Inflammatory Tinea Capitis Mimicking Dissecting Cellulitis in a Healthy Woman.

Introduction: Inflammatory tinea capitis (TC) is uncommon in adults. Case Presentation: A 29-year-old healthy woman presented with a 2-year history of scalp alopecia with purulent discharge. Clinical, trichoscopic, and histological features and the negativity of a first fungal sampling were consistent with the diagnosis of dissecting cellulitis of the scalp. A second mycological examination guided by trichoscopy was carried out, showing tinea endothrix. Fungal culture isolated trichophyton violaceum. The patient was treated with terbinafine with complete healing. Conclusion: The diagnosis of adult TC is challenging, mainly the inflammatory form. An exhaustive trichoscopic examination of all alopecic plaques may help make a rapid diagnosis and provide a guide to the mycological examination.

Confluent and reticulated papillomatosis of Gougerot-Carteaud in a North African patient.

Confluent and reticulated papillomatosis (CRP) is an underdiagnosed skin condition of uncertain etiology. The antibacterial and most importantly the anti-inflammatory mechanisms of some antibiotics seem to explain the effectiveness of these medications. Other measures such as reducing weight and treating an underlying endocrine disorder may be helpful.

New-onset guttate psoriasis secondary to COVID-19.

SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), is associated with flares of psoriasis in patients with well-documented disease. Both viral infection and medications used for treatment, like hydroxychloroquine, were incriminated. Herein, we report the case of a 25-year-old male patient who presented a first-onset guttate psoriasis following a COVID-19 infection. We have not found previous descriptions of de novo guttate psoriasis post-COVID-19.

Magnetic Resonance Imaging in the Diagnosis of Onychomatricoma: A Case Report.

Onychomatricoma (OM) is a rare benign tumour of the nail matrix characterized by specific clinical and histologic features. The main clinical signs are thickening of the nail plate, xanthonychia, overcurvature of the nail plate, and multiple splinter haemorrhages. The diagnosis is based on clinical, radiological and histopathological findings. Histologically, the tumour is characterized by filiform epithelial projections. The objective of this study is to present the first reported Tunisian case of OM, focusing on the contribution of magnetic resonance imaging to the diagnosis of OM. A review on the subject is also presented.

Addictive behaviors, cardiovascular and metabolic comorbidities in North African psoriatic patients: case-control study.

We propose to study the epidemiological aspects of North African psoriasis and determine the cardiovascular comorbidities and addictive behaviors associated with psoriasis. This is a North African case-control study which was conducted over a five year period (October 2008 through August 2013), involving 671 psoriatic patients and 1,242 controls identified in various Algerian, Tunisian and Moroccan university hospitals. For each patient, epidemiological characteristic, addictive behaviors, and cardiovascular pathologies associated with psoriasis were noted. Six hundred and seventy one psoriasis patients and 1,242 controls were included in this study. The average age was 47.24 years and the M/F sex-ratio was 1.11 (354 men and 317 women). Statistical analysis showed that psoriasis patients were more likely to develop addictive behaviors than controls (smoking p<10-5 and alcohol consumption: p < 10-5), together with dyslipidemia (30.1% of patients p < 10-5), obesity (23.8% of patients p < 10-4), hypertension (22.3% of patients p < 10-5), diabetes (21.7% of occurrences p < 10-5) and metabolic syndrome (37.4% of patients p<10-5). The relative risk for developing psoriasis was 1.9 in hypertensive patients, 1.7 in diabetic patients, 3.9 in dyslipidemic patients, 1.8 in obese patients, 2.6 in those with metabolic syndrome, 2.1 in smokers and 2.8 in alcoholics. Our work confirms the high incidence of addictive behaviors and of cardiovascular and metabolic comorbidities during the North-African psoriasis, hence the need for a multidisciplinary comprehensive care based on a guideline suited to the characteristics of North-African psoriatic patients.

Family-based association study in Tunisian familial psoriasis.

