possible atteinte systémique ou syndromique. Le but de cet article est de revoir les atteintes unguéales pédiatriques les plus couramment observées et de souligner les signes unguéaux nécessitant des investigations plus approfondies. De plus, un bref aperçu de la prise en charge de ces différentes atteintes unguéales est donné.

PASS Syndrome: An IL-1-Driven Autoinflammatory Disease.

PASS syndrome is a rare inflammatory disease characterized by a chronic-relapsing course of pyoderma gangrenosum, acne vulgaris, hidradenitis suppurativa and ankylosing spondylitis. Here, we describe a case of a patient with spontaneously recurrent purulent skin lesions along with seronegative spondylarthritis consistent with the PASS syndrome. During his disease exacerbation, the patient displayed episodes of fever along with elevated serum levels of interleukin (IL)-1ß. Skin lesions were characterized by sterile neutrophilic infiltrates and showed a rapid response to the IL-1 receptor antagonist anakinra (Kineret®) consistent with the autoinflammatory nature of this disease. However, unlike other autoinflammatory diseases such as PAPA and PAPASH, we did not find mutations in the gene PSTPIP1, raising the possibility that other specific mutations in the IL-1 pathway may be involved.

[Fever and lymphadenopathy: acute toxoplasmosis in an immunocompetent patient]. / Fièvre, adénopathie: une situation clinique de toxoplasmose aiguë chez une patiente immunocompétente.

Toxoplasmosis is an infectious disease caused by the intracellular parasite Toxoplasma gondii. In Switzerland about a third of the population has antibodies against this pathogen and has thus already been in contact with the parasite or has contracted the disease. Immunocompetent patients are usually asymptomatic (80-90%) during primary infection. The most common symptom is neck or occipital lymphadenopathy. Serology is the diagnostic gold standard in immunocompetent individuals. The presence of IgM antibodies is however not sufficient to make a definite diagnosis of acute toxoplasmosis. Distinction between acute and chronic toxoplasmosis requires additional serological tests (IgG avidity test). If required, the most used and probably most effective treatment is the combination of pyrimethamine and sulfadiazine, with folinic acid.