Assessment, Prevalence, and Correlates of Frailty among Moroccan People Aged 50 and above Living with HIV.

BACKGROUND: Persons living with HIV experience many challenges, such as premature aging and geriatric syndromes. Frailty has become an important determinant of a series of adverse health outcomes. This research aimed to evaluate the prevalence and risk factors for frailty in this population. METHODS: A cross-sectional outpatient investigation was conducted in an urban HIV clinic. Patients aged 50 and older living with HIV were included. Frailty phenotype was evaluated using the original Fried criteria, and we calculated the Veterans Aging Cohort Study (VACS) index, Charlson Comorbidity Index, Fracture Risk Assessment Tool scores, and Mini-mental State Exam scores. RESULTS: One hundred and nine individuals were studied. Ninety-two (84.4%) were men, with a mean age of 57.65.2 years. Fourteen (12.8%) participants were frail. Frail participants were older (P = 0.001) and less likely to be virally suppressed (P = 0.01). Having ≥3 comorbidities, VACS index, polypharmacy, and 5-year mortality risk was significantly greater in the frail group. Frailty was significantly associated with poorer quality of life (P = 0.02). The cognitive impairment, falls, and malnutrition risk were significantly associated with a risk to manifest a frail phenotype. CONCLUSION: Frailty is common among Moroccans with HIV, and it is associated with greater morbidity and mortality rates. Our findings should serve as a warning sign to standardize frailty and geriatric syndrome screening in this population.

Epidemiology and prognostic factors of 114 patients with mycosis fungoides in a Moroccan cohort: a 29-year review.

Limited data regarding survival of Moroccan patients with mycosis fungoides (MF). To evaluate the clinical profile and long-term outcomes of these patients. A retrospective review of 114 MF cases diagnosed from 1993 to 2022 who were followed up for more than 6 months of diagnosis was performed. Of 114 patients, 71.9% were male and the median age at diagnosis was 56 years. Approximately 64 and 36% of the patients had an early stage and advanced stage, respectively. Median follow-up duration was 56 months, and median duration of symptoms before diagnosis was 31 months. Various subtypes were observed, including mycosis fungoides folliculotropic (12.3%), poikilodermatous (11.4%), and palmaris et plantaris MF (5.3%). The 10-year overall survival was 89% in early-stage patients and 48.8% in advanced-stage patients. Complete response to treatment occurred in 45.6%, stable disease in 16.7% and disease progression in 7.9% of patients. Older age of > 60 years, higher T-stage (T3/T4) and advanced-stage MF were statistically significant in predicting poorer outcomes in MF. Despite delay in diagnosis, most cases of MF in Morocco were diagnosed in early stages. We observed a high proportion of classic MF and favorable prognosis.

Hepatic Metastasis Revealing a Melanoma of the Penis: Case Report.

Melanoma of the penis is a rare tumor with a poor prognosis. We report the case of a 73-year-old patient with no significant medical history, admitted for deterioration of the general condition and bilateral inguinal lymph nodes. An abdominal ultrasound and thoraco-abdomino-pelvic CT (computed tomography) scan revealed metastatic liver nodules, the tumoral nature of which was confirmed by an anatomopathological examination. Further clinical examination revealed papular and ulcerated lesions of the penis located at the urethral meatus and glans penis. These lesions were biopsied and histologically assessed as melanoma. The contribution of imaging in penile tumors is generally not useful for diagnosis as clinical examination is key. However, it has its place in the assessment of locoregional and distant extension. In our case, it was the distant lesions that helped orient the diagnosis. The patient underwent immunotherapical treatment and is still alive 19 months after the diagnosis.

Predictive factors for relapse in adults with dermatomyositis.

INTRODUCTION: Dermatomyositis (DM) is a severe disease that can be chronic with relapses and severe morbidity. The objective of this study was to analyze clinical features at presentation that predict non-paraneoplastic DM relapse in adult patients. METHODS: A multicenter retrospective study focused on 33 patients diagnosed with DM and treated using corticosteroids from 2000 to 2015. This study also aimed to compare patients with and without relapse based on some predictive factors such as demographic characteristics and clinical symptoms. A Cox model was used to estimate hazard ratios (HRs). RESULTS: We identified 33 patients with an average age of 41.8 ± 12 years (range 18-68 years). The sex ratio of females to males was 2:1. During the 13.5-month follow-up period, two (6%) patients died and 21 (63.6%) suffered from a relapse. In univariate analysis, skin ulceration in the initial presentation of disease (HR = 3.1, range 1.1 to 15.1) was significantly associated with a relapsing course. CONCLUSIONS: This study demonstrates that in the initial presentation of the disease skin ulceration is significant in allowing prediction of the occurrence of DM relapse.

[Vitiligo revealing Vogt -Koyanagi-Harada disease]. / Vitiligo révélant une maladie de Vogt-Koyanagi-Harada.

Vitiligo is a chronic auto-immune skin disease, often associated or discovers other autoimmune pathologies. His association with Ophthalmological type pan uveitis and/or neurological type of meningitis and/or inner ear type of hearing loss determines the disease or Vogt -Koyanagi-Harada syndrome (VKH). We related the case of a young woman who consulted for recurrent uveitis for a year, and it was only with the onset of vitiligo lesions that VKH disease diagnosis was discussed and confirmed.

[Skin metastases revealing a bronchial adenocarcinoma]. / Métastases cutanées révélant un adénocarcinome bronchique.

We report the case of bronchial carcinoma revealed by metastatic skin nodules on the scalp. This fairly common mode of discovery is often associated with poor prognosis. This study aims to underline the importance of directing the search for a primary lung cancer in cases of secondary skin involvement.

[Extragenital lichen sclerosus et atrophicus: about a case]. / Lichen scléro-atrophique extra-génital: à propos d'un cas.

Lichen sclerosus et atrophicus is a chronic inflammatory dermatosis, characterized by a specific external genital mucosal tissue tropism. Isolated cutaneous manifestation is rare. We report a case of lichen sclerosus et atrophicus in a woman with purely cutaneous involvement, in order to highlight the importance of evoking this diagnosis in the absence of obvious genital involvement.

[Multiple and extensive skin necrosis revealing anti phospholipid antibody syndrome]. / Nécroses cutanées multiples et extensives révélant un syndrome des anticorps anti phospholipids.

Antiphospholipid antibody syndrome (APS) is an acquired thrombophilic state resulting from autoantibodies activity against phospholipides and/or their cofactors. It may be primary or associated with various diseases, including systemic lupus erythematosus (SLE), which represents a potential severity marker. We here report the case of a young girl with multiple cutaneous necrosis suffering from APS secondary to SLE. Skin lesions associated with APS are common, polymorphic, sometimes inaugural and may be the only clinical manifestation of the syndrome. However, skin necrosis are rare; their treatment is based on anticoagulation therapy and appropriate local care. Rigorous long term follow up associated with closer cooperation between the dermatologist and the internist is justified by unpredictable outcomes and poor prognosis.