BACKGROUND: The pathogenesis of all forms of psoriasis remains obscure. Segregation analysis and twin studies together with ethnic differences in disease frequency all point to an underlying genetic susceptibility to psoriasis, which is both complex and likely to reflect the action of a number of genes. MATERIALS AND METHODS: In the present study, we performed a family-based association study, and a transmission dysequilibrium test using the PLINK program, in a set of seven Tunisian multiplex families using a panel of 96 single-nucleotide polymorphisms localized in several regions across the genome. Ninety-five of them were reported to be associated with psoriasis in different populations. RESULTS: Besides the confirmation of association between previous associated regions: 6p, 1p, 2p, 13q, 14q, and 20p, and cutaneous psoriasis, we identified a new association with the rs1249564 in the IL17RD gene. CONCLUSION: Our results support the complex genetic basis of psoriasis.

Association analysis of LCE3C-LCE3B deletion in Tunisian psoriatic population.

An association between a common deletion comprising the late cornified envelope LCE3B and LCE3C genes (LCE3C_LCE3B-del) and psoriasis has been reported in Caucasian and Asian populations. To investigate whether this deletion plays a role in the genetic of psoriasis in Tunisian population, we determined the LCE3C_LCE3B-del genotype in 180 Ps patients and 208 healthy controls from different regions of Tunisia. The LCE3B and LCE3C gene variant was determined in the patients through PCR amplification and the SPSS software package. The frequency of the LCE3C_LCE3B-del was similar between patients and healthy controls. Subanalyses by family history revealed that the frequency of LCE3C_LCE3B-del was significantly higher in patients with a positive family history than in control individuals, as well as in individuals with a positive family history versus those without in the case cohort. However, no significant difference was observed between psoriatic patients with no family history and controls. We also evaluated the relationship between LCE3C_LCE3B-del and PSORS1. No significant epistatic effect was observed suggesting that there was no significant epistasis of the two loci in the Tunisian population. Our findings indicate that the LCE3C_LCE3B-del might play a role in familial psoriasis in the Tunisian population.

[Immunogenetics of psoriasis: update]. / Immunogénétique du psoriasis : actualités.

BACKGROUND: Psoriasis is a chronic inflammatory skin disease often benign, affecting 2-3% of the total world population. Psoriasis is a multifactorial disease. AIM: To present recent advances in the immunologic mechanisms and susceptibility genes involved in the pathogenesis of psoriasis. METHODS: We presented a literature review of recent genetic and immunological basis of psoriasis to better understand the pathomecanisms of this disease and discuss the contribution of the Tunisian work in this area. RESULTS: Recent works focalized mainly in immunology and genetics. Current progresses in molecular biology have allowed to better characterize the immunogenetic abnormalities in psoriasis. CONCLUSION: Psoriasis is a multifactorial disease model in which environmental factors (psychological, climate, traumatic, infectious, and viral) seem to be triggering factors when associated with a particular immunogenetics predisposition.

Risk factors for erysipelas of the leg in Tunisia: a multicenter case-control study.

BACKGROUND: Risk factors for erysipelas (cellulitis) were rarely evaluated in controlled studies. Regional variations of these risk factors have never be assessed. OBJECTIVE: To assess risk factors for erysipelas of the leg in Tunisia. SUBJECTS AND METHODS: Case-control study in seven hospital centers in Tunisia. Cases were 114 consecutive patients with erysipelas of the leg [sudden onset (<24 h) of a well-demarcated dermo-hypodermatitis with fever or chills]. Two controls were matched to each case for age, sex, and hospital (n = 208). Main outcome measures are local and general suspected risk factors for erysipelas of the leg. RESULTS: In multivariate analysis, disruption of the cutaneous barrier (i.e. traumatic wound, toe-web intertrigo, excoriated leg dermatosis or plantar squamous lesions) and leg edema were independently associated with erysipelas of the leg, with respective odds ratios of 13.6 (95% confidence interval: 6.0-31) and 7.0 (1.3-38). No association was observed with diabetes, alcoholism, or smoking. CONCLUSIONS: We confirmed the major role of local risk factors and the minor role of general risk factors for erysipelas of the leg, in a setting different than the one previously studied. Detecting and treating toe-web intertrigo and traumatic wounds should be considered in the prevention of erysipelas of the leg